Ukuqhubela phambili kwizixhobo zokuhlola isifo se-Alzheimer
- PMID: 31942517
- PMCID: PMC6880670
- DOI: 10.1002/agm2.12069
Abstract
Kwisiseko sayo esisisiseko, Isifo se-Alzheimer (AD) yinkqubo ye-pathological echaphazela i-neuroplasticity, ekhokelela ekuphazamiseni okuthile kwimemori ye-episodic. Olu phononongo luya kubonelela ngengqiqo yokufowuna kwisikrini ukuze kubonwe kwangethuba isifo se-Alzheimer, ukuvavanya izixhobo zokuqonda ezikhoyo ngoku zokufumanisa isifo se-Alzheimer, kwaye ugxininise ekuphuhliseni iMemTrax. uvavanyo lwememori kwi-intanethi, ebonelela ngendlela entsha yokufumanisa ukubonakaliswa kwangaphambili kunye nokuqhubela phambili kwengqondo ehambelana nesifo se-Alzheimer's. I-MemTrax ivavanya iimetrics ezibonisa iziphumo zeenkqubo ze-neuroplastic ekufundeni, kwimemori, nasekuqondeni, ezichatshazelwa bubudala kunye Isifo se-Alzheimer, ngakumbi imisebenzi yememori ye-episodic, engenakulinganiswa ngoku ngokuchanekileyo ngokwaneleyo ukuze kusetyenziswe okunentsingiselo. Uphuhliso olongezelelweyo lweMemTrax luya kuba lixabiso elikhulu kwi ukufunyanwa kwangoko kwesifo sika-Alzheimer kwaye iza kubonelela ngenkxaso kuvavanyo longenelelo kwangethuba.
INTSHAYELELO
Isifo se-Alzheimer (AD) sisifo se-neurodeergenerative esifihlakeleyo, esiqhubela phambili, nesingenakuguqulwa okwangoku sithathwa njengesiqalo esichaphazela ingqondo malunga neminyaka engama-50 ngaphambi kokubonakaliswa kwesifo esipheleleyo (inqanaba leBraak V). Njengokhokelayo unobangela wesifo sengqondo esiyingozi, i-akhawunti ye-60-70% yazo zonke iimeko ze-dementia, i-AD ichaphazela malunga ne-5.7 yaseMelika kunye nabantu abangaphezu kwezigidi ezingama-30 emhlabeni jikelele. Ngokutsho “kwehlabathi Ingxelo ye-Alzheimer 2018, "kukho imeko entsha ye-dementia iphuhliswe yonke imizuzwana ye-3 emhlabeni jikelele kwaye i-66% yezigulane ze-dementia zihlala kumazwe anengeniso ephantsi kunye nephakathi.
Isifo sika-Alzheimer sesona sifo siphambili ngoku esingenazo iindlela ezisebenzayo zokunyanga, ukubuyisela umva, ukubamba, okanye nokucothisa ukukhula kwesifo xa iimpawu ziqala. Ngaphandle kwenkqubela phambili eyenziweyo ukuqonda i-pathophysiology esisiseko se-Alzheimer's disease, unyango lwesi sifo luye lwahamba kancinci ukusukela oko i-AD yachazwa okokuqala ngu-Alois Alzheimer ngo-1906. Ulawulo lokutya kunye neziyobisi e-US unyango lwe-AD, kubandakanywa ne-cholinesterase inhibitors ezine-tetrahydroaminoacridine (i-Tacrine, eyayitsalwa kwiimarike ngenxa yemicimbi yetyhefu), i-donepezil (i-Aricept), i-rivastigmine (i-Exelon), kunye ne-galantamine (i-Razadyne)-enye i-NMDA receptor modulator (memantine [Namenda) ]), kunye nendibaniselwano ye-memantine kunye ne-donepezil (Namzaric). Ezi arhente zibonise kuphela izakhono ezithobekileyo zokuguqula iziphumo ze Isifo sika-Alzheimer ekufundeni, inkumbulo, kunye nokuqonda ixesha elifutshane ngokwentelekiso, kodwa azikhange zibonise ziphumo zibalulekileyo ekuqhubekeni kwesifo. Ngomlinganiselo wekhosi yesifo se-8-12 iminyaka kunye neminyaka yokugqibela efuna ukunakekelwa kwe-clock-clock, ixabiso eliqikelelweyo lehlabathi jikelele le-dementia ngo-2018 laliyi-US $ 1 yezigidigidi kwaye oku kuya kunyuka kwi-US $ 2 yetriliyoni ngo-2030. Kukholelwa ukuba kujongelwa phantsi xa kujongwa ubunzima kuvavanyo lokuxhaphaka kwesifo sengqondo esiyingozi kunye neendleko. Ngokomzekelo, uJia et al uqikelele ukuba iindleko zesifo se-Alzheimer e-China zaziphezulu kakhulu kunaloo manani asetyenziswe kwi-"World Alzheimer Report 2015" esekelwe kuWang et al.
