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Using Optical Coherence Tomography to Screen for Cognitive Impairment and Dementia
Journal of Alzheimer’s Disease ( IF 4 ) Pub Date : 2021-09-22 , DOI: 10.3233/jad-210328
James E Galvin 1, 2 , Michael J Kleiman 1 , Marcia Walker 1
Affiliation  

Background:Screening for Alzheimer’s disease and related disorders (ADRD) and mild cognitive impairment (MCI) could increase case identification, enhance clinical trial enrollment, and enable early intervention. MCI and ADRD screening would be most beneficial if detection measures reflect neurodegenerative changes. Optical coherence tomography (OCT) could be a marker of neurodegeneration (part of the amyloid-tau-neurodegeneration (ATN) framework). Objective:To determine whether OCT measurements can be used as a screening measure to detect individuals with MCI and ADRD. Methods:A retrospective cross-sectional study was performed on 136 participants with comprehensive clinical, cognitive, functional, and behavioral evaluations including OCT with a subset (n = 76) completing volumetric MRI. Pearson correlation coefficients tested strength of association between OCT and outcome measures. Receiver operator characteristic curves assessed the ability of OCT, patient-reported outcomes, and cognitive performance measures to discriminate between individuals with and without cognitive impairment. Results:After controlling for age, of the 6 OCT measurements collected, granular cell layer-inner plexiform layer (GCL + IPL) thickness best correlated with memory, global cognitive performance, Clinical Dementia Rating, and hippocampal atrophy. GCL + IPL thickness provided good discrimination in cognitive status with a cut-off score of 75μm. Combining GCL + IPL thickness as a proxy marker for hippocampal atrophy with a brief patient-reported outcome and performance measure correctly classified 87%of MCI and ADRD participants. Conclusion:Multimodal approaches may improve recognition of MCI and ADRD. OCT has the potential to be a practical, non-invasive biomarker for ADRD providing a screening platform to quickly identify at-risk individuals for further clinical evaluation or research enrollment.

中文翻译:

使用光学相干断层扫描筛查认知障碍和痴呆症

背景:筛查阿尔茨海默病及相关疾病 (ADRD) 和轻度认知障碍 (MCI) 可以增加病例识别、加强临床试验注册并实现早期干预。如果检测措施反映神经退行性变化,MCI 和 ADRD 筛查将是最有益的。光学相干断层扫描 (OCT) 可能是神经变性的标志(淀粉样蛋白-tau-神经变性 (ATN) 框架的一部分)。目的:确定 OCT 测量是否可以用作检测患有 MCI 和 ADRD 的个体的筛查措施。方法:对 136 名参与者进行了一项回顾性横断面研究,他们进行了全面的临床、认知、功能和行为评估,包括 OCT,其中一个子集 (n = 76) 完成了体积 MRI。Pearson 相关系数测试了 OCT 与结果测量之间的关联强度。接受者操作员特征曲线评估了 OCT、患者报告的结果和认知表现测量区分有和没有认知障碍的个体的能力。结果:在控制年龄后,在收集到的 6 个 OCT 测量值中,颗粒细胞层-内丛状层 (GCL + IPL) 厚度与记忆力、整体认知能力、临床痴呆评分和海马萎缩的相关性最好。GCL + IPL 厚度在认知状态方面提供了良好的辨别力,截止分数为 75μm。将 GCL + IPL 厚度作为海马萎缩的代理标记与简短的患者报告结果和性能测量相结合,正确分类了 87% 的 MCI 和 ADRD 参与者。结论:多模式方法可以提高对 MCI 和 ADRD 的识别。OCT 有可能成为 ADRD 的一种实用的、非侵入性的生物标志物,提供一个筛选平台来快速识别有风险的个体,以进行进一步的临床评估或研究招募。
更新日期:2021-09-24
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