Intuthuko kumathuluzi okuhlola isifo i-Alzheimer's
- I-PMID: 31942517
- I-PMCID: I-PMC6880670
- I-DOI: 10.1002/agm2.12069
abstract
Ngesisekelo sayo esiyisisekelo, Isifo i-Alzheimer (AD) inqubo ye-pathological ethinta i-neuroplasticity, okuholela ekuphazamisekeni okuthile kwenkumbulo ye-episodic. Lokhu kubuyekezwa kuzohlinzeka ngesizathu sezingcingo zokuhlola ukutholwa kusenesikhathi kwesifo i-Alzheimer's, kubuyekeze amathuluzi okuqonda atholakalayo njengamanje okutholwa kwesifo i-Alzheimer's, futhi kugxile ekuthuthukisweni kwe-MemTrax. inkumbulo test online, okunikeza indlela entsha yokuthola ukubonakaliswa kokuqala nokuqhubeka kokuwohloka komqondo okuhlobene nesifo i-Alzheimer's. I-MemTrax ihlola amamethrikhi abonisa imiphumela yezinqubo ze-neuroplastic ekufundeni, kwinkumbulo, nasekuqondeni, okuthintwa iminyaka yobudala kanye Isifo i-Alzheimer, ikakhulukazi imisebenzi yenkumbulo yesiqephu, engakwazi okwamanje ukukalwa ngokunemba okwanele ukuze isetshenziswe ngendlela enenjongo. Ukuthuthukiswa okuqhubekayo kwe-MemTrax kungaba wusizo olukhulu ku- ukutholwa kusenesikhathi kwesifo i-Alzheimer's futhi izohlinzeka ukwesekwa kokuhlolwa kokungenelela kusenesikhathi.
ISINGENISO
Isifo i-Alzheimer (AD) yisifo esicashile, esiqhubekayo, futhi esingenakulungiseka se-neurodegenerative okwamanje esibhekwa njengesiqala ukuthinta ubuchopho eminyakeni engaba ngu-50 ngaphambi kokuvela kwesifo esigcwele (Braak stage V). Njengomholi imbangela yokuwohloka komqondo, ebalelwa ku-60-70% wazo zonke izimo zokuwohloka komqondo, i-AD ithinta abantu baseMelika abangaba ngu-5.7 kanye nabantu abangaphezu kwezigidi ezingu-30 emhlabeni wonke. Ngokusho kwe "World Umbiko we-Alzheimer 2018,” kukhona icala elisha lokuwohloka komqondo ithuthukiswe njalo ngemizuzwana emi-3 emhlabeni wonke kanti ama-66% eziguli eziwohlokayo ahlala emazweni anemali engenayo ephansi naphakathi.
Isifo i-Alzheimer's yisona kuphela isifo esikhulu esingenazo izindlela ezisebenzayo zokwelapha, zokuhlehlisa, zokubopha, noma zehlise ijubane ukuqhubeka kwesifo uma izimpawu seziqalile. Naphezu kwentuthuko eyenziwe ku ukuqonda i-pathophysiology eyisisekelo yesifo i-Alzheimer's, ukwelashwa kwalesi sifo kuye kwathuthuka kancane kusukela i-AD yabikwa okokuqala ngu-Alois Alzheimer ngo-1906. Ukuphathwa Kwezokudla Nezidakamizwa e-US ukwelashwa kwe-AD, okuhlanganisa ama-inhibitors amane e-cholinesterase-tetrahydroaminoacridine (i-Tacrine, eyakhishwa emakethe ngenxa yezinkinga zobuthi), i-donepezil (i-Aricept), i-rivastigmine (i-Exelon), ne-galantamine (i-Razadyne) -imodulator eyodwa ye-NMDA receptor (memantine [Namenda] ]), kanye nenhlanganisela ye-memantine ne-donepezil (Namzaric). Lawa ma-ejenti abonise amakhono anesizotha kuphela okushintsha imiphumela Isifo i-Alzheimer's ekufundeni, inkumbulo, nokuqonda isikhathi esifushane uma kuqhathaniswa, kodwa azizange zibonise imiphumela ephawulekayo ekuqhubekeleni phambili kwesifo. Ngenkambo yesifo esiyisilinganiso seminyaka eyi-8-12 kanye neminyaka yokugcina edinga ukunakekelwa ubusuku nemini, inani elilinganiselwe lezindleko zomhlaba wonke zokuwohloka komqondo ngo-2018 lalingama-US $ 1 trillion futhi lokhu kuzokhuphukela ku-US $ 2 trillion ngo-2030. Lezi zindleko ezilinganisiwe okukholakala ukuthi kubukelwa phansi uma kubhekwa ubunzima ekuhloleni ukusabalala kokuwohloka komqondo kanye nezindleko. Isibonelo, u-Jia et al walinganisela ukuthi izindleko zesifo i-Alzheimer's e-China zaziphakeme kakhulu kunalezo zibalo ezisetshenziswe ku-"World Alzheimer Report 2015" esekelwe ku-Wang et al.
