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“何时”很重要:阿尔茨海默病临床连续统中记忆标志物的证据。

The "when" matters: Evidence from memory markers in the clinical continuum of Alzheimer's disease.

机构信息

Geroscience Center for Brain Health and Metabolism.

School of Psychological Sciences and Health, University of Strathclyde.

出版信息

Neuropsychology. 2023 Oct;37(7):753-768. doi: 10.1037/neu0000891. Epub 2023 May 25.

Abstract

OBJECTIVE

Cognitive assessment able to detect impairments in the early neuropathological stages of Alzheimer's disease (AD) is urgently needed. The visual short-term memory binding task (VSTMBT) and the Free and Cued Selective Reminding Test (FCSRT) have been recommended by the neurodegenerative disease working group as promising tests to aid in the early detection of AD. In this study, we investigated their complementary value across the clinical stages of the AD continuum.

METHOD

One hundred and seventeen older adults with subjective cognitive complaint (SCC), 79 with mild cognitive impairment (MCI), 31 patients with AD dementia (ADD), and 37 cognitively unimpaired (CU) subjects, underwent assessment with the VSTMBT and the picture version of the Spanish FCSRT.

RESULTS

After controlling for multiple comparisons, significant differences were found across groups. The VSTMBT was the only test that "marginally" differentiated between CU and SCC ( = 0.47, = .052). Moreover, whereas the FCSRT showed a gradient (CU = SCC) > MCI > ADD, the VSTMBT gradient was CU > SCC > (MCI = ADD) suggesting that conjunctive binding deficits assessed by the latter may be sensitive to the very early stages of the disease.

CONCLUSIONS

Our results suggest that the VSTMBT and the FCSRT are sensitive to the clinical continuum of AD. Whereas the former detects changes in the early prodromal stages, the latter is more sensitive to the advanced prodromal stages of AD. These novel tests can aid in the early detection, monitor disease progression and response to treatment, and thus support drug development programs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

目的

迫切需要能够在阿尔茨海默病(AD)的早期神经病理学阶段检测到认知障碍的认知评估方法。视觉短期记忆结合任务(VSTMBT)和自由和线索选择性回忆测试(FCSRT)已被神经退行性疾病工作组推荐为有希望的测试方法,有助于早期发现 AD。在这项研究中,我们研究了它们在 AD 连续体的临床阶段中的互补价值。

方法

117 名有主观认知主诉(SCC)的老年人、79 名轻度认知障碍(MCI)患者、31 名 AD 痴呆(ADD)患者和 37 名认知正常(CU)受试者接受了 VSTMBT 和西班牙语 FCSRT 的图片版本的评估。

结果

在控制了多次比较后,发现组间存在显著差异。VSTMBT 是唯一能够“勉强”区分 CU 和 SCC 的测试( = 0.47, =.052)。此外,虽然 FCSRT 显示出梯度(CU = SCC)> MCI > ADD,但 VSTMBT 的梯度是 CU > SCC > (MCI = ADD),这表明后者评估的联合结合缺陷可能对疾病的早期阶段敏感。

结论

我们的结果表明,VSTMBT 和 FCSRT 对 AD 的临床连续体敏感。前者检测早期前驱阶段的变化,后者对 AD 的早期前驱阶段更敏感。这些新的测试可以帮助早期发现、监测疾病进展和对治疗的反应,从而支持药物开发计划。(PsycInfo 数据库记录(c)2023 APA,保留所有权利)。

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