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Berron D, Glanz W, Clark L, Basche K, Grande X, Güsten J, Billette OV, Hempen I, Naveed MH, Diersch N, Butryn M, Spottke A, Buerger K, Perneczky R, Schneider A, Teipel S, Wiltfang J, Johnson S, Wagner M, Jessen F, Düzel E. A remote digital memory composite to detect cognitive impairment in memory clinic samples in unsupervised settings using mobile devices. NPJ Digit Med 2024; 7:79. [PMID: 38532080 DOI: 10.1038/s41746-024-00999-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 01/03/2024] [Indexed: 03/28/2024] Open
Abstract
Remote monitoring of cognition holds the promise to facilitate case-finding in clinical care and the individual detection of cognitive impairment in clinical and research settings. In the context of Alzheimer's disease, this is particularly relevant for patients who seek medical advice due to memory problems. Here, we develop a remote digital memory composite (RDMC) score from an unsupervised remote cognitive assessment battery focused on episodic memory and long-term recall and assess its construct validity, retest reliability, and diagnostic accuracy when predicting MCI-grade impairment in a memory clinic sample and healthy controls. A total of 199 participants were recruited from three cohorts and included as healthy controls (n = 97), individuals with subjective cognitive decline (n = 59), or patients with mild cognitive impairment (n = 43). Participants performed cognitive assessments in a fully remote and unsupervised setting via a smartphone app. The derived RDMC score is significantly correlated with the PACC5 score across participants and demonstrates good retest reliability. Diagnostic accuracy for discriminating memory impairment from no impairment is high (cross-validated AUC = 0.83, 95% CI [0.66, 0.99]) with a sensitivity of 0.82 and a specificity of 0.72. Thus, unsupervised remote cognitive assessments implemented in the neotiv digital platform show good discrimination between cognitively impaired and unimpaired individuals, further demonstrating that it is feasible to complement the neuropsychological assessment of episodic memory with unsupervised and remote assessments on mobile devices. This contributes to recent efforts to implement remote assessment of episodic memory for case-finding and monitoring in large research studies and clinical care.
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Affiliation(s)
- David Berron
- German Center for Neurodegenerative Diseases, Magdeburg, Germany.
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
- neotiv GmbH, Magdeburg, Germany.
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases, Magdeburg, Germany
- Institute for Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
| | - Lindsay Clark
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin, US
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Kristin Basche
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin, US
| | - Xenia Grande
- German Center for Neurodegenerative Diseases, Magdeburg, Germany
- Institute for Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
| | - Jeremie Güsten
- German Center for Neurodegenerative Diseases, Magdeburg, Germany
- Institute for Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
| | | | | | | | | | - Michaela Butryn
- German Center for Neurodegenerative Diseases, Magdeburg, Germany
- Institute for Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases, Munich, Germany
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Ageing Epidemiology Research Unit (AGE), Imperial College London, London, UK
| | - Anja Schneider
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Stefan Teipel
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
- German Center for Neurodegenerative Diseases, Rostock, Germany
| | - Jens Wiltfang
- German Center for Neurodegenerative Diseases, Göttingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, University of Göttingen, Göttingen, Germany
| | - Sterling Johnson
- Department of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin, US
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Michael Wagner
- German Center for Neurodegenerative Diseases, Bonn, Germany
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases, Cologne, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases, Magdeburg, Germany.
- neotiv GmbH, Magdeburg, Germany.
- Institute for Cognitive Neurology and Dementia Research, Otto-von-Guericke University, Magdeburg, Germany.
