非匹配负波对遗忘型轻度认知障碍诊断和预后的价值

目的 前瞻性探讨事件相关电位-非匹配负波(event-related potential mismatch negativity,ERP-MMN)在评估遗忘型轻度认知障碍(amnestic mild cognitive impairment,aMCI)患者的诊断和预后的价值.方法 181例研究对象分为aMCI组102例、对照组79名,所有研究对象均进行神经心理虽表、头颅影像学和MMN检奁,分析其峰潜伏期和波幅.随访1年,依据神经心理量表及临床表现等评估MMN在aMCI预后中的价值.结果 aMCI组MMN的峰潜伏期[(312.7±25.7)ms]较对照组[(285.1±28.8)ms]明显延长(t=6.81,P<0.01),波幅[(3.48±1.32)μV]较对照组[(4.66 ±1.12)μV]明显降低(t=-6.37,P<0.01).转化为阿尔茨海默病(AD)的aMCI亚组MMN的峰潜伏期[(332.2±24.1)ms]较未转化为AD的aMCI亚组[(307.5±24.0)ms]明显延长(t=2.75,P=0.007);转化的aMCI亚组MMN的神经心理量表检查和波幅较未转化的aMCI亚组差异无统计学意义.结论 MMN能辅助诊断aMCI并判断其预后,反映和监测aMCI患者认知功能状态的改变.     

非匹配负波对遗忘型轻度认知障碍诊断和预后的价值

Objective To evaluate the value of event-related potential mismatch negativity(ERP-MMN)for diagnosis and prognosis of amnestic mild cognitive impairment(aMCI).Methods 181 people were enrolled in this study,including 102 aMCI patients and 79 normal people and all of them underwent the clinical symptom and performance of neuropsychologieal measures and cranium imaging and examination of MMN.aMCI patients were judged to progress to Alzheimer's disease(AD)or not by clinical symptom and performance of neuropsychological measures during 1 year follow-up period.Through analysis of peak latency (PL)and amplitude(Amp),the value of MMN in diagnosis of aMCI and normal subjects was assessed,judging aMCI progress to AD or not.Results In contrast to normal control subjects(NC),PL of MMN in subjects of aMCl was significantly longer and Amp was significantly shorter,PL of MMN(312.7±25.7)ms vs(285.1±28.8)ms(t=6.81,P<0.01),Amp(3.5 ±1.3)μV vs(4.7±1.1)μV(t=-6.37,P<0.01).Moreover,PL of MMN in subjects of aMCl which would progress to AD was significantly longer than of subjects of aMCI which would not progress,(332.2±24.1)ms vs(307.5 ±24.0)ms(t=2.75,P=0.007).However.significantly difference was not observed in Amp of MMN and neuropsychological measures between subjects of aMCI would progress and not.Conclusions MMN can be used in auxiliary diagnosis and judging prognosis of aMCI.It is appropriate when is required to reflect and monitor periodic cognitive state of subjects of aMCI.     

载脂蛋白E基因对轻度认知障碍患者听觉诱发电位的影响

目的探讨载脂蛋白(ApoE)基因型对轻度认知障碍(MCI)患者听觉诱发电位(AEP)的影响。方法健康老年对照60名,MCI患者60例,其中MCI低危组(未携带ApoE ε4基因的MCI患者)和高危组(携带ApoEε4基因的MCI患者)各30例。对所有观察对象均进行AEP和ApoE基因检测,并对脑干AEP Ⅰ波、Ⅲ波、Ⅴ波潜伏期和波峰间潜伏期,N200、P300潜伏期和波幅进行比较。结果 (1)MCI低危组、高危组与健康对照组Ⅰ、Ⅲ、Ⅴ波潜伏期及波峰间潜伏期均无统计学差异(P0.05)。(2)与健康对照组[N200、P300波幅分别为(5.97±0.76)、(10.69±1.57)μV、潜伏期分别为(240.20±16.45)、(300.06士20.50)ms]比较,MCI高危组患者N200、P300波幅[分别为(5.36±0.62)、(9.95±1.20)μV]降低、潜伏期[分别为(246.97±11.6)、(313.34士26.19)ms]延长(P0.05)。与MCI低危组N200波幅[(5.81士0.62)μV]相比,高危组N200波幅降低(P0.05)。高危组、低危组及健康对照组三组间N200、P300波幅比较均有统计学差异(分别P0.01、P0.05)。结论携带ApoEε4基因的MCI患者N200、P300波幅减小,潜伏期延长。AEP有可能作为个人认知功能变化的测量指标。     