Iphuhliswe ngokuqhubekayo, i-AD iqala ngesigaba sokuqala seklinikhi esingenazimpawu kwaye siqhubeke nesigaba sokuqala kunye ukuphazamiseka kwengqondo okuphakathi (MCI; okanye i-prodromal AD) echaphazela amandla okugcina ulwazi olutsha kwimemori ye-episodic kunye nokulahlekelwa okuqhubekayo kweenkumbulo zakudala ngaphambi kokukhokelela ekugqibeleni kwi-dementia ebonakaliswe ngokupheleleyo.
INZUZO YOKUFUMANA KWANGXESHA I-AD
Okwangoku, ukuxilongwa okuqinisekileyo kwe-AD kusaxhomekeke kuvavanyo lwe-postmortem pathological, nangona olu hlalutyo lunokuba nzima. Nangona inkqubela ebonakalayo yenziwe kwii-biomarkers ze-AD, ukuxilongwa kwekliniki ye-AD kuseyinkqubo yokuphelisa ezinye izizathu ze-dementia. Kuqikelelwa ukuba malunga ne-50% yezigulane ze-AD azikho bafunyaniswa ngexesha lokuphila kwabo kumazwe athuthukileyo kunye nesifo se-Alzheimer's Izigulana kumazwe anengeniso ephantsi kunye nephakathi kusenokwenzeka ukuba azifunyaniswanga.
Ugxininiso ekubhaqweni kwangethuba ngongenelelo lwakwangoko luye lwanda ukuzuza ukuthamba njengeyona ndlela ilungileyo yokulwa ne-AD. Iinzame ezibalulekileyo zenziwe malunga nokuchongwa okusebenzayo amanyathelo okuthintela anokunciphisa izehlo ze-dementia kunye nesifo se-Alzheimer. Izifundo zokulandelela ixesha elide zibonise, umzekelo, ukuba ukuthotyelwa kweMeditera-Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) yokutya yayiyi. ehambelana nokuncipha kwe-53% kuphuhliso lwe-AD kunye nokuba imisebenzi yangaphakathi yomzimba neyengqondo inxulumene nokwehla okukhulu kwi-dementia. uphuhliso kunye necaveat yokuba ezi ntlobo zezifundo kunzima ukuzilawula.
Nangona ukuhlolwa kwe-dementia kubantu abangenazo iimpawu akukhuthazwa yi-United States Preventative Services Task Force ngokusekelwe kubungqina obukhoyo ngaphambi kokuphela kwe-2012, ukuhlolwa kwabantu abaneempawu kunye nomngcipheko omkhulu Isifo sika-Alzheimer sibalulekile ekubhaqweni kwangethuba kunye nokuxilongwa kwesifo i-Alzheimer's, kwaye kubaluleke kakhulu ekulungiseleleni izigulane kunye namalungu osapho malunga nokuxilongwa kwesi sifo kwixesha elizayo. Ngaphaya koko, kunikwe ubungqina obutsha bamanyathelo othintelo anokuthi asebenze kunye neenzuzo zakwangoko ukuxilongwa kwesifo sika-Alzheimer ukuba i-Alzheimer's Association ichaza kwingxelo ekhethekileyo enesihloko esithi "i-Alzheimer's Disease: Izibonelelo zezeMali kunye noBuqu bokuxilongwa kwangaphambili" kwi-2018 yayo "i-Alzheimer's Disease Figures and Facts" -kuquka izibonelelo zonyango, ezemali, ezentlalo kunye nezeemvakalelo sikholelwa ukuba i-United States Preventative I-Service Task Force inokuhlaziya izindululo zabo kwikamva elingekude ukuze kujongwe abantu abangaphezulu kweminyaka ethile ngaphandle kweempawu zeAD.
