Mild behavioral impairment linked to progression to Alzheimer's disease and cortical thinning in amnestic mild cognitive impairment

被引:17
作者
Yoon, Eun Jin [1 ,2 ]
Lee, Jun-Young [3 ,4 ,5 ]
Kwak, Seyul [6 ]
Kim, Yu Kyeong [2 ,7 ]
机构
[1] Seoul Natl Univ, Memory Network Med Res Ctr, Seoul, South Korea
[2] SMG SNU Boramae Med Ctr, Dept Nucl Med, Seoul, South Korea
[3] SMG SNU Boramae Med Ctr, Dept Psychiat, Seoul, South Korea
[4] Seoul Natl Univ, Coll Med, Dept Psychiat, Seoul, South Korea
[5] Seoul Natl Univ, Coll Med, Dept Med Device Dev, Seoul, South Korea
[6] Pusan Natl Univ, Dept Psychol, Busan, South Korea
[7] Seoul Natl Univ, Coll Med, Dept Nucl Med, Seoul, South Korea
基金
新加坡国家研究基金会;
关键词
mild behavioral impairment; mild cognitive impairment; Alzheimer's disease; neuropsychiatric symptoms; magnetic resonance imaging; cortical thickness; SUBJECTIVE MEMORY COMPLAINTS; NEUROPSYCHIATRIC SYMPTOMS; CEREBRAL-CORTEX; ATROPHY; RISK; THICKNESS; DEMENTIA; DEPRESSION; CONVERSION; TAU;
D O I
10.3389/fnagi.2022.1051621
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
BackgroundMild behavioral impairment (MBI) is a neurobehavioral syndrome characterized by later life emergence of sustained neuropsychiatric symptoms, as an at-risk state for dementia. However, the associations between MBI and a risk of progression to Alzheimer's disease (AD) and its neuroanatomical correlates in mild cognitive impairment (MCI) are still unclear. MethodA total 1,184 older adults with amnestic MCI was followed for a mean of 3.1 +/- 2.0 years. MBI was approximated using a transformation algorithm for the Neuropsychiatric Inventory at baseline. A two-step cluster analysis was used to identify subgroups of individuals with amnestic MCI based on profiles of 5 MBI domain symptoms (decreased motivation, affective dysregulation, impulse dyscontrol, social inappropriateness, abnormal perception/thought content). A Cox regression analysis was applied to investigate differences in the risk of progression to AD between subgroups. A subset of participants (n = 202) underwent 3D T1-weighted MRI scans at baseline and cortical thickness was compared between the subgroups of amnestic MCI patients. ResultThe cluster analysis classified the patients into 3 groups: (1) patients without any MBI domain symptoms (47.4%, asymptomatic group); (2) those with only affective dysregulation (29.4%, affective dysregulation group); (3) those with multiple MBI domain symptoms, particularly affective dysregulation, decreased motivation and impulse dyscontrol (23.2%, complex group). Compared to the asymptomatic group, the complex group was associated with a higher risk of progression to AD (hazard ratio = 2.541 [1.904-3.392], p < 0.001), but the affective dysregulation group was not (1.214 [0.883-1.670], p = 0.232). In cortical thickness analysis, the complex group revealed cortical thinning bilaterally in the inferior parietal, lateral occipital, lateral superior temporal, and frontopolar regions compared with the affective dysregulation group. ConclusionThe multiple co-occuring MBI domains in individuals with amnestic MCI are associated with a higher risk of progression to AD and cortical thinning in temporal, parietal and frontal areas. These results suggest that evaluation of MBI could be useful for risk stratification for AD and appropriate intervention in MCI individuals.
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页数:12
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