脑显像对轻度认知障碍预后预测价值的Meta分析

目的 利用Meta分析评价和比较氟脱氧葡萄糖-正电子发射断层显像(fluorodeoxyglucose-positron-emission tomography,FDG-PET)、单光子发射计算机断层显像(single-photon emission tomography,SPECT)及结构性磁共振成像(magneti...     

轻度认知障的非匹配负波研究

有研究表明非匹配负波(MMN)能较客观地反映帕金森病(Parkinson disease,PD)患者早期额叶认知功能障碍[1].MMN主要用于老年性痴呆(Alzheimer's disease,AD)、PD、精神分裂症等的研究,但极少有用于轻度认知障碍(mild cognitive impairment,MCI)的研究报道.故本研究对MMN诊断MCI的价值进行了探讨.     

记忆测试预测遗忘型轻度认知障碍患者海马形态改变的研究

目的 明确何种类型的记忆测试能更好地预测1年后遗忘型轻度认知障碍向阿尔茨海默病（Alzheimer’s disease,AD）转变相关的海马形态学改变。方法 用海马冠状位磁共振扫描T1像0～4分的视觉等级评分法,比较3组遗忘型轻度认知障碍患者的海马萎缩程度,分组为听觉记忆受损组（n =30）、视觉记忆受损组（n =28）、视觉与听觉记忆均受损组（n =44）。患者均接受了多奈哌齐、艾斯能或加兰他敏中的任一药物治疗。结果 基线资料显示听觉记忆受损组存在较高比例（80%）的海马萎缩,高于视觉记忆受损组海马萎缩的比例（43%）,视觉与听觉记忆均受损组海马萎缩的比例达91%,且萎缩的皮层更广泛。1年后,听觉记忆受损组、视觉记忆受损组和视觉听觉记忆均受损组向临床痴呆的转化率分别为20.0%、10.7%和31.8%。有极高比例的听觉记忆受损患者（50%）和视觉听觉记忆均受损者（68.2%）出现双侧海马萎缩或萎缩程度较前加重,而仅有较少比例（28.6%）的视觉记忆受损患者出现双侧海马的轻度萎缩。结论 听觉记忆受损和视觉听觉记忆均受损的遗忘型轻度认知障碍患者更可能是AD的前期状态,听觉记忆测试较视觉记忆测试更能敏感预测1年后遗忘型轻度认知障碍患者海马萎缩程度     

遗忘型轻度认知障碍患者听觉事件相关电位的临床研究

目的研究听觉事件相关电位(AERPs)在遗忘型轻度认知障碍(aMCI)患者中的临床特点以及与认知功能、脑血流动力学的关系。方法收集2012年4月至2016年6月来源于首都医科大学附属复兴医院神经内科,确诊为aMCI的患者50例,选择同时期认知正常健康体检者44例为正常对照组(NC组)。所有受试者分别进行AERPs、神经心理学量表和经颅多普勒超声(TCD)检查,分析AERPs的临床特点,以及与认知量表评分、脑血流动力学的相关性。。结果与NC组比较,aMCI组计数准确率下降,反应时间延长(均P0.05);P300潜伏期延长(P0.05);P300波幅减低,但差异无统计学意义(P0.05)。两组之间N100、P200、N200的波幅、潜伏期差异无统计学意义(P0.05)。与NC组比较,aMCI组MCA的搏动指数(PI)升高(P0.05)。相关性分析显示:aMCI组P300潜伏期与蒙特利尔认识评估量表(Mo CA)评分呈负相关(r=-0.492,P0.01),与简短智能检测(MMSE)评分无相关性(P0.05)。aMCI组P300潜伏期与MCA的PI值呈正相关(r=0.325,P0.05)。结论 aMCI患者的P300潜伏期较正常人延长,P300潜伏期的延长可能与认知功能的受损和MCA的PI值升高有一定关系。     