Ithuthukiswe ngokuqhubekayo, i-AD iqala ngesigaba sokuqala esingenazimpawu zomtholampilo futhi iqhubeke nesigaba sokuqala nge ukukhubazeka kwengqondo okuncane (MCI; noma i-prodromal AD) ethinta ikhono lokugcina ulwazi olusha kunkumbulo yesiqephu kanye nokulahlekelwa okuqhubekayo kwezinkumbulo ezindala ngaphambi kokuholela ekugcineni ekuwohlokeni komqondo okubonakala ngokugcwele.
INZUZO YOKUTHOLAKALA NGOKUSHESHA KWE-AD
Njengamanje, ukuxilongwa okuqondile kwe-AD kusancika ekuhlolweni kwe-postmortem pathological, nakuba nalokhu kuhlaziywa kungase kube inkimbinkimbi. Nakuba kuye kwenziwa inqubekelaphambili ebalulekile kuma-biomarker e-AD, ukuhlonzwa komtholampilo kwe-AD kusewuhlelo lokuqeda ezinye izimbangela zokuwohloka komqondo. Kulinganiselwa ukuthi cishe u-50% weziguli ze-AD azikho baxilongwa ngesikhathi besaphila emazweni athuthukile kanye nesifo i-Alzheimer's iziguli emazweni anemali engenayo ephansi naphakathi cishe azitholakali.
Ukugcizelelwa kokutholwa kusenesikhathi ngokungenelela kwangaphambi kwesikhathi okwalandela kuye kwazuza ukwanda njengenkambo engcono kakhulu yokulwa ne-AD. Imizamo emikhulu yenziwe mayelana nokuhlonzwa okusebenzayo izinyathelo zokuvimbela ezingase zehlise izehlakalo zokuwohloka komqondo kanye nesifo i-Alzheimer's. Ucwaningo olulandela isikhathi eside luye lwabonisa, isibonelo, ukuthi ukunamathela ku-Mediterranean-Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) yokudla kwaba. okuhlotshaniswa nokwehliswa kwama-53% ekukhuleni kwe-AD kanye nokuthi imisebenzi yomzimba neyengqondo ye-midlife ihlotshaniswa nokwehla okukhulu kokuwohloka komqondo. ukuthuthukiswa nge-caveat ukuthi lezi zinhlobo zezifundo okunzima ukuzilawula.
Nakuba ukuhlolelwa ukuwohloka komqondo kubantu abangenazimpawu akuzange kunconywe yi-United States Preventative Services Task Force ngokusekelwe ebufakazini obutholakala ngaphambi kokuphela kuka-2012, ukuhlolwa kubantu abanezimpawu futhi abasengozini enkulu yokugula. Isifo i-Alzheimer's sibalulekile ekutholakaleni kusenesikhathi kanye nokuxilongwa kwesifo i-Alzheimer's, futhi kubaluleke kakhulu ekulungiseleleni iziguli namalungu omndeni ukubikezelwa kwalesi sifo esikhathini esizayo. Ngaphezu kwalokho, kunikezwe ubufakazi obusha bezinyathelo zokuvimbela ezingase zibe yimpumelelo kanye nezinzuzo zangaphambi kwesikhathi ukuxilongwa kwesifo i-Alzheimer's ukuthi i-Alzheimer's Association iveza embikweni okhethekile onesihloko esithi “I-Alzheimer’s Disease: Izinzuzo Zezezimali Nezomuntu Zokuxilonga Kwasekuqaleni” ku-2018 yayo ethi “Alzheimer’s Disease Figures and Facts”—kuhlanganise nezinzuzo zezokwelapha, ezezimali, ezenhlalo, nezomzwelo sikholelwa ukuthi i-United States Preventative I-Service Task Force ingase ibuyekeze isincomo sabo esikhathini esizayo esiseduze ukuze ivune ukuhlolwa kwabantu abangaphezu kweminyaka ethile ngaphandle kwezimpawu ze-AD.