Inkumbulo ye-Episodic yeyokuqala umsebenzi wokuqonda ochatshazelwa sisifo sika-Alzheimer kunye nokubhaqwa kwangethuba kwesifo sika-Alzheimer kuthintelwa kukunqongophala kwesixhobo esiluncedo, esiphindaphindwayo, esithembekileyo, esifutshane, nesiyolisayo esibonelela ngomkhondo ozenzekelayo wokuqhubela phambili ekuhambeni kwexesha kwaye kulula ukusilawula. Kukho imfuneko enkulu yezixhobo zovavanyo lwenkumbulo ye-episodic eziqinisekisiweyo nezifumaneka ngokubanzi ukuba zisetyenziswe ikhaya nakwiofisi kagqirha ukuze kujongwe kwaye kubhaqwe kwangethuba isifo sengqondo esixhalabisayo kunye nesifo sika-Alzheimer. Nangona kuye kwenziwa inkqubela phambili kusetyenziswa igazi kunye ne-cerebrospinal fluid biomarkers, uvavanyo lwemfuzo yemfuza yomngcipheko, kunye nokucinga kwengqondo (kubandakanya i-MRI kunye ne-positron-emission tomography) ukulungiselela kwangaphambili ukufunyanwa kwangoko kwe-Alzheimer's isifo, amanyathelo noncognitive ezinjalo kuphela enxulumene kude Alzheimer isifo pathology. Akukho siphawuli singqongqo se-biochemical ngoku esibonisa naluphi na utshintsho lobuchopho ngokusondeleyo kumba osisiseko wesifo sika-Alzheimer, ngakumbi utshintsho kunye ukulahleka komsebenzi we-synaptic onxulumene nokufakwa kwekhowudi yolwazi olutsha kwimemori ye-episodic. Ukucinga ngengqondo ibonisa ilahleko ye-synapse, ebonakala njengelahleko yemetabolism yasekhaya okanye ukwehla kokuhamba kwegazi, okanye iyancipha kwiimpawu ze-synaptic kwizigulana eziphilayo, kodwa ayibonakalisi ngokwaneleyo ukungasebenzi kwengqondo yokwenyani ebonisa ukuphambana kwesifo i-Alzheimer's. Ngelixa i APOE I-genotype ichaphazela iminyaka yobudala be-AD ukuqala kwangoko, Iimpawu ze-amyloid biomarkers zibonisa kuphela ukuchaphazeleka kwi-dementia, kwaye i-tau inobudlelwane obuntsokothileyo kodwa obungacaciswanga kunye ne-dementia. Onke loo manyathelo kunzima ukuwafumana, kuyabiza, kwaye akanako ukuphindwa ngokulula okanye rhoqo. Iingxoxo ezineenkcukacha zezi zinto zinxulumene nesifo se-Alzheimer zininzi kuncwadi kwaye abafundi abanomdla banokuphonononga uphononongo oluninzi kunye neembekiselo kuzo.
Kukho iintlobo ezintathu Uvavanyo lwengqondo izixhobo zokuhlola isifo se-Alzheimer: (1) izixhobo ezilawulwa ngumboneleli wezempilo; (2) izixhobo ezizilawula ngokwazo; kunye (3) nezixhobo zokunika ingxelo. Olu phononongo luya kushwankathela ngokufutshane izixhobo ezikhoyo ngoku ezilawulwa ngumnikezeli wezempilo kunye nesimo sesixhobo sokuhlola esikwaziyo (1) ukufumanisa iinguqu zengqondo ezinxulumene ne-AD ngaphambi kokuba iimpawu ziqale kwaye (2) ukuvavanya ukuqhubela phambili kwesifo.
IZIXHOBO ZOKUHLOLA I-AD ULAWULWA NGUMBONI WEZEMPILO
Oku kulandelayo kufuneka kuthathelwe ingqalelo xa ukhetha i Ukuhlolwa kwesifo sika-Alzheimer isixhobo okanye izixhobo ezongezelelweyo:
- Iinjongo kunye nezicwangciso zephulo lokuhlola. Ngokomzekelo, kwiprogram enkulu yokuhlola isifo se-Alzheimer kwilizwe lonke, ukusebenzisa isixhobo esilula, esinamandla kunye nesisebenzayo kuya kukhethwa. Ngakolunye uhlangothi, kwimeko yeklinikhi, ukuchaneka kunye nokukwazi ukwahlula iintlobo ezahlukeneyo ze-dementia kuya kunqweneleka ngakumbi.
