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自由和线索选择性回忆测试在预测轻度认知障碍和轻度痴呆患者 [18F]氟比他滨 PET 结果中的作用。

The Role of Free and Cued Selective Reminding Test in Predicting [18F]Florbetaben PET Results in Mild Cognitive Impairment and Mild Dementia.

机构信息

Department of Medicine and Surgery, Unit of Neurology, Azienda Ospedaliero-Universitaria, Parma, Italy.

Sigmund Freud University, Milano, Italy.

出版信息

J Alzheimers Dis. 2020;73(4):1647-1659. doi: 10.3233/JAD-190950.

Abstract

BACKGROUND

Free and Cued Selective Reminding Test (FCSRT) is a reliable cognitive marker for Alzheimer's disease (AD), and the identification of neuropsychological tests sensitive to the early signs of AD pathology is crucial both in research and clinical practice.

OBJECTIVE

The study aimed to ascertain the ability of FCSRT in predicting the amyloid load as determined from amyloid PET imaging (Amy-PET) in patients with cognitive disorders.

METHODS

For our purpose, 79 patients (71 MCI, 8 mild dementia) underwent a complete workup for dementia, including the FCSRT assessment and a [18F]florbetaben PET scan. FCSRT subitem scores were used as predictors in different binomial regression models.

RESULTS

Immediate free recall and delayed free recall were the best predictors overall in the whole sample; whereas in patients <76 years, all models further improved with immediate total recall (ITR) and Index of Sensitivity of Cueing (ISC) resulting the most accurate in anticipating Amy-PET results, with a likelihood of being Amy-PET positive greater than 85% for ITR and ISC scores of less than 25 and 0.5, respectively.

CONCLUSION

FCSRT proved itself to be a valid tool in dementia diagnosis, also being able to correlate with amyloid pathology. The possibility to predict Amy-PET results through a simple and reliable neuropsychological test might be helpful for clinicians in the dementia field, adding value to a paper and pencil tool compared to most costly biomarkers.

摘要

背景

自由和线索选择性回忆测试(FCSRT)是阿尔茨海默病(AD)的可靠认知标志物,识别对 AD 病理早期迹象敏感的神经心理学测试在研究和临床实践中都至关重要。

目的

本研究旨在确定 FCSRT 在预测认知障碍患者的淀粉样蛋白负荷(通过淀粉样蛋白 PET 成像[Amy-PET]确定)方面的能力。

方法

为此,79 名患者(71 名 MCI,8 名轻度痴呆)接受了全面的痴呆评估,包括 FCSRT 评估和[18F]florbetaben PET 扫描。FCSRT 分项得分被用作不同二项式回归模型的预测因子。

结果

即时自由回忆和延迟自由回忆是整个样本中总体上的最佳预测因子;而在<76 岁的患者中,所有模型进一步通过即时总回忆(ITR)和线索敏感性指数(ISC)得到改善,结果表明 ITR 和 ISC 得分<25 和 0.5 时最能准确预测 Amy-PET 结果,阳性 Amy-PET 的可能性大于 85%。

结论

FCSRT 被证明是一种有效的痴呆诊断工具,也能够与淀粉样蛋白病理学相关。通过简单可靠的神经心理学测试预测 Amy-PET 结果的可能性可能对痴呆领域的临床医生有帮助,与大多数昂贵的生物标志物相比,为纸笔工具增加了价值。

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