脑血管储备功能在老年遗忘型轻度认知障碍中的应用价值

目的研究老年遗忘型轻度认知障碍(aMCI)患者脑血管储备(CVR)功能的特点。方法收集2012-4—2016-1就诊于首都医科大学附属复兴医院、年龄≥60岁、确诊为aMCI的患者40例,同时选择认知功能正常的健康者42名为正常对照组。所有受试者分别进行经颅多普勒超声(TCD)屏气试验及听觉事件相关电位(AERPs)检查,分析屏气指数(BHI)与认知功能及脑血流动力学的相关性。结果 aMCI组BHI较正常组下降(P0.01);aMCI组BHI与蒙特利尔量表(Montreal cognitive assessment,MoCA)评分呈正相关(r=0.634,P0.01),与P300潜伏期呈负相关(r=-0.426,P0.01);aMCI组患者BHI与大脑中动脉(MCA)的搏动指数(PI)呈负相关(r=-0.365,P0.05);aMCI患者PI异常者其BHI较PI正常者降低(P0.05)。结论老年aMCI患者CVR功能下降,其认知功能受损与CVR减低有一定相关性。     

基于体素的MRI形态学测量对遗忘型轻度认知障碍和轻度阿尔茨海默病脑灰质萎缩的研究

目的：利用磁共振3DT1WI成像研究遗忘型轻度认知障碍（aMCI）、轻度阿尔茨海默病（AD）患者相对于正常老年人灰质体积改变的特点。方法：采用3．0T磁共振,对33例aMCI患者（aMCI组）、32例轻度AD患者（轻度AD组）及31名正常老年人（对照组）进行3DT1WI扫描,利用基于SPM5的DARTEL工具箱对扫描获得的结构图像进行预处理,再对aMCI组、轻度AD组和对照组的全脑灰质体积进行基于体素的统计学比较。结果：与对照组比较,aMCI组左侧海马、海马旁回、舌回、颞上回,双侧岛叶和颞中回等结构的灰质体积萎缩,其差异有显著统计学意义（P〈0．01,FDR corrected,K〉50体素）。轻度AD组的双侧海马、海马旁回及杏仁核、双侧丘脑、双侧颞顶叶皮质等结构灰质体积萎缩,额叶和枕叶皮质也出现灰质萎缩,其差异也有统计学意义（P〈0．05,FDR corrected,K≥50体素）。结论：基于体素的MRI形态学测量能够客观揭示AD早期阶段的脑灰质萎缩改变,对左侧海马萎缩的识别有助于AD的早期诊断。     