- Ukuqwalaselwa kweendleko, kubandakanywa iindleko zesixhobo kunye noqeqesho lwababoneleli bezempilo kunye nexesha lolawulo.
- Iingqwalasela ezisebenzayo, kubandakanywa nokwamkelwa kwesixhobo kwii-arhente ezilawulayo, oogqirha, izigulane; ukukhululeka kolawulo, amanqaku, kunye nokutolikwa kwamanqaku, kubandakanywa injongo yesixhobo (okt, impembelelo yengcali / ugqirha olawula uvavanyo kuzo zombini uvavanyo kunye namanqaku); ubude bexesha elifunekayo ukugqiba; kunye neemfuno zokusingqongileyo.
- Iingqwalasela zepropati yesixhobo, kubandakanywa: ubuntununtunu kwiminyaka yobudala, isini, imfundo, ulwimi, kunye nenkcubeko; iimpawu ze-psychometric, kubandakanywa uluhlu oluguqukayo; ukuchaneka nokuchaneka; ukunyaniseka kunye nokuthembeka, kubandakanywa ukuguquguquka (ukunciphisa utshintsho oluhambelana nokusetyenziswa kwesixhobo, umzekelo, abavavanyi abahlukeneyo kwiziphumo zovavanyo) kunye nokuqina (ukunciphisa ukuguquguquka kweziphumo zovavanyo ezinxulumene neendawo ezahlukeneyo kunye nokusingqongileyo); kunye neenkcukacha ezithile kunye novakalelo. Uburhabaxa kunye nokomelela zizinto ezibalulekileyo eziqwalaselwayo xa ukhetha isixhobo esiza kusisebenzisa kwiphulo elikhulu lesizwe lokuhlola isifo se-Alzheimer.
Isixhobo esifanelekileyo sokujongwa kwesifo se-Alzheimer siya kusebenza kwisini, ubudala, kunye novelwano utshintsho lwangaphambili lubonisa i-Alzheimer's isifo phambi kokubonakaliswa okucacileyo kweempawu zeklinikhi. Ngaphaya koko, isixhobo esilolu hlobo kufuneka sibe nolwimi-, imfundo-, kunye nenkcubeko-ingathathi hlangothi (okanye ubuncinane sitshintshelwe) kwaye sikwazi ukusetyenziswa kwihlabathi jikelele kunye neemfuno zokuqinisekiswa okunqamlezayo kwiinkcubeko ezahlukeneyo. Isixhobo esinjalo asifumaneki okwangoku nangona iinzame ziqalisiwe kweli cala ngophuhliso lwe Uvavanyo lwememori yeMemTrax inkqubo, ekuza kuxoxwa ngayo kwicandelo elilandelayo.
Oogqirha baqala ukuphuhlisa izixhobo zovavanyo lwengqondo ngeminyaka yoo-1930 kwaye inani elikhulu lezixhobo liye laphuhliswa kule minyaka idlulileyo. Ukuphononongwa okugqwesileyo kuye kwapapashwa kwinani lezixhobo-kubandakanya i-Mini-Mental State Examination, iMontreal Cognitive Assessment (MoCA), i-Mini-Cog, Ukukhubazeka kweMemori Isikrini (MIS), kunye ne-Brief Alzheimer Screen (BAS)-enokuthi isetyenziswe ekuhlolweni nasekufumaneni kwangaphambili isifo se-Alzheimer esilawulwa ngumboneleli wezempilo. Olunye lolona vavanyo luphuhliswe ngononophelo yiBAS, ethatha malunga nemizuzu emi-3. Ngasinye kwezi sixhobo sithatha umlinganiselo okhethekileyo kodwa osoloko udibana ngokweseti yemisebenzi yokuqonda. Kuqondwa kakuhle ukuba uvavanyo ngalunye luneempawu zalo ezizodwa kunye luncedo kwaye indibaniselwano yezixhobo ihlala isetyenziselwa ukwenza uvavanyo olupheleleyo kwimeko yeklinikhi. Qaphela, uninzi lwezi zixhobo zaqala ukuphuhliswa kulwimi lwesiNgesi kwimeko yenkcubeko yaseNtshona kwaye ke ngoko zifuna ukuqhelana nazo zombini. Kwangaphandle okuphawulekayo kubandakanya Inkumbulo kunye noHlolo oluLawulayo (MES), eyaphuhliswa ngesiTshayina, kunye noVavanyo lweMemory Alteration, olwaphuhliswa ngeSpanish.