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2
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Brugnolo A, Orso B, Girtler N, Ferraro PM, Arnaldi D, Mattioli P, Massa F, Famà F, Argenti L, Biffa G, Morganti W, Buonopane S, Uccelli A, Morbelli S, Pardini M. Tracking the progression of Alzheimer's disease: Insights from metabolic patterns of SOMI stages. Cortex 2024; 171:413-422. [PMID: 38113612 DOI: 10.1016/j.cortex.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/14/2023] [Accepted: 11/08/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND SOMI (Stages of Objective Memory Impairment) is a novel classification that identifies six stages of memory decline in Alzheimer's Disease (AD) using the Free and Cued Selective Reminding Test (FCSRT). However, the relationship between SOMI stages and brain metabolism remains unexplored. This study aims to investigate the metabolic correlates of SOMI stages using FDG-PET in Mild Cognitive Impairment due to AD (MCI-AD) and early AD patients. METHODS One hundred twenty-nine-patients (99 aMCI-AD and 30 AD), and 42 healthy controls (HCs) (MMSE = 29.2 ± .8; age:69.1 ± 8.6 years; education:10.7 ± 3.8 years) who underwent an extensive neuropsychological battery including FCSRT and brain FDG-PET were enrolled. According to their clinical relevance and available sample sizes, SOMI-4 (N = 24 subjects; MMSE score:26.6 ± 2.6: age:75.4 ± 3.2; education:9.9 ± 4.5) and SOMI-5 groups (N = 97; MMSE:25.3 ± 2.6; age:73.9 ± 5.8; education:9.4 ± 4.1) were investigated. RESULTS Compared to HCs, SOMI-4 showed hypometabolism in the precuneus, medial temporal gyrus bilaterally, right pecuneus and angular gyrus. SOMI-5 exhibited broader hypometabolism, extending to the left posterior cingulate and medial frontal gyrus bilaterally. The conjunction analysis revealed overlapping areas in the precuneus, medial temporal gyrus bilaterally, and in the right angular gyrus and cuneus. The disjunction analysis identified SOMI-5 specific hypometabolism encompassing left inferior temporal gyrus, uncus and parahippocampal gyrus, and medial frontal gyrus bilaterally (p < .001, p-value (FWE) < .05). DISCUSSION SOMI-4 relates to posterior hypometabolism, while SOMI-5 to more extensive hypometabolism further encompassing frontal cortices, suggesting SOMI as a biologically relevant classification system of memory decline. CONCLUSION Memory decline staged with SOMI is associated with hypometabolism spreading in amnesic MCI-AD/AD, suggesting its usefulness as a clinical marker of increasing neurodegeneration.
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Affiliation(s)
- Andrea Brugnolo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (DINOGMI), University of Genoa, Italy; Clinical Psychology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Beatrice Orso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (DINOGMI), University of Genoa, Italy.
| | - Nicola Girtler
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (DINOGMI), University of Genoa, Italy; Clinical Psychology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | | | - Dario Arnaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (DINOGMI), University of Genoa, Italy; Neurology Clinics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Pietro Mattioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (DINOGMI), University of Genoa, Italy; Neurology Clinics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (DINOGMI), University of Genoa, Italy; Neurology Clinics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Francesco Famà
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (DINOGMI), University of Genoa, Italy; Neurology Clinics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Lucia Argenti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (DINOGMI), University of Genoa, Italy.
| | - Gabriella Biffa
- Clinical Psychology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Wanda Morganti
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genoa, Italy.
