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Diagnostic differentiation of mild cognitive impairment due to Alzheimer's disease using a hippocampus-dependent test of spatial memory.

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cam.issuedOnline2015-03-26
dc.contributor.authorMoodley, Kuven
dc.contributor.authorMinati, Ludovico
dc.contributor.authorContarino, Valeria
dc.contributor.authorPrioni, Sara
dc.contributor.authorWood, Ruth
dc.contributor.authorCooper, Rebecca
dc.contributor.authorD'Incerti, Ludovico
dc.contributor.authorTagliavini, Fabrizio
dc.contributor.authorChan, Dennis
dc.contributor.orcidChan, Dennis [0000-0002-4265-3718]
dc.date.accessioned2019-06-06T11:22:09Z
dc.date.available2019-06-06T11:22:09Z
dc.date.issued2015-07-17
dc.description.abstractThe hippocampus is one of the earliest brain regions affected in Alzheimer's disease (AD) and tests of hippocampal function have the potential to detect AD in its earliest stages. Given that the hippocampus is critically involved in allocentric spatial memory, this study applied a short test of spatial memory, the 4 Mountains Test (4MT), to determine whether test performance can differentiate mild cognitive impairment (MCI) patients with and without CSF biomarker evidence of underlying AD and whether the test can distinguish patients with MCI and mild AD dementia when applied in different cultural settings. Healthy controls (HC), patients with MCI, and mild AD dementia were recruited from study sites in UK and Italy. Study numbers were: HC (UK 20, Italy 10), MCI (UK 21, Italy 14), and AD (UK 11, Italy 9). Nineteen UK MCI patients were grouped into CSF biomarker-positive (MCI+, n = 10) and biomarker-negative (MCI-, n = 9) subgroups. Behavioral data were correlated with hippocampal volume and cortical thickness of the precuneus and posterior cingulate gyrus. Spatial memory was impaired in both UK and Italy MCI and AD patients. Test performance additionally differentiated between MCI+ and MCI- subgroups (P = 0.001). A 4MT score of ≤8/15 was associated with 100% sensitivity and 90% specificity for detection of early AD (MCI+ and mild AD dementia) in the UK population, and with 100% sensitivity and 50% specificity for detection of MCI and AD in the Italy sample. 4MT performance correlated with hippocampal volume in the UK population and cortical thickness of the precuneus in both study populations. In conclusion, performance on a hippocampus-sensitive test of spatial memory differentiates MCI due to AD with high diagnostic sensitivity and specificity. The observation that similar diagnostic sensitivity was obtained in two separate study populations, allied to the scalability and usability of the test in community memory clinics, supports future application of the 4MT in the diagnosis of pre-dementia due to AD.
dc.description.sponsorshipAlzheimer's Research UK (D.C.) and Italian Ministry of Health (F.T.)
dc.identifier.doi10.17863/CAM.40584
dc.identifier.eissn1098-1063
dc.identifier.issn1050-9631
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/293435
dc.languageeng
dc.language.isoeng
dc.publisherWiley
dc.publisher.urlhttps://onlinelibrary.wiley.com/doi/full/10.1002/hipo.22417
dc.subjectAlzheimer's disease
dc.subjecthippocampus
dc.subjectmild cognitive impairment
dc.subjectprecuneus
dc.subjectspatial memory
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectAlzheimer Disease
dc.subjectAnalysis of Variance
dc.subjectCognitive Dysfunction
dc.subjectDiagnosis, Differential
dc.subjectFemale
dc.subjectHippocampus
dc.subjectHumans
dc.subjectImage Processing, Computer-Assisted
dc.subjectItaly
dc.subjectMagnetic Resonance Imaging
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectNeuropsychological Tests
dc.subjectPsychiatric Status Rating Scales
dc.subjectROC Curve
dc.subjectSpace Perception
dc.subjectSpatial Memory
dc.subjectStatistics as Topic
dc.subjectUnited Kingdom
dc.titleDiagnostic differentiation of mild cognitive impairment due to Alzheimer's disease using a hippocampus-dependent test of spatial memory.
dc.typeArticle
dcterms.dateAccepted2015-01-09
prism.endingPage951
prism.issueIdentifier8
prism.publicationDate2015
prism.publicationNameHippocampus
prism.startingPage939
prism.volume25
rioxxterms.licenseref.startdate2015-07-17
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionAM
rioxxterms.versionofrecord10.1002/hipo.22417

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