itafile 1 uluhlu lwezixhobo eziqinisekisiweyo ezifanelekileyo kwi-Alzheimer's screening phantsi kwezicwangciso ezahlukeneyo kwaye zinconywe nguDe Roeck et al ngokusekelwe kuphononongo olucwangcisiweyo lwezifundo zeqela. Kwisikrini esibanzi sabantu bonke, i-MIS icetyiswa njengesixhobo sokuhlola esifutshane (<5 imizuzu) kunye ne-MoCA njengesixhobo sokuhlola ixesha elide (>10 imizuzu). Zombini ezi mvavanyo zaphuhliswa ngesiNgesi, kwaye i-MoCA ineenguqulelo ezininzi kunye neenguqulelo ngoko ke umahluko phakathi kweenguqulelo kufuneka uqwalaselwe. Kwimeko yeklinikhi yememori, i-MES iyacetyiswa ukongeza kwi-MIS kunye ne-MoCA ukwahlula ngcono phakathi Isifo sika-Alzheimer sohlobo lwe-dementia kunye nesifo sengqondo esixhalabisayo sodidi olungaphambili. Yi kubalulekile ukuqaphela ukuba iziphumo zovavanyo lokuhlola Ayiloxilongo kodwa linyathelo lokuqala elibalulekileyo ekubhaqweni ngokufanelekileyo kunye nonyango lweAD ngoogqirha. Itheyibhile 1. Izixhobo ezicetyiswayo zovavanyo lwesikrini se-Alzheimer's (AD) esicetyiswa nguDe Roeck et al.
| Ubude (imizuzu) | Imemori | ulwimi | NgezoBomi | Imisebenzi yolawulo | umkhuba | Izakhono zeVisuospatial | ingqalelo | Efanelekileyo | Ukuchaneka kwe-AD | Uvakalelo lweAD | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MIS | 4 | Y | Isikrini esisekwe kubemi | 97% | 86% | ||||||
| Ikliniki | 97% | NR | |||||||||
| MoCA | 10-15 | Y | Y | Y | Y | Y | Y | Y | Isikrini esisekwe kubemi | 82% | 97% |
| Ikliniki | 91% | 93% | |||||||||
| INYANGA | 7 | Y | Y | Ikliniki | 99% | 99% |
- AD, isifo sika-Alzheimer; I-MES, iMemori kunye nokuHlola okuLawulayo; I-MIS, i-Memory Impairment Screen; I-MoCA, i-Montreal Cognitive Assessment; NR, ayixelwanga; Y, umsebenzi obonisiweyo ulinganisiwe.
Ngokuqonda ukuba Isifo i-Alzheimer's sikhula ngokuqhubekayo ixesha elide elinokuthi libuyele emva kwamashumi amahlanu eminyaka ngaphambi kokubonakaliswa kwe-dementia epheleleyo., isixhobo esinokulinganisa ngokuphindaphindiweyo inkumbulo ye-episodic kunye neminye imisebenzi yokuqonda, enjengokuqwalasela, ukuphunyezwa, kunye nesantya sokuphendula, ubude kunye neemeko ezahlukeneyo (ikhaya ngokuchasene neziko lezempilo) kwihlabathi jikelele, lifuneka kakhulu.