| | - Silvia Buonopane
- Geriatrics Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Antonio Uccelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (DINOGMI), University of Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Silvia Morbelli
- Department of Health Sciences, University of Genoa, Italy; Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (DINOGMI), University of Genoa, Italy; Neurology Clinics, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
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3
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Grober E, Lipton RB, Sperling RA, Papp KV, Johnson KA, Rentz DM, Veroff AE, Aisen PS, Ezzati A. Associations of Stages of Objective Memory Impairment With Amyloid PET and Structural MRI: The A4 Study. Neurology 2022; 98:e1327-e1336. [PMID: 35197359 PMCID: PMC8967421 DOI: 10.1212/wnl.0000000000200046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/03/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The goal of this work was to investigate the neuroimaging correlates of the Stages of Objective Memory Impairment (SOMI) system operationalized with the Free and Cued Selective Reminding Test (FCSRT), a widely used episodic memory measure. METHODS The FCSRT begins with a study phase in which items (e.g., grapes) are identified in response to unique semantic cues (e.g., fruit) that are used in the test phase to prompt recall of items not retrieved by free recall. There are 3 test trials of the 16 items (maximum 48). Data from 4,484 cognitively unimpaired participants from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) study were used. All participants had amyloid PET imaging, and a subset of 1,262 β-amyloid (Aβ)-positive had structural MRIs. We compared the Aβ mean cortical standardized uptake value ratio (SUVR) and volumetric measures of hippocampus, parahippocampal gyrus, entorhinal cortex, and inferior temporal cortex between the 5 SOMI stages. RESULTS Participants had a mean age of 71.3 (SD 4.6) years; 40.6% were male; and 34.6% were APOE ε4 positive. Half had no memory impairment; the other half had retrieval deficits, storage limitations, or both. Analysis of covariance in the entire sample while controlling for age, sex, education, and APOE ε4 showed that individuals in higher SOMI stages had higher global amyloid SUVR (p < 0.001). Both SOMI-4 and -3 subgroups had higher amyloid SUVR than SOMI-0 and SOMI-1 subgroups. Individuals in higher SOMI stages had smaller hippocampal volume (p = 0.003), entorhinal cortex (p < 0.05), and inferior temporal lobes (p < 0.05), but there was no difference between parahippocampal gyrus volume of different SOMI stages. Pairwise comparison of SOMI subgroups showed that the SOMI-4, -3, and -2 subgroups had smaller hippocampal volume than the SOMI-0 and -1 subgroup. The SOMI-4 subgroup had significantly smaller entorhinal cortex and smaller inferior temporal lobe compared to all other groups. DISCUSSION Presence of Alzheimer disease pathology is closely related to memory impairment according to SOMI stages in the cognitively unimpaired sample of A4. Results from structural MRIs suggest that memory storage impairment (SOMI-3 and -4) is present when there is widespread medial temporal lobe atrophy. TRIAL REGISTRATION INFORMATION ClinicalTrials.gov identifier: NCT02008357. CLASSIFICATION OF EVIDENCE This study provides Class I evidence that, in normal older individuals, higher stages of memory impairment assessed with FCSRT were associated with higher amyloid imaging burden and lower volume of hippocampus, entorhinal cortex, and inferior temporal lobes.
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Affiliation(s)
- Ellen Grober
- From the Department of Neurology (E.G., R.B.L., A.E.V., A.E.), Albert Einstein College of Medicine, Bronx, NY; Harvard Aging Brain Study (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; and Alzheimer's Therapeutic Research Institute (P.S.A.), University of Southern California, San Diego.
| | - Richard B Lipton
- From the Department of Neurology (E.G., R.B.L., A.E.V., A.E.), Albert Einstein College of Medicine, Bronx, NY; Harvard Aging Brain Study (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; and Alzheimer's Therapeutic Research Institute (P.S.A.), University of Southern California, San Diego
| | - Reisa A Sperling
- From the Department of Neurology (E.G., R.B.L., A.E.V., A.E.), Albert Einstein College of Medicine, Bronx, NY; Harvard Aging Brain Study (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; and Alzheimer's Therapeutic Research Institute (P.S.A.), University of Southern California, San Diego
| | - Kathryn V Papp
- From the Department of Neurology (E.G., R.B.L., A.E.V., A.E.), Albert Einstein College of Medicine, Bronx, NY; Harvard Aging Brain Study (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; and Alzheimer's Therapeutic Research Institute (P.S.A.), University of Southern California, San Diego
