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Subtypes of Amnestic Mild Cognitive Impairment Based on Memory Impairment Pattern and Its Potential Clinical Significance

김상윤|양현덕|양영순|Benalfew T. Legesse
대한치매학회 (Korean Dementia Association)|2012.06|Dementia and Neurocognitive Disorders(대한치매학회지) (Dementia and Neurocognitive Disorders)|제11권 제2호|pp. 59-66

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MemoryMild cognitive impairmentAlzheimer’s diseaseDisease progression
주제분류신경과학

초록

Background: Episodic memory impairment can be subdivided into two subtypes, encoding failure vs. retrieval deficit. We defined two subtypes of amnestic mild cognitive impairment (aMCI) according to recognition performance on the memory test: aMCI with encoding failure or aMCI-E and aMCI with retrieval deficit or aMCI-R. We hypothesized that compared to aMCI-R, subjects with aMCI-E are more likely to convert to Alzheimer’s disease, as encoding failure suggests that medial temporal lobes are affected early in the disease process. We also investigated whether aMCI-E can be a predictor for progression to AD. Methods: Using the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database, a total of 397 aMCI subjects were included. APOE genotype, cerebrospinal fluid (CSF) fluid biomarkers, and a set of neuropsychological measures were also collected. Unadjusted and adjusted odds ratios were calculated to predict the conversion to AD dementia. The Spearman’s rs test was used to measure the degree of correlation between aMCI subtypes and the prognostic factors for progression to AD. Results: Among the 397 subjects, 209 (52.6%) subjects were classified into aMCI-E and 188 (47.4%) into aMCI-R. One hundred two (48.8%) subjects with aMCI-E and 57 (30.3%) of those with aMCI-R progressed to AD (unadjusted odds ratio=2.19 with 95% confidence interval [CI] 1.45-3.31) over 3 years. However, when adjusted odds ratio by a logistic regression was calculated, probability value of aMCI-E disappeared with the odds of conversion by of 1.47 (95% CI 0.89-2.43). There were statistically significant correlations between aMCI-E subtype and MMSE, CDR Memory, RAVLT delayed recall, CSF biomarkers, and genotypes. Conclusions: This analysis did not show that aMCI-E is an independent prognostic factor to predict the progression to AD. However, this subtype significantly correlates with other prognostic factors for progression. This may suggest that aMCI-E might be a later stage of aMCI and aMCI-R an earlier stage which might be a better target than aMCI-E for therapeutic intervention. Further studies are needed to validate this conjecture.

Abstract

Background: Episodic memory impairment can be subdivided into two subtypes, encoding failure vs. retrieval deficit. We defined two subtypes of amnestic mild cognitive impairment (aMCI) according to recognition performance on the memory test: aMCI with encoding failure or aMCI-E and aMCI with retrieval deficit or aMCI-R. We hypothesized that compared to aMCI-R, subjects with aMCI-E are more likely to convert to Alzheimer’s disease, as encoding failure suggests that medial temporal lobes are affected early in the disease process. We also investigated whether aMCI-E can be a predictor for progression to AD. Methods: Using the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database, a total of 397 aMCI subjects were included. APOE genotype, cerebrospinal fluid (CSF) fluid biomarkers, and a set of neuropsychological measures were also collected. Unadjusted and adjusted odds ratios were calculated to predict the conversion to AD dementia. The Spearman’s rs test was used to measure the degree of correlation between aMCI subtypes and the prognostic factors for progression to AD. Results: Among the 397 subjects, 209 (52.6%) subjects were classified into aMCI-E and 188 (47.4%) into aMCI-R. One hundred two (48.8%) subjects with aMCI-E and 57 (30.3%) of those with aMCI-R progressed to AD (unadjusted odds ratio=2.19 with 95% confidence interval [CI] 1.45-3.31) over 3 years. However, when adjusted odds ratio by a logistic regression was calculated, probability value of aMCI-E disappeared with the odds of conversion by of 1.47 (95% CI 0.89-2.43). There were statistically significant correlations between aMCI-E subtype and MMSE, CDR Memory, RAVLT delayed recall, CSF biomarkers, and genotypes. Conclusions: This analysis did not show that aMCI-E is an independent prognostic factor to predict the progression to AD. However, this subtype significantly correlates with other prognostic factors for progression. This may suggest that aMCI-E might be a later stage of aMCI and aMCI-R an earlier stage which might be a better target than aMCI-E for therapeutic intervention. Further studies are needed to validate this conjecture.

참고문헌 (38)