IMEKO YANGOKU YEZIXHOBO ZOKUHLOLA I-AD EZINOKUZILAWULA
Umlinganiselo ochanekileyo we Isifo i-Alzheimer's ukusuka kwisigaba saso sangaphambili ukuya kwi-dementia ethambileyo iyimfuneko ekuchongeni isifo sika-Alzheimer kwangoko., kodwa isixhobo esomeleleyo asikachongwa ngale njongo. Njengoko isifo sika-Alzheimer sisininzi sisifo se-neuroplasticity, indawo esembindini umba uba sisixhobo okanye izixhobo ezinokuphanda ngokuchanekileyo isifo sika-Alzheimer utshintsho oluthile kuzo zonke izigaba zesifo sika-Alzheimer. Kukwabalulekile ukuba ukwazi ukulinganisa olu tshintsho kusetyenziswa iimetrics jikelele kubemi kodwa bebodwa umntu ngokuhamba kwexesha, ukubona intsebenziswano phakathi kwesifo sika-Alzheimer kunye nesequelae yokuguga okuqhelekileyo, kunye nokuvavanya ukuba isifundo silele phi na ekuqhubekekeni kwangoko. ukuhla kwengqondo ezinxulumene nesifo sika-Alzheimer xa kuthelekiswa nokuguga okuqhelekileyo. Eso sixhobo okanye izixhobo ziyakuqinisekisa ngokufanelekileyo ubhaliso olwaneleyo, ukuthotyelwa kwemigaqo, kunye nokugcinwa kwezifundo ezinokuthi zixhamle kungenelelo lonyango kunye nokwenza uyilo lonyango kunye novavanyo lokusebenza kwabo.
Uphononongo lweethiyori ezininzi zokuqonda kunye neendlela zovavanyo lwenkumbulo zichonge umsebenzi wokwamkelwa oqhubekayo (CRT) njengeparadigm enesiseko sethiyori esifanelekileyo sokuphuhlisa inkcazo. Isifo sika-Alzheimer sokuqala isixhobo sokulinganisa. Ii-CRT zisetyenziswe kakhulu kwiindawo zemfundo ukuze funda inkumbulo ye-episodic. Ukusebenzisa iCRT yekhompyutha kwi-intanethi, inkumbulo ye-episodic inokulinganiswa ngalo naliphi na ixesha, rhoqo kaninzi ngemini. I-CRT enjalo inokuchaneka ngokwaneleyo ukulinganisa utshintsho olufihlakeleyo oluhambelana nokuqala Isifo sika-Alzheimer kwaye sahlula olu tshintsho kwezinye iziphazamiso zemithambo-luvo kunye neziqhelekileyo utshintsho olunxulumene nobudala. Uvavanyo lwememori ye-MemTrax ephuhliswe kule njongo yenye ye-CRT ye-intanethi kwaye sele ikhona kwi-World Wide Web ukususela ngo-2005 (www.memtrax.com). I-MemTrax inobuso obuqinileyo- kunye nokwakha-ukusebenza. Imifanekiso yakhethwa njengezivuseleli ukwenzela ukuba iimpembelelo zolwimi, imfundo, kunye nenkcubeko zincitshiswe ukuze kube lula ukuziqhelanisa namazwe ahlukeneyo kwihlabathi jikelele, nto leyo engqineke injalo ngokuphunyezwa kwenguqulelo yesiTshayina eTshayina (www.memtrax). cn kunye nophuhliso mini WeChat inguqulelo yenkqubo ukulungiselela imikhwa yomsebenzisi eTshayina).
The Uvavanyo lwememori yeMemTrax lunikeza I-50 ye-stimuli (imifanekiso) kwizifundo eziyalelwe ukuba ziqwalasele i-stimulus nganye kwaye zibone ukuphindaphinda kwe-stimulus nganye ngempendulo enye eyenziwe ngokukhawuleza njengoko isifundo sinako. A Uvavanyo lwe-MemTrax luhlala ngaphantsi kwe-2.5-imizuzu kunye nemilinganiselo yokuchaneka kwememori yezinto ezifundiweyo (ezimelwe njengepesenti echanekileyo [PCT]) kunye nexesha lokuqaphela (ixesha lokuphendula eliqhelekileyo leempendulo ezichanekileyo [RGT]). Imilinganiselo ye-PCT ye-MemTrax ibonisa iziganeko ze-neurophysiological ezenzeka ngexesha le-encoding, ukugcinwa, kunye nezigaba zokubuyisela ezixhasa imemori ye-episodic. Imilinganiselo ye-MemTrax ye-RGT ibonisa ukusebenza kakuhle kwenkqubo yokubonwa kwengqondo kunye nothungelwano olubonwayo lokuqaphela ukuchonga i-stimuli ephindaphindiweyo, kunye ne-executive kunye neminye imisebenzi yokuqonda kunye nesantya semoto. Ingqondo inamanyathelo amaninzi okucubungula ulwazi olubonakalayo kunye nokulugcina kuthungelwano olusasazwe lwe-neurons. Isantya sokuqonda sibonisa ukuba lingakanani ixesha uthungelwano lobuchopho olufunayo ukuze lutshatise uvuselelo olusandul’ ukuboniswa kwaye luphumeze impendulo. Intsilelo esisiseko yesifo i-Alzheimer's kwasekuqaleni kukungaphumeleli kokusekwa kwe-encoding yenethiwekhi, ukuze ulwazi lugcinwe kancinci ngokwaneleyo ukuze lubonwe ngokuchanekileyo okanye ngokufanelekileyo.