Inkumbulo ye-Episodic ingeyokuqala umsebenzi womqondo othintwa isifo i-Alzheimer's kanye nokutholwa kusenesikhathi kwesifo i-Alzheimer's kuthikamezwa ukuntuleka kwethuluzi elikahle, eliphindaphindwayo, elithembekile, elifushane, nelijabulisayo elihlinzeka ngokulandela umkhondo ngokuzenzakalelayo kokuqhubeka kwesikhathi futhi kulula ukulisebenzisa. Kunesidingo esikhulu samathuluzi okuhlola inkumbulo ye-episodic aqinisekisiwe futhi atholakala kabanzi ukuze asetshenziswe ikhaya kanye nasehhovisi likadokotela ukuze kuhlolwe futhi kutholakale kusenesikhathi ukuwohloka komqondo kanye nesifo i-Alzheimer's. Nakuba inqubekelaphambili yenziwe kusetshenziswa igazi kanye nezimpawu ze-cerebrospinal fluid, ukuhlolwa kofuzo kwezakhi zofuzo eziyingozi, ne-imaging yobuchopho (okuhlanganisa i-MRI kanye ne-positron-emission tomography) ukuze kubikezelwe futhi ukutholwa kusenesikhathi kwe-Alzheimer's Izifo, lezi zinyathelo zokungaziqondi zihlobene kuphela ne-Alzheimer's pathology. Alukho uphawu oluqinile lwamakhemikhali ezinto eziphilayo okwamanje olubonisa noma yiziphi izinguquko zobuchopho ezihlobene eduze nesici esibalulekile sesifo i-Alzheimer's, ikakhulukazi ushintsho kanye ukulahleka komsebenzi we-synaptic okuhlobene nokufakwa kwekhodi kolwazi olusha lwenkumbulo ye-episodic. Izingqondo zobuchopho ibonisa ukulahleka kwe-synapse, okubonakala njengokulahleka kwendawo kokusebenza komzimba noma ukuncipha kokugeleza kwegazi, noma ukuncipha komaka be-synaptic ezigulini eziphilayo, kodwa akubonisi ngokwanele ukukhubazeka kwangempela kwengqondo okubonisa ukuwohloka komqondo kwesifo i-Alzheimer's. Ngenkathi i I-APOE i-genotype ithinta iminyaka yobudala ye-AD ukuqala kwasekuqaleni, izimpawu eziphilayo ze-amyloid zibonisa kuphela ukuthambekela kokuwohloka komqondo, futhi i-tau inobudlelwane obuyinkimbinkimbi kodwa obungaqondile nokuwohloka komqondo. Zonke lezi zinyathelo zinzima ukuzithola, zibiza, futhi azikwazi ukuphindwa kalula noma kaningi. Izingxoxo ezinemininingwane zalezi zici ezihlobene nesifo i-Alzheimer ziningi ezincwadini futhi abafundi abanentshisekelo bangahlola ukubuyekezwa okuningana kanye nezinkomba lapho.
Kunezinhlobo ezintathu ukuhlola kwengqondo amathuluzi okuhlolwa kwesifo i-Alzheimer's: (1) amathuluzi alawulwa umhlinzeki wezempilo; (2) izinsimbi ezisebenza ngokwazo; kanye (3) nezinsiza zokubika ngolwazi. Lokhu kubuyekezwa kuzofingqa kafushane amathuluzi atholakalayo njengamanje alawulwa ngumnikezeli wezempilo kanye nesimo sethuluzi lokuhlola elizilawulayo elinamandla (1) okuthola izinguquko zangaphambi kwesikhathi eziphathelene ne-AD ngaphambi kokuba izimpawu ziqale kanye (2) nokuhlola ukuqhubeka kwesifo.