轻度认知障碍和阿尔茨海默病患者血清中兴奋性氨基酸的含量

目的 研究遗忘型轻度认知障碍(amnestic mild cognitive impairment,aMCI)及阿尔茨海默病(Alzheimer's disease,AD)患者血清中兴奋性氨基酸(EAAs)含量的变化,探讨EAAs在二者发病中的作用.方法 使用高效液相法对30例aMCI、32例AD患者以及34名健康对照者血清中EAAs[谷氨酸、天门冬氨酸(Asp)]及EAAs N-甲基-D-Asp(N-methyl-D-aspartate,NMDA)受体的协同激动剂甘氨酸、丝氨酸、丙氨酸含量进行测定和比较.结果 aMCI组血清中的谷氨酸[(39.6±22.1)μmol/L]和丙氨酸[(282.5±71.3)μmol/L]含量高于健康对照组[(30.0±11.6)μmol/L,P=0.044;(240.7±46.3)μmol/L,P=0.007].而AD组血清中谷氨酸[(42.2±21.8)μmol/L]、甘氨酸[(464.2±142.6)μmol/L]明显高于健康对照组[P=0.010;(395.6±88.8)μmol/L,P=0.010];但aMCI组和AD组之间差异无统计学意义.AD组血清中Asp(P=0.011)和谷氨酸(P=0.017)的含量与MMSE得分呈正相关,轻度AD患者血清中这两种氨基酸含量[(42.1±21.3)、(55.0±29.0)μmol/L]要高于中重度AD患者[(25.4±9.2)μmol/L,P=0.023;(34.6±11.1)μmol/L,P=0.036].结论 EAAs可能参与AD的发病,并且与AD的严重程度存在一定的相关性;aMCI患者也存在着EAAs代谢的紊乱,提示其可能和AD有着类似的发病机制.     

Visual mismatch negativity highlights abnormal pre-attentive visual processing in mild cognitive impairment and Alzheimer's disease

Alzheimer's disease (AD) and mild cognitive impairment (MCI) are traditionally characterised in relation to abnormalities in higher-level brain function, particularly memory. However, in the study presented here we report significant abnormality in pre-attentive visual processing in both MCI and AD compared to healthy ageing. The functional integrity of the automatic change detection system was determined by measuring the visual mismatch negativity (vMMN) component of the N2 visual event-related potential (ERP) in 8 individuals with amnestic MCI, 10 individuals with AD and 10 healthy older adult controls. Compared to healthy ageing, both the MCI and AD groups displayed a significant abnormally increased vMMN over the 140–250 ms measurement epoch although such effects were not apparent over the later 250–400 ms epoch. These novel findings support the view that deficits in brain function in both AD and MCI are not exclusively high-level and indeed that abnormal output from ‘low level’ or pre-attentive processes (as evinced by the abnormal vMMN) is likely to contribute to the high-level processing deficits so characteristic of these clinical disorders.     

遗忘型轻度认知损害患者海马三维磁共振影像特点

Objective To identify the characteristics of hippocampal 3-dimensional MRI in patients diagnosed as having subtypes of amnestic mild cognitive impairment(aMCI)using hippocampal surfacebased analytic technique.Methods Fifry aMCI patients and 16 healthy controls who were equivalent in age and education(NC)were recruited.Every subiect carried out a 3-dimensional MRI scan.After the imaging data were acquired.the borders of the hippocampus were manually traced in coronal vlew using the software of InsightSNAP1.4.1. Hippocampal volume was computed automatically and statistically analysed.Hippocampal 3-dimension MRI were transformed into 3-dimension parametric surface mesh models of 400×200 prids.Hippocampal radial distance measures which was the distance from the surface point to the central axis were statistically compared between two groups.The radial atrophy significance maps were acquired and adjusted for multiple comparisons.Hippocampal morphological difference maps of aMCI in contrast with NC were acquired.Results The average normalized volume of left hippocampus were(3247.5±600.2)mm3 in aMCI patients and(3467.9±451.3)mm3 in NC subjects.The average normalized volume of right hippocampus were(3416.8±699.1)mm3 in aMCI patients and(3469.1±358.9)mm3 in NC subjects.Comparison of hippocampal volume did not differ significantly between aMCI patients and NC subjects(t=1.161,P=0.255;U=0.178,P=0.859).By using hippocampal surface-based morphologic analytic technique,3-dimension hippocampal morphological difference maps between two groups were acquired,showing significant atrophy on the lateral and inferior hippocampal surface which corresponded to CA1 and subiculum hippocampal subfields bilaterally in aMCI patients compared with NC subjects. Conclusions aMCI patients do not have significant volume loss in the hippocampus. Through hippocampal surface-based morphologic analyses, partial regional atrophy of hippocampus at some degree is found, mainly localizing in the lateral and inferior hippocampal regions which correspond to CA1 and subiculum hippocampal subfields bilaterally in aMCI compared with NC. These results may reflect the early image marker in aMCI.     

