Distinguish mild cognitive impairment and normal cognitive change by β-amyloid PET imaging / 中华核医学与分子影像杂志

Objective:To explore the association of the impaired cognition and the deposition of β-amyloid (Aβ) in normal cognitive (NC) and mild cognitive impairment (MCI).Methods:From December 2018 to January 2021, 305 subjects (113 males, 192 females; age (64.0±7.7) years) who completed neuropsychological tests and MRI in Shanghai Sixth People′s Hospital, Shanghai Jiao Tong University and 18F-florbetapir (AV45) PET imaging in Huashan Hospital, Fudan University were retrospectively analyzed. The subjects were divided into MCI group and NC group based on neuropsychological tests, and each group was further divided into Aβ-positive and Aβ-negative based on PET imaging results. Independent-sample t test, Mann-Whitney U test and χ2 test were used to analyze the data. Results:There were 118 subjects in MCI group and 187 subjects in NC group. The Aβ-positive rate in MCI group (37.3%, 44/118) was higher than that in NC group (26.2%, 49/187; χ2=4.19, P=0.041). The assessment performances of MCI group in general cognitive function, memory function, language function and executive function were inferior to those of NC group ( t values: from -10.63 to -6.31, z values: from -11.01 to -6.03, all P<0.001). The Auditory Verbal Learning Test-Long Delay Recall (AVLT-LDR) score of Aβ-positive subjects was lower than that of Aβ-negative subjects in MCI group (1.00(0.00, 3.00) and 3.00(1.00, 4.00); z=-2.49, P=0.013). The Montreal Cognitive Assessment Basic (MoCA-B) score of Aβ-positive subjects was lower than that of Aβ-negative subjects in NC group (25.29±2.67 and 26.36±2.42; t=-2.61, P=0.010). Conclusion:Compared to Aβ-negative subjects, MCI patients with Aβ-positive perform worse on memory tests, and NC subjects with Aβ-positive perform worse on general cognitive function.

Imaging study of β-amyloid deposits in preclinical Alzheimer′s disease patients in communities of Shanghai / 中华核医学与分子影像杂志

Objective:To explore the β-amyloid (Aβ) deposition pattern of subjects with the preclinical Alzheimer′s disease (AD), community-derived amnestic mild cognitive impairment (aMCI) and normal cognition (NC) from communities of Shanghai.Methods:According to the inclusion and exclusion criteria, 273 subjects (104 males, 169 females; age (64.2±7.6) years) were recruited from Shanghai community and memory clinics from December 2018 to July 2020. All subjects underwent MRI, 18F-AV45 PET imaging and neuropsychological scale tests and were grouped into AD, aMCI and NC groups based on clinical diagnosis. Differences in demographic information, the neuropsychological scale tests′ scores and positive rate of Aβ deposition among each group were analyzed by one-way analysis of variance or χ2 test. Aβ deposition patterns of AD and MCI groups were analyzed at voxel level, and the differences of Aβ deposition among different groups were compared. Results:Among 273 patients, the positive rates of Aβ deposition in AD, aMCI and NC groups were 84.4%(38/45), 36.4%(20/55) and 23.1%(40/173), respectively ( χ2=58.37, P<0.001). Among AD, aMCI, NC and NC (Aβ-) groups ( n=132), the education years of AD group was the lowest ((9.7±4.6) years; F=8.86, P<0.001). In addition, there were significant differences in the scores of several neuropsychological scale tests among AD, aMCI, NC groups and NC (Aβ-) group ( F values: 27.68-235.50, all P<0.001). Compared with subjects in NC(Aβ-) group, the Aβ depositions in the aMCI and AD groups were widely distributed in the whole cerebral cortex; and AD group had higher Aβ deposition in bilateral frontal, parietal, temporal, occipital lobe, cingulate gyrus and precuneus than aMCI group. Conclusions:The positive rate of Aβ deposition in the preclinical AD population from the Shanghai community is obtained. There are significant different Aβ deposition patterns in subjects at different stages of AD.

The clinical and mechanistic roles of bile acids in depression, Alzheimer's disease, and stroke.

