Traschütz Andreas, Enkirch S Jonas, Polomac Nenad, Widmann Catherine N, Schild Hans H, Heneka Michael T, Hattingen Elke
Department of Neurology, University Hospital of Bonn, Bonn, Germany.
Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany.
J Alzheimers Dis. 2020;75(1):99-108. doi: 10.3233/JAD-181150.
Structural magnetic resonance imaging (MRI) is routinely performed in patients with mild cognitive impairment (MCI), but diagnostic accuracy to detect early cerebral atrophy is limited.
To validate the visual entorhinal cortex atrophy (ERICA) rating scale regarding diagnosis, biomarker status, neuropsychological profile, and dementia risk in MCI.
The ERICA score was retrospectively assessed regarding its discrimination of MCI (n = 80) from subjective cognitive decline and Alzheimer's disease (AD) dementia (n = 60, respectively), its prediction of conversion to dementia (median follow-up 28 months) and amyloid/tau biomarker status, and its association with neuropsychological tests.
The ERICA score achieved 97% positive predictive value (PPV) for the presence of MCI. Discrimination between MCI and AD dementia (area under the curve: 0.71) was comparable to volumetry, and superior to the medial temporal lobe atrophy (MTA) score (p = 0.006). The PPV of the ERICA score for conversion to dementia was 83%, equivalent to tau status. It achieved 90% PPV for conversion when combined with tau, and 100% negative predictive value with verbal recall. While no measure predicted the predominantly positive amyloid status, the ERICA score was at least comparable to volumetry, and superior to the MTA score in predicting tau positivity (92% PPV for phospho-tau). The ERICA score was associated with verbal learning and memory, and, unlike the MTA score, also with AD-specific deficits in cued verbal recall.
The ERICA score is a simple and valuable tool to exploit structural MRI for diagnosis and prognosis in MCI and is non-inferior to volumetry.
轻度认知障碍（MCI）患者通常会进行结构磁共振成像（MRI）检查，但检测早期脑萎缩的诊断准确性有限。
验证视觉内嗅皮质萎缩（ERICA）评分量表在MCI的诊断、生物标志物状态、神经心理学特征和痴呆风险方面的作用。
回顾性评估ERICA评分，以区分MCI（n = 80）与主观认知衰退和阿尔茨海默病（AD）痴呆（分别为n = 60），预测其向痴呆的转化（中位随访28个月）以及淀粉样蛋白/ tau生物标志物状态，并评估其与神经心理学测试的关联。
ERICA评分对MCI存在的阳性预测值（PPV）达到97%。MCI与AD痴呆之间的区分度（曲线下面积：0.71）与体积测量相当，且优于内侧颞叶萎缩（MTA）评分（p = 0.006）。ERICA评分对转化为痴呆的PPV为83%，与tau状态相当。与tau联合使用时，其转化的PPV达到90%，言语回忆的阴性预测值为100%。虽然没有指标能预测主要为阳性的淀粉样蛋白状态，但在预测tau阳性方面（磷酸化tau的PPV为92%），ERICA评分至少与体积测量相当，且优于MTA评分。ERICA评分与言语学习和记忆相关，与MTA评分不同，它还与线索性言语回忆中的AD特异性缺陷相关。
ERICA评分是利用结构MRI对MCI进行诊断和预后评估的一种简单且有价值的工具，并不逊色于体积测量。