| | - Keith A Johnson
- From the Department of Neurology (E.G., R.B.L., A.E.V., A.E.), Albert Einstein College of Medicine, Bronx, NY; Harvard Aging Brain Study (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; and Alzheimer's Therapeutic Research Institute (P.S.A.), University of Southern California, San Diego
| | - Dorene M Rentz
- From the Department of Neurology (E.G., R.B.L., A.E.V., A.E.), Albert Einstein College of Medicine, Bronx, NY; Harvard Aging Brain Study (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; and Alzheimer's Therapeutic Research Institute (P.S.A.), University of Southern California, San Diego
| | - Amy E Veroff
- From the Department of Neurology (E.G., R.B.L., A.E.V., A.E.), Albert Einstein College of Medicine, Bronx, NY; Harvard Aging Brain Study (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; and Alzheimer's Therapeutic Research Institute (P.S.A.), University of Southern California, San Diego
| | - Paul S Aisen
- From the Department of Neurology (E.G., R.B.L., A.E.V., A.E.), Albert Einstein College of Medicine, Bronx, NY; Harvard Aging Brain Study (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; and Alzheimer's Therapeutic Research Institute (P.S.A.), University of Southern California, San Diego
| | - Ali Ezzati
- From the Department of Neurology (E.G., R.B.L., A.E.V., A.E.), Albert Einstein College of Medicine, Bronx, NY; Harvard Aging Brain Study (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School; Center for Alzheimer Research and Treatment (R.A.S., K.V.P., K.A.J., D.M.R.), Department of Neurology, Brigham and Women's Hospital, Boston, MA; and Alzheimer's Therapeutic Research Institute (P.S.A.), University of Southern California, San Diego
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4
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Alegret M, Sotolongo-Grau O, de Antonio EE, Pérez-Cordón A, Orellana A, Espinosa A, Gil S, Jiménez D, Ortega G, Sanabria A, Roberto N, Hernández I, Rosende-Roca M, Tartari JP, Alarcon-Martin E, de Rojas I, Montrreal L, Morató X, Cano A, Rentz DM, Tárraga L, Ruiz A, Valero S, Marquié M, Boada M. Automatized FACEmemory® scoring is related to Alzheimer's disease phenotype and biomarkers in early-onset mild cognitive impairment: the BIOFACE cohort. Alzheimers Res Ther 2022; 14:43. [PMID: 35303916 PMCID: PMC8933921 DOI: 10.1186/s13195-022-00988-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/10/2022] [Indexed: 11/13/2022]
Abstract
Background FACEmemory® is the first computerized, self-administered verbal episodic memory test with voice recognition. It can be conducted under minimal supervision and contains an automatic scoring system to avoid administrator errors. Moreover, it is suitable for discriminating between cognitively healthy and amnestic mild cognitive impairment (MCI) individuals, and it is associated with Alzheimer’s disease (AD) cerebrospinal fluid (CSF) biomarkers. This study aimed to determine whether FACEmemory scoring is related to performance on classical memory tests and to AD biomarkers of brain magnetic resonance imaging (MRI) and CSF in patients with early-onset MCI (EOMCI). Methods Ninety-four patients with EOMCI from the BIOFACE study completed FACEmemory, classical memory tests (the Spanish version of the Word Free and Cued Selective Reminding Test -FCSRT-, the Word List from the Wechsler Memory Scale, third edition, and the Spanish version of the Rey–Osterrieth Complex Figure Test), and a brain MRI. Eighty-two individuals also underwent a lumbar puncture. Results FACEmemory scoring was moderately correlated with FCSRT scoring. With regard to neuroimaging MRI results, worse execution on FACEmemory was associated with lower cortical volume in the right prefrontal and inferior parietal areas, along with the left temporal and associative occipital areas. Moreover, the total FACEmemory score correlated with CSF AD biomarkers (Aβ1-42/Aβ1-40 ratio, p181-tau, and Aβ1-42/p181-tau ratio). When performance on FACEmemory was compared among the ATN classification groups, significant differences between the AD group and normal and SNAP groups were found. Conclusions FACEmemory is a promising tool for detecting memory deficits sensitive to early-onset AD, but it also allows the detection of memory-impaired cases due to other etiologies. Our findings suggest that FACEmemory scoring can detect the AD endophenotype and that it is also associated with AD-related changes in MRI and CSF in patients with EOMCI. The computerized FACEmemory tool might be an opportunity to facilitate early detection of MCI in younger people than 65, who have a growing interest in new technologies.