The burden of neurological and neuropsychiatric disorders continues to grow with significant impacts on human health and social economy worldwide. Increasing clinical and preclinical evidences have implicated that bile acids (BAs) are involved in the onset and progression of neurological and neuropsychiatric diseases. Here, we summarized recent studies of BAs in three types of highly prevalent brain disorders, depression, Alzheimer's disease, and stroke. The shared and specific BA profiles were explored and potential markers associated with disease development and progression were summarized. The mechanistic roles of BAs were reviewed with focuses on inflammation, gut-brain-microbiota axis, cellular apoptosis. We also discussed future perspectives for the prevention and treatment of neurological and neuropsychiatric disorders by targeting BAs and related molecules and gut microbiota. Our understanding of BAs and their roles in brain disorders is still evolving. A large number of questions still need to be addressed on the emerging crosstalk among central, peripheral, intestine, and their contribution to brain and mental health.

Application of 18F-AV45 PET imaging in subtle cognitive decline and mild cognitive impairment patients / 中华核医学与分子影像杂志

Objective:To investigate the correlations between cerebral β-amyloid (Aβ) deposition assessed by 18F-florbetapir (AV45) PET imaging and clinical cognitive symptoms in patients with subtle cognitive decline (SCD) and mild cognitive impairment (MCI). Methods:Data of twenty-four patients (11 males, 13 females, age: (63.2±7.6) years) diagnosed as SCD ( n=15) or MCI ( n=9) from December 2018 to March 2019 in Shanghai Jiao Tong University Affiliated Sixth People′s Hospital were collected prospectively. All patients underwent 18F-AV45 PET imaging, brain MRI T 1 scan and Mini-Mental State Examination (MMSE) within two weeks. 18F-AV45 PET images were analyzed visually (positive, mild positive, negative). After being pretreated according to the MRI, 18F-AV45 PET images were analyzed semi-quantitatively by calculating the standardized uptake value ratio (SUVR) of Aβ deposition in 8 regions of interest (ROIs; frontal lobe, lateral parietal lobe, lateral temporal lobe, medial temporal lobe, occipital lobe, basal ganglia, posterior cingulate and precuneus), with cerebellar gray matter as the reference. Partial correlation coefficients between regional SUVRs and MMSE score were calculated. Results:18F-AV45 PET imaging showed that 16 patients with positive results and 8 patients with mild positive results. MMSE score of 24 patients was 28.2±2.0, and the SUVR was 0.93-1.87. Correlation analysis revealed that Aβ deposition in frontal cortex ( r=-0.432), posterior cingulate lobe ( r=-0.434) and precuneus ( r=-0.418) was negatively correlated with MMSE score (all P<0.05); and no significant correlations between SUVR and MMSE in other brain regions were found ( r values: from -0.412 to -0.110, all P>0.05). Conclusion:18F-AV45 PET imaging can noninvasively detect brain Aβ deposition in patients, and can effectively reflect the clinical cognitive status of patients with SCD and MCI to a certain extent.

Influence of chronic caregiving stress on chronic diseases risk to family caregivers of patients with dementia: A research progression / 中华老年医学杂志

Dementia care is a chronic stressor severely influencing on physical and mental health and social life of family caregivers.In the research field of dementia care,the studies are inadequate regarding to the influence of caregiving stress on physical and mental health,especially on the risk of suffering from common chronic disease of family caregivers.So far,the studies are mainly based on hypotheses associated with chronic stress-induced three perspectives,i.e.,excessive activation of sympathetic nervous system,endothelial injury,and excessive activation of pro-inflammatory and procoagulant factors.This paper summarizes the research progress from these three perspectives.

