Nnwale MemTrax Tụnyere Ntụle Nleba anya nke Montreal nke Mmebi Nghọta dị nro.
Ụdị edemede: MemTrax Research Nkeji edemede
Ndị edemede: van der Hoek, Marjanne D. | Nieuwenhuizen, Arie | Keijer, Jaap | Ashford, J. Wesson
Mgbakwunye: Mahadum Stanford, Stanford, CA, USA - Department of Psychiatry and Behavioral Sciences, Applied Research Center Food and Dairy, Van Hall Larenstein University of Applied Sciences, Leeuwarden, Netherlands | Physiology nke mmadụ na anụmanụ, Mahadum Wageningen, Wageningen, Netherlands | Ogige ọmụmụ ihe gbasara ọrịa na mmerụ ahụ agha, VA Palo Alto HCS, Palo Alto, CA, USA
DOI: 10.3233/JAD-181003
Akwụkwọ akụkọ: Journal of Ọrịa Alzheimer, mp. 67, ee e. 3, p. 1045-1054, 2019
nkịtị
Mmebi nke ọgụgụ isi bụ isi ihe na-akpata adịghị arụ ọrụ na ndị agadi. Mgbe ole obere nghọta mmebi (MCI) na-eme na ndị agadi, ọ na-abụkarị ọnọdụ prodromal maka dementia. Ntụle ọgụgụ isi nke Montreal (MoCA) bụ ngwá ọrụ a na-ejikarị enyo maka MCI. Agbanyeghị, ule a chọrọ nlekọta ihu na ihu ma mejupụtara ajụjụ dị iche iche nke ọnụ ọgụgụ agbakwunyere nzaghachi ha ọnụ iji nye akara nke ihe ọ pụtara bụ arụmụka. Emebere ọmụmụ ihe a iji nyochaa arụmọrụ nke kọmpụta ule nchekwa (MemTrax), nke bụ mmegharị nke ọrụ nnabata na-aga n'ihu, gbasara MoCA. A na-ewepụta usoro nsonaazụ abụọ site na Nnwale MemTrax: MemTraxspeed na MemTrax ziri ezi. Edere isiokwu ndị MoCA na ndị Nnwale MemTrax. Dabere na nsonaazụ nke MoCA, e kewara isiokwu n'ime otu abụọ nke ọnọdụ ọgụgụ isi: cognition nkịtị (n = 45) na MCI (n = 37). Ọnụ ọgụgụ MemTrax pụtara dị obere na MCI karịa n'òtù ọgụgụ isi nkịtị. Mgbanwe nsonaazụ MemTrax niile jikọtara nke ọma na MoCA. Ụzọ abụọ, na-agbakọ nkezi Ejiri akara MemTrax na nkwụghachi ahịrị ahịrị iji tụọ ụkpụrụ mbelata nke ule MemTrax iji chọpụta MCI. Ụzọ ndị a gosipụtara na maka nsonaazụ MemTraxọsọ akara n'okpuru oke nke 0.87 - 91 s-1 bụ ihe ngosi nke MCI, yana maka nsonaazụ MemTraxziri ezi akara n'okpuru oke nke 85 - 90% bụ ihe ngosi maka MCI.
OKWU
Ọnụ ọgụgụ ndị bi n'ụwa nile, nke Europe, North America, na Northern Asia na-edu, emeela agadi, na-eme ka ọnụ ọgụgụ ndị agadi na-abawanye ngwa ngwa. Ka afọ na-abawanye, a na-enwe ọganihu na-aga n'ihu nke ọma, mmụba dị ukwuu nke mmepe nke nkwarụ ọgụgụ isi, dementia, na Ọrịa Alzheimer (AD), nke na-eduga n'ịba ụba nke ọnụ ọgụgụ ndị nwere ọnọdụ ndị a. Nchọpụta mmalite na njirimara nke nsogbu uche nwere ike ime ka nlekọta ndị ọrịa dịkwuo mma, belata ụgwọ nlekọta ahụike, ma nwee ike inye aka n'igbu oge mmalite nke mgbaàmà ndị ka njọ, si otú a nwere ike inye aka belata ibu na-eto ngwa ngwa nke dementia na AD. Ya mere, a na-achọ ngwá ọrụ ka mma iji nyochaa ọrụ ọgụgụ isi na ndị agadi.
Iji mee nyocha nyocha nke ụlọ ọgwụ nke ọrụ ọgụgụ isi na omume nke ndị agadi, ndị dọkịta na ndị nchọpụta emepụtala ọtụtụ narị ngwaọrụ nyocha na nkenke, na ọtụtụ ule abanyela n'ọrụ. Otu n'ime ngwaọrụ ndị a na-ejikarị eme ihe maka nyocha ụlọ ọgwụ nke nkwarụ dị nro (MCI) na ntọala agụmakwụkwọ bụ Ntụle ọgụgụ isi nke Montreal (MoCA).
MoCA na-enyocha ọrụ ọgụgụ isi asaa: onye isi, ịkpọ aha, nlebara anya, asụsụ, abstraction, ebe nchekwa / ncheta oge, na nhazi. Achọpụtara ebe nchekwa / ncheta oge na nghazi nke MoCA dị ka ihe kachasị emetụ n'ahụ maka nrụrụ ụdị Alzheimer n'oge, nke butere echiche na nchekwa nchekwa bụ isi ihe kpatara usoro neuropathological AD wakporo. Ya mere, n'ime ngwá ọrụ ụlọ ọgwụ maka ntule nke mmetụ uche nke metụtara AD, ebe nchekwa bụ isi ihe dị mkpa iji tụlee, ebe mmebi ndị ọzọ, gụnyere aphasia, apraxia, agnosia, na executive dysfunction, ọ bụ ezie na AD na-akpaghasịkarị ya, nwere ike jikọta ya. na nkwụsị nke usoro nhazi ebe nchekwa neuroplastic na mpaghara neocortical na-akwado.
