Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, V. Ardeatina, 306, 00179, Rome, Italy.
Department of Systems Medicine, Tor Vergata University, Rome, Italy.
J Neurol. 2019 Jan;266(1):102-111. doi: 10.1007/s00415-018-9108-0. Epub 2018 Nov 1.
The research of reliable procedures for predicting cognitive decline or stability in persons with amnestic mild cognitive impairment (a-MCI) is a major goal for the early identification of subjects in the prodromal stages of dementia. The aim of this study was to evaluate whether different memory performances on two procedures commonly used for the neuropsychological assessment of episodic memory (i.e., free recall and recognition) might be a key in predicting a-MCI patients' subsequent progression to Alzheimer's disease (AD). For this purpose, 80 patients diagnosed with a-MCI at the first assessment and followed-up for at least 3 years were included. During this time, 41 subjects remained in a stable condition of cognitive impairment or improved (stable-MCI) and 39 patients converted to AD dementia (converter-MCI). Sixty-two age- and education-matched healthy individuals were also recruited as healthy controls (HC). Baseline memory performance on the free recall (5th immediate and 15-min delayed) and yes/no recognition (the sensitivity measure d') of a 15-word list were analyzed. Results showed that stable-MCIs forgot significantly more information from immediate to delayed recall of the word list than HC, but exhibited a pronounced improvement of memory performance in the recognition test format. On the contrary, converter-MCIs showed diminished sensitivity in benefiting from cues for recognizing studied words. Word list recognition correctly classified group membership with good overall accuracy, which was higher compared to the classification of converter and stable a-MCIs provided by free recall; therefore, it could be a useful diagnostic tool for predicting progression to AD dementia from the prodromal stage.
研究可靠的程序来预测有遗忘型轻度认知障碍（a-MCI）的人认知能力下降或稳定是早期识别痴呆前阶段受试者的主要目标。本研究旨在评估两种常用于情景记忆神经心理学评估的程序（即自由回忆和识别）上的不同记忆表现是否可能是预测 a-MCI 患者随后进展为阿尔茨海默病（AD）的关键。为此，共纳入了 80 名在首次评估时被诊断为 a-MCI 并随访至少 3 年的患者。在此期间，41 名患者保持认知障碍稳定或改善（稳定-MCI），39 名患者转化为 AD 痴呆（转化-MCI）。还招募了 62 名年龄和教育程度匹配的健康个体作为健康对照组（HC）。分析了基线时自由回忆（第 5 次即时回忆和 15 分钟延迟回忆）和 yes/no 识别（敏感性指标 d'）的 15 个单词列表的记忆表现。结果表明，稳定-MCI 比 HC 从即时回忆到延迟回忆时忘记了更多的信息，但在识别测试格式中表现出记忆性能的显著改善。相反，转化-MCI 对识别学习单词的线索表现出敏感性降低。单词列表识别正确地将组归属分类为高总体准确性，与自由回忆提供的对转化和稳定 a-MCI 的分类相比更高；因此，它可能是一种有用的诊断工具，可用于从前驱期预测向 AD 痴呆的进展。