Characteristics of cerebral glucose metabolism in patients with corticobasal degeneration / 中华核医学与分子影像杂志

Objective To identify abnormal cerebral glucose metabolism characteristics in patients with corticobasal degeneration (CBD) using 18 F-fluorodeoxyglucose (FDG) PET imaging. Methods From January 2014 to January 2017, resting-state brain 18 F-FDG PET imaging was performed in 10 CBD patients (5 males, 5 females; average age: (63.4±6.2) years) and 20 age-matched healthy subjects (8 males, 12 female; average age: (63.6±6.2) years). Voxel-based statistical parametric mapping (SPM) was used to analyze images to obtain the CBD-related brain metabolic characteristics. The regional cerebral metabolic rate of glucose (rCMRglc) was compared between 2 groups by two-sample t test. Results Compared with healthy controls, CBD group demonstrated asymmetrically decreased glucose metabolism mainly in the cere-bral hemisphere opposite to the more clinically affected body side, including the superior, middle and inferi-or frontal gyrus, the precentral gyrus, the superior and inferior parietal lobule, the angular gyrus, the supra-marginal gyrus, the precuneus, the middle occipital gyrus, the middle and inferior temporal gyrus, Heschl gyrus, the fusiform gyrus, the insula and the thalamus. And relatively increased glucose metabolism was present in ipsilateral precentral and postcentral gyrus, hippocampus, insula and putamen, bilateral cerebel-lum, paracentral lobules and pontine. The rCMRglc in those regions was significantly different between CBD patients and healthy controls (t values: 4.236-9.044, all P<0.01). Conclusion The asymmetric cerebral glucose metabolism features in CBD based on 18 F-FDG PET imaging contribute to the differential diagnosis between CBD patients and healthy subjects.

The 4 year follow-up investigation of cognitive function in patients after acute stroke / 中华老年医学杂志

Objective To investigate the 4-year follow up of cognitive function outcomes and characteristics in patients after stroke.Methods Sixty three cases according with the diagnostic standard of acute unifocal subcortical stroke were consecutively collected in neurological ward from December 2009 to November 2010.They were followed up for average four years.Forty one out of them completed the neuropsychology tests identical to the baseline,which covered the general cognition function,attention,execution,memory,language,spatial,etc.According to the standard of clinical diagnosis,cognition function is divided into five degrees,including normal,VCI-ND,mild VaD,moderate VaD,and severe VaD.The improved group had 13 cases whose cognition function was improved by one or more ranks.The progressive group had 12 cases whose cognition function progressed by one or more ranks.The stable group had 16 cases whose cognition function remained the same as the baseline.Results According to qualitative analysis on the baseline versus 4-year follow-up outcome,in 13 improved cases,8 were VCI-ND and 5 were mild VaD.In 16 stable cases,11 were normal,4 were VCI-ND and 1 was mild VaD.In 12 progressive cases,3 were normal (change to mild VaD after follow-up),5 were VCI-ND (change to mild and moderate VaD after follow-up) and 4 were mild VaD (change to moderate VaD after 4-year follow-up).In the comparison of baseline cognition function among the improved,progressive and stable group,there was only one significantly different score (the right number of SCWT-A) in the improved and progressive group.The cognition function of improved group had significant differences in CFT-copy,right number of SCWT-C and the time of TMT-B before versus after follow-up.The cognition function of progressive group had significant differences in AVLT-Delay Recall and CFT-Recall.Conclusion Long-term cognitive function outcome after stroke is heterogenetic.The location of cognitive impairment or progression is not the same model for different cognitive outcome group.

Application of cerebral MR perfusion imaging using pulsed arterial spin labeling technique in patients with amnestic-type mild cognitive impairment and mild Alzheimer disease / 中华放射学杂志

