Cabinio Monia, Rossetto Federica, Isernia Sara, Saibene Francesca Lea, Di Cesare Monica, Borgnis Francesca, Pazzi Stefania, Migliazza Tommaso, Alberoni Margherita, Blasi Valeria, Baglio Francesca
IRCCS Fondazione Don Carlo Gnocchi ONLUS, via Capecelatro 66, 20148 Milan, Italy.
Consorzio di Bioingegneria e Informatica medica (CBIM), 27100 Pavia, Italy.
J Clin Med. 2020 May 6;9(5):1355. doi: 10.3390/jcm9051355.
Due to the lack of pharmacological treatment for dementia, timely detection of subjects at risk can be of seminal importance for preemptive rehabilitation interventions. The aim of the study was to determine the usability of the smart aging serious game (SASG), a virtual reality platform, in assessing the cognitive profile of an amnestic mild cognitive impairment (aMCI) population, its validity in discriminating aMCI from healthy controls (HC), and in detecting hippocampal degeneration, a biomarker of clinical progression towards dementia. Thirty-six aMCI and 107 HC subjects were recruited and administered the SASG together with a neuropsychological evaluation. All aMCI and 30 HC subjects performed also an MRI for hippocampal volume measurement. Results showed good usability of the SASG despite the low familiarity with technology in both groups. ROC curve analyses showed similar discriminating abilities for SASG and gold standard tests, and a greater discrimination ability compared to non-specific neuropsychological tests. Finally, linear regression analysis revealed that the SASG outperformed the Montreal cognitive assessment test (MoCA) in the ability to detect neuronal degeneration in the hippocampus on the right side. These data show that SASG is an ecological task, that can be considered a digital biomarker providing objective and clinically meaningful data about the cognitive profile of aMCI subjects.
由于缺乏针对痴呆症的药物治疗，及时发现有风险的受试者对于预防性康复干预可能具有至关重要的意义。本研究的目的是确定智能衰老严肃游戏（SASG）这一虚拟现实平台在评估遗忘型轻度认知障碍（aMCI）人群的认知特征方面的可用性，其在区分aMCI与健康对照（HC）方面的有效性，以及在检测海马体退化（临床向痴呆症进展的生物标志物）方面的有效性。招募了36名aMCI受试者和107名HC受试者，并让他们进行了SASG测试以及神经心理学评估。所有aMCI受试者和30名HC受试者还进行了磁共振成像（MRI）以测量海马体体积。结果显示，尽管两组对技术的熟悉程度较低，但SASG仍具有良好的可用性。ROC曲线分析表明，SASG和金标准测试具有相似的区分能力，并且与非特异性神经心理学测试相比，SASG具有更强的区分能力。最后，线性回归分析显示，在检测右侧海马体神经元退化的能力方面，SASG优于蒙特利尔认知评估测试（MoCA）。这些数据表明，SASG是一项生态任务，可以被视为一种数字生物标志物，能够提供有关aMCI受试者认知特征的客观且具有临床意义的数据。
