SPECT predictors of cognitive decline and Alzheimer's disease in mild cognitive impairment.
Baseline brain single photon emission computed tomography (SPECT) was evaluated in eighty subjects with mild cognitive impairment (MCI) who were followed for a mean of about two years, when twelve patients developed Alzheimer's disease (AD), nineteen showed memory decline (D), and forty-three had normal cognition assessment (stable: S) (six drop-out). Volumetric Regions of Interest (VROI) analysis was performed in six associative cortical areas in each hemisphere. ANOVA for repeated measures showed significant effects for both the group (S, D, and AD; p < 0.004) and VROI (p < 0.0001) factors, with significant group*region interaction (p < 0.01). At post-hoc comparison, hippocampal VROIs values were lower in AD than in D and S, while parietal VROIs values were lower in D and AD than in S. These four VROI significantly correlated with verbal delayed recall score at follow-up visit. Receiver operating characteristic (ROC) curves for the mean hippocampal VROI value showed 0.81 sensitivity with 0.86 specificity in separation of S+D from AD (p < 0.0001), and 0.69 sensitivity with 0.75 specificity in separation of S from D+AD (p < 0.0002). ROC curves for the mean parietal VROI value showed 0.62 sensitivity with 0.70 specificity in separation of S from D+AD (p < 0.0002). Baseline SPECT can support outcome prediction in subjects with MCI.
Nobili
Flavio
F
Clinical Neurophysiology Unit, Department of Endocrinological and Medical Sciences, University of Genoa, Genoa, Italy.flaviomariano.nobili@hsanmartino.it
De Carli
Fabrizio
F
Frisoni
Giovanni B
GB
Portet
Florence
F
Verhey
Frans
F
Rodriguez
Guido
G
Caroli
Anna
A
Touchon
Jacques
J
Morbelli
Silvia
S
Guerra
Ugo P
UP
Dessi
Barbara
B
Brugnolo
Andrea
A
Visser
Pieter Jelle
PJ
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000704:Analysis of Variance; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging; D003071:Cognition; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon