Lorentzen Ingrid Myrvoll, Espenes Jacob, Eliassen Ingvild Vøllo, Hessen Erik, Waterloo Knut, Nakling Arne, Gísladóttir Berglind, Jarholm Jonas, Fladby Tormod, Kirsebom Bjørn-Eivind
Department of Psychology, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway.
Department of Psychology, University of Oslo, Oslo, Norway.
Appl Neuropsychol Adult. 2025 Jul-Aug;32(4):1074-1086. doi: 10.1080/23279095.2023.2236262. Epub 2023 Aug 8.
The 4 Mountain Test (4MT) is a test of allocentric spatial working memory and has been proposed as an earlier marker of predementia Alzheimer's disease (AD) than episodic verbal memory. We here compare the 4MT to the CERAD word list memory recall in both cognitively normal (CN) and mild cognitive impairment (MCI) cases with or without cerebrospinal fluid markers (CSF) of Alzheimer's disease pathology. Linear regression was used to assess the influence of CSF determined Aβ-plaque (Aβ-/+) or neurofibrillary tau tangles (Tau-/+) on 4MT and CERAD recall performance. Analyses were performed in the full sample and the CN and MCI sub-samples. Pearson correlations were calculated to examine the relationship between 4MT and tests of psychomotor speed, verbal memory, cognitive flexibility, verbal fluency, and visuo-spatial perception. Analyses showed no significant differences in 4MT scores between Aβ-/Aβ+, nor Tau-/Tau + participants, irrespective of cognitive status. In contrast, CERAD recall scores were lower in both Aβ+ compared to Aβ- (<.01), and Tau + compared to Tau- participants (<.01) in the full sample analyses. There were no significant differences in CERAD recall performance between Aβ- vs. Aβ+ and Tau- vs. to Tau + in the in CN/MCI sub-samples. 4MT scores were significantly correlated with tests of psychomotor speed, cognitive flexibility, and visuo-spatial perception in the full sample analyses. In conclusion, the CERAD recall outperformed the 4MT as a cognitive marker of CSF determined AD pathology. This suggests that allocentric working memory, as measured by the 4MT, may not be used as an early marker of predementia AD.
四山测试（4MT）是一种以自我为中心的空间工作记忆测试，并且已被提议作为早发性痴呆型阿尔茨海默病（AD）的一个比情景性言语记忆更早的标志物。我们在此比较了在认知正常（CN）和轻度认知障碍（MCI）病例中，无论有无阿尔茨海默病病理的脑脊液标志物（CSF）情况下，4MT与CERAD单词列表记忆回忆情况。使用线性回归来评估脑脊液确定的Aβ斑块（Aβ - / +）或神经原纤维缠结（Tau - / +）对4MT和CERAD回忆表现的影响。在全样本以及CN和MCI子样本中进行了分析。计算了Pearson相关性以检验4MT与心理运动速度、言语记忆、认知灵活性、言语流畅性和视觉空间感知测试之间的关系。分析表明，无论认知状态如何，Aβ - /Aβ +参与者之间以及Tau - /Tau +参与者之间的4MT分数均无显著差异。相比之下，在全样本分析中，Aβ +参与者的CERAD回忆分数低于Aβ -参与者（<.01），Tau +参与者的CERAD回忆分数低于Tau -参与者（<.01）。在CN/MCI子样本中，Aβ -与Aβ +以及Tau -与Tau +之间的CERAD回忆表现无显著差异。在全样本分析中，4MT分数与心理运动速度、认知灵活性和视觉空间感知测试显著相关。总之，作为脑脊液确定的AD病理的认知标志物，CERAD回忆表现优于4MT。这表明，通过4MT测量的以自我为中心的工作记忆可能不能用作早发性痴呆型AD的早期标志物。
