Curiel Cid Rosie E, Zheng D Diane, Kitaigorodsky Marcela, Adjouadi Malek, Crocco Elizabeth A, Georgiou Mike, Gonzalez-Jimenez Christian, Ortega Alexandra, Goryawala Mohammed, Nagornaya Natalya, Pattany Pradip, Sfakianaki Efrosyni, Visser Ubbo, Loewenstein David A
Center for Cognitive Neuroscience and Aging and Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA.
Center for Advanced Technology and Education, Department of Electrical and Computer Engineering, College of Engineering and Computing, Florida International University, Miami, Florida, USA.
Adv Alzheimer Dis. 2023 Sep;12(3):38-54. doi: 10.4236/aad.2023.123004. Epub 2023 Sep 12.
During the prodromal stage of Alzheimer's disease (AD), neurodegenerative changes can be identified by measuring volumetric loss in AD-prone brain regions on MRI. Cognitive assessments that are sensitive enough to measure the early brain-behavior manifestations of AD and that correlate with biomarkers of neurodegeneration are needed to identify and monitor individuals at risk for dementia. Weak sensitivity to early cognitive change has been a major limitation of traditional cognitive assessments. In this study, we focused on expanding our previous work by determining whether a digitized cognitive stress test, the Loewenstein-Acevedo Scales for Semantic Interference and Learning, Brief Computerized Version (LASSI-BC) could differentiate between Cognitively Unimpaired (CU) and amnestic Mild Cognitive Impairment (aMCI) groups. A second focus was to correlate LASSI-BC performance to volumetric reductions in AD-prone brain regions. Data was gathered from 111 older adults who were comprehensively evaluated and administered the LASSI-BC. Eighty-seven of these participants (51 CU; 36 aMCI) underwent MR imaging. The volumes of 12 AD-prone brain regions were related to LASSI-BC and other memory tests correcting for False Discovery Rate (FDR). Results indicated that, even after adjusting for initial learning ability, the failure to recover from proactive semantic interference (frPSI) on the LASSI-BC differentiated between CU and aMCI groups. An optimal combination of frPSI and initial learning strength on the LASSI-BC yielded an area under the ROC curve of 0.876 (76.1% sensitivity, 82.7% specificity). Further, frPSI on the LASSI-BC was associated with volumetric reductions in the hippocampus, amygdala, inferior temporal lobes, precuneus, and posterior cingulate.
在阿尔茨海默病（AD）的前驱期，通过测量MRI上AD易损脑区的体积损失可识别神经退行性变化。需要足够敏感以测量AD早期脑-行为表现且与神经退行性变生物标志物相关的认知评估，来识别和监测有痴呆风险的个体。对早期认知变化的弱敏感性一直是传统认知评估的主要局限。在本研究中，我们专注于扩展我们之前的工作，确定数字化认知应激测试——洛温斯坦-阿塞韦多语义干扰与学习量表简版计算机化版本（LASSI-BC）能否区分认知未受损（CU）组和遗忘型轻度认知障碍（aMCI）组。第二个重点是将LASSI-BC的表现与AD易损脑区的体积减少相关联。数据收集自111名接受了全面评估并进行了LASSI-BC测试的老年人。其中87名参与者（51名CU；36名aMCI）接受了磁共振成像。12个AD易损脑区的体积与LASSI-BC及其他记忆测试相关，并对错误发现率（FDR）进行了校正。结果表明，即使在调整了初始学习能力之后，LASSI-BC上未能从主动语义干扰中恢复（frPSI）仍可区分CU组和aMCI组。LASSI-BC上frPSI与初始学习强度的最佳组合产生的ROC曲线下面积为0.876（敏感性76.1%，特异性82.7%）。此外，LASSI-BC上的frPSI与海马体、杏仁核、颞下回、楔前叶和后扣带回的体积减少相关。
