Prediction of conversion from mild cognitive impairment to Alzheimer's disease dementia based upon biomarkers and neuropsychological test performance

NEUROBIOLOGY OF AGING

卷:33

Article

Ewers, Michael^1,2  Walsh, Cathal³  Trojanowski, John Q.^4,5  Shaw, Leslie M.^4,5  Petersen, Ronald C.⁶  Jack, Clifford R., Jr.⁷  Feldman, Howard H.^8,9  Bokde, Arun L. W.^10,11  Alexander, Gene E.^12,13  Scheltens, Philip¹⁴  Vellas, Bruno¹⁵  Dubois, Bruno¹⁶  Weiner, Michael^1,2  Hampel, Harald¹⁷ 

[1] Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA

[2] VA Med Ctr, Ctr Imaging Neurodegenerat Dis, San Francisco, CA USA

[3] Trinity Coll Dublin, Dept Stat, Dublin, Ireland

[4] Univ Penn, Sch Med, Dept Pathol & Lab Med, Philadelphia, PA 19104 USA

[5] Univ Penn, Sch Med, Inst Aging, Alzheimers Dis Core Ctr,Ctr Neurodegenerat Dis, Philadelphia, PA 19104 USA

[6] Mayo Clin, Dept Neurol, Coll Med, Rochester, MN USA

[7] Mayo Clin & Mayo Fdn, Rochester, MN USA

[8] Bristol Myers Squibb Co, Wallingford, CT 06492 USA

[9] Univ British Columbia, Div Neurol, Vancouver, BC V5Z 1M9, Canada

[10] Univ Dublin, Discipline Psychiat, Sch Med, Trinity Coll, Dublin, Ireland

[11] Univ Dublin, Inst Neurosci TCIN, Lab Neuroimaging & Biomarker Res, Trinity Coll, Dublin, Ireland

[12] Univ Arizona, Dept Psychol, Tucson, AZ 85721 USA

[13] Univ Arizona, Evelyn F McKnight Brain Inst, Tucson, AZ USA

[14] Vrije Univ Amsterdam, Alzheimer Ctr, Med Ctr, Amsterdam, Netherlands

[15] Univ Toulouse, Dept Geriatr Med, Toulouse, France

[16] Univ Paris 06, Salpetriere Hosp, APHP, INSERM,U610,UMRS 610, Paris, France

[17] Goethe Univ Frankfurt, Dept Psychiat Psychosomat Med & Psychotherapy, D-6000 Frankfurt, Germany

关键词: Alzheimer's disease;    Dementia;    Mild cognitive impairment;    Mild cognitive impairment (MCI);    Autopsy-confirmation;    Biomarkers;    Early detection;    Cerebrospinal fluid;    Cerebrospinal fluid (CSF);    A beta(1-42);    Tau;    p-tau;    MRI;    Hippocampus;    Volumetry;    Entorhinal cortex;    Prodromal;    ADNI;   

DOI  :  10.1016/j.neurobiolaging.2010.10.019

来源: Elsevier

【 摘 要 】

The current study tested the accuracy of primary MRI and cerebrospinal fluid (CSF) biomarker candidates and neuropsychological tests for predicting the conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) dementia. In a cross-validation paradigm, predictor models were estimated in the training set of AD (N = 81) and elderly control subjects (N = 101). A combination of CSF t-tau/A beta(1-4) ratio and MRI biomarkers or neuropsychological tests (free recall and trail making test B (TMT-B)) showed the best statistical fit in the AD vs. HC comparison, reaching a classification accuracy of up to 64% when applied to the prediction of MCI conversion (3.3-year observation interval, mean = 2.3 years). However, several single-predictor models showed a predictive accuracy of MCI conversion comparable to that of any multipredictor model. The best single predictors were right entorhinal cortex (prediction accuracy - 68.5% (95% CI (59.5, 77.4))) and TMT-B test (prediction accuracy 64.6% (95% CI (55.5, 73.4%))). In conclusion, short-term conversion to AD is predicted by single marker models to a comparable degree as by multimarker models in amnestic MCI subjects. (C) 2012 Elsevier Inc. All rights reserved.

【 授权许可】

Free