Cognitive and Behavioral Neurology最新文献

Background: Mild cognitive impairment (MCI) is a neurocognitive disorder that adversely affects cognitive function and is often a precursor to dementia. Early diagnosis of MCI can guide timely treatment and delay dementia onset. The Montreal Cognitive Assessment (MoCA) is an effective screening tool for MCI. Remotely administered versions of the MoCA have gained popularity during the recent pandemic.

Objective: This study aimed to validate a new Hindi version of the Telephone MoCA (T-MoCA) in older adult outpatients at a tertiary hospital in Delhi, India.

Methods: We developed and validated a Hindi version of the T-MoCA (T-MoCA-Hindi) using the previously validated MoCA-Hindi as the gold standard. We administered both instruments to older adult patients with a 2-week gap between sessions. To assess the reliability of the new T-MoCA-Hindi, we used the Bland-Altman plot and Cronbach alpha. We used a receiver operating characteristic curve to estimate accuracy.

Results: A total of 243 individuals enrolled in this study. The T-MoCA-Hindi and the MoCA-Hindi showed a high level of agreement. A Cronbach alpha of 0.84 indicated good internal consistency. The area under the curve in the receiver operating characteristic analysis was 93.5%, indicating excellent accuracy and validity and demonstrating high sensitivity and specificity at an optimal cut-off score of 18/19 points.

Conclusion: These findings show that the T-MoCA-Hindi is a valid tool for remote identification of MCI in India. The use of remote versions of diagnostic tools can be leveraged to conduct research when in-person approaches may not be feasible.

Here we present the cases of two individuals with language and behavioral symptoms indicative of the early clinical manifestations of both Alzheimer disease (AD) and frontotemporal lobar degeneration (FTLD). Phonological language symptoms similar to those evident in logopenic variant primary progressive aphasia suggested AD pathology, while semantic impairment and behavioral changes (ie, abnormal eating behavior and disinhibition) suggested a diagnosis of FTLD. Multimodal neuroimaging studies revealed underlying neuropathology indicative of primary tauopathy with presumable 3/4-repeat isoform, devoid of amyloid deposition. We suggest that these cases may represent a previously unrecognized syndrome associated with non-Alzheimer primary tauopathy.

Background: NeuroQuant volumetric data proposes to assist clinical diagnoses of mild cognitive impairment (MCI) and Alzheimer disease (AD) through normative hippocampal volume measurements (HVs) and hippocampal occupancy scores (HOCs). We investigated the diagnostic utility of NeuroQuant HVs and HOCs within an academic memory disorders clinic.

Methods: Participants ( n = 181) underwent neurologic examination, MRI with NeuroQuant, and neuropsychological assessment. Clinical diagnoses included subjective cognitive concerns ( n = 39), non-amnestic MCI ( n = 33), amnestic MCI ( n = 74), AD ( n = 35). Objective memory impairment ( n = 125) was determined using actuarial criteria (≥2 memory measures ≤1.5 SD below the mean) for each participant. Differences in HVs and HOCs were assessed using ANOVA and χ 2 , while Pearson correlations examined their relationship with the California Verbal Learning Test-2nd Edition (CVLT-II). Receiver operator characteristic curves were used to calculate sensitivity, specificity, predictive values, Youden's Index, and predictive summary index scores.

Results: Participants with amnestic MCI, AD, and objective memory impairment had lower HVs and HOCs and a higher frequency of hippocampal atrophy (≤5th percentile) than participants with subjective cognitive concerns, non-amnestic MCI, and no objective memory impairment ( P' s <0.05). However, the sensitivity (0.31-0.77) and specificity (0.68-0.91) of HVs and HOCs were variable for determining objective memory impairment, and correlations with the CVLT-II were modest ( r = 0.20-0.44).

Discussion: NeuroQuant HVs and HOCs were lower in participants with amnestic MCI, AD, and memory impairment, but had poor sensitivity and specificity to predict memory impairment, and only a modest association with measurable memory impairment. These measures should be used cautiously as supporting diagnostic tools.