Ngaphaya koko, iMemTrax ikwavavanya inhibition. Isifundo siyalelwe ukuba siphendule ngexesha lovavanyo kuphela xa kukho i-stimulus/signal ephindaphindiweyo. Ukuchaswa okuchanekileyo kuxa umbandela ongaphenduliyo kumfanekiso oboniswe okokuqala. Ngenxa yoko, umbandela kufuneka uthintele impembelelo yokusabela kumfanekiso omtsha, nto leyo enokuba ngumngeni ngakumbi emva kokuba kubonisiwe imifanekiso emibini okanye emithathu ephindaphindiweyo. Ngoko ke, iimpendulo zobuxoki ziyimbonakaliso yentsilelo kwiinkqubo zokuthintela ii-lobes zangaphambili, kwaye umzekelo onjalo wokusilela ubonakala kwizigulane ezine-frontotemporal dementia (i-Ashford, ukubonwa kweklinikhi).
I-MemTrax ngoku isetyenziswe ngabantu abangaphezu kwe-200,000 kumazwe amane: iFransi (HAPPYneuron, Inc.); iunited States (Impilo yeBongo I-Registry, inkokeli ekuqeshweni kwesifo se-Alzheimer kunye nezifundo ze-MCI, eNetherlands (iYunivesithi yaseWageningen); kunye neChina (SJN Biomed LTD). Idatha Ukuthelekisa iMemTrax kunye ne-MoCA kwizigulana ezisele zikhulile zaseNetherlands zibonisa ukuba iMemTrax inokuvavanya umsebenzi wokuqonda ukwahlula abantu abadala abaqhelekileyo kubantu abanobuthathaka. ukungasebenzi kakuhle kwengqondo. Ngaphaya koko, iMemTrax ibonakala yahlula iParkinsonian/Lewy isifo sengqondo esiyingozi emzimbeni (ixesha elincitshisiweyo lokuqaphela) ukusuka kwi-Alzheimer's type dementia ngokusekelwe kwixesha lokuqaphela, elinokuthi libe negalelo ekuchanekeni kokuxilonga. Uphononongo olupapashiweyo lwabonisa ukuba iMemTrax ingasetyenziselwa ukulandelela ukusebenza ngempumelelo kunyango olusebenzayo I-Alzheimer yokuqala izigulane zezifo.
Uphononongo olongezelelweyo luyafuneka ukumisela:
- Ukuchaneka kwe-MemTrax, ngokukodwa ekuhlukaniseni iziphumo eziqhelekileyo ezinxulumene nobudala kwi-cognition, kubandakanywa ukufunda nokukhumbula, ukusuka kwiinguqu ze-longitudinal ezinxulumene ne-AD yokuqala.
- Ubudlelwane obukhethekileyo beMemTrax metrics ukuya kuqhubekeko lwe Ukuqhubela phambili kwesifo sika-Alzheimer ukusuka kuphazamiseko olungephi lwengqondo ukuya kwidementia ephakathi. Njengoko i-MemTrax inokuphinda iphindwe rhoqo, le ndlela inokuthi ibonelele ngesiseko sokuqonda kwaye ingabonisa utshintsho olufanelekileyo lweklinikhi ngokuhamba kwexesha.