遗忘型轻度认知损害患者海马三维磁共振影像特点

Objective To identify the characteristics of hippocampal 3-dimensional MRI in patients diagnosed as having subtypes of amnestic mild cognitive impairment(aMCI)using hippocampal surfacebased analytic technique.Methods Fifry aMCI patients and 16 healthy controls who were equivalent in age and education(NC)were recruited.Every subiect carried out a 3-dimensional MRI scan.After the imaging data were acquired.the borders of the hippocampus were manually traced in coronal vlew using the software of InsightSNAP1.4.1. Hippocampal volume was computed automatically and statistically analysed.Hippocampal 3-dimension MRI were transformed into 3-dimension parametric surface mesh models of 400×200 prids.Hippocampal radial distance measures which was the distance from the surface point to the central axis were statistically compared between two groups.The radial atrophy significance maps were acquired and adjusted for multiple comparisons.Hippocampal morphological difference maps of aMCI in contrast with NC were acquired.Results The average normalized volume of left hippocampus were(3247.5±600.2)mm3 in aMCI patients and(3467.9±451.3)mm3 in NC subjects.The average normalized volume of right hippocampus were(3416.8±699.1)mm3 in aMCI patients and(3469.1±358.9)mm3 in NC subjects.Comparison of hippocampal volume did not differ significantly between aMCI patients and NC subjects(t=1.161,P=0.255;U=0.178,P=0.859).By using hippocampal surface-based morphologic analytic technique,3-dimension hippocampal morphological difference maps between two groups were acquired,showing significant atrophy on the lateral and inferior hippocampal surface which corresponded to CA1 and subiculum hippocampal subfields bilaterally in aMCI patients compared with NC subjects. Conclusions aMCI patients do not have significant volume loss in the hippocampus. Through hippocampal surface-based morphologic analyses, partial regional atrophy of hippocampus at some degree is found, mainly localizing in the lateral and inferior hippocampal regions which correspond to CA1 and subiculum hippocampal subfields bilaterally in aMCI compared with NC. These results may reflect the early image marker in aMCI.     

轻中度阿尔茨海默病与遗忘型轻度认知功能障碍患者的平衡功能

目的 探讨遗忘型轻度认知功能障碍(amnestic mild cognitive impairment,aMCI)和轻中度阿尔茨海默(Alzheimer's disease,AD)患者的平衡功能变化,以及人体姿势平衡仪在鉴别aMCI、轻中度AD以及健康人群中的应用价值.方法 应用人体姿势平衡仪对20例aMCI和20例轻中度AD患者的平衡功能进行测试,并选取20名年龄性别相匹配的健康体检者作为对照.结果 轻中度AD患者的所有平衡仪检测指标均与健康对照有显著差异,其中AD组支撑面积(15 398±926)mm2,睁眼状态时X轴平均位移(Mean X,10.2±4.1)mm、Y轴平均位移(Mean Y,-29.8±10.2)mm、X轴最大值(Max X,30.5±9.5)mm、Y轴最大值(Max Y,42.7±11.4)mm、姿势图长度(LSKG,528.4±105.4)mm、姿势图面积(SSKG,252.5±89.7)mm2,闭眼状态时Mean X(13.1±4.5)mm、Mean Y(-58.2±16.9)mm、Max X(37.7±10.5)mm、Max Y(78.5±18.7)mm、LSKG(816.6±171.3)mm、SSKG(649.0±129.7)mm2,与健康对照组各指标[支撑面积(31 654±2132)mm2,睁眼状态时分别为(5.8±1.4)mm、(-14.9±4.4)mm、(18.3±4.1)mm、(23.3±6.8)mm、(390.3±68.4)mm、(178.8±40.9)mm2;闭眼状态时(7.9±1.5)mm、(-25.6±5.4)mm、(24.7±7.3)mm、(39.9±9.9)mm、(533.5±97.4)mm、(290.5±73.3)mm2]比较差异均有统计学意义(支撑面积t=8.57,睁眼状态时F值分别为17.41、38.10、60.46、102.10、29.31、27.85,闭眼状态时F值分别为37.20、541.79、34.51、185.56、122.83、384.27,均P＜0.05);支撑面积和Mean Y在aMCI组[(23 921±1637)mm2,(-39.8±8.6)mm]和健康对照组[(31 654±2132)mm2,(-25.6±5.4)mm]之间差异有统计学意义(t=6.50,P=0.038;t=-15.34,P=0.012).结论 轻中度AD及aMCI患者均存在平衡功能障碍,人体姿势平衡仪检测对临床上运动表现和平衡能力均在正常范围的aMCI、轻中度AD以及健康人群具有鉴别意义.