IZITHUBA ZOKUHLOLA IZIKHANGISO ILAWULWA Umhlinzeki WEZEMPILO
Okulandelayo kufanele kucatshangelwe lapho ukhetha i Ukuhlolwa kwesifo i-Alzheimer's insimbi noma amathuluzi ahambisanayo:
- Izinjongo nezilungiselelo zomkhankaso wokuhlola. Isibonelo, ngohlelo olukhulu lukazwelonke lokuhlola isifo se-Alzheimer, kungakhethwa ukusebenzisa ithuluzi elilula, eliqinile, nelivumelekile. Ngakolunye uhlangothi, esimweni somtholampilo, ukunemba kanye nekhono lokuhlukanisa izinhlobo ezahlukene zokuwohloka komqondo kungafiseleka kakhulu.
- Ukucatshangelwa kwezindleko, okuhlanganisa izindleko zethuluzi kanye nokuqeqeshwa kwabahlinzeki bezempilo kanye nesikhathi sokuphatha.
- Ukucatshangelwa okusebenzayo, okuhlanganisa ukwamukelwa kwethuluzi kuma-ejensi alawulayo, odokotela, iziguli; ukuphatha kalula, ukushaya amaphuzu, nokuchazwa kwamaphuzu, okuhlanganisa ukucabangela kwethuluzi (okungukuthi, umthelela kachwepheshe/umtholampilo olawula ukuhlolwa kukho kokubili ukuhlolwa kanye nezikolo); ubude besikhathi esidingekayo ukuze kuqedwe; kanye nezidingo zemvelo.
- Ukucatshangelwa kwempahla yamathuluzi, okuhlanganisa: ukuzwela ubudala, ubulili, imfundo, ulimi, namasiko; izakhiwo ze-psychometric, kufaka phakathi ububanzi obuguquguqukayo; ukunemba nokunemba; ukufaneleka nokuthembeka, okuhlanganisa ukumangeleka (ukunciphisa izinguquko ezihlobene nokusetshenziswa kwethuluzi, isibonelo, kubahloli abahlukene emiphumeleni yokuhlolwa) nokuqina (ukunciphisa ukuhlukahluka kwemiphumela yokuhlola ehlobene nezindawo nezindawo ezihlukene); kanye nokucacisa nokuzwela. Ukuqina nokuqina kubaluleke kakhulu ukucatshangelwa lapho kukhethwa ithuluzi ozolisebenzisela umkhankaso omkhulu kazwelonke wokuhlolwa kwesifo i-Alzheimer's.
Ithuluzi elikahle lokuhlolwa kwesifo i-Alzheimer lizosebenza kubo bonke ubulili, ubudala, nokuzwela kulo izinguquko zakuqala eziphakamisa i-Alzheimer's isifo ngaphambi kokubonakaliswa okucacile kwezimpawu zomtholampilo. Ngaphezu kwalokho, ithuluzi elinjalo kufanele libe ngolimi-, imfundo-, kanye nesiko-maphakathi (noma okungenani livumelane nezimo) futhi likwazi ukusetshenziswa emhlabeni wonke ngezidingo ezimbalwa zokuqinisekisa okuphambene emasikweni ahlukene. Ithuluzi elinjalo alitholakali okwamanje nakuba imizamo isiqalisiwe ngale ndlela ngokuthuthukiswa kwe Ukuhlolwa kwememori ye-MemTrax uhlelo, okuzoxoxwa ngalo esigabeni esilandelayo.
Odokotela baqala ukwenza amathuluzi okuhlola okuqonda ngeminyaka yawo-1930 futhi inani elikhulu lamathuluzi lakhiwe eminyakeni edlule. Ukubuyekezwa okuhle kakhulu kushicilelwe ezintweni eziningi—okuhlanganisa iMini-Mental State Examination, iMontreal Cognitive Assessment (MoCA), iMini-Cog, Ukukhubazeka Kwenkumbulo Isikrini (MIS), kanye ne-Brief Alzheimer Screen (BAS)—engasetshenziswa ekuhloleni nasekuhlonzweni kusenesikhathi kwesifo i-Alzheimer’s esilawulwa umhlinzeki wezempilo. Esinye sezivivinyo zokuhlola ezithuthukiswe ngokucophelela yi-BAS, ethatha cishe imizuzu emi-3. Ngayinye yalezi zinsimbi ikala amasethi emisebenzi yokuqonda ehlukile kodwa evame ukugqagqana. Kuqashelwa kahle ukuthi ukuhlolwa ngakunye kunezici zakhona ezihlukile kanye nensizakalo futhi inhlanganisela yamathuluzi ivamise ukusetshenziselwa ukwenza ukuhlola okuphelele esimweni somtholampilo. Okuqaphelekayo, iningi lalawa mathuluzi aqala ukuthuthukiswa ngolimi lwesiNgisi esimweni samasiko aseNtshonalanga ngakho-ke adinga ukujwayelana nakho kokubili. Okuhlukile okuphawulekayo kufaka phakathi Imemori kanye nokuhlolwa kwe-Executive (MES), eyathuthukiswa ngesiShayina, kanye neMemory Alteration Test, eyathuthukiswa ngeSpanishi.
