Data-driven prognostic features of cognitive trajectories in patients with amnestic mild cognitive impairments View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-12

AUTHORS

Yeo Jin Kim, Seong-Kyoung Cho, Hee Jin Kim, Jin San Lee, Juyoun Lee, Young Kyoung Jang, Jacob W. Vogel, Duk L. Na, Changsoo Kim, Sang Won Seo

ABSTRACT

BACKGROUND: Although amnestic mild cognitive impairment (aMCI) is generally considered to be a prodromal stage of Alzheimer's disease, patients with aMCI show heterogeneous patterns of progression. Moreover, there are few studies investigating data-driven cognitive trajectory in aMCI. We therefore classified patients with aMCI based on their cognitive trajectory, measured by clinical dementia rating sum of boxes (CDR-SOB). Then, we compared the clinical and neuroimaging features among groups classified by cognitive trajectory. METHODS: We retrospectively recruited 278 patients with aMCI who underwent three or more timepoints of neuropsychological testing. They also had magnetic resonance imaging (MRI) including structured three-dimensional volume images. Cortical thickness was measured using surface-based methods. We performed trajectory analyses to classify our aMCI patients according to their progression and investigate their cognitive trajectory using CDR-SOB. RESULTS: Trajectory analyses showed that patients with aMCI were divided into three groups: stable (61.8%), slow decliner (31.7%), and fast decliner (6.5%). Changes throughout a mean follow-up duration of 3.7 years in the CDR-SOB for the subgroups of stable/slow/fast decliners were 1.3-, 6.4-, and 12-point increases, respectively. Decliners were older and carried apolipoprotein E4 (APOE4) genotypes more frequently than stable patients. Compared with the stable group, decliners showed a higher frequency of aMCI patients with both visual and verbal memory dysfunction, late stage aMCI, and multiple domain dysfunction. In addition, compared with the stable group, the slow decliners showed cortical thinning predominantly in bilateral parietotemporal areas, while the fast decliners showed cortical thinning predominantly in bilateral frontotemporal areas. Both decliner groups showed worse cognitive function in attention, language, visuospatial, memory, and frontal/executive domains than the stable group. CONCLUSIONS: Our data-driven trajectory analysis provides new insights into heterogeneous cognitive trajectories of aMCI and further suggests that baseline clinical and neuroimaging profiles might predict aMCI patients with poor prognosis. More... »

PAGES

10

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s13195-018-0462-z

DOI

http://dx.doi.org/10.1186/s13195-018-0462-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1111593823

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30670089


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252 schema:name Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
253 Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
254 Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, 135-710, Seoul, Republic of Korea
255 Neuroscience Center, Samsung Medical Center, Seoul, Korea
256 rdf:type schema:Organization
257 https://www.grid.ac/institutes/grid.411231.4 schema:alternateName Kyung Hee University Medical Center
258 schema:name Department of Neurology, Kyung Hee University Hospital, Seoul, Korea
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260 https://www.grid.ac/institutes/grid.411665.1 schema:alternateName Chungnam National University Hospital
261 schema:name Department of Neurology, Chungnam National University Hospital, Daejeon, Korea
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263 https://www.grid.ac/institutes/grid.414964.a schema:alternateName Samsung Medical Center
264 schema:name Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
265 Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, 135-710, Seoul, Republic of Korea
266 Neuroscience Center, Samsung Medical Center, Seoul, Korea
267 rdf:type schema:Organization
 




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