Objective To study the value of relative cerebral blood flow(rCBF)changes in patients with amnestic-type mild cognitive impairment (aMCI)and mild Alzheimer disease(AD) using MRI pulsed arterial spin labeling(PASL).Methods A prospective study recruited 37 aMCI patients (aMCI group),30 mild AD patients(mild AD group) and 30 healthy volunteers (normal control group) from March 2011 to December 2013,MRI using PASL for cerebral perfusion imaging was performed and data of rCBF were collected.Taking age as covariate,analysis of variance (ANONA)was carried out to assess the difference of rCBF among all the three groups,then Bonferroni was done between every two groups.A follow-up examination using PASL was performed in the seventeen patients of the aMCI group.And paired t-test was used for comparing the longitudinal change of their rCBF data.Results Compared with the normal control group,the aMCI group showed significant increase of rCBF in bilateral posterior cingulate cortices and precuneus (cluster number 2 785,P＜0.05).While the mild AD group showed decrease of rCBF in the left inferior and superior parietal lobes,the angular,middle frontal lobe,as well as the right superior temporal lobe (cluster number 3 459-5 206,P＜0.05).When compared with the aMCI group,the mild AD group showed regional hypoperfusion in bilateral middle frontal lobes,the left precuneus,the right postcentral and inferior parietal lobe (cluster number 3 236-19 863,P＜0.05).In the longitudinal study of the 17 aMCI patients,an increased rCBF was found to coexist with reduced rCBF in the left inferior frontal and lateral occipital cortex,bilateral frontal poles and paracingulate gyrus,with hyperperfusion dominated.Increased rCBF was also detected in the left temporal lobe,the angular gyrus and precuneus,while decreased rCBF was present in the left putamen,the operculum and right corpus callosum (P＜0.05).Conclusions ASL perfusion imaging is a valuable method for dynamic monitoring of the cerebral perfusion changes in aMCI and AD patients.PASL will assist in finding a useful imaging biomarker for early diagnosis of AD.

"Effect of Chinese version of ""Reading the Mind in the Eyes"" test on the diagnosis of mild cognitive impairment and Alzheimer's dementia" / 中华老年医学杂志

Objective To investigate the effect of the revision of Chinese Versions of Reading the Mind in the Eyes Test(RME) on the diagnosis of mild cognitive impairment (MCI) and mild Alzheimer's dementia (AD).Methods We compared performance on the cognitive test battery between 96 patients with MCI and 55 patients with AD and 95 control individuals.Neuropsychological tests, encompassing RME-T, Mini Mental State Examination (MMSE) and Auditory Verbal Learning Test (AVLT), were conducted on 96 patients with MCI, 55 patients with AD and 95 healthy control individuals.Completion rate of RME-T in the normal group and the total scores and each item score of RME-T were analyzed, and the feature between RME-T and RME-S (RME-short) was compared.Results The total score of RME-T was (23.7±4.7) in normal group, (19.9 ± 4.9) in MCI group,and (19.9±7.5) in AD group.There were significant differences in the total score of RME-T among the three groups (t=13.9, P＜0.01).The differences in the total score of RME-T between normal group and AD group, between normal group and MCI group were also significant (both P＜0.01).RME-S was composed of 20 items after rejecting 16 items of RME T whose project completion rate was lower than 50％ in the normal group and in which there was no significant difference among normal, MCI and AD groups.The correlations between the total score of RME-T and 3 item scores of RME-T were not significant (P＞0.05).However, the total score of RME-S was highly correlated with each item score of RME-S (P＜0.01).The total score of RME-T and RME S were highly correlated with each total score of the cognitive test battery (P＜0.01).With the normal and MCI groups, normal and AD groups as the subjects, the receiver operating characteristic (ROC) curve analysis found that AUC(RME-S) was＞ AUC(RME-T) in normal and AD groups (P＜0.01), whereas, AUC(RME-S) was＜AUC(RME-T) in normal and MCI groups (P＞0.05).Conclusions RME has good reliability and validity, and RME-S is better than RME-T in internal consistency, which is more suitable for identifying mild cognitive impairment and Alzheimer's disease in Chinese population, and it is worthy of further popularization and application.