Ithebula 1 ibala amathuluzi aqinisekisiwe afanele ukuhlolwa kwesifo se-Alzheimer ngaphansi kwezilungiselelo ezihlukene futhi anconywe u-De Roeck et al ngokusekelwe ekubuyekezweni okuhlelekile kwezifundo zeqembu. Kusikrini esibanzi sabantu, i-MIS iyanconywa njengethuluzi lokuhlola elifushane (<5 amaminithi) kanye ne-MoCA njengethuluzi lokuhlola elide (>imizuzu eyi-10). Kokubili lokhu kuhlola kwasungulwa ngesiNgisi, futhi i-MoCA inezinguqulo eziningi nezinguqulo ngakho-ke umehluko phakathi kwezinguqulo udinga ukucatshangelwa. Esimeni somtholampilo wenkumbulo, i-MES iyanconywa ngaphezu kwe-MIS ne-MoCA ukuze kuhlukaniswe kangcono phakathi Uhlobo lwesifo i-Alzheimer's dementia kanye nohlobo lokuwohloka komqondo we-frontotemporal. Ikona kubalulekile ukuqaphela ukuthi imiphumela yokuhlolwa kokuhlolwa akusona ukuxilongwa kodwa isinyathelo sokuqala esibalulekile sokutholwa nokwelashwa okufanele kwe-AD ngodokotela. Ithebula 1. Amathuluzi okuhlola anconyiwe esikrinini se-Alzheimer's (AD) esinconywe ngu-De Roeck et al.
| Isikhathi (iminithi) | Memory | Ulimi | UkuJayela | Imisebenzi Yokuphatha | Praxis | Amakhono we-Visuospatial | Attention | Kuyafaneleka | Ukucaciswa kwe-AD | Ukuzwela kwe-AD | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| I-MIS | 4 | Y | Isikrini esisekelwe kubantu | 97% | 86% | ||||||
| Umtholampilo | 97% | NR | |||||||||
| MoCA | 10-15 | Y | Y | Y | Y | Y | Y | Y | Isikrini esisekelwe kubantu | 82% | 97% |
| Umtholampilo | 91% | 93% | |||||||||
| MONTH | 7 | Y | Y | Umtholampilo | 99% | 99% |
- AD, isifo i-Alzheimer's; I-MES, iMemori kanye nokuhlolwa kwe-Executive; I-MIS, Isikrini Sokukhubazeka Kwenkumbulo; I-MoCA, i-Montreal Cognitive Assessment; I-NR, ayibikwanga; Y, umsebenzi obonisiwe ulinganisiwe.
Ngokuqaphela lokho Isifo i-Alzheimer's sikhula ngokuqhubekayo isikhathi eside esingahle sibuyele emuva eminyakeni engamashumi amahlanu ngaphambi kokubonakala kokuwohloka komqondo okugcwele., ithuluzi elingakala ngokuphindaphindiwe inkumbulo yesiqephu neminye imisebenzi yokuqonda kwengqondo, njengokunaka, ukwenza, nesivinini sokuphendula, ngobude nangokuqukethwe okuhlukile (ekhaya uma kuqhathaniswa nesikhungo sokunakekelwa kwezempilo) emhlabeni wonke, sidingeka kakhulu.