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Affiliation(s)
- Montserrat Alegret
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain. .,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.
| | - Oscar Sotolongo-Grau
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Ester Esteban de Antonio
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain
| | - Alba Pérez-Cordón
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain
| | - Adelina Orellana
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Espinosa
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Silvia Gil
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Jiménez
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain
| | - Gemma Ortega
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Angela Sanabria
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Natalia Roberto
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Hernández
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Maitee Rosende-Roca
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain
| | - Juan Pablo Tartari
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain
| | - Emilio Alarcon-Martin
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain
| | - Itziar de Rojas
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Montrreal
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain
| | - Xavier Morató
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain
| | - Amanda Cano
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain
| | - Dorene M Rentz
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Lluís Tárraga
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Agustín Ruiz
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergi Valero
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Marquié
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona-Universitat Internacional de Catalunya, Gran Via de Carles III, 85 bis, 08028, Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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5
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Grober E, Qi Q, Kuo L, Hassenstab J, Perrin RJ, Lipton RB. Stages of Objective Memory Impairment Predict Alzheimer's Disease Neuropathology: Comparison with the Clinical Dementia Rating Scale-Sum of Boxes. J Alzheimers Dis 2021; 80:185-195. [PMID: 33492286 PMCID: PMC8075392 DOI: 10.3233/jad-200946] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The ultimate validation of a clinical marker for Alzheimer's disease (AD) is its association with AD neuropathology. OBJECTIVE To examine how well the Stages of Objective Memory Impairment (SOMI) system predicts intermediate/high AD neuropathologic change and extent of neurofibrillary tangle (NFT) pathology defined by Braak stage, in comparison to the Clinical Dementia Rating (CDR) Scale sum of boxes (CDR-SB). METHODS 251 well-characterized participants from the Knight ADRC clinicopathologic series were classified into SOMI stage at their last assessment prior to death using the free recall and total recall scores from the picture version of the Free and Cued Selective Reminding Test with Immediate Recall (pFCSRT + IR). Logistic regression models assessed the predictive validity of SOMI and CDR-SB for intermediate/high AD neuropathologic change. Receiver operating characteristics (ROC) analysis evaluated the discriminative validity of SOMI and CDR-SB for AD pathology. Ordinal logistic regression was used to predict Braak stage using SOMI and CDR-SB in separate and joint models. RESULTS The diagnostic accuracy of SOMI for AD diagnosis was similar to that of the CDR-SB (AUC: 85%versus 83%). In separate models, both SOMI and CDR-SB predicted Braak stage. In a joint model SOMI remained a significant predictor of Braak stage but CDR-SB did not. CONCLUSION SOMI provides a neuropathologically validated staging system for episodic memory impairment in the AD continuum and should be useful in predicting tau positivity based on its association with Braak stage.
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Affiliation(s)
- Ellen Grober
- Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Qi Qi
- Department of Statistics, University of Connecticut, CT, USA
| | - Lynn Kuo
- Department of Statistics, University of Connecticut, CT, USA
| | - Jason Hassenstab
- Knight Alzheimer Disease Research Center, Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Richard J Perrin
- Knight Alzheimer Disease Research Center, Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
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6
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Bertoux M, Cassagnaud P, Lebouvier T, Lebert F, Sarazin M, Le Ber I, Dubois B, Auriacombe S, Hannequin D, Wallon D, Ceccaldi M, Maurage CA, Deramecourt V, Pasquier F. Does amnesia specifically predict Alzheimer's pathology? A neuropathological study. Neurobiol Aging 2020; 95:123-130. [PMID: 32795849 DOI: 10.1016/j.neurobiolaging.2020.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 12/14/2022]
Abstract
Amnesia is a key component of Alzheimer's disease (AD) and the most important feature of its clinical diagnosis but its specificity has recently been challenged. This study investigated the ability of amnesia to predict AD in a clinicopathological dementia series. Ninety-one patients to which free and cued verbal memory assessment was administered during early cognitive decline, were followed until autopsy. Patients' histological diagnoses were classified as pure AD, mixed AD, and non-AD pathologies. Data-driven automated classification procedures explored the correspondence between memory performance and pathological diagnoses. Classifications revealed 3 clusters of performance reflecting different levels of amnesia. Little correspondence between these clusters and the presence of AD pathology was retrieved. A third of patients with pure/mixed AD pathology were non-amnesic at presentation and ≈45% of patients without AD pathology were amnesic. Data-driven prediction of AD pathology based on memory also had a poor accuracy. Free and cued memory assessments are fair tools to diagnose an amnesic syndrome but lack accuracy to predict AD pathology.
