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基于遗忘型轻度认知障碍患者临床及MRI变量的淀粉样蛋白PET阳性预测量表

Predictive Scale for Amyloid PET Positivity Based on Clinical and MRI Variables in Patients with Amnestic Mild Cognitive Impairment.

作者信息

Chun Min Young, Kim Geon Ha, Park Hee Kyung, Yang Dong Won, Kim SangYun, Choi Seong Hye, Jeong Jee Hyang

机构信息

Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.

Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul 07985, Korea.

出版信息

J Clin Med. 2022 Jun 15;11(12):3433. doi: 10.3390/jcm11123433.

Abstract

The presence of amyloid-β (Aβ) deposition is considered important in patients with amnestic mild cognitive impairment (aMCI), since they can progress to Alzheimer's disease dementia. Amyloid positron emission tomography (PET) has been used for detecting Aβ deposition, but its high cost is a significant barrier for clinical usage. Therefore, we aimed to develop a new predictive scale for amyloid PET positivity using easily accessible tools. Overall, 161 aMCI patients were recruited from six memory clinics and underwent neuropsychological tests, brain magnetic resonance imaging (MRI), apolipoprotein E () genotype testing, and amyloid PET. Among the potential predictors, verbal and visual memory tests, medial temporal lobe atrophy, genotype, and age showed significant differences between the Aβ-positive and Aβ-negative groups and were combined to make a model for predicting amyloid PET positivity with the area under the curve (AUC) of 0.856. Based on the best model, we developed the new predictive scale comprising integers, which had an optimal cutoff score ≥ 3. The new predictive scale was validated in another cohort of 98 participants and showed a good performance with AUC of 0.835. This new predictive scale with accessible variables may be useful for predicting Aβ positivity in aMCI patients in clinical practice.

摘要

淀粉样β蛋白(Aβ)沉积的存在被认为在遗忘型轻度认知障碍(aMCI)患者中很重要,因为他们可能会进展为阿尔茨海默病性痴呆。淀粉样正电子发射断层扫描(PET)已被用于检测Aβ沉积,但其高昂的成本是临床应用的重大障碍。因此,我们旨在使用易于获取的工具开发一种新的淀粉样PET阳性预测量表。总体而言,从六个记忆诊所招募了161名aMCI患者,他们接受了神经心理学测试、脑磁共振成像(MRI)、载脂蛋白E()基因分型测试和淀粉样PET检查。在潜在预测因素中,言语和视觉记忆测试、内侧颞叶萎缩、基因分型和年龄在Aβ阳性组和Aβ阴性组之间显示出显著差异,并将它们组合起来建立了一个预测淀粉样PET阳性的模型,曲线下面积(AUC)为0.856。基于最佳模型,我们开发了由整数组成的新预测量表,其最佳截断分数≥3。新预测量表在另一组98名参与者中得到验证,表现良好,AUC为0.835。这种具有可获取变量的新预测量表可能有助于在临床实践中预测aMCI患者的Aβ阳性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d475/9224873/74d44fd99187/jcm-11-03433-g001.jpg

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