Ọ bụ ezie na a na-eji MoCA eme ihe n'ọtụtụ ebe maka ịlele MCI, nchịkwa nke MoCA na-eme ihu na ihu, nke na-ewe oge ma na-achọ nhụta ụlọ ọgwụ na ya mere ọ chọrọ nnukwu ego maka nchịkwa ọ bụla. N'ime nyocha, oge achọrọ iji nye nnwale na-abawanye izi ezi nke ntule, yabụ mmepe n'ọdịnihu ga-eburu n'uche mmekọrịta a iji mepụta ule dị mma karị.
Ihe dị oke egwu na mpaghara a bụ ihe a chọrọ maka ntule ọgụgụ isi ka oge na-aga. Ntụle mgbanwe n'ime oge bụ dị mkpa maka ịchọpụta na ikpebi ọganihu nke mmebi ahụ, ịdị irè nke ọgwụgwọ, na nyocha nke nchọpụta ọgwụgwọ ọgwụgwọ. Ọtụtụ ngwa ndị dị otú ahụ adịghị adabara ma ọ bụ emebere ya maka ọkwa dị elu nke ziri ezi na enweghị ike ịnye ya ngwa ngwa ugboro ugboro. A na-atụ aro ihe ngwọta iji meziwanye ntule ọgụgụ isi ka ọ bụrụ kọmpụta, ma ọtụtụ mgbalị ndị dị otú ahụ enyela ntakịrị ihe karịa kọmputa nke ule neuropsychological a na-ejikarị eme ihe , ma emebeghị ya iji dozie okwu ndị dị oke egwu nke nyocha nke uche chọrọ iji ghọta n'oge. nsogbu na ọganihu ya. Ya mere, ngwá ọrụ nleba anya ọhụrụ kwesịrị ịbụ kọmpụta ma dabere na ebe a na-akparaghị ókè nke ule atụnyere, nke na-ejighị asụsụ ma ọ bụ omenala, nke na-enye ọkwa ziri ezi, nkenke, na ntụkwasị obi nke nwere ike ime ka ọ dịkwuo mma. Na mgbakwunye, ule ndị dị otú ahụ ga-abụrịrị ihe na-atọ ụtọ ma na-adọrọ mmasị, nke mere na a ga-ewere ule ugboro ugboro dị ka ihe dị mma karịa ahụmahụ dị egwu. Nnwale ịntanetị, karịsịa, na-enye ikike iji gboo mkpa a, ebe ọ na-enye nchịkọta ngwa ngwa na nyocha nke data, na-enye nzaghachi ozugbo nye ndị mmadụ, ndị dọkịta, na ndị nyocha na-esonye.
Emebere ihe ọmụmụ a ugbu a iji chọpụta uru nke ngbanwe n'ịntanetị nke ụkpụrụ ọrụ nnabata na-aga n'ihu (CRT), maka nyochaa ọrụ ọgụgụ isi n'ime ọnụ ọgụgụ ndị bi n'ime obodo bụ ndị a na-achọpụtaghị na ha nwere nkwarụ. A na-eji ụkpụrụ CRT eme ihe na agụmakwụkwọ ọmụmụ nke ebe nchekwa usoro. Ebu ụzọ mejuputa usoro CRT dị ka ihe ngosi ihe ngosi nke ndị na-ege ntị na-enye data na ndị nwere mmasị nsogbu ncheta. N'ikpeazụ, ụlọ ọrụ France (HAPPYneuron, Inc.) mebere ule a n'ịntanetị; site na ụlọ ọrụ US, MemTrax, LLC (http://www.memtrax.com); site na Brain Health Ndebanye aha nke Dr. Michael Weiner, UCSF, na ndị otu ya mebere iji kwado mbanye maka ọmụmụ ihe gbasara nsogbu uche; na ụlọ ọrụ China SJN Biomed, LTD). Nnwale a, dịka nke June 2018, enwetala data sitere n'aka ndị ọrụ 200,000, ọ nọkwa na ule n'ọtụtụ mba.
N'ime ọmụmụ ihe ugbu a, MemTrax (MTX), nyocha nke dabeere na CRT, ka a na-enye ya na MoCA na ndị agadi nọ na-adị ndụ onwe ha na ugwu Netherlands. Ihe ọmụmụ a bụ iji chọpụta njikọ dị n'etiti arụmọrụ na mmejuputa a nke CRT na MoCA. Ajụjụ a bụ ma MTX ọ ga-aba uru maka ịkọ ọrụ ọgụgụ isi nke MoCA na-enyocha, nke nwere ike igosi na ọ ga-ekwe omume ụlọ ọgwụ.
AKỤRỤNGWA NA ỤZỌ
Onu ogugu
N'agbata Ọktoba 2015 na Mee 2016, a na-eme ọmụmụ ihe n'akụkụ n'etiti ndị agadi bi na obodo na ugwu Netherlands. A na-ewebata isiokwu (≥75y) site na nkesa akwụkwọ ozi na n'oge nzukọ otu a haziri maka ndị agadi. A gara leta isiokwu ndị nwere ike ime n'ụlọ iji lelee maka nsonye nsonye na nwepu tupu edebanye aha ha na ọmụmụ ihe a. Ndị mmadụ nwere nsogbu (nke onwe ha) dementia ma ọ bụ ndị nwere nnukwu ọhụụ ma ọ bụ ịnụ ihe nke ga-emetụta nchịkwa nke ule ọgụgụ isi anabataghị isonye na ọmụmụ ihe a. Na mgbakwunye, isiokwu dị mkpa iji nwee ike ịsụ na ịghọta asụsụ Dutch ma ghara ịbụ ndị na-agụghị akwụkwọ. Emere ọmụmụ ihe a dịka nkwupụta Helsinki nke 1975 si dị na ndị niile sonyere bịanyere aka na ya nkwupute nkwenye ụdị mgbe ị nwetasịrị nkọwa zuru ezu nke ọmụmụ ihe.