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Affiliation(s)
- Maxime Bertoux
- Univ Lille, Lille Neuroscience & Cognition (Inserm UMRS1172) Degenerative and Vascular Cognitive Disorders, CHU Lille, Laboratory of Excellence Distalz (Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease), Lille, France.
| | - Pascaline Cassagnaud
- Univ Lille, CHU Lille, Laboratory of Excellence Distalz (Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease), Lille, France
| | - Thibaud Lebouvier
- Univ Lille, Lille Neuroscience & Cognition (Inserm UMRS1172) Alzheimer & Tauopathies, CHU Lille, Laboratory of Excellence Distalz (Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease), Lille, France
| | - Florence Lebert
- Univ Lille, Lille Neuroscience & Cognition (Inserm UMRS1172) Degenerative and Vascular Cognitive Disorders, CHU Lille, Laboratory of Excellence Distalz (Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease), Lille, France
| | - Marie Sarazin
- Unit of Neurology of Memory and Language, GHU-Paris Psychiatrie et Neurosciences, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; UMR 1023 IMIV, Service Hospitalier Frédéric Joliot, CEA, Inserm, Université Paris Sud, CNRS, Université Paris-Saclay, Orsay, France
| | - Isabelle Le Ber
- Brain & Spine Institute, UMR 975, Paris, France; Neurology Department, CHU Pitié-Salpêtrière, IM2A, Paris, France
| | - Bruno Dubois
- Brain & Spine Institute, UMR 975, Paris, France; Neurology Department, CHU Pitié-Salpêtrière, IM2A, Paris, France
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- Brain & Spine Institute, UMR 975, Paris, France
| | | | - Didier Hannequin
- Neurology Department, Univ Rouen, CHU Charles Nicolle, Rouen, France
| | - David Wallon
- Neurology Department, Univ Rouen, CHU Charles Nicolle, Rouen, France
| | - Mathieu Ceccaldi
- Neurology and Neuropsychology Department, CHU La Timone, Marseille, France
| | - Claude-Alain Maurage
- Univ Lille, Lille Neuroscience & Cognition (Inserm UMRS1172), Development and Plasticity of the Neuroendocrine Brain, Lille, France; Department of Neuropathology, Univ Lille, CHU Lille, Lille, France
| | - Vincent Deramecourt
- Univ Lille, Lille Neuroscience & Cognition (Inserm UMRS1172) Alzheimer & Tauopathies, CHU Lille, Laboratory of Excellence Distalz (Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease), Lille, France; Department of Neuropathology, Univ Lille, CHU Lille, Lille, France
| | - Florence Pasquier
- Univ Lille, Lille Neuroscience & Cognition (Inserm UMRS1172) Degenerative and Vascular Cognitive Disorders, CHU Lille, Laboratory of Excellence Distalz (Development of Innovative Strategies for a Transdisciplinary approach to ALZheimer's disease), Lille, France
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7
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Sala I, Illán-Gala I, Alcolea D, Sánchez-Saudinós MB, Salgado SA, Morenas-Rodríguez E, Subirana A, Videla L, Clarimón J, Carmona-Iragui M, Ribosa-Nogué R, Blesa R, Fortea J, Lleó A. Diagnostic and Prognostic Value of the Combination of Two Measures of Verbal Memory in Mild Cognitive Impairment due to Alzheimer's Disease. J Alzheimers Dis 2018; 58:909-918. [PMID: 28527215 DOI: 10.3233/jad-170073] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Episodic memory impairment is the core feature of typical Alzheimer's disease. OBJECTIVE To evaluate the performance of two commonly used verbal memory tests to detect mild cognitive impairment due to Alzheimer's disease (MCI-AD) and to predict progression to Alzheimer's disease dementia (AD-d). METHODS Prospective study of MCI patients in a tertiary memory disorder unit. Patients underwent an extensive neuropsychological battery including two tests of declarative verbal memory: The Free and Cued Selective Reminding Test (FCSRT) and the word list learning task from the Consortium to Establish a Registry for Alzheimer's disease (CERAD-WL). Cerebrospinal fluid (CSF) was obtained from all patients and MCI-AD was defined by means of the t-Tau/Aβ1-42 ratio. Logistic regression analyses tested whether the combination of FCSRT and