Development and validity of Huashan Naming Test / 中华行为医学与脑科学杂志

Objective To present the development of the Naming test tool ( Huashan Naming Test, HNT)for Chinese cultural and by amnestic mild cognitive impairment ( aMCI ) and mild Alzheimer' s disease (AD) between the detection of memory decline,and to analyze the validity of its trial.Methods 100 normal elders from communities in Shanghai, 100 patients with amnestic mild cognitive impairment (aMCI), and 95 patients with mild Alzheimer's disease (AD) who received an education of junior high school or above and were evaluated by neuropsychological tests including mini mental state examination ( MMSE), auditory verbal memory test, Huashan Naming tests etc.8 cognitive tests.The groups of MCI and AD patients finished cranial MRI.100 items with HNT including 20 animals,10 vegetables,10 fruits ,20 tools ,20 household , 10 vehicles, 10 stationery.Results 1.HNT items to determine: 22 items were excluded due to the completion of the three groups were not significantly different; 8 items were excluded due to the completion of the normal elderly group was lower than 75%; 10 items were excluded from the analysis of variance Fvalue of the minimum value.The remaining 60 items,according to the size of the arrangement and completion rates were divided into two versions of odd and even, respectively HNT-Ⅰ and HNT-Ⅱ.2.HNT characteristics:in normal elderly group age, sex were found to had no significant factors affecting overall scores of HNT-Ⅰ and HNT-Ⅱ but level of education, MMSE score was significantly correlated (P ＜0.05).As cut-off score ≤ 26 for spontaneous naming of HNT,the sensitivities of HNT-Ⅰ for aMCI ,mild AD were 44%, 84% respectively, specificities were all around 84%; the sensitivities of HNT-Ⅱ for aMCI , mild AD were 56% ,83% respectively,specificities were all around 80%.Conclusion HNT is a Chinese cultural background,time-consuming short and good name validity test,and it is worth further promoting the application.

Visuospatial-visuoconstructional ability in mild cognitive impairment / 中华神经科杂志

Objective To investigate visuospatial-visuoconstructional ability in patients with mild cognitive impairment(MCI).Methods The subjects were divided into three groups:122(51 males and 71 females)in the normal control group; 205(95 males and 110 females)in the MCI group,including 133 amnestic MCI(aMCI)and 72 non-amnestic MCI(naMCI),and 75(36 males and 39 females)in the Alzheimer' s disease(AD)group.The subjects were assessed for visuospatial-visuoconstructional ability by three tests:Rey-Osterrieth Complement Fixation Test(CFT),Clock Drawing Task(CDT),and Stick Test.Mini-mental State Examination(MMSE)was also performed in all groups.SPSS 11.5 statistical software was used for statistic analysis; Chi-square test was used to analyze enumeration data; One-way analysis of variance was used in pairwise comparison between the groups,and Bonferroni and LSD methods were used for multiple comparison.Results(1)The average MMSE score in the normal control group,MCI group and AD group was 28.24 ± 1.74,27.39 ± 1.83 and 19.98 ±3.23,respectively.(2)In the normal control group,either CFT imitating score or total CDT score had no obvious correlation with age or education,while Stick Test-Rotating part(STR)was correlated with age(r =-0.179,P ＜ 0.05),but had no significant correlation with education.(3)There were correlations between CFT imitating score and total CDT score (r =0.337),CFT imitating score and STR(r =0.232),and total CDT score and STR(r =0.235).The correlations were statistically significant(P ＜ 0.01).(4)CFT imitating and total CDT showed the greatest correlation with Trail Making Test B and Stroop Color Word Test Card C time consumption,an indicator of executive function.STR had greatest correlation with Auditory Verbal Learning Test,an index of memory.There were significant differences in CFT imitating,total CDT score and STR among the normal,MCI and AD groups(P ＜ 0.01).(5)STR is a more informative test to be used in diagnosis of MCI than CFT imitating and total CDT score,as shown by comparison of these tests in three subjects groups.Conclusion Visuospatial-visuoconstructional ability impairment is one of the symptoms of MCI.In detection of MCI,the assessment of space rotating ability is better than CFT imitating and total CDT score.

A functional magnetic resonance imaging study on resting state brain default mode network in patients with mild cognitive impairment / 中华老年医学杂志

