Relevance of Minor Neuropsychological Deficits in Patients With Subjective Cognitive Decline

被引：13

作者：

Stark, Melina ^{[1
,2
]}

Wolfsgruber, Steffen ^{[1
,2
]}

Kleineidam, Luca ^{[1
,2
]}

Frommann, Ingo ^{[2
]}

Altenstein, Slawek ^{[3
,4
]}

Bartels, Claudia ^{[5
]}

Brosseron, Frederic ^{[1
]}

Buerger, Katharina ^{[6
,7
]}

Burow, Lena ^{[8
]}

Butryn, Michaela ^{[9
]}

Ewers, Michael ^{[6
,7
]}

Fliessbach, Klaus ^{[1
,2
]}

Gabelin, Tatjana ^{[10
]}

Glanz, Wenzel ^{[9
]}

Goerss, Doreen ^{[11
,12
]}

Gref, Daria ^{[10
]}

Hansen, Niels ^{[5
]}

Heneka, Michael T. ^{[13
]}

Hinderer, Petra ^{[14
]}

Incesoy, Enise I. ^{[9
,15
,16
]}

Janowitz, Daniel ^{[7
]}

Kilimann, Ingo ^{[11
,12
]}

Kimmich, Okka ^{[1
]}

Laske, Christoph ^{[14
,17
,18
]}

Munk, Matthias H. ^{[14
,18
]}

Perneczky, Robert ^{[6
,8
,19
,20
]}

Peters, Oliver ^{[3
,10
]}

Preis, Lukas ^{[10
]}

Priller, Josef ^{[3
,4
,21
,22
,23
]}

Rauchmann, Boris-Stephan ^{[8
,24
,25
]}

Rostamzadeh, Ayda ^{[26
]}

Roy-Kluth, Nina ^{[1
]}

Sanzenbacher, Carolin ^{[14
]}

Schneider, Anja ^{[1
,2
]}

Schott, Bjoern H. ^{[5
,27
]}

Spottke, Annika ^{[1
,28
]}

Spruth, Eike Jakob ^{[3
,4
]}

Teipel, Stefan ^{[11
,12
]}

Vogt, Ina R. ^{[1
]}

Wiltfang, Jens ^{[5
,27
,29
]}

Duzel, Emrah ^{[9
,15
]}

Jessen, Frank ^{[1
,26
,30
]}

Wagner, Michael ^{[1
,2
]}

机构：

[1] German Ctr Neurodegenerat Dis DZNE, Bonn, Germany

[2] Univ Bonn, Dept Neurodegenerat Dis & Geriatr Psychiat, Med Ctr, Bonn, Germany

[3] German Ctr Neurodegenerat Dis DZNE, Berlin, Germany

[4] Charite Univ Med Berlin, Dept Psychiat & Psychotherapy, Campus Charite Mitte, Berlin, Germany

[5] Univ Goettingen, Univ Med Ctr Goettingen, Dept Psychiat & Psychotherapy, Gottingen, Germany

[6] German Ctr Neurodegenerat Dis DZNE, Munich, Germany

[7] Ludwig Maximilians Univ Munchen, Univ Hosp, Inst Stroke & Dementia Res ISD, Munich, Germany

[8] Ludwig Maximilians Univ Munchen, Univ Hosp, Dept Psychiat & Psychotherapy, Munich, Germany

[9] German Ctr Neurodegenerat Dis DZNE, Magdeburg, Germany

[10] Charite Univ Med Berlin, Dept Psychiat & Psychotherapy, Campus Benjamin Franklin, Berlin, Germany

[11] German Ctr Neurodegenerat Dis DZNE, Rostock, Germany

[12] Rostock Univ, Med Ctr, Dept Psychosomat Med, Rostock, Germany

[13] Univ Luxembourg, Luxembourg Ctr Syst Biomed LCSB, Esch Sur Alzette, Luxembourg

[14] German Ctr Neurodegenerat Dis DZNE, Tubingen, Germany

[15] Otto Von Guericke Univ, Inst Cognit Neurol & Dementia Res IKND, Magdeburg, Germany