Usoro ọmụmụ
Mgbe edebanye aha na ọmụmụ ihe ahụ, a na-enye akwụkwọ nyocha n'ozuzu ya, nke gụnyere ajụjụ gbasara ihe gbasara igwe mmadụ, dị ka afọ na afọ agụmakwụkwọ (malite na ụlọ akwụkwọ praịmarị), akụkọ ahụike ahụike, na ịṅụ mmanya na-aba n'anya. Mgbe emechara akwụkwọ ajụjụ a, a na-eme ule MoCA na MTX n'usoro n'usoro.
MemTrax - Ebe nyocha ahụike
Dịka nkwado nke MemTrax, LLC (Redwood City, CA, USA), e nyere ụdị ule MTX n'efu. N'ime ule a, a na-egosi usoro onyonyo 50 ruo sekọnd atọ ọ bụla. Mgbe kpọmkwem onyonyo a na-emegharị ugboro ugboro pụtara (25/50), a gwara ndị isiokwu ka ha meghachi omume na onyonyo a na-emegharị ngwa ngwa o kwere mee site na ịpị oghere oghere (nke e gosiri site na teepu na-acha uhie uhie). Mgbe isiokwu ahụ zara ihe onyonyo, egosipụtara onyonyo na-esote ozugbo. Mgbe emechara ule ahụ, mmemme ahụ na-egosi pasentị nzaghachi ziri ezi (MTXziri ezi) na nkezi oge mmeghachi omume n'ime sekọnd maka onyonyo ugboro ugboro, nke na-egosipụta oge achọrọ iji pịa oghere oghere mgbe ị na-amata onyonyo ugboro ugboro. Iji dakọọ akụkụ nke usoro abụọ a, oge mmeghachi omume gbanwere ka ọ bụrụ ọsọ mmeghachi omume (MTXọsọ) site n'ikewa 1 site na oge mmeghachi omume (ie, 1/MTXoge mmeghachi omume). Akụkọ ule nke akara MemTrax niile na nkwado ha ka echekwara na ntanetị ozugbo na akaụntụ ule ahụ. A na-enyocha izi ezi nke ule niile emere, chọrọ nzaghachi dị mma 5 ma ọ bụ ole na ole, nnabata 10 ma ọ bụ karịa, yana oge nnabata n'etiti 0.4 na 2 sekọnd, yana naanị ule ziri ezi ka etinyere na nyocha ahụ.
Tupu a na-enyocha ule MTX n'ezie, a kọwapụtara ule ahụ n'ụzọ zuru ezu ma nyekwa isiokwu ndị ahụ ule omume. Nke a gụnyere ọ bụghị naanị ule n'onwe ya, kamakwa ntụziaka na ịgụta ibe iji mee ka onye so na ya mara nhazi saịtị na omume mbụ dị mkpa, tupu mmalite nke ule ahụ. Iji zere ikwugharị onyonyo n'oge ule n'ezie, a na-eji onyonyo etinyeghị na nchekwa data MemTrax maka nnwale omume.
Nyocha ọgụgụ isi nke Montreal ngwá ọrụ
Enwetara ikike site na MoCA Institute & Clinique (Quebec, Canada) iji MoCA maka nyocha a. MoCA Dutch dị na ụdị atọ, nke enyere isiokwu ndị a na-enweghị usoro. Akara MoCA bụ nchikota arụmọrụ na ngalaba ọgụgụ isi dị iche iche enyochara ma nwee akara kacha nke isi iri atọ. Dịka ndụmọdụ gọọmentị si kwuo, agbakwunyere ihe mgbakwunye ma ọ bụrụ na onye so na ya nwere ≤30 agụmakwụkwọ afọ (ọ bụrụ <12 isi). A na-eji ntuziaka nnwale gọọmentị dị ka ntuziaka n'oge nchịkwa nke ule. Ndị nyocha atọ a zụrụ azụ mere ule a yana nchịkwa otu ule were ihe dị ka nkeji iri ruo iri na ise.
Nyocha data MemTrax
Dabere na nsonaazụ nke MoCA, bụ nke edoziziri maka agụmakwụkwọ, a na-ekewa isiokwu ndị ahụ n'òtù abụọ nke ọnọdụ uche: cognition nkịtị (NC) na adịghị ike nghọta dị nro (MCI). A na-eji akara MoCA nke 23 mee ihe dị ka mbelata maka MCI (akara 22 na n'okpuru ka a na-ewere MCI), ebe egosipụtara na akara a gosipụtara n'ozuzu 'nchọpụta nchọpụta kachasị mma n'ofe dị iche iche'' ma e jiri ya tụnyere akara mbụ akwadoro nke 26 ma ọ bụ ụkpụrụ nke 24 ma ọ bụ 25. Maka nyocha niile, a na-eji akara MoCA emezi emezi ka a na-eji akara a na ntọala ụlọ ọgwụ.
Nnwale MTX na-enye nsonaazụ abụọ, ya bụ MTXoge mmeghachi omume, nke agbanwere ka ọ bụrụ MTXọsọ site na 1/MTXoge mmeghachi omume, na MTXziri ezi.
A na-eme nyocha ndekọ ọnụ ọgụgụ site na iji R (ụdị 1.0.143, Rstudio Team, 2016). A na-enyocha ụkpụrụ maka mgbanwe niile site na ule Shapiro-Wilk. Mgbanwe nke ọnụ ọgụgụ ọmụmụ ihe niile, na nke ndị NC na MCI, ka akọọrọ dị ka ± standard deviation (SD), median na interquartile range (IQR) ma ọ bụ dị ka ọnụọgụ na pasent. T-ule nke onwe na Wilcoxon Sum Rank ule maka mgbanwe mgbanwe na-aga n'ihu na ule Chi-squared maka ụdị mgbanwe dị iche iche ka emere iji tụnyere njirimara nke otu NC na MCI. Ejiri ule Kruskal-Wallis na-abụghị parametric iji chọpụta ma ụdị atọ nke MoCA na ndị nchịkwa atọ ahụ metụtara nsonaazụ MoCA. Tụkwasị na nke ahụ, a na-eme ule T-ule nke onwe ma ọ bụ Wilcoxon Sum Rank iji chọpụta ma usoro nchịkwa nke MoCA na MTX metụtara nsonaazụ ule (dịka, akara MoCA, MTX).ziri ezi, na MTXọsọ). Emere nke a site n'ịchọpụta ma ọnụọgụgụ pụtara dị iche iche maka isiokwu ndị natara mbụ MoCA na MemTrax ma ọ bụ ndị natara MTX na mbụ na MoCA.