Objective To explore the activity and its possible neural mechanism of brain default mode network by using resting state functional magnetic resonance imaging (fMRI) in patients with mild cognitive impairment (MCI). Methods The 20 amnestic MCI patients and 25 healthy controls were included in this study, and all subjects underwent mini-mental state examination (MMSE), auditory verbal learning test (AVLT) and fMRI. The data were analyzed by amplitude of low frequency fluctuation (ALFF), and the enhanced and weakened regions of ALFF were observed and compared in both MCI patients and healthy controls. Results MMSE and AVLT tests showed that the memory function was seriously impaired in MCI patients compared with healthy controls, which is based on the short and long delayed episodic memory impairment (2.4±1.7 vs. 6.6±1.4, t=3.70, P＜0.01; 2.1±1.6 vs. 6.7±1.5, t=4.16, P＜0.01). The resting state fMRI showed that MCI patients had significant decreases of ALFF in hippocampal formation, parahippocampal cortex and lateral temporal cortex as compared with health controls (t=2.58, 2.43 and 1.75, all P＜0.01), which were closely relevant to the episodic memory. And they had significant increases in temporal-parietal joint and inferior parietal lobule (t=3.14 and 2.77, both P＜0.01). Conclusions MCI patients show significant decreased active intensity of some DMN nodes that is related to episodic memory in resting state. Increased active intensity in MCI patients would be some type of compensation.

Longitudinal study of two subtypes of mild cognitive impairment / 中华神经科杂志

Objective To investigate the conversion rate of subtypes of amnestic mild cognitive impairment (aMCI) to Alzheimer' s disease (AD) and assess the contribution of neuropsychological disturbance in progression from MCI to AD over 2 years. Method Subjects from memory clinic of Huashan hospital including 130 of who met the operational criteria for Mayo Clinic defined aMCI by neuropsychological tests covering global cognitive function, executive function, memory function, language function and visual spatial skills. They underwent multidimensional assessment and a neuropsychological battery at baseline and at follow-up, after about 2 years. Diagnosis for dementia was based on National Institute of Neurological and Communicative Disorders and Stroke; Alzheimer' s Disease and Related Disorders Association (NINCDS-ADRDA) criteria. Results Forty-four cases of 130 (33. 8% ) elder people with aMCI converted to probable AD with 17 aMCI-s and 27 aMCI-m subjects within an average 23.8 (6. 8 ) months. There was significant difference between the reversion rate of aMCI-s and aMCI-m (26. 2% vs 42. 9%, x2 = 3.957,P = 0. 047). Moreover, as the disease progressing,the two groups declined similarly in memory and executive function while in the aMCI-s group, the function of spatial structure relatively reserved in aMCI-s but function of language and attention diminished faster, and in the aMCI-m group, the ability of spatial structure declined even more significantly. Conclusion The aMCI-m is more likely to progress to AD than aMCI-s and it' s necessary to divide aMCI into aMCI-s and aMCI-m to help determine prognosis.

The characteristics of Parkinson's disease with dementia and Alzheimer's disease with impaired cognitive function / 中华内科杂志

Objective To analyze the characterization of cognitive function in Parkinson's disease with dementia and Alzheimer's disease. Methods Cognitive function was examined in Parkinson's disease with dementia (PDD) patients ( n = 30) , Alzheimer's disease (AD) patients ( n = 30) and healthy elderly control subjects ( n = 60) . Neuropsychological evaluation contained semantic fluency test, phonemic fluency test, action fluency test, objective and action naming tests. Results In PDD group , the score of semantic fluency test is 9. 33 ±2. 78, 6. 17 ± 1.67 of phonemic fluency test and 7.03 ±2. 34 of action fluency test,it is 6.90 ±2.47, 7.87±2.01,8.30±3. 17 of AD group. The score of objective and action naming tests is 36.33 ±3.39, 17.63 ±2. 17 in PDD group,while AD patients is 33.23 ±3.56 and 22.33 ±2.37. The verbal fluency tests and naming tests were impaired in PDD and AD patients compared with the healthy elderly control group (P ＜ 0. 01 ), phonemic fluency, action fluency and action naming were more impaired in PDD patients compared with the AD group , while semantic fluency and objective naming were more impaired in AD patients (P ＜ 0. 01 ). Conclusions Executive function deficit and naming impairment are found in PDD and AD patients, it shows that PDD is characterized by the addition of cortical dysfunction upon a predominant and progressive fronto-subcortical impairment. There is subcortical dysfunction in AD patients.