[16] Univ Clin Magdeburg, Dept Psychiat & Psychotherapy, Magdeburg, Germany

[17] Univ Tubingen, Hertie Inst Clin Brain Res, Sect Dementia Res, Tubingen, Germany

[18] Univ Tubingen, Dept Psychiat & Psychotherapy, Tubingen, Germany

[19] Munich Cluster Syst Neurol SyNergy, Munich, Germany

[20] Imperial Coll London, Sch Publ Hlth, Ageing Epidemiol Res Unit AGE, London, England

[21] Tech Univ Munich, Sch Med, Dept Psychiat & Psychotherapy, Munich, Germany

[22] Univ Edinburgh, Edinburgh, Scotland

[23] UK DRI, Edinburgh, Scotland

[24] Ludwig Maximilians Univ Munchen, Univ Hosp, Dept Neuroradiol, Munich, Germany

[25] Univ Sheffield, Sheffield Inst Translat Neurosci SITraN, Sheffield, England

[26] Univ Cologne, Med Fac, Dept Psychiat, Cologne, Germany

[27] German Ctr Neurodegenerat Dis DZNE, Gottingen, Germany

[28] Univ Bonn, Med Ctr, Dept Neurol, Bonn, Germany

[29] Univ Aveiro, Inst Biomed iBiMED, Dept Med Sci, Neurosci & Signaling Grp, Aveiro, Portugal

[30] Univ Cologne, Excellence Cluster Cellular Stress Responses Agin, Cologne, Germany

来源：

NEUROLOGY | 2023年 / 101卷 / 21期

关键词：

ALZHEIMERS-DISEASE; TOTAL SCORE; IMPAIRMENT; RECOMMENDATIONS; DIAGNOSIS;

D O I：

10.1212/WNL.0000000000207844

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and ObjectivesTo determine the relevance of minor neuropsychological deficits (MNPD) in patients with subjective cognitive decline (SCD) with regard to CSF levels of Alzheimer disease (AD) biomarkers, cognitive decline, and clinical progression to mild cognitive impairment (MCI).MethodsThis study included patients with clinical SCD and SCD-free, healthy control (HC) participants with available baseline CSF and/or longitudinal cognitive data from the observational DZNE Longitudinal Cognitive Impairment and Dementia study. We defined MNPD as a performance of at least 0.5SD below the mean on a demographically adjusted total score derived from the Consortium to Establish a Registry for Alzheimer's Disease neuropsychological assessment battery. We compared SCD patients with MNPD and those without MNPD with regard to CSF amyloid-beta (A beta)42/A beta 40, phosphorylated tau (p-tau181), total tau and A beta 42/p-tau181 levels, longitudinal cognitive composite trajectories, and risk of clinical progression to incident MCI (follow-up M +/- SD: 40.6 +/- 23.7 months). In addition, we explored group differences between SCD and HC in those without MNPD.ResultsIn our sample (N = 672, mean age: 70.7 +/- 5.9 years, 50% female), SCD patients with MNPD (n = 55, 12.5% of SCD group) showed significantly more abnormal CSF biomarker levels, increased cognitive decline, and a higher risk of progression to incident MCI (HR: 4.07, 95% CI 2.46-6.74) compared with SCD patients without MNPD (n = 384). MNPD had a positive predictive value of 57.0% (95% CI 38.5-75.4) and a negative predictive value of 86.0% (95% CI 81.9-90.1) for the progression of SCD to MCI within 3 years. SCD patients without MNPD showed increased cognitive decline and a higher risk of incident MCI compared with HC participants without MNPD (n = 215; HR: 4.09, 95% CI 2.07-8.09), while AD biomarker levels did not differ significantly between these groups.DiscussionOur results suggest that MNPD are a risk factor for AD-related clinical progression in cognitively normal patients seeking medical counseling because of SCD. As such, the assessment of MNPD could be useful for individual clinical prediction and for AD risk stratification in clinical trials. However, SCD remains a risk factor for future cognitive decline even in the absence of MNPD.

引用

页码：E2185 / E2196

页数：12

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