Mmekọrịta Pearson agbakọrọ ule iji chọpụta njikọ dị n'etiti MTX na MoCA yana n'etiti ma MemTrax nsonaazụ ule, dịka MTXspeed na MTX ezighi ezi. Ngụkọta nha nha nke emere n'oge gara aga gosiri na maka nnwale njikọ njikọ Pearson nwere otu ọdụ (ike = 80%, α = 0.05), na-eche na nke a ọkara mmetụta size (r = 0.3), a obere sample size nke n = 67 dị mkpa. A gbakọrọ ule njikọ polyserial iji chọpụta njikọ dị n'etiti nsonaazụ ule MTX na ngalaba MoCA dị iche iche site na iji ngwugwu psych na R.
A gbakọrọ akara MoCA nhata maka akara MemTrax enyere site na ịgbakọ nkezi akara MemTrax maka akara MoCA ọ bụla enwere ike yana nrụgharị ahịrị ka emere iji tụọ nha anya metụtara usoro ndị a. Na mgbakwunye, iji chọpụta ụkpụrụ mbelata nke ule MemTrax maka MCI tụrụ site na MoCA, yana nghọta kwekọrọ na ụkpụrụ akọwapụtara, a na-eme nyocha nke onye na-enweta ihe na-arụ ọrụ (ROC) site na iji ngwugwu pROC na R. Non-parametric stratified bootstrapping (n) = 2000) ejiri tụnyere mpaghara n'okpuru akụkụ (AUCs) na oge ntụkwasị obi kwekọrọ. Ejiri usoro Youden gbakọọ akara mbelata kacha mma, nke na-ebuli ezigbo ihe dị mma ma na-ebelata ihe dị mma.
Maka nyocha ndekọ ọnụ ọgụgụ niile, a na-ewere p-uru dị n'akụkụ abụọ nke <0.05 dị ka ọnụ ụzọ maka mkpa ndekọ aha, ma e wezụga maka nyocha iji nyochaa njikọ dị n'etiti MTX na MoCA (ya bụ, nyocha mmekọrịta na nkwụghachi azụ dị mfe) nke otu- A na-ahụta p-uru nke <0.05 dị ka ihe dị mkpa.
Nsonaazụ MemTrax
Ndị isi
Na mkpokọta, ihe ọmụmụ 101 gụnyere ihe ọmụmụ a. Ewepụla data nke mmadụ 19 na nyocha, ebe ọ bụ na echekwaghị nsonaazụ MemTrax sitere na isiokwu iri na abụọ site na mmemme ahụ, isiokwu 12 nwere nsonaazụ ule MemTrax na-ezighi ezi, otu isiokwu nwere akara MoCA nke isi 6, na-egosi nnukwu nsogbu ọgụgụ isi, nke bụ. ihe mwepu criterer. Ya mere, data sitere na isiokwu 8 gụnyere na nyocha. Enweghị nnukwu ọdịiche dị na nsonaazụ ule MoCA dị n'etiti ụdị dị iche iche nke MoCA na n'etiti ndị nchịkwa. Na mgbakwunye, usoro nchịkwa ule enweghị mmetụta dị ukwuu na akara ule ọ bụla (MoCA, MTXọsọ, MTXziri ezi). Dabere na nsonaazụ ule MoCA, etinyere isiokwu n'ime otu NC ma ọ bụ MCI (dịka, MoCA ≥ 23 ma ọ bụ MoCA <23, n'otu n'otu). A na-egosipụta njirimara isiokwu maka ọnụ ọgụgụ ọmụmụ ihe zuru ezu, na ndị NC na MCI dị na tebụl 1. Ọ dịghị ọdịiche dị ịrịba ama dị n'etiti otu dị iche iche, ma e wezụga akara MoCA nke etiti (25 (IQR: 23-26) megide 21 (IQR: 19-22). ) isi, Z = -7.7, p <0.001).
Isiokwu 1
Atụmatụ isiokwu
| Ngụkọta ọnụ ọgụgụ ndị ọmụmụ (n = 82) | NC (n = 45) | MCI (n = 37) | p | |
| Afọ (y) | 83.5 5.2 ± | 82.6 4.9 ± | 84.7 5.4 ± | 0.074 |
| Nwanyị, Mba. (%) | 55 (67) | 27 (60) | 28 (76) | 0.133 |
| Agụmakwụkwọ (y) | 10.0 (8.0 - 13.0) | 11.0 (8.0 - 14.0) | 10.0 (8.0 - 12.0) | 0.216 |
| Ịṅụ mmanya na-aba n'anya (# iko/izu) | 0 (0 - 4) | 0 (0 - 3) | 0 (0 - 5) | 0.900 |
| Akara MoCA (ọnụọgụ #) | 23 (21 - 25) | 25 (23 - 26) | 21 (19 - 22) | ọma |
A na-egosipụta ụkpụrụ dị ka pụtara ± sd, etiti (IQR) ma ọ bụ dị ka ọnụọgụ na pasent.
Ọkwa ọgụgụ isi nke MemTrax tụrụ
A tụrụ ọkwa ọgụgụ isi site na ule MTX. Ọgụgụ 1 na-egosi nsonaazụ nke ule nghota nsonaazụ nke isiokwu NC na MCI. Ihe akara MTX pụtara (dịka, MTXọsọ na MTXziri ezi) dị nnọọ iche n'etiti otu abụọ ahụ. Isiokwu NC (0.916 ± 0.152 s-1) nwere nnukwu mmeghachi omume ngwa ngwa ma e jiri ya tụnyere isiokwu MCI (0.816 ± 0.146 s-1); t (80) = 3.01, p = 0.003) (Fig. 1A). Na mgbakwunye, isiokwu NC nwere akara ka mma na MTXziri ezi agbanwe karịa isiokwu MCI (91.2 ± 5.0% megide 87.0 ± 7.7% n'otu n'otu; tw (59) = 2.89, p = 0.005) (Fig. 1B).
