Almkvist Ove, Gyllenhammar Måns, Norberg Sofia, Roeseler Mia Lu, Westman Eric, Ekman Urban
Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Neo Building Floor 7, 14157, Stockholm, Sweden.
Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
Sci Rep. 2025 Jul 2;15(1):23071. doi: 10.1038/s41598-025-07664-5.
The objective cognitive status is incompletely known in Subjective Cognitive Impairment (SCI) and similar constructs. To characterize subspan and supraspan memory performance in groups with SCI, Mild Cognitive Impairment (MCI), and Cognitively Unimpaired individuals (CU) in relation to brain atrophy and CSF biomarkers. Performance on subspan (Digit Span Forward) and supraspan memory (trial 1 in the Rey Auditory Verbal Learning test) was investigated in patients diagnosed with SCI (n = 237) and MCI (n = 1038) from memory clinics in the Stockholm region and CU individuals from Stockholm university, Department of Psychology (n = 124). All participants had an extensive cognitive assessment. In addition, MCI and SCI patients had a comprehensive clinical examination, brain imaging scan (medial temporal lobe, cortical global atrophy, and white-matter-hyperintensities), and CSF biomarker analyses (Abeta, p-tau, and total-tau). Groups differed significantly in demographic characteristics, which were adjusted for in all analyses. The three groups differed significantly on supraspan, but not subspan, memory performance in line with the severity of cognitive impairment. The test-by-group interaction was also significant showing that SCI was characterized by selective supraspan impairment in conjunction with memory overload and in contrast to the previous conception of no objective impairment in SCI. CSF biomarkers and brain abnormality in MTA, GCA, and WMH did not provide additional predictive power over the diagnostic group on supraspan in SCI. Supraspan memory performance differed by diagnostic group in relation to the degree of cognitive impairment in memory clinic participants (CU > SCI > MCI) indicating objective memory impairment in SCI interpreted as due to supraspan overload.
在主观认知障碍(SCI)和类似概念中,客观认知状态尚不完全清楚。为了描述SCI组、轻度认知障碍(MCI)组和认知未受损个体(CU)的子跨度和超跨度记忆表现与脑萎缩和脑脊液生物标志物的关系。对来自斯德哥尔摩地区记忆诊所被诊断为SCI(n = 237)和MCI(n = 1038)的患者以及来自斯德哥尔摩大学心理学系的CU个体(n = 124)进行了子跨度(数字广度顺背)和超跨度记忆(雷伊听觉词语学习测试中的试验1)表现的研究。所有参与者都进行了广泛的认知评估。此外,MCI和SCI患者还进行了全面的临床检查、脑成像扫描(内侧颞叶、皮质整体萎缩和白质高信号)以及脑脊液生物标志物分析(β淀粉样蛋白、磷酸化tau蛋白和总tau蛋白)。各组在人口统计学特征上有显著差异,在所有分析中都进行了调整。三组在超跨度记忆表现上有显著差异,但在子跨度记忆表现上无显著差异,这与认知障碍的严重程度一致。组间与测试的交互作用也很显著,表明SCI的特征是与记忆过载相关的选择性超跨度损伤,这与之前认为SCI无客观损伤的概念相反。脑脊液生物标志物以及MTA、GCA和WMH中的脑异常在预测SCI的超跨度方面并没有比诊断组提供更多的预测能力。在记忆诊所参与者中,超跨度记忆表现因诊断组而异,与认知障碍程度相关(CU > SCI > MCI),这表明SCI中存在客观记忆损伤,被解释为由于超跨度过载。