Executive dysfunction in different subtypes of vascular cognitive impairment / 中华神经科杂志

Objective To investigate the executive function features of different subtypes of vascular cognitive impairment (VCI). Methods Sixty-four subjects with subcortical ischaemic vascular disease (SIVD) presumed by medical history and neuroimaging (cranial MRI) were recruited. The clinical and neuropsychological features of the 4 groups were compared: cognitive normal control (n=25), simple executive impairment of VCI-ND (s-VCI-ND, n=16), multi-domain impairment of VCI-ND (m-VCI-ND, n=26) and vascular dementia (VaD) patients (n=22). All participants underwent neuropsychological tests covering global cognitive function, executive function, memory function, language function and visual spatial skills. The executive tests included 15 independent subtest reflect set shifting, inhibition of prepotent responses, working memory, concept formation and fluency. Results Tower of Hanoi, self ordered pointing test and paced auditory serial addition test were not suitable for identification of VCI-ND because their finish rates were less 50%. Performance of trail making test (216.5±69.3 vs 137.4±37.9), Stroop color words test (115.4±30.1 vs 72.9±17.5), California cards sorting test-Chinese version (1.9±1.4 vs 2.7±1.2)and animal category fluency test(14.2±2.3 vs 17.7±4.4) had significant difference between s-VCI-ND group and cognitive normal control group (t=4.73, 5.72, 2.04 and 3.53, all P<0.05) and these tests were applicable and sensitive assessment tools in all executive tests. Time-consuming index showed more sensitivity than correct index in executive function. Neuropsychological deficits of m-VCI-ND patients showed lower than that of s-VCI-ND group and better than that of VaD patients. It was likely that the m-VCI-ND was a transition state between normal aging and VaD. Conclusion Executive dysfunction of VCI caused by SIVD is short of specificity. Some tests may appear earlier in screening of VCI-ND.

Prevalence of dementia in diabetics: a community-based case-control study / 中华神经科杂志

Objective To determine prevalence of dementia in diabetics and non-diabetics, and in different age and gender groups. Methods A case-control study was conducted among participants aged 50 and over in Jing' an temple community in Shanghai. Subjects in diabetics group were matched to non-diabetics groups for age and sex with 1:1 matching. Personal information and case history were collected through questionnaire. The subjects were screened for dementia using the Mini Mental State Examination (MMSE). Subjects that screened positively (indicated by an MMSE score below 19, 21 and 24 among those with illiteracy, elementary school and above junior middle school education, respectively) were subsequently examined by a series of neuropsychological tests. Based on all available information, a diagnosis of dementia was defined according to the Diagnostic and Statistical Manual of Mental Disorders ( DSM )-Ⅳ criteria Results Prevalence of dementia of 4. 75% (23/484, 95% CI: 3. 03%-7.04%) in diabetics was higher than that of 2. 24% (11/490,95% CI: 1.13% -3.98%) in non-diabetics (X~2 = 4.54, P=0.03).Prevalence of dementia among diabetics in age groups of 60-69, 70-79 and 80 and above was 1.94% (2/103), 4. 43 % (9/203) and 14.12% (12/85, trend X~2 =18.04, P <0.01), and in non-diabetics was 1.43% (2/140), 2. 86% (6/210) and 5.00% (3/60, trend X~2 = 4.58, P=0.03), respectively.Prevalence of dementia among female and male in diabetics was 6.55% (19/299) and 2.06% (4/194) (X~2 = 5.18, P = 0.02), respectively, and in non-diabetics was 3.01% (9/299) and 1.05% (2/191).Conclusions Prevalence of dementia is significantly higher in diabetics than in non-diabetics, higher in women than men, and increases as age rises.

Research on regional cerebral blood flow in patients of amnestic mild cognitive impairment and vascular cognitive impairment-no dementia / 中华神经科杂志