  1. Farias ST, "Progression of mild cognitive impairment to dementia in clinic- vs community-based cohorts", Arch Neurol, 66, pp.1151~1157 (2009)
  2. Petersen RC, "Current concepts in mild cognitive impairment", Arch Neurol, 58, pp.1985~1992 (2001)
  3. de Mendonça A, "Mild cognitive impairment: focus on diagnosis", J Mol Neurosci, 23, pp.143~148 (2004)
  4. Dubois B, "Amnestic MCI or prodromal Alzheimer’s disease?", Lancet Neurol, 3, pp.246~248 (2004)
  5. Lopez OL, "Prevalence and classification of mild cognitive impairment in the Cardiovascular Health Study Cognition Study: part 1", Arch Neurol, 60, pp.1385~1389 (2003)
  6. Visser PJ, "Medial temporal lobe atrophy and memory dysfunction as predictors for dementia in subjects with mild cognitive impairment", J Neurol, 246, pp.477~485 (1999)
  7. Corder EH, "Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer’s disease in late onset families", Science, 261, pp.921~923 (1993)
  8. He J, "Differences in brain volume, hippocampal volume, cerebrovascular risk factors, and apolipoprotein E4 among mild cognitive impairment subtypes", Arch Neurol, 66, pp.1393~1399 (2009)
  9. Petersen RC, "Thibodeau SN, et al. Apolipoprotein E status as a predictor of the development of Alzheimer’s disease in memory-impaired individuals", JAMA, 273, pp.1274~1278 (1995)
  10. Aggarwal NT, "Bennett DA. The apolipoprotein E epsilon4 allele and incident Alzheimer’s disease in persons with mild cognitive impairment", Neurocase, 11, pp.3~7 (2005)
  11. Fox NC, "Correlation between rates of brain atrophy and cognitive decline in AD", Neurology, 52, pp.1687~1689 (1999)
  12. Jack CR, "MRI as a biomarker of disease progression in a therapeutic trial of milameline for AD", Neurology, 60, pp.253~260 (2003)
  13. Kantarci K, "1H magnetic resonance spectroscopy in dementia", Br J Radiol, 80(2), pp.146~152 (2007)
  14. Vannini P, "Reduced neuronal efficacy in progressive mild cognitive impairment: a prospective fMRI study on visuospatial processing", Psychiatry Res, 156, pp.43~57 (2007)
  15. Dickerson BC, "Medial temporal lobe function and structure in mild cognitive impairment", Ann Neurol, 56, pp.27~35 (2004)
  16. Miller SL, "Hippocampal activation in adults with mild cognitive impairment predicts subsequent cognitive decline", J Neurol Neurosurg Psychiatry, 79, pp.630~635 (2008)
  17. Hansson O, "Association between CSF biomarkers and incipient Alzheimer’s disease in patients with mild cognitive impairment: a follow-up study", Lancet Neurol, 5, pp.228~234 (2006)
  18. Mattsson N, "CSF biomarkers and incipient Alzheimer disease in patients with mild cognitive impairment", JAMA, 302, pp.385~393 (2009)
  19. Shaw LM, "Cerebrospinal fluid biomarker signature in Alzheimer’s disease neuroimaging initiative subjects", Ann Neurol, 65, pp.403~413 (2009)
  20. Wolk DA, "Amyloid imaging in mild cognitive impairment subtypes", Ann Neurol, 65, pp.557~568 (2009)
  21. Jack CR, "11C PiB and structural MRI provide complementary information in imaging of Alzheimer’s disease and amnestic mild cognitive impairment", Brain, 131, pp.665~680 (2008)
  22. Blumenfeld RS, "Prefrontal cortex and long-term memory encoding: an integrative review of findings from neuropsychology and neuroimaging", Neuroscientist, 13, pp.280~291 (2007)
  23. Barbeau EJ, "Profile of memory impairment and gray matter loss in amnestic mild cognitive impairment", Neuropsychologia, 46, pp.1009~1019 (2008)
  24. 정은혜, "기억상실형 경도인지장애를 기억장애의 양상에 따라 세분화할 수 있는가?: 예비연구", Dementia and Neurocognitive Disorders(대한치매학회지), 11(1), pp.18~24 (2012), 대한치매학회
  25. Rabin LA, "Differential memory test sensitivity for diagnosing amnestic mild cognitive impairment and predicting conversion to Alzheimer’s disease", Neuropsychol Dev Cogn B Aging Neuropsychol Cogn, 16, pp.357~376 (2009)
  26. Petersen RC, "Alzheimer’s Disease Neuroimaging Initiative (ADNI): clinical characterization", Neurology, 74, pp.201~209 (2010)
  27. Mueller SG, "The Alzheimer’s disease neuroimaging initiative", Neuroimaging Clin N Am, 15, pp.869~877 (2005)
  28. Petersen RC, "Mild cognitive impairment as a diagnostic entity", J Intern Med, 256, pp.183~194 (2004)
  29. Rosen WG, "Pathological verification of ischemic score in differentiation of dementias", Ann Neurol, 7, pp.486~488 (1980)
  30. Sheikh J, "Geriatric Depression Score (GDS): recent evidence and development of a shorter version", pp.165~173 (1986), The Howarth Press
  31. Weschler D, "WMS-R Weschler Memory Scale Revised Manual", pp.1987, The Psychological Corporation
  32. Rey A, "L’examen Clinique en Psychologie" (1964), Presses Universitaires de France
  33. Marshall GA, "Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer’s disease", Alzheimers Dement, 7, pp.300~308 (2011)
  34. Ravaglia G, "Conversion of mild cognitive impairment to dementia: predictive role of mild cognitive impairment subtypes and vascular risk factors", Dement Geriatr Cogn Disord, 21, pp.51~58 (2006)
  35. Yaffe K, "Subtype of mild cognitive impairment and progression to dementia and death", Dement Geriatr Cogn Disord, 22, pp.312~319 (2006)
  36. Tabert MH, "Neuropsychological prediction of conversion to Alzheimer disease in patients with mild cognitive impairment", Arch Gen Psychiatry, 63, pp.916~924 (2006)
  37. Busse A, "Mild cognitive impairment: long-term course of four clinical subtypes", Neurology, 67, pp.2176~2185 (2006)
  38. Seo SW, "Cortical thickness in single- versus multiple-domain amnestic mild cognitive impairment", Neuroimage, 36, pp.289~297 (2007)

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