Abstract：

Objective To investigate alterations of balance function in patients with mild-moderate Alzheimer's disease (AD) and with amnestic mild cognitive impairment (aMCI),and the possibility of using posturography to differentiate aMCI,mild-moderate AD and normal subjects. Methods The balance function of 20 patients with mild-moderate AD and 20 patients with aMCI were evaluated by posturography,and 20 healthy subjects of the same age range were recruited as controls.Results All posturography measures were significantly altered in mild-moderate AD patients compared with normal controls,with limits of stability( ( 15 398 ± 926 ) mm2 vs ( 31 654 ± 2132 ) mm2 ),open-eyed Mean X ( ( 10. 2 ± 4. 1 ) mm vs (5.8 ± 1. 4)mm) ,Mean Y(( -29.8 ± 10.2)mm vs ( -14.9 ±4.4) mm),Max X((30.5 ±9.5)mm vs (18.3 ±4. 1)mm ),Max Y((42.7 ± 11.4)mm vs (23.3 ±6.8)mm),LSKG((528.4 ± 105.4)mm vs (390. 3 ± 68.4 ) mm ),SSKG ( ( 252. 5 ± 89. 7 ) mm2 vs ( 178.8 ± 40. 9 ) mm2 ),close-eyed Mean X ((13. 1 ±4. 5) mm vs (7.9 ± 1.5)mm) ,Mean Y (( -58.2 ± 16. 9) mm vs ( -25.6 ±5.4) mm) ,Max X ((37.7±10.5)mm vs (24.7 ±7.3) mm ),Max Y ((78.5±18.7)mm vs (39.9 ±9.9) mm),LSKG ((816.6±171.3) mm vs (533.5 ±97.4) mm),SSKG((649.0 ± 129.7) mm2 vs (290.5 ±73.3) mm2),respectively ( t = 8.57; open-eyed F = 17.41,38. 10,60. 46,102. 10,29. 31,27. 85; close-eyed F = 37.20,541.79,34. 51,185.56,122. 83,384. 27 ;all P ＜0. 05) ;limits of stability ( (23 921 ± 1637 )mm2 vs (31 654 ±2132 ) mm2 ) and mean Y ( Antero-posterior sway,( - 39. 8 ± 8. 6 ) mm vs ( - 25.6±5.4 ) mm) were the only parameters which discriminated between aMCI and normal controls,respectively ( t = 6. 50,P = 0. 038; t =- 15.34,P = 0. 012). Conclusions Impairment in balance is a feature not only of mild-moderate AD,but also of aMCI,and posturography may be used as a possible test in differentiating between normal subjects,patients with aMCI and patients with mild-moderate AD whose motor performance and balance features are otherwise clinically normal,limits of stability and mean Y are the most sensitive parameters.     