Fig.1
Igbe igbe nke nsonaazụ ule MTX maka otu NC na MCI. A) MTXọsọ nsonaazụ ule na B) MTXziri ezi nsonaazụ ule. Mgbanwe nsonaazụ abụọ nke ule MTX dị ntakịrị ala na otu MCI ma e jiri ya tụnyere NC. Agba isi awọ na-egosi isiokwu NC, ebe agba ntụ ntụ na-egosi isiokwu MCI.
Igbe igbe nke nsonaazụ ule MTX maka otu NC na MCI. A) Nsonaazụ ule MTXspeed yana B) MTX elele ule ziri ezi. Mgbanwe nsonaazụ abụọ nke ule MemTrax dị ntakịrị ala na otu MCI ma e jiri ya tụnyere NC. Agba isi awọ na-egosi isiokwu NC, ebe agba ntụ ntụ na-egosi isiokwu MCI.
Mmekọrịta dị n'etiti MemTrax na MOCA
E gosipụtara mkpakọrịta n'etiti akara ule MTX na MoCA na Fig. 2. Ma MTX variables nwere njikọ chiri anya na MoCA. MTXọsọ na MoCA gosipụtara njikọ dị ịrịba ama nke r = 0.39 (p = 0.000), na njikọ dị n'etiti MTXziri ezi na MoCA bụ r = 0.31 (p = 0.005). Enweghị njikọ n'etiti MTXọsọ na MTXziri ezi.
Fig.2
Mkpakọrịta dị n'etiti A) MTXọsọ na MoCA; B) MTXziri ezi na MoCA; C) MTXziri ezi na MTXọsọ. E gosipụtara isiokwu NC na MCI nwere ntụpọ na triangles n'otu n'otu. N'akụkụ aka nri nke eserese nke ọ bụla, a na-egosi rho na uru p kwekọrọ na njikọ dị n'etiti mgbanwe abụọ ahụ.
Njikọ dị n'etiti A) MTXspeed na MoCA; B) MTX ziri ezi na MoCA; C) MTX ziri ezi na MTXspeed. E gosipụtara isiokwu NC na MCI nwere ntụpọ na triangles n'otu n'otu. N'akụkụ aka nri nke eserese nke ọ bụla, a na-egosi rho na uru p kwekọrọ na njikọ dị n'etiti mgbanwe abụọ ahụ.
Njikọ dị n'etiti A) MTXspeed na MoCA; B) MTX ziri ezi na MoCA; C) MTX ziri ezi na MTXspeed. E gosipụtara isiokwu NC na MCI nwere ntụpọ na triangles n'otu n'otu. N'akụkụ aka nri ala nke eserese ọ bụla, a na-egosipụta rho na uru p kwekọrọ na njikọ dị n'etiti mgbanwe abụọ ahụ.[/caption]
A gbakọrọ njikọ polyserial n'etiti akara ule MemTrax na ngalaba MoCA iji chọpụta njikọ nke ngalaba ọ bụla na metrik MemTrax. E gosipụtara njikọ polyserial na Tebụl 2. A na-ejikọta ọtụtụ ngalaba nke MoCA na MTX.ọsọ . Ngalaba "abstraction" gosipụtara njikọ kachasị elu, ọ bụ ezie na ọ dị oke oke, na MTXọsọ (r = 0.35, p = 0.002). Ngalaba “ịkpọ aha” na “asụsụ” gosipụtara mkpakọrịta dị mkpa na-adịghị ike ma na-agafeghị oke na MTXọsọ (r = 0.29, p = 0.026 na r = 0.27, p = 0.012, n'otu n'otu). MTXziri ezi Ejikọtaghị nke ọma na ngalaba MoCA, belụsọ maka mmekọrịta adịghị ike na ngalaba "visuospatial" (r = 0.25, p = 0.021).
Isiokwu 2
Mmekọrịta polyserial nke nsonaazụ ule MTX na ngalaba MoCA
| MTXọsọ | MTXziri ezi | |||
| r | p | r | p | |
| Visuospatial | 0.22 | 0.046 | 0.25 | 0.021 |
| Ịkpọ aha | 0.29 | 0.026 | 0.24 | 0.063 |
| ige nti | 0.24 | 0.046 | 0.09 | 0.477 |
| asụsụ | 0.27 | 0.012 | 0.160 | 0.165 |
| Abstraction | 0.35 | 0.002 | 0.211 | 0.079 |
| Cheta | 0.15 | 0.159 | 0.143 | 0.163 |
| Nhazi | 0.21 | 0.156 | 0.005 | 0.972 |
Mara: E gosipụtara mmekọ ndị dị mkpa na nkwuwa okwu.
MemTrax rịgoro na ọnụ ahịa mbelata maka MCI
Iji chọpụta akara MemTrax na MoCA kwekọrọ, akara MemTrax nke akara MoCA ọ bụla bụ nkezi yana gbakọọ nlọghachi azụ n'ahịrị iji buru amụma mmekọrịta na nha anya kwekọrọ. Nsonaazụ nke regression linear gosiri na MTXọsọ kọwara 55% nke ọdịiche dị na MoCA (R2 = 0.55, p = 0.001). Mgbanwe MTXziri ezi kọwara 21% nke ọdịiche dị na MoCA (R2 = 0.21, p = 0.048). Dabere na nha nhata nke mmekọrịta ndị a, a na-agbakọ akara MoCA nhata maka inye akara MTX, nke egosiri na Tebụl 3. Dabere na nha nha ndị a, ụkpụrụ cutoff kwekọrọ (dịka, akara MoCA nke isi 23) maka MTXọsọ na MTXziri ezi bụ 0.87 s-1 na 90%. Na mgbakwunye, a na-eme ọtụtụ regression linear na ma MemTrax variables, mana mgbanwe MTXziri ezi enyeghị oke aka na ihe nlereanya ya mere egosighi nsonaazụ ya.