ISIMO SAMANJE SEMISEBENZI YOKUHLOLA ISIKHANGISO ENGAZIMISELA UQOBO
Isilinganiso esinembile se Isifo i-Alzheimer's kusukela esigabeni saso sangaphambi kokudlulela phambili ngokuya ekuwohlokeni komqondo omaphakathi kuyadingeka ukuze kubonwe isifo i-Alzheimer's kusenesikhathi., kodwa ithuluzi eliqinile alikaziwa le njongo. Njengoba isifo i-Alzheimer's siwukuphazamiseka kwe-neuroplasticity, okuphakathi Inkinga iba ukukhomba ithuluzi noma amathuluzi angaphenya ngokunembile isifo i-Alzheimer's izinguquko ezithile kuzo zonke izigaba zesifo i-Alzheimer's. Kubalulekile futhi ukwazi ukukala lezi zinguquko usebenzisa amamethrikhi emhlabeni wonke kubantu kodwa okuhlukile kumuntu ngokuhamba kwesikhathi, ukuthola ukuxhumana phakathi kwesifo i-Alzheimer kanye nemiphumela yokuguga okuvamile, kanye nokuhlola ukuthi isifundo silele kuphi ekuqhubekeni kwasekuqaleni. ukwehla kwengqondo okuhlotshaniswa nesifo i-Alzheimer's ngokuhlobene nokuguga okuvamile. Ithuluzi elinjalo noma amathuluzi azoqinisekisa ngokufanelekile ukubhaliswa okwanele, ukulandelwa kwephrothokholi, nokugcinwa kwezihloko ezingahle zizuze ekungeneni kwezokwelapha futhi zinike amandla ukuklanywa kokwelashwa nokuhlolwa kokusebenza kwazo.
Ukucutshungulwa kwemibono eminingana yokuqonda kanye nezindlela zokuhlola inkumbulo kuhlonze umsebenzi wokuqashelwa okuqhubekayo (CRT) njengepharadigm enesisekelo sethiyori esifanele sokuthuthukisa Isifo i-Alzheimer's ekuqaleni ithuluzi lokulinganisa. Ama-CRT asetshenziswe kakhulu kuzilungiselelo zemfundo ukuze funda inkumbulo ye-episodic. Ngokusebenzisa i-CRT ekhompuyutha ku-inthanethi, inkumbulo ye-episodic ingalinganiswa nganoma yisiphi isikhawu, kaningi izikhathi ezimbalwa ngosuku. I-CRT enjalo ingaba nenemba ngokwanele ukukala izinguquko ezicashile ezihlotshaniswa nangaphambi kwesikhathi Isifo i-Alzheimer's futhi uhlukanise lezi zinguquko kwezinye izinkinga zemizwa nezivamile izinguquko ezihlobene nobudala. Ukuhlolwa kwenkumbulo ye-MemTrax okwenzelwe le njongo kungenye ye-CRT eku-inthanethi futhi ibitholakala ku-World Wide Web kusukela ngo-2005 (www.memtrax.com). I-MemTrax inobuso obuqinile kanye nokufaneleka kokwakha. Izithombe zikhethwe njengezisusa ukuze kuncishiswe imithelela yolimi, imfundo, namasiko ukuze kujwayelwe kalula emazweni ahlukene emhlabeni jikelele, okubonakale kunjalo ngokuqaliswa kwenguqulo yesiShayina eShayina (www.memtrax.) cn kanye nokuthuthukiswa kwe-WeChat mini inguqulo yohlelo ukuze kuhlangatshezwane nemikhuba yabasebenzisi eChina).
The MemTrax inkumbulo test presents 50 izisusa (izithombe) ezifundweni eziyalelwe ukuthi zibheke isivuseleli ngasinye futhi zithole ukuphindaphinda kwesisusa ngasinye ngempendulo eyodwa ekhiqizwe ngokushesha ngangokunokwenzeka isihloko. A Ukuhlolwa kwe-MemTrax kuthatha ngaphansi kwemizuzu engu-2.5 futhi kukala ukunemba kwenkumbulo zezinto ezifundiwe (ezimelelwe njengephesenti elilungile [PCT]) kanye nesikhathi sokuqashelwa (isikhathi esimaphakathi sokuphendula sezimpendulo ezifanele [RGT]). Izinyathelo ze-MemTrax PCT zibonisa izehlakalo ze-neurophysiological ezenzeka phakathi nezigaba zombhalo wekhodi, ukugcinwa, kanye nokubuyisa ezisekela inkumbulo ye-episodic. Izinyathelo ze-MemTrax RGT zibonisa ukusebenza kahle kwesistimu yokubuka yobuchopho kanye namanethiwekhi okubona okubonwayo ukuze kutholakale izisusa eziphindaphindiwe eziyinkimbinkimbi, kanye nemisebenzi yokuphatha kanye neminye yokuqonda kanye nesivinini semoto. Ubuchopho bunezinyathelo ezimbalwa zokucubungula ulwazi olubukwayo nokulugcina kunethiwekhi esabalalisiwe yama-neurons. Isivinini sokubonwa sibonisa ukuthi singakanani isikhathi amanethiwekhi obuchopho asidingayo ukuze afane nesikhuthazo esisanda kwethulwa futhi akhiphe impendulo. Ukushoda okuyisisekelo kwesifo i-Alzheimer's ekuqaleni ukwehluleka ukusungulwa kombhalo wekhodi wenethiwekhi, ukuze ulwazi lugcinwe kancane ngokwanele ukuze lubonakale ngokunembile noma ngempumelelo.