Reduced mismatch negativity in mild cognitive impairment: associations with neuropsychological performance

Mild cognitive impairment (MCI) refers to a transitory state between healthy aging and dementia. Biomarkers are needed to facilitate early identification of MCI and predict progression to dementia. One potential neurophysiological biomarker, mismatch negativity (MMN), is an event-related potential reflecting fundamental, pre-attentive cognitive processes. MMN is reduced in normal aging and dementia and in neuropsychiatric samples and is associated with verbal memory deficits and poor executive functioning. This study aimed to investigate auditory MMN and its relationship to neuropsychological performance in MCI. Twenty-eight MCI participants and fourteen controls, aged ≥50 years, underwent neurophysiological and neuropsychological assessment, and completed questionnaires pertaining to disability. Relative to controls, the MCI group demonstrated reduced temporal MMN amplitude (p < 0.01). Reduced right temporal MMN was significantly associated with poorer verbal learning (r = 0.496; p < 0.01) and reduced left temporal MMN was significantly associated with increased self-reported disability (r = -0.419; p < 0.05). These results indicate that patients with MCI exhibit altered pre-attentive information processing, which in turn is associated with memory and psychosocial deficits. These findings overall suggest that MMN may be a viable neurophysiological biomarker of underlying disease in this 'at risk' group.     

老年遗忘型轻度认知损害患者语言工作记忆损害特点

目的 探讨老年遗忘型轻度认知损害(aMCI)患者语言工作记忆损害的特点及机制.方法 采用语言工作记忆检查软件对30例老年aMCI患者进行视觉语言工作记忆及词语流畅性和数字广度测试等神经心理学检查,并选择30名健康老人作对照.结果 aMCI患者的视觉语义工作记忆测试成绩正确率低于对照组,差异具有统计学意义(79.83%±3.22%与87.00%±1.93%,t=-1.03,P=0.002);视觉语音工作记忆测试成绩也低于对照组,但差异无统计学意义(78.92%±8.60%与86.80%±2.14%,t=-2.34,P=0.060);逆序数字广度测试(1.53±0.86与3.63±0.56,t=-1.23,P=0.027)和词语流畅性测试分值均低于对照组(22.96±2.31与31.53±3.72,t=-1.08,P=0.004),差异具有统计学意义.结论 老年aMCI患者的视觉语义性语言工作记忆受损,语音性语言工作记忆相对保留;逆序数字广度和词语流畅性测试成绩亦显著降低.     

Multiple cognitive deficits in amnestic mild cognitive impairment

OBJECTIVE: To determine if more widespread cognitive deficits are present in a narrowly defined group of patients with the amnestic form of mild cognitive impairment (MCI). METHODS: From a larger sample of patients clinically diagnosed as meeting the criteria of Petersen et al. for amnestic MCI, we selected 22 subjects who had Clinical Dementia Rating scores of zero on all domains besides memory and orientation. These MCI subjects with presumably isolated memory impairments were compared to 35 age-matched normal controls and 33 very mild Alzheimer's disease (AD) patients on a battery of neuropsychological tests. RESULT: In addition to the expected deficits in episodic memory, the amnestic MCI group performed less well than the controls but better than the AD group on design fluency, category fluency, a set shifting task and the Stroop interference condition. Over half the amnestic MCI group (vs. none of the normal controls) scored at least 1 standard deviation below control means on 4 or more of the nonmemory cognitive tasks. CONCLUSIONS: Isolated memory impairment may be fairly uncommon in clinically diagnosed amnestic MCI patients, even when the criteria for amnestic MCI are fairly narrow. Additional cognitive impairments are likely to include fluency and executive functioning. These more diffuse deficits argue for comprehensive cognitive assessments, even when the patient and family are reporting only memory decline, and are consistent with the increase in attention paid to the heterogeneity of MCI.