Isiokwu 3
Atụnyere akara MoCA nhata maka akara MemTrax nyere
| MoCA (isi ihe) | Dakọtara MTXọsọ (s-1)a | CI nke amụma na MTXọsọ (isi ihe) | Dakọtara MTXziri ezi (%)b | CI nke amụma na MTXziri ezi (isi ihe) |
| 15 | 0.55 | 7 - 23 | 68 | 3 - 28 |
| 16 | 0.59 | 8 - 24 | 71 | 5 - 28 |
| 17 | 0.63 | 10 - 24 | 73 | 6 - 28 |
| 18 | 0.67 | 11 - 25 | 76 | 8 - 28 |
| 19 | 0.71 | 12 - 26 | 79 | 9 - 29 |
| 20 | 0.75 | 13 - 27 | 82 | 11 - 29 |
| 21 | 0.79 | 14 - 28 | 84 | 12 - 30 |
| 22 | 0.83 | 15 - 29 | 87 | 13 - 30 |
| 23 | 0.87 | 16 - 30 | 90 | 14 - 30 |
| 24 | 0.91 | 17 - 30 | 93 | 15 - 30 |
| 25 | 0.95 | 18 - 30 | 95 | 16 - 30 |
| 26 | 0.99 | 19 - 30 | 98 | 16 - 30 |
| 27 | 1.03 | 20 - 30 | 100 | 17 - 30 |
| 28 | 1.07 | 21 - 30 | 100 | 17 - 30 |
| 29 | 1.11 | 21 - 30 | 100 | 17 - 30 |
| 30 | 1.15 | 22 - 30 | 100 | 17 - 30 |
aUsoro eji: 1.1 + 25.2 *MTXọsọ; b Usoro eji: –9.7 + 0.36 *MTXziri ezi.
Na mgbakwunye, MTX cutoff ụkpụrụ na nghọta kwekọrọ ekwekọ na kpọmkwem ka e kpebisiri ike site na nyocha ROC. A na-egosi akụkụ ROC nke mgbanwe MemTrax na Fig. 3. AUC maka MTXọsọ na MTXziri ezi bụ, otu, 66.7 (CI: 54.9 - 78.4) na 66.4% (CI: 54.1 - 78.7). AUC nke mgbanwe MemTrax ejiri iji nyochaa MCI nke MoCA guzobere adịchaghị iche. Tebụl 4 na-egosi nghọta na nkọwapụta nke isi ihe mbelata dị iche iche nke mgbanwe MemTrax. Akara mbelata kacha mma, nke mere ka ọ dịkwuo mma ma na-ebelata ihe dị mma, maka MTXọsọ na MTXziri ezi bụ 0.91 s-1 (uche = 48.9% nkọwapụta = 78.4%) na 85% (uche = 43.2%; nkọwapụta = 93.3%), n'otu n'otu.
Fig.3
ROC na-atụgharị nke nsonaazụ ule MTX iji nyochaa MCI nke MoCA kwadoro. Ahịrị nwere ntụpọ na-egosi MTXọsọ na ahịrị siri ike MTXziri ezi. Ahịrị isi awọ na-anọchi anya ahịrị ntụaka nke 0.5.
ROC na-atụgharị nke nsonaazụ ule MTX iji nyochaa MCI nke MoCA kwadoro. Ahịrị nwere ntụpọ na-egosi MTXspeed yana ahịrị siri ike MTX ziri ezi. Ahịrị isi awọ na-anọchi anya ahịrị ntụaka nke 0.5.
Isiokwu 4
MTXọsọ na MTXziri ezi isi nkwụsị na nkọwapụta kwekọrọ na uche
| Ebe nkwụsị | Tp (#) | tn (#) | Fp (#) | Fn (#) | Nkọwapụta (%) | Mmetụta (%) | |
| MTXọsọ | 1.20 | 37 | 1 | 44 | 0 | 2.2 | 100 |
| 1.10 | 36 | 7 | 38 | 1 | 15.6 | 97.3 | |
| 1.0 | 33 | 13 | 32 | 4 | 28.9 | 89.2 | |
| 0.90 | 28 | 22 | 23 | 9 | 48.9 | 75.7 | |
| 0.80 | 18 | 34 | 11 | 19 | 75.6 | 48.6 | |
| 0.70 | 9 | 41 | 4 | 28 | 91.1 | 24.3 | |
| 0.60 | 3 | 45 | 0 | 34 | 100 | 8.1 | |
| MTXziri ezi | 99 | 36 | 3 | 42 | 1 | 97.3 | 6.7 |
| 95 | 31 | 11 | 34 | 6 | 83.8 | 24.4 | |
| 91 | 23 | 23 | 22 | 14 | 62.2 | 51.1 | |
| 89 | 20 | 28 | 17 | 17 | 54.1 | 62.2 | |
| 85 | 16 | 42 | 3 | 21 | 43.2 | 93.3 | |
| 81 | 8 | 44 | 1 | 29 | 21.6 | 97.8 | |
| 77 | 3 | 45 | 0 | 34 | 8.1 | 100 |
tp, ezi mma; tn, ezi adịghị mma; fp, nke ọma; fn, ezighi ezi.