- Ingaba i-MemTrax inokulinganisa ukuhla kwengqondo yesifundo (SCD). Okwangoku, akukho zixhobo zovavanyo lwenjongo ezinokubhaqa i-SCD. Iipropathi ezizodwa ze-MemTrax zifuna uphononongo olunzulu malunga nokusetyenziswa kwayo ekuchongeni i-SCD kwaye uphononongo olunye lusaqhubeka e-China kulo mba.
- Ubungakanani apho Uvavanyo lweMemTrax iyakwazi ukuqikelela utshintsho lwexesha elizayo kwizigulane ze-Alzheimer's isifo ngokwaso kwaye ngokubambisana nezinye iimvavanyo kunye ne-biomarkers.
- Uncedo lwe I-MemTrax kunye neemetrics ezivela kwimilinganiselo ye-MemTrax yodwa okanye ngokubambisana nezinye iimvavanyo kunye ne-biomarkers njenge-Alzheimer's ukuxilongwa kwezifo kwiklinikhi.
IMIQATHANGO YOKUGQIBELA
Ukwamkelwa kwezonyango kunye noluntu, kufuneka kubekho uhlalutyo "lokufaneleka kweendleko" ukumisela inzuzo yovavanyo lokufumanisa isifo se-Alzheimer kwangethuba kunye nezixhobo zokubhaqa kwangoko. Xa uvavanyo lwesifo i-Alzheimer kufuneka luqale ngumba obalulekileyo ofuna ukuqwalaselwa kwixesha elizayo. Oku kumiselwa kuxhomekeke kakhulu kwindlela ekwangoko ngaphambi kokuba kuqale kweempawu intsilelo enxulumene nempilo inokubonwa. Kukho izifundo ezibonisa ukuba eyokuqala Utshintsho olubonakalayo lwengqondo olunxulumene nokukhula kwengqondo kwenzeka kwiminyaka eyi-10 ngaphambi kokuqala kweempawu ezinokufunyaniswa kliniki. Izifundo ze-Neurofibrillary kwi-autopsy zilandelela isifo sika-Alzheimer sibuyela emva ukuya kutsho kwiminyaka emalunga nama-50 kwaye inokwandiswa nasekufikiseni. Akukaqinisekwa ukuba ngaba olu tshintsho lwangaphambili lunokuguqulelwa kwiziphawuli ezinokubonwa ukungasebenzi kakuhle kwengqondo. Ngokuqinisekileyo, izixhobo zangoku azinalo eli nqanaba lovakalelo. Umbuzo ke ngowokuba ingaba ikamva, linovakalelo kakhulu, Iimvavanyo ziyakwazi ukuchonga utshintsho lwangaphambili kakhulu kwengqondo umsebenzi onxulumene nesifo se-Alzheimer kunye neenkcukacha ezaneleyo. Ngokuchaneka kweMemTrax, ngakumbi ngovavanyo oluphindaphindiweyo oluphindaphindiweyo kwixesha elide, kunokwenzeka okokuqala ukulandelela imemori kunye utshintsho lwengqondo kubantu abasemngciphekweni kwisithuba seminyaka elishumi ngaphambi kokuphazamiseka kwengqondo okubonakalayo iphuhlisa. Idatha ngeentlobo ngeentlobo zezinto ze-epidemiological (umzekelo, ukutyeba, uxinzelelo lwegazi, ukuphazamiseka kwengqondo emva kokwenzakala, ukwenzakala kwengqondo) icebisa ukuba abanye abantu utyekele kukukhubazeka kwenkumbulo kunye/okanye ekuphuhliseni isifo sengqondo esiyingozi kunye nesifo i-Alzheimer's kwiminyaka engamashumi amane okanye ngaphambili. Aba bemi bandile e Umngcipheko ubonisa isidingo esicacileyo sokuchonga kunye nokumisela iimpawu zokuqala zengqondo ze-neurodegeneration yokuqala kunye nesifo se-Alzheimer. ngezixhobo ezifanelekileyo zokuhlola.
AMAKHODI
Ababhali babulela uMelissa Zhou ngokugxeka kwakhe ukufundwa kwenqaku.
IZIXHOBO ZOKUTHENGA
I-XZ ithathe inxaxheba ekucingeni uphononongo kwaye iyilwe umbhalo-ngqangi; I-JWA ithathe inxaxheba ekuboneleleni ngeziqulatho ezinxulumene ne-MemTrax kunye nokuhlaziya umbhalo-ngqangi.