Data-driven prognostic features of cognitive trajectories in patients with amnestic mild cognitive impairments

Alzheimer’s Research & Therapy

卷:11

Yeo Jin Kim¹  Juyoun Lee²  Jin San Lee³  Sang Won Seo⁴  Young Kyoung Jang⁴  Duk L. Na⁴  Hee Jin Kim⁴  Changsoo Kim⁵  Seong-Kyoung Cho⁵  Jacob W. Vogel⁶ 

[1] Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine;

[2] Department of Neurology, Chungnam National University Hospital;

[3] Department of Neurology, Kyung Hee University Hospital;

[4] Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine;

[5] Institute of Human Complexity and Systems Science, Yonsei University;

[6] Montreal Neurological Institute, McGill University;

关键词: Amnestic mild cognitive impairment;    Cognitive trajectory;    Data-driven;   

DOI  :  10.1186/s13195-018-0462-z

来源: DOAJ

【 摘 要 】

Abstract Background Although amnestic mild cognitive impairment (aMCI) is generally considered to be a prodromal stage of Alzheimer’s disease, patients with aMCI show heterogeneous patterns of progression. Moreover, there are few studies investigating data-driven cognitive trajectory in aMCI. We therefore classified patients with aMCI based on their cognitive trajectory, measured by clinical dementia rating sum of boxes (CDR-SOB). Then, we compared the clinical and neuroimaging features among groups classified by cognitive trajectory. Methods We retrospectively recruited 278 patients with aMCI who underwent three or more timepoints of neuropsychological testing. They also had magnetic resonance imaging (MRI) including structured three-dimensional volume images. Cortical thickness was measured using surface-based methods. We performed trajectory analyses to classify our aMCI patients according to their progression and investigate their cognitive trajectory using CDR-SOB. Results Trajectory analyses showed that patients with aMCI were divided into three groups: stable (61.8%), slow decliner (31.7%), and fast decliner (6.5%). Changes throughout a mean follow-up duration of 3.7 years in the CDR-SOB for the subgroups of stable/slow/fast decliners were 1.3-, 6.4-, and 12-point increases, respectively. Decliners were older and carried apolipoprotein E4 (APOE4) genotypes more frequently than stable patients. Compared with the stable group, decliners showed a higher frequency of aMCI patients with both visual and verbal memory dysfunction, late stage aMCI, and multiple domain dysfunction. In addition, compared with the stable group, the slow decliners showed cortical thinning predominantly in bilateral parietotemporal areas, while the fast decliners showed cortical thinning predominantly in bilateral frontotemporal areas. Both decliner groups showed worse cognitive function in attention, language, visuospatial, memory, and frontal/executive domains than the stable group. Conclusions Our data-driven trajectory analysis provides new insights into heterogeneous cognitive trajectories of aMCI and further suggests that baseline clinical and neuroimaging profiles might predict aMCI patients with poor prognosis.

【 授权许可】

Unknown