NKWASỊTA
Emebere ọmụmụ ihe a iji nyochaa ngwa MemTrax dị n'ịntanetị, ule dabere na CRT, na-eji MoCA dịka ntụaka. A họọrọ MoCA n'ihi na a na-eji ule a eme ihe ugbu a iji nyochaa MCI. Agbanyeghị, ebe kacha mma maka MoCA ewepụtabeghị nke ọma [28]. Ntụnyere nke MemTrax n'otu n'otu na MoCA na-egosi na ule dị mfe, nkenke, na ntanetị nwere ike ijide oke dị ịrịba ama nke ọdịiche dị na ịrụ ọrụ ụbụrụ na ụbụrụ uche. Na nyocha a, a hụrụ mmetụta kachasị ike maka ọsọ ọsọ. Ntụzi ziri ezi gosiri mmekọrịta na-esighị ike. Nchọpụta dị ịrịba ama bụ na ọ dịghị njikọ ọ bụla a hụrụ n'etiti ọsọ MTX na nhazi ziri ezi, na-egosi na mgbanwe ndị a na-atụle akụkụ dị iche iche nke ihe dị n'okpuru. ọrụ nhazi ụbụrụ. N'ihi ya, ọ dịghị ihe gosiri na a na-ahụta ọsọ-n'ụzọ ziri ezi ahịa n'ofe isiokwu. Tụkwasị na nke ahụ, a na-eji ụzọ abụọ dị iche iche iji chọpụta ụkpụrụ nkwụsị nke ule ebe nchekwa MemTrax iji chọpụta MCI. Usoro ndị a gosipụtara na maka nsonaazụ ọsọ na izi ezi, akara n'okpuru oke nke 0.87-91 s.-1 na 85 – 90% bụ ihe na-egosi na ndị mmadụ nwetara akara n'okpuru otu n'ime ọkwa ndị ahụ nwere ike ịnwe MCI. "Nnyocha uru bara uru" ga-egosi mgbe a ga-adụ onye mmadụ ọdụ ka ọ gakwuru dọkịta gbasara ime ule zuru oke iji nyochaa maka MCI [8-35].
N'ime ọmụmụ ihe ugbu a, achọpụtara na ngalaba "aha", "asụsụ", na "abstraction" nke MoCA tụrụ na-enwe mmekọrịta kachasị elu na otu n'ime nsonaazụ MemTrax, ọ bụ ezie na njikọ ndị ahụ adịghị ike na-agafeghị oke. Nke a dị iche na ihe a tụrụ anya ya, ebe ọ bụ na ọmụmụ ihe gara aga gosiri na nyocha nke Obere-uche steeti ule n'iji Theory Response Theory, na ngalaba "ncheta/echeta oge echere" na "nhazi" bụ ihe kacha emetụ n'ahụ n'oge AD [12]. Na nke a mbido mmalite nke dysfunction cognitive, ọ na-egosi na MoCA na-egosi adịghị ike dị nro na aha, asụsụ, na abstraction na-enwe mmetụta nke ọma na MCI karịa usoro nke ebe nchekwa na nghazi, kwekọrọ na nchoputa gara aga na Ntụle Nzaghachi Ihe nke MoCA [36]. Ọzọkwa, ndị MemTrax nke ọsọ njirimara na-egosi na ọ na-egosipụta adịghị ike nke mbụ a tupu ebe nchekwa amata dị ka MTX tụrụ (nke nwere mmetụta dị n'uko ụlọ). Nke a kpakpando nke mmetụta na-egosi na akụkụ mgbagwoju anya nke pathology na-akpata MCI na-egosipụta ụbụrụ mbụ mgbanwe nke siri ike iji ụzọ neurocognitive dị mfe chepụta echiche ma nwee ike igosipụta ọganihu nke neuropathology dị n'okpuru [37].
Isi ihe siri ike na ọmụmụ ihe ugbu a bụ na nha nlele (n = 82) karịrị nke ọma iji chọpụta mmekọrịta dị n'etiti MoCA na MTX na ọnụ ọgụgụ ndị a dịtụ ochie. Tụkwasị na nke ahụ, e mere ule omume n'ihe ọmụmụ niile, nke mere na ndị agadi bụ ndị na-ejighị kọmputa nwee ohere ime mgbanwe na gburugburu ebe ule na ngwá ọrụ. Tụnyere MoCA, isiokwu ndị gosiri na MemTrax na-atọ ụtọ karịa ime, ebe MoCA nwere mmetụta dị ka ule. Afọ ndị isiokwu a na nnwere onwe obodo ha gbochiri nleba anya nyocha na otu a ahọpụtara nke ndị nwere oke ọrụ, mana otu a so na ndị kacha sie ike maka njirimara nkwarụ.
N'ime ndetu, ọ bụ ezie na a na-ewere ya dị ka ule nyocha ọkọlọtọ, MoCA bụ naanị ule maka igosi ọnụnọ MCI ga-ekwe omume, ọ bụghị ngwá ọrụ nyocha ma ọ bụ nhụta zuru oke nke adịghị arụ ọrụ nke uche. Yabụ, n'otu aka ahụ, ntụnyere nke MoCA na MTX bụ ihe ikwu, ma ọ ga-abụ na ọ weghaara ọdịiche nke onwe na njirimara MCI. N'ihi ya, otu okwu dị mkpa na akwụkwọ akụkọ bụ mgbalị iji kọwaa uru nke MoCA [38], nkwado ya [39], nguzobe nke akara ngosi [40], ntụnyere na nyocha ndị ọzọ dị mkpirikpi [41-45]. , na uru ya dị ka ngwá ọrụ nyocha maka MCI [46] (nke Carson et al., 2017 [28] nyochara), yana ntinye nke ụdị eletrọnịkị [47]. Ntụle ndị dị otú ahụ gụnyere nyocha nke uche na nkọwapụta, na-ejikarị nyocha ROC na nha nke "mpaghara n'okpuru usoro", yana nkwenye nke mbelata maka "nchọpụta nchọpụta". Agbanyeghị, na enweghị usoro ọ bụla maka ikpebi ebe mmadụ na-edina n'ihu nhụsianya dị nro, yana nnukwu mgbanwe dị n'okpuru. ụbụrụ na-arụ ọrụ na-enye aka na mmebi ahụ, ngwa ọrụ niile dị otú ahụ nwere ike inye naanị nleba anya nke puru omume. Inye njikọ dị n'etiti usoro dị iche iche na-egosi naanị na a na-edozi ọnọdụ dị n'okpuru ebe a n'ụzọ ziri ezi, mana enweghị ike ịkọwapụta ọnọdụ ndụ n'ezie na usoro a. Ọ bụ ezie na nyocha nke ọkwa dị elu nwere ike ịba uru n'ụlọ ọgwụ, nguzobe nke ọrụ dị otú ahụ chọrọ nleba anya ọzọ n'ihe anọ: ọnụ ọgụgụ nke ọnọdụ ahụ na ndị mmadụ; Ọnụ ego nke ule, ọnụ ahịa nke nsonaazụ ụgha na-ezighị ezi, na uru ihe onwunwe nke ezi nchoputa ziri ezi [8, 35].
