RESUMEN
Decline in visuo-spatial skills and memory failures are considered symptoms of Alzheimer's Disease (AD) and they can be assessed at early stages employing clinical tests. However, performance in a single test is generally not indicative of AD. Functional neuroimaging, such as functional Near Infrared Spectroscopy (fNIRS), may be employed during these tests in an ecological setting to support diagnosis. Indeed, neuroimaging should not alter clinical practice allowing free doctor-patient interaction. However, block-designed paradigms, necessary for standard functional neuroimaging analysis, require tests adaptation. Novel signal analysis procedures (e.g., signal complexity evaluation) may be useful to establish brain signals differences without altering experimental conditions. In this study, we estimated fNIRS complexity (through Sample Entropy metric) in frontal cortex of early AD and controls during three tests that assess visuo-spatial and short-term-memory abilities (Clock Drawing Test, Digit Span Test, Corsi Block Tapping Test). A channel-based analysis of fNIRS complexity during the tests revealed AD-induced changes. Importantly, a multivariate analysis of fNIRS complexity provided good specificity and sensitivity to AD. This outcome was compared to cognitive tests performances that were predictive of AD in only one test. Our results demonstrated the capabilities of fNIRS and complexity metric to support early AD diagnosis.
RESUMEN
Working memory deficit is a signature of Alzheimer's disease (AD). The free and cued selective reminding test (FCSRT) is a clinical test that quantifies memory deficit for AD diagnosis. However, the diagnostic accuracy of FCSRT may be increased by accompanying it with neuroimaging. Since the test requires doctor-patient interaction, brain monitoring is challenging. Functional near-infrared spectroscopy (fNIRS) could be suited for such a purpose because of the fNIRS flexibility. We investigated whether the complexity, based on sample entropy and multiscale entropy metrics, of the fNIRS signal during FCSRT was correlated with memory deficit in early AD. fNIRS signals were recorded over the prefrontal cortex of healthy and early AD participants. Group differences were tested through Wilcoxon-Mann-Whitney test ([Formula: see text]). At group level, we found significant differences for Brodmann areas 9 and 46. The results, although preliminary, demonstrate the feasibility of performing ecological studies on early AD with fNIRS. This approach may provide a potential neuroimaging-based method for diagnosis of early AD, viable at the doctor's office level, improving test-based diagnosis. The increased entropy of the fNIRS signal in early AD suggests the opportunity for further research on the neurophysiological status in AD and its relevance for clinical symptoms.
RESUMEN
BACKGROUND: Alzheimer's disease (AD) is a form of dementia characterized by failure of memory that becomes more severe with the progression of the disease. The Free and Cued Selective Reminding Test (FCSRT) is a clinical test used to evaluate such a deficit. However, since the cognitive performances could depend also on the psychophysiological state of the individual, it is important to monitor that state through the peripheral autonomic activity during the execution of the test. Thermal infrared imaging has been used for this kind of assessment in order to preserve the free and unbiased interaction between doctor and patient, thanks to the contactless features of the technique. OBJECTIVE: To investigate whether the variation of facial temperature parameters during the FCSRT is indicative of different autonomic states in the early AD with respect to healthy controls (HC). RESULTS: At a group level, a greater sympathetic activity for the HC with respect to AD during the execution of the test was found, indicative of a suppression of anxiety associated with the performances of the FCSRT in AD patients. CONCLUSION: These results indicate that AD and HC may present different autonomic activity associated with the execution of a cognitive task, thus suggesting a different modulation of high-cognition and emotion network.