Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri.
Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Alzheimers Dement. 2020 Mar;16(3):491-500. doi: 10.1002/alz.12031. Epub 2020 Feb 11.
Spatial navigation deficits are observed in Alzheimer's disease cross-sectionally, but prediction of longitudinal clinical decline has been less examined.
Cognitive mapping (CM) was assessed in 95 participants and route learning (RL) was assessed in 65 participants at baseline. Clinical progression over an average of 4 to 5 years was assessed using the clinical dementia rating (CDR) scale. Relative predictive ability was compared to episodic memory, hippocampus, and cerebrospinal fluid biomarkers (phosphorylated tau/amyloid β 42 (ptau /Aβ ) ratio).
CM and RL were predictors of clinical progression (P's < 0.032). All measures, except RL-Learning remained predictors with episodic memory in models (P's < 0.048). Only RL-Retrieval remained a predictor when ptau /Aβ was included (P < 0.001). CM interacted with hippocampus and ptau /Aβ in prediction (P's < 0.013). CM, RL, and episodic memory evidenced strong diagnostic accuracy (area under the curve (AUC) = 0.894, 0.794, and 0.735, respectively); CM tended to perform better than episodic memory (P = 0.056).
Baseline spatial navigation performance may be appropriate for assessing risk of clinical progression.
在阿尔茨海默病中，空间导航缺陷是横向观察到的，但对纵向临床下降的预测研究较少。
在基线时，对 95 名参与者进行认知绘图（CM）评估，对 65 名参与者进行路线学习（RL）评估。使用临床痴呆评定量表（CDR）评估平均 4 至 5 年的临床进展情况。相对预测能力与情景记忆、海马体和脑脊液生物标志物（磷酸化 tau/淀粉样蛋白β 42（ptau/Aβ）比值）进行比较。
CM 和 RL 是临床进展的预测因素（P 值均<0.032）。除 RL-Learning 外，所有指标在模型中均与情景记忆一起成为预测因素（P 值均<0.048）。当包括 ptau/Aβ 时，只有 RL-Retrieval 仍然是一个预测因素（P<0.001）。CM 与海马体和 ptau/Aβ 在预测中相互作用（P 值均<0.013）。CM、RL 和情景记忆具有较高的诊断准确性（曲线下面积（AUC）分别为 0.894、0.794 和 0.735）；CM 的表现优于情景记忆（P=0.056）。
基线空间导航表现可用于评估临床进展的风险。