CERAD-WL measures significantly improved the prediction of MCI-AD. Progression to AD-d was analyzed in a Cox regression model. RESULTS A total of 202 MCI patients with a mean follow-up of 34.2±24.2 months were included and 98 (48.5%) met the criteria for MCI-AD. The combination of FCSRT and CERAD-WL measures improved MCI-AD classification accuracy based on CSF biomarkers. Both tests yielded similar global predictive values (59.9-65.3% and 59.4-62.8% for FCSRT and CERAD-WL, respectively). MCI-AD patients with deficits in both FCSRT and CERAD-WL had a faster progression to AD-d than patients with deficits in only one test. CONCLUSIONS The combination of FCSRT and CERAD-WL improves the classification of MCI-AD and defines different prognostic profiles. These findings have important implications for clinical practice and the design of clinical trials.
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Affiliation(s)
- Isabel Sala
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Ignacio Illán-Gala
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Daniel Alcolea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Ma Belén Sánchez-Saudinós
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Sergio Andrés Salgado
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Estrella Morenas-Rodríguez
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Andrea Subirana
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Laura Videla
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Barcelona Down Medical Center, Fundació Catalana de Síndrome de Down, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Jordi Clarimón
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - María Carmona-Iragui
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Barcelona Down Medical Center, Fundació Catalana de Síndrome de Down, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Roser Ribosa-Nogué
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Rafael Blesa
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Juan Fortea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Barcelona Down Medical Center, Fundació Catalana de Síndrome de Down, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Spain
| | - Alberto Lleó
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Spain
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8
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Grober E, Veroff AE, Lipton RB. Temporal unfolding of declining episodic memory on the Free and Cued Selective Reminding Test in the predementia phase of Alzheimer's disease: Implications for clinical trials. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2018; 10:161-171. [PMID: 29552631 PMCID: PMC5852329 DOI: 10.1016/j.dadm.2017.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction Free and Cued Selective Reminding Test (FCSRT) performance identifies patients with preclinical disease at elevated risk for developing Alzheimer's dementia, predicting diagnosis better than other memory tests. Methods Based on literature mapping FCSRT performance to clinical outcomes and biological markers, and on longitudinal preclinical data from the Baltimore Longitudinal Study of Aging, we developed the Stages of Objective Memory Impairment (SOMI) model. Five sequential stages of episodic memory decline are defined by Free Recall (FR) and Total Recall (TR) score ranges and years prior to dementia diagnosis. We sought to replicate the SOMI model using longitudinal assessments of 142 Einstein Aging Study participants who developed AD over 10 years. Results Time to diagnosis was at least seven years if FR was intact, at least four years if TR was intact, and two years if TR was impaired, consistent with SOMI model predictions. The SOMI identified incipient dementia with excellent sensitivity and specificity. Discussion The SOMI model provides an efficient approach for clinical trial cognitive screening in advance of more costly biomarker studies and ultimately in clinical practice, and provides a vocabulary for understanding AD biomarker patterns and for re-analysis of existing clinical trial data.