Objective To investigate the regional cerebral blood flow (rCBF) in amnestic mild cognitive impairment (aMCI) and vascular cognitive impairment-no dementia (VCI-ND) subjects. Methods Sixteen normal elders, 10 patients of aMCI, 12 patients of VCI-ND who were aged from 50 to 80 years old and received an education of middle school or higher. All participants finished cranial CT or MRI. Xe-CT was used to evaluate rCBF of different cerebral regions of all participants. Results The distribution of rCBF of basal ganglia, the cortex and white matter was (76. 4 ± 8. 6), (48.0 ± 7. 1) and (20. 5 ± 1.7) ml· 100 g-1 ·min-1, respectively. When compared in 3 groups, the temporal and parietal lobe rCBF had a decreasing tendency in aMCI group, while in VCI-ND group, the most dominant decreasing parts were mainly concentrated in white matter region ((17. 7±2. 3) ml·100 g-1·min-1, F = 5. 740, P = 0. 002). Whatever the depth or the width was, beth periventricular and subeortical deep white matter, anterior and posterior ventricular regions were all involved. There are no dominant difference of rCBF in caudate nucleus, lentiform nucleus and thalamus. Conclusion The difference in rCBF reflects the pathological difference between aMCI and VCI-ND.

A primary cliulcal study for the Chinese words reading test / 中华行为医学与脑科学杂志

Objective To draw up the Chinese Words Reading Test and try to use it as way of premorbid intelligence. Methods 373 health middle-elderly people as study subjects, from five communities in Shanghai city, are between age 55 and 85, and their edueational background is junior high school or above, and their MMSE scores are more than 24 points. 34 of the cases have finished CWRT and Weehsler Adult Intelligence Scale (WAIS) Chinese Revised edition. The main analysis indicators of CWRT: CWRT-Ⅰ for number of right reading 50 characters and CWRT-Ⅱ for 50 words. Results Both CWRT-Ⅰ and CWRT-Ⅱ are relative to education level( r = 0.462,0.489, and P < 0.01), while the correlation with age is not signifieant. Performance of the male participants are better than that of the female. The coefficient of correlation between scores of CWRT-Ⅰ and full IQ of WAIS is 0.79. The mean and standard deviation of scores of CWRT-Ⅰ and CWRT-Ⅱ for the normal elder people with different education levels and gender are provided. Conclusion CWRT is not very diffieuh or easy, and is highly relative to score of WAIS. So it can be used as an evaluating tool for premorbid intelligence.

A study of validity of a new scoring system of clock drawing test / 中华神经科杂志

Objective To set up and verify a new scoring system of clock drawing test(CDT).Methods CDT and other neuropsychological tests were applied to 180 normal individuals.170 subjects with mild cognitive impairment(MCI),and 31 patients with mild Alzheimer's disease(AD).The first step of the 30-score system of CDT was to anchor the 4 points of"12-3-6-9".totaling a score of 4 which was the "30-score system A(Anchoring)part";and the other 13 items reflecting the drawing results and totaling a score of 26 made up the so called"30-score system C(Clockfaee)part".the two together had a total score of 30.Thirty-eight subjects underwent Xe-enhanced computed tomography(Xe-CT)scanning for quantitively measuring regional cerebral blood flow(rCBF)of 26 regions of brain.Results Correlations coefficients of the scores of 14 items with the total score in 30-score system of CDT were in the range of 0.48to 0.71(P＜0.01).30-score system C part was closely correlated with indicators of visuospatial and executive function,while 30-score system A part with memory indicators.The sensitivity and specificity of the 30-score system A part score≤2 for detecting MCl were 70.6%and 73.9%.respectively.The sensitivity the specificity of 30-score system C part score≤17 for mild AD were 75.3%and 75.9%.respectively.In the regression equation of 30-score system A and C part.the combined independent variables were the CBF of left frontal cortex and right white matter,respectively.Conclusion The 30-score system A and C part have difierent meanings:30-score system C part could be used to identify AD while 30-score system A part is helpful for identiring MCI.

Discrepancy of the Two Clock Drawing Tests in Evaluating Alzheimer’s Disease / 中国临床心理学杂志

Objective: To probe the significance of spontaneous and mimicking clock drawing tests (CDT) to evaluate the severity of Alzheimer’s disease (AD). Methods: 30 normal middle aged to senile people as the control, and 20 amnestic mild cognitive impairment patients, 20 mild AD patients, 19 moderate AD patients and 14 severe AD patients were asked to finish the series of neuropsychologic test including the spontaneous and mimicking clock drawing tests. Results: For spontaneous CDT, there was significant difference in the "anchoring part"(draw the four key points-12-3-69 first) between the MCI patients and normal controls (P