根据大脑缩模式,预测从主观认知衰退到轻度认知障碍或痴呆的进展
Ondrej Lerch1,2, Daniel Ferreira3,4, Erik Stomrud5,6
1Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, 15006, Czech Republic. ondrej.lerch.2@ki.se.
Alzheimer's research & therapy
|July 5, 2024
概括
从主观认知衰退中预测阿尔茨海默病的进展,使用在轻度认知障碍数据上训练的模型比在高级痴呆症数据中更准确. 这种方法可以改善风险人群的早期检测.
科学领域:
- 神经成像是一种神经成像.
- 神经退行性疾病 神经退行性疾病
- 生物标志物 生物标志物
背景情况:
- 阿尔茨海默病 (AD) 病理在症状出现前几十年就开始了.
- 结构性MRI和数据分析可以识别具有主观认知衰退 (SCD) 的个体,他们有很高的AD痴呆症进展风险.
- 目前在先进的AD上训练的模型可能不适合SCD的早期预测.
研究的目的:
- 为了比较使用两个不同的模型预测SCD进展的准确性.
- 评估一个在AD痴呆症上训练的标准模型与一个在粉样β (Aβ) 阳性记忆力轻度认知障碍 (aMCI) 上训练的新型模型.
主要方法:
- 利用了504名参与者的结构性MRI数据 (认知正常,SCD,aMCI,AD痴呆症).
- 开发了两种预测模型,将认知正常的个人与Aβ阳性aMCI或AD痴呆症区分开来.
- 对SCD个体应用模型,将缩模式分类为高风险或低风险,评估8年纵向数据的准确性.
主要成果:
- 基于aMCI的模型显示,与基于痴呆症的模型相比,SCD进展的预测准确度更高.
- 基于aMCI的模型实现了72.3%的灵敏度和60.9%的特异性 (AUC=0.72),而基于痴呆症的模型则达到10.6%的灵敏度和100%的特异性 (AUC=0.57).
- 基于aMCI的模型显示,在预测从SCD转换为MCI或痴呆症方面,有统计学上的显著改善 (P=0.037).
结论:
- 在较轻微的缩模式上训练的模型,如aMCI,为预测从SCD转化为MCI或痴呆症提供了卓越的临床价值.
- 结构性MRI分析与定制的预测模型可以增强早期检测阿尔茨海默病的进展.
- 这项研究强调了模型选择对于在神经退行性疾病早期阶段准确的风险分层的重要性.
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