神经相关性的日常功能：一个针对白质退行假说和三个独立的基于表现的功能评估的初步研究。
Neural correlates of daily function: A pilot study of the white matter retrogenesis hypothesis and three separate performance-based functional assessments.
机构信息
Department of Psychology, University of Houston.
Department of Neurology, School of Medicine, University of Colorado.
出版信息
Neuropsychology. 2021 Jan;35(1):103-110. doi: 10.1037/neu0000649.
OBJECTIVE
Increasing evidence points to mild alterations in everyday functioning early in the course of Alzheimer's disease and related dementias (ADRD), despite prior research suggesting functional declines occur primarily in later stages. However, daily function assessment is typically accomplished with subjective self- or informant-report, which can be prone to error due to various factors. Performance-based functional assessments (PBFAs) allow for objective evaluation of daily function abilities, but little is known on their sensitivity to the earliest ADRD-related brain alterations. We aimed to determine the neural correlates of three different PBFAs in a pilot study.
METHOD
A total of 40 older participants (age = 70.9 ± 6.5 years; education = 17.0 ± 2.6 years; 51.5% female; 10.0% non-White; 67.5% cognitively normal) completed standardized PBFAs related to medication management (MM), finances (FIN), and communication abilities (COM). Participants underwent diffusion tensor imaging (DTI) scans, from which mean fractional anisotropy (FA) composite scores of late- (LMF) and early myelinated (EMF) fibers were calculated. Linear regression analyses controlling for age and global cognition were used to assess the relationship of PBFAs with FA.
RESULTS
Better performance on MM was associated with higher mean FA on LMF composite (t38 = 2.231, p = .032), while FIN and COM were not (ps > .05). PBFAs were not associated with EMF (p > .05).
CONCLUSIONS
Our preliminary findings demonstrate better performance on a PBFA of medication management is associated with higher FA in late-myelinated white matter tracts. Despite a small sample size, these results are consistent with growing evidence that performance-based functional assessments may be a useful tool in identifying early changes related to ADRD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
目的
越来越多的证据表明，在阿尔茨海默病及相关痴呆症（ADRD）的病程早期，日常功能就会出现轻微改变，尽管先前的研究表明，功能下降主要发生在后期。然而，日常功能的评估通常是通过主观的自我报告或知情者报告来完成的，这可能由于各种因素而容易出现错误。基于表现的功能评估（PBFAs）可以客观地评估日常功能能力，但对于它们对最早的 ADRD 相关大脑改变的敏感性，我们知之甚少。我们旨在通过一项初步研究来确定三种不同的 PBFAs 的神经相关性。
方法
共有 40 名老年参与者（年龄=70.9±6.5 岁；教育=17.0±2.6 年；51.5%为女性；10.0%为非白人；67.5%认知正常）完成了与药物管理（MM）、财务（FIN）和沟通能力（COM）相关的标准化 PBFAs。参与者接受了弥散张量成像（DTI）扫描，从中计算出晚期（LMF）和早期髓鞘化（EMF）纤维的平均分数各向异性（FA）综合评分。使用控制年龄和整体认知的线性回归分析来评估 PBFAs 与 FA 的关系。
结果
MM 的表现越好，LMF 综合平均 FA 越高（t38=2.231，p=0.032），而 FIN 和 COM 则不然（p>.05）。PBFAs 与 EMF 无关（p>.05）。
结论
我们的初步研究结果表明，在药物管理的基于表现的功能评估中表现越好，与晚期髓鞘化白质束的 FA 越高相关。尽管样本量较小，但这些结果与越来越多的证据一致，即基于表现的功能评估可能是识别与 ADRD 相关的早期变化的有用工具。
Zotero 插件