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预测主观认知下降向轻度认知障碍的 7 年转化率。

Prediction of 7-year's conversion from subjective cognitive decline to mild cognitive impairment.

机构信息

Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Alzheimer's Disease and Related Disorders Center of Shanghai Jiaotong University, Shanghai, China.

出版信息

Hum Brain Mapp. 2021 Jan;42(1):192-203. doi: 10.1002/hbm.25216. Epub 2020 Oct 8.

Abstract

Subjective cognitive decline (SCD) is a high-risk yet less understood status before developing Alzheimer's disease (AD). This work included 76 SCD individuals with two (baseline and 7 years later) neuropsychological evaluations and a baseline T1-weighted structural MRI. A machine learning-based model was trained based on 198 baseline neuroimaging (morphometric) features and a battery of 25 clinical measurements to discriminate 24 progressive SCDs who converted to mild cognitive impairment (MCI) at follow-up from 52 stable SCDs. The SCD progression was satisfactorily predicted with the combined features. A history of stroke, a low education level, a low baseline MoCA score, a shrunk left amygdala, and enlarged white matter at the banks of the right superior temporal sulcus were found to favor the progression. This is to date the largest retrospective study of SCD-to-MCI conversion with the longest follow-up, suggesting predictable far-future cognitive decline for the risky populations with baseline measures only. These findings provide valuable knowledge to the future neuropathological studies of AD in its prodromal phase.

摘要

主观认知衰退(SCD)是发生阿尔茨海默病(AD)之前的一种高风险但了解较少的状态。这项工作包括 76 名 SCD 个体,他们进行了两次神经心理学评估(基线和 7 年后)和基线 T1 加权结构 MRI。基于 198 个基线神经影像学(形态计量学)特征和一系列 25 项临床测量值,训练了一个基于机器学习的模型,以区分在随访中转化为轻度认知障碍(MCI)的 24 名进行性 SCD 患者和 52 名稳定 SCD 患者。该模型结合特征对 SCD 进展进行了令人满意的预测。研究发现,有中风史、教育程度低、基线 MoCA 评分低、左侧杏仁核缩小以及右侧上颞叶沟白质增大,这些因素都有利于病情进展。这是迄今为止 SCD 向 MCI 转化的最大规模回顾性研究,也是最长随访时间的研究,仅通过基线测量就可以预测风险人群未来认知能力的衰退。这些发现为 AD 前驱期的未来神经病理学研究提供了有价值的知识。

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