Ngaphezu kwalokho, i-MemTrax ihlola nokuvinjelwa. Isihloko siyalwa ukuthi siphendule ngesikhathi sokuhlolwa kuphela lapho isikhuthazo/isignali ephindaphindiwe ikhona. Ukwenqatshwa okulungile yilapho ophathwayo engaphenduli esithombeni esikhonjiswa okokuqala. Ngakho-ke, isihloko kufanele sivimbele umfutho wokuphendula isithombe esisha, okungaba inselele ikakhulukazi ngemva kokuboniswa kwezithombe ezimbili noma ezintathu eziphindaphindiwe ezilandelanayo. Ngakho-ke, izimpendulo zamanga ziyinkomba yokushoda ezinhlelweni ezivimbelayo ze-lobes yangaphambili, futhi iphethini enjalo yokushoda ivela ezigulini ezinokuwohloka komqondo we-frontotemporal (Ashford, ukubhekwa komtholampilo).
I-MemTrax manje isisetshenziswe abantu abangaphezu kuka-200,000 emazweni amane: France (HAPPYneuron, Inc.); I-the united states (Brain Health Registry, umholi ekuqasheni isifo i-Alzheimer kanye nezifundo ze-MCI, e-Netherlands (University of Wageningen); kanye neChina (SJN Biomed LTD). Idatha ukuqhathanisa i-MemTrax ne-MoCA ezigulini esezikhulile ezivela eNetherlands kukhombisa ukuthi i-MemTrax ingahlola ukusebenza kwengqondo ehlukanisa abantu abadala abavamile kubantu abanobumnene. ukungasebenzi kahle komqondo. Ngaphezu kwalokho, i-MemTrax ibonakala ihlukanisa i-Parkinsonian/Lewy ukuwohloka komqondo komzimba (isikhathi esinensayo sokuqashelwa) kusukela ekuwohlokeni komqondo wohlobo lwesifo i-Alzheimer ngokususelwe esikhathini sokuqashelwa, okungase kube nomthelela ekunembeni kokuxilongwa okwengeziwe. Ucwaningo lwecala olushicilelwe luphinde lwaveza ukuthi iMemTrax ingasetshenziswa ukulandelela ukusebenza ngempumelelo kokungenelela kokwelapha okusebenzayo ekuqaleni kwe-Alzheimer's abagulayo.
Kudingeka olunye ucwaningo ukuze kunqunywe:
- Ukunemba kwe-MemTrax, ikakhulukazi ekuhlukaniseni imiphumela evamile ehlobene nobudala ekuqondeni, okuhlanganisa ukufunda kanye nenkumbulo, kusukela kuzinguquko ze-longitudinal ezihlobene ne-AD yokuqala.
- Ubudlelwano obuthile be-MemTrax metrics nokuqhubeka kwe Ukuqhubeka kwesifo i-Alzheimer's kusukela ekukhubazekeni kwengqondo kwangaphambi kwesikhathi kuya kokuwohloka komqondo okumaphakathi. Njengoba i-MemTrax ingaphinda iphindwe kaningi, le ndlela ingase inikeze isisekelo somqondo futhi ingabonisa izinguquko ezifanele ngokomtholampilo ngokuhamba kwesikhathi.
- Ukuthi i-MemTrax ingakwazi yini ukukala ukwehla komqondo wesifundo (SCD). Okwamanje, awekho amathuluzi okuhlola okuhlosiwe angathola i-SCD. Izakhiwo ezihlukile ze-MemTrax zidinga ucwaningo olunzulu mayelana nokusetshenziswa kwayo ukuthola i-SCD futhi ucwaningo olulodwa okwamanje lusaqhubeka eShayina mayelana nalokhu.
- Izinga i Ukuhlolwa kwe-MemTrax ingabikezela izinguquko zesikhathi esizayo ezigulini ze-Alzheimer's zizodwa futhi ngokuhlanganyela nezinye izivivinyo nama-biomarker.
- Isisetshenziswa se I-MemTrax namamethrikhi asuselwa kuzinyathelo ze-MemTrax iyodwa noma ngokuhlangana nezinye izivivinyo nama-biomarker njenge-Alzheimer's ukuxilongwa kwezifo emtholampilo.
IMISEBENZI YOKUGQIBELA
Ukuze kwamukelwe emitholampilo nasemphakathini, kufanele kube nokuhlaziywa “kokufaneleka kwezindleko” ukuze kutholwe inzuzo yokuhlola yokutholwa kwesifo i-Alzheimer kusenesikhathi kanye namathuluzi okubona kusenesikhathi. Uma ukuhlolelwa isifo i-Alzheimer kufanele kuqale wudaba olubalulekile oludinga ukucatshangelwa esikhathini esizayo. Lokhu kuzimisela kuncike kakhulu ekutheni kungasheshe kutholwe kanjani ukushoda okuhlobene nomtholampilo ngaphambi kokuqala kwezimpawu. Kukhona izifundo ezikhombisa ukuthi eyokuqala izinguquko eziqaphelekayo ezihambisana nokukhula kokuwohloka komqondo kwenzeka eminyakeni eyi-10 ngaphambi kokuqala kwezimpawu ezitholakala emtholampilo. Izifundo ze-Neurofibrillary ku-autopsy zilandelela isifo i-Alzheimer's emuva cishe eminyakeni engama-50 futhi zingadlulela nasebusheni. Kusazonqunywa ukuthi lezi zinguquko zangaphambi kwesikhathi zingahunyushelwa yini omaka be ukungasebenzi kahle kwengqondo. Impela, izinsimbi zamanje azinalo leli zinga lokuzwela. Umbuzo-ke uthi ingabe ikusasa, libucayi kakhulu, izivivinyo zingakhomba izinguquko zangaphambili kakhulu engqondweni umsebenzi ohlobene nesifo i-Alzheimer kanye nokucaciswa okwanele. Ngokunemba kwe-MemTrax, ikakhulukazi ngokuhlolwa okuningi okuphindaphindwa njalo esikhathini eside, kungenzeka okokuqala ngqa ukulandelela inkumbulo futhi izinguquko zengqondo kubantu abasengozini ngaphezu kweminyaka eyishumi ngaphambi kokukhubazeka okubonakala ngokomtholampilo iyathuthuka. Idatha yezici ezihlukahlukene ze-epidemiological (isb., ukukhuluphala, umfutho wegazi ophakeme, ukuphazamiseka kwengcindezi yangemva kwenhlekelele, ukulimala kwengqondo okubuhlungu) iphakamisa ukuthi abanye abantu kakade ethambekele ekukhubazekeni kwenkumbulo kanye/noma ekuthuthukiseni ukuwohloka komqondo kanye nesifo i-Alzheimer's eminyakeni engamashumi amane noma ngaphambili. Lezi zibalo zabantu ezisabalele e ubungozi bukhombisa isidingo esicacile sokukhomba nokunquma izimpawu zokuqala zokuqalwa kwe-neurodegeneration kanye nesifo i-Alzheimer's. ngezinsimbi zokuhlola ezifanele.
UKUBONGA
Ababhali babonga uMelissa Zhou ngokugxeka kwakhe ukufundwa kwesihloko.
IMIPHAKATHI YOKUXHUMANA
I-XZ ibambe iqhaza ekwenziweni kokubuyekezwa futhi yabhala umbhalo wesandla; I-JWA ibambe iqhaza ekuhlinzekeni okuqukethwe okuhlobene ne-MemTrax nasekubuyekezeni umbhalo wesandla.