Isi akụkụ nke nsogbu n'ịtụle AD na mmejọ nke ọgụgụ isi metụtara ya bụ na ọ dịghị adị "usoro" [48], kama ọ bụ ihe na-aga n'ihu n'ihu [8, 17, 49]. Ọdịiche nke "nkịtị" sitere na MCI bụ n'ezie ihe siri ike karịa ịmata nke ọ bụla n'ime ọnọdụ ndị a na nke dị nro. dementia jikọtara na AD [50, 51]. N'iji echiche nke "Theory Test Modern", okwu a na-ekpebi ebe na continuum onye ọ bụla nwere ike ịnọ n'ime otu oge ntụkwasị obi, nyere otu akara ule. Iji mee mkpebi ndị dị otú ahụ, a na-achọ nyocha ziri ezi karịa nke a na-enye n'ọtụtụ nleba anya nkenke, mana dịka nke MTX na-enye. Mmụba nkenke na mwepụ nke echiche ndị na-ekiri ihe na-enyo enyo site na nyocha kọmputa bụ ntụziaka na-ekwe nkwa. Ọzọkwa, ule kọmpụta, dị ka MemTrax, na-enye ohere nke nnwale atụnyere enweghị oke, na-ebelata n'ụzọ dị iche iche nke nleba anya nrụrụ aka. Ọzọkwa, n'ụkpụrụ, nnwale kọmputa nwere ike ịnwale ọtụtụ ngalaba metụtara ebe nchekwa nke AD metụtara. Ọmụmụ ihe a atụnyeghị MTX n'ọtụtụ ule kọmputa ndị ọzọ emepụtara (lee mmeghe), mana ọ nweghị nke ndị dị ugbu a na-eji ụzọ siri ike nke CRT na-enye. Mmepe ọzọ nke nyocha kọmputa bụ mpaghara dị mkpa maka nleba anya na nkwado ọzọ. N'ikpeazụ, mmetụta ọzụzụ enwere ike itinye ya na nyocha.
N'oge a, nyocha kọmputa nke ịntanetị abụghị usoro siri ike ihuenyo maka dementia, nyochaa adịghị ike nghọta, ma ọ bụ mee nchọpụta ụlọ ọgwụ ọ bụla. Otú ọ dị, ike na ikike nke ụzọ a, karịsịa iji CRT, iji nyochaa ebe nchekwa episodic (obere oge), dị oke egwu na ọ ga-adị mkpa na ngwa nyocha n'ọdịnihu, gụnyere. nyocha nke dementia na ntule, nyochaa mgbagwoju anya mgbe arụchara ọrụ gasịrị, nguzobe nke ikike iche echiche maka ime mkpebi, ịchọpụta ụkọ mgbagwoju anya, na atụmatụ nke nwere ike ịdaba maka nchekwa ịkwọ ụgbọala. N'ime ọmụmụ ihe a, egosiri na MemTrax nwere ike weghara oke dị ukwuu nke ọdịiche nke enweghị uche. Na mgbakwunye, a na-ewepụta ụkpụrụ mbelata maka mgbanwe MTX nke ha nhata akara mbelata nke MoCA maka MCI. Maka nyocha n'ọdịnihu, a na-atụ aro ka ị nyochaa n'ọtụtụ buru ibu, ndị akọwapụtara nke ọma iji guzobe MemTrax dị ka ngwaọrụ nyocha maka MCI. Ọnụ ọgụgụ ndị dị otú ahụ kwesịrị ịgụnye ihe nlele ụlọ ọgwụ ebe enwere ike ịkọwa okwu gbasara nchọpụta dị ka nke ọma dị ka o kwere mee yana MTX na ule ọgụgụ isi ndị ọzọ na-esochi isiokwu. Nyocha ndị dị otú ahụ nwere ike ikpebi ọdịiche dị na trajectories nke ịda mbà n'obi, metụtara ma ịka nká nkịtị na ọnọdụ dị iche iche nke pathological. Ka nyocha na ndekọ kọmputa na-etolite, ọtụtụ ozi ndị ọzọ gbasara ọkwa nke ahụ ike ga-adị ma obi abụọ adịghị ya na ọ ga-ebute ọganihu dị ukwuu na nlekọta ahụike na olile anya na-abịaru nso iji gbochie ọnọdụ ndị dị ka AD.
ACKNOWLEDGMENTS
Anyị ga-achọ ikele Anne van der Heijden, Hanneke Rasing, Esther Sinnema, na Melinda Lodders maka ọrụ ha na ọmụmụ ihe a. Na mgbakwunye, ọ ga-amasị anyị ikele MemTrax, LLC maka ịnye ụdị ule MemTrax n'efu. Ọrụ a bụ akụkụ nke mmemme nyocha, nke mpaghara Fryslân (01120657) na-akwado, Netherlands na Alfasigma Nederland BV (onyinye kpọmkwem iji nye nọmba 01120657). Ebipụtara: 12 Febrụwarị 2019
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Keywords: ọrịa Alzheimer, ọrụ na-aga n'ihu na-arụ ọrụ, nkwarụ, ndị agadi, ebe nchekwa, nkwarụ dị nro, nyocha.
Njikọ njikọ:
New Nnwale ịpị aka - Nnwale ọsọ Psychomotor
Nri MIND: Nri Brain maka Brain Booster
Mgbaàmà Coronavirus - Ụbụrụ ụbụrụ