Ukuhlolwa kwe-MemTrax Kuqhathaniswa Nesilinganiso Sokuhlola Ingqondo saseMontreal Sokukhubazeka Kwengqondo Okumaphakathi

Uhlobo lwesihloko: MemTrax Ucwaningo esihlokweni

Ababhali: van der Hoek, Marjanne D. | Nieuwenhuizen, Arie | Keijer, Jaap | Ashford, J. Wesson

Ukubambisana:  I-Stanford University, Stanford, CA, USA - Department of Psychiatry and Behavioral Sciences, Applied Research Centre Ukudla Nezobisi, Van Hall Larenstein University of Applied Sciences, Leeuwarden, Netherlands | I-Human and Animal Physiology, Wageningen University, Wageningen, Netherlands | Isikhungo Sokufunda Sezifo Ezihlobene Nempi Nokulimala, VA Palo Alto HCS, Palo Alto, CA, USA

I-DOI: 10.3233/JAD-181003

Ijenali: Ijenali ye Isifo Se-Alzheimer's, ivol. I-67, cha. I-3, iphe. 1045-1054, 2019

abstract

Ukukhubazeka kwengqondo kuyimbangela ehamba phambili yokungasebenzi kahle kwasebekhulile. Nini ukukhubazeka kwengqondo okuncane (MCI) kwenzeka kubantu asebekhulile, kuvame ukuba yisimo se-prodromal kuya ekuwohlokeni komqondo. I-Montreal Cognitive Assessment (MoCA) iyithuluzi elivame ukusetshenziswa ukuhlolela i-MCI. Nokho, lolu hlolo ludinga ukuphathwa kobuso nobuso futhi lwakhiwe imibuzo ehlukahlukene lapho izimpendulo zayo zengezwa ndawonye umhlaziyi ukuze anikeze amaphuzu incazelo yawo enembile ibilokhu impikiswano. Lolu cwaningo lwenzelwe ukuhlola ukusebenza kwekhompyutha ukuhlolwa kwememori (i-MemTrax), okuwukuguqulwa komsebenzi wokuqashelwa okuqhubekayo, maqondana ne-MoCA. Izinyathelo ezimbili zemiphumela zenziwe kusukela ku- Ukuhlolwa kwe-MemTrax: I-MemTraxspeed ne-MemTrax ilungile. Izifundo zaphathwa i-MoCA kanye ne Ukuhlolwa kwe-MemTrax. Ngokusekelwe emiphumeleni ye-MoCA, izihloko zahlukaniswa ngamaqembu amabili esimo sokuqonda: ukuqonda okuvamile (n = 45) kanye ne-MCI (n = 37). Amaphuzu e-MemTrax asho ukuthi abephansi kakhulu ku-MCI kuneqembu elivamile le-cognition. Zonke izinguquko zemiphumela ye-MemTrax zazihlotshaniswa kahle ne-MoCA. Izindlela ezimbili, computing isilinganiso Isikolo se-MemTrax nokuhlehla komugqa kusetshenziswe ukulinganisa amanani anqamule ohlolo lwe-MemTrax ukubona i-MCI. Lezi zindlela zibonise lokho kumphumela we-MemTraxijubane amaphuzu angaphansi kwebanga lika-0.87 - 91 s-1 kuyinkomba ye-MCI, kanye nomphumela we-MemTraxkulungile amaphuzu angaphansi kwebanga lama-85 – 90% yinkomba ye-MCI.

ISINGENISO

Inani labantu emhlabeni wonke, eliholwa iYurophu, iNyakatho Melika, neNyakatho ye-Asia liyaguga, okubangela ukwanda okusheshayo kwenani labantu asebekhulile. Ngokukhula kweminyaka, kunokuthuthuka okuqinisekisiwe, ukwanda okubonakalayo kokuthuthukiswa kokukhubazeka kwengqondo, ukuwohloka komqondo, kanye nokuwohloka komqondo. Isifo i-Alzheimer (AD), okuholela ekwandeni okukhulu kwenani labantu abanalezi zimo. Ukutholwa kusenesikhathi kanye nokuhlonzwa kokuphazamiseka kwengqondo kungathuthukisa ukunakekelwa kwesiguli, kwehlise izindleko zokunakekelwa kwezempilo, futhi kungasiza ekubambezeleni ukuqala kwezimpawu ezinzima kakhulu, ngaleyo ndlela kusize ekwehliseni umthwalo okhula ngokushesha wokuwohloka komqondo kanye ne-AD. Ngakho-ke, amathuluzi angcono ayadingeka ukuze kuqashwe ukusebenza kwengqondo kubantu asebekhulile.

Ukuze kwenziwe ukuhlolwa komtholampilo kwemisebenzi yengqondo neyokuziphatha yabantu asebekhulile, odokotela nabacwaningi baye basungula amakhulukhulu wamathuluzi okuhlola kanye namathuluzi okuhlola amafushane, futhi ukuhlola okuningana sekusebenziseke okufanayo. Elinye lamathuluzi asetshenziswa kaningi okuhlolwa komtholampilo kokukhubazeka okuncane kokuqonda (MCI) ezilungiselelweni zezemfundo Ukuhlolwa Kokuqonda Okuqondwayo kweMontreal (MoCA).

I-MoCA ihlola imisebenzi yengqