Predicting progression of amnesic MCI: The integration of episodic memory impairment with perfusion SPECT

Psychiatry Res Neuroimaging. 2018 Jan 30:271:43-49. doi: 10.1016/j.pscychresns.2017.10.008. Epub 2017 Oct 24.

Abstract

The present study aimed at assessing if the ability to predict progression from amnesic Mild Cognitive Impairment (aMCI) to dementia is improved by considering the presence at the baseline of Single Photon Emission Computed Tomography (SPECT) perfusion abnormalities in addition to a defect of long term memory. The Episodic Memory Score (EMS), a global index which integrates results obtained in subtests of the Rey's Verbal Learning Test and the Rey-Osterrieth Figure recall, were taken into account to evaluate defects of long term memory. The study sample consisted of 42 subjects affected by aMCI, who were followed-up during a two-year period. At the final follow-up 15 subjects progressed to AD. The EMS predicted progression from aMCI to dementia with a high level of sensitivity and a lower level of specificity, but the association of neuropsychological (EMS) and SPECT data (hypoperfusion in the Posterior Cingulate Cortex) increased the accuracy in predicting conversion from aMCI to AD. The association of results obtained by aMCI patients on memory tests and perfusion SPECT may improve the accuracy in detecting subjects who will progress to dementia. The use of currently available and low-cost investigations could be advantageous in terms of public health policies.

Keywords: (99m)Tc-HMPAO-SPECT hypoperfusion; Alzheimer's Disease; Amnesic Mild Cognitive Impairment; Conversion to dementia; Episodic memory score; Posterior Cingulate Cortex.

MeSH terms

  • Aged
  • Amnesia / diagnostic imaging*
  • Amnesia / metabolism
  • Cognitive Dysfunction / diagnostic imaging*
  • Cognitive Dysfunction / metabolism
  • Disease Progression*
  • Female
  • Gyrus Cinguli / diagnostic imaging*
  • Gyrus Cinguli / metabolism
  • Humans
  • Male
  • Memory, Episodic*
  • Mental Recall / physiology
  • Middle Aged
  • Neuropsychological Tests
  • Predictive Value of Tests
  • Prospective Studies
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Tomography, Emission-Computed, Single-Photon / trends
  • Verbal Learning / physiology