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Affiliation(s)
- Ellen Grober
- Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | | | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
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9
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Cerami C, Dubois B, Boccardi M, Monsch AU, Demonet JF, Cappa SF. Clinical validity of delayed recall tests as a gateway biomarker for Alzheimer's disease in the context of a structured 5-phase development framework. Neurobiol Aging 2017; 52:153-166. [PMID: 28317646 DOI: 10.1016/j.neurobiolaging.2016.03.034] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 03/05/2016] [Accepted: 03/22/2016] [Indexed: 11/27/2022]
Abstract
Although Alzheimer's disease criteria promote the use of biomarkers, their maturity in clinical routine still needs to be assessed. In the light of the oncology framework, we conducted a literature review on measures used to assess delayed recall impairment due to medial temporal lobe dysfunction (i.e., free and cued word list recall tests). Ample evidence is available for phases 1 (rationale for use), 2 (discriminative ability), and 3 (early detection ability) for many of the tests in routine use. Evidence about phase 4 (performance in real world) and phase 5 (quantify impact and costs) is yet to come. Administration procedures have been standardized and cutoff scores are well validated in large Alzheimer's disease and mild cognitive impaired series. Some aspects (e.g., different task formats), however, hamper the comparability of results among different populations and the reproducibility between laboratories. No definite guideline for their use can thus be proposed at the moment. Accordingly, the maturity of such markers is not yet sufficient and requires future investigation to promote the proper use of memory measures in clinical settings.
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10
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Grober E, Wakefield D, Ehrlich AR, Mabie P, Lipton RB. Identifying memory impairment and early dementia in primary care. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2017; 6:188-195. [PMID: 28289701 PMCID: PMC5338866 DOI: 10.1016/j.dadm.2017.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION This study examined the operating characteristics of two-stage case finding to identify memory impairment and very mild dementia. METHODS Primary care patients underwent two-stage testing and a subsequent diagnostic assessment to assess outcomes. Patients who screen positive for subjective cognitive decline on the Informant Questionnaire on Cognitive Decline in the Elderly undergo memory testing with the Free and Cued Selective Reminding Test with Immediate Recall. Outcomes were determined without access to these data. A split-half design with discovery and confirmatory samples was used. RESULTS One hundred seventeen of 563 (21%) patients had dementia and 68 (12%) had memory impairment but not dementia. Operating characteristics were similar in the discovery and confirmatory samples. In the pooled sample, combined, patients with memory impairment or dementia were identified with good sensitivity (72%) and high specificity (90%). Differences in ethnicity, educational level, or age (≤75, >75) did not affect classification accuracy. DISCUSSION Two-stage screening facilitates the efficient identification of older adults with memory impairment or dementia.
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Affiliation(s)
- Ellen Grober
- Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | | | - Amy R. Ehrlich
- Division of Geriatrics, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Peter Mabie
- Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
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11
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Prediction of Free and Cued Selective Reminding Test Performance Using Volumetric and Amyloid-Based Biomarkers of Alzheimer's Disease. J Int Neuropsychol Soc 2016; 22:991-1004. [PMID: 27903329 DOI: 10.1017/s1355617716000813] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Relatively few studies have investigated relationships between performance on clinical memory measures and indexes of underlying neuropathology related to Alzheimer's disease (AD). This study investigated predictive relationships between Free and Cued Selective Reminding Test (FCSRT) cue efficiency (CE) and free-recall (FR) measures and brain amyloid levels, hippocampal volume (HV), and regional cortical thickness. METHODS Thirty-one older controls without memory complaints and 60 patients presenting memory complaints underwent the FCSRT, amyloid imaging using [F18]-flutemetamol positron emission tomography, and surface-based morphometry (SBM) using brain magnetic resonance imaging. Three groups were considered: patients with high (Aβ+P) and low (Aβ- P) amyloid load and controls with low amyloid load (Aβ- C). RESULTS Aβ+P showed lower CE than both Aβ- groups, but the Aβ- groups did not differ significantly. In contrast, FR discriminated all groups. SBM analyses revealed that CE indexes were correlated with the cortical thickness of a wider set of left-lateralized temporal and parietal regions than FR. Regression analyses demonstrated that amyloid load and left HV independently predicted FCSRT scores. Moreover, CE indexes were predicted by the cortical thickness of some regions involved in early AD, such as the entorhinal cortex. CONCLUSIONS Compared to FR measures, CE indexes appear to be more specific for differentiating persons on the basis of amyloid load. Both CE and FR performance were predicted independently by brain amyloid load and reduced left HV. However, CE performance was also predicted by the cortical thickness of regions known to be atrophic early in AD. (JINS, 2016, 22, 991-1004).
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