Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Int J Geriatr Psychiatry. 2021 Sep;36(9):1407-1414. doi: 10.1002/gps.5546. Epub 2021 Apr 2.
Previous research has identified that dementia with Lewy bodies (DLB) has abnormal pareidolic responses which are associated with severity of visual hallucinations (VH), and the pareidolia test accurately classifies DLB with VH. We aimed to assess whether these findings would also be evident at the earlier stage of mild cognitive impairment (MCI) with Lewy bodies (MCI-LB) in comparison to MCI due to AD (MCI-AD) and cognitively healthy comparators.
One-hundred and thirty-seven subjects were assessed prospectively in a longitudinal study with a mean follow-up of 1.2 years (max = 3.7): 63 MCI-LB (22% with VH) and 40 MCI-AD according to current research diagnostic criteria, and 34 healthy comparators. The pareidolia test was administered annually as a repeated measure.
Probable MCI-LB had an estimated pareidolia rate 1.2-6.7 times higher than MCI-AD. Pareidolia rates were not associated with concurrent VH, but had a weak association with total score on the North East Visual Hallucinations Inventory. The pareidolia test was not an accurate classifier of either MCI-LB (Area under curve (AUC) = 0.61), or VH (AUC = 0.56). There was poor sensitivity when differentiating MCI-LB from controls (41%) or MCI-AD (27%), though specificity was better (91% and 89%, respectively).
Whilst pareidolic responses are specifically more frequent in MCI-LB than MCI-AD, sensitivity of the pareidolia test is poorer than in DLB, with fewer patients manifesting VH at the earlier MCI stage. However, the high specificity and ease of use may make it useful in specialist clinics where imaging biomarkers are not available.
先前的研究已经确定，路易体痴呆（DLB）患者存在异常的幻觉图形，这与视觉幻觉（VH）的严重程度有关，而幻觉图形测试可以准确地区分伴有 VH 的 DLB。我们旨在评估这些发现是否也存在于轻度认知障碍（MCI）伴有路易体（MCI-LB）的早期阶段，与 MCI 归因于阿尔茨海默病（MCI-AD）以及认知健康对照组相比。
在一项前瞻性纵向研究中，137 名受试者接受了评估，平均随访时间为 1.2 年（最长为 3.7 年）：63 名 MCI-LB（22%伴有 VH）和 40 名 MCI-AD，根据当前的研究诊断标准，以及 34 名认知健康对照组。幻觉图形测试每年作为重复测量进行一次。
可能的 MCI-LB 的幻觉图形率估计比 MCI-AD 高 1.2-6.7 倍。幻觉图形率与同期 VH 无关，但与东北视觉幻觉清单的总分呈弱相关。幻觉图形测试不能准确地区分 MCI-LB（曲线下面积（AUC）为 0.61）或 VH（AUC 为 0.56）。从对照组（41%）或 MCI-AD（27%）中区分 MCI-LB 的敏感性较差，特异性较好（分别为 91%和 89%）。
虽然在 MCI-LB 中比在 MCI-AD 中更频繁地出现幻觉图形，但幻觉图形测试的敏感性不如 DLB 好，在更早的 MCI 阶段，较少患者出现 VH。然而，高特异性和易用性可能使其在没有成像生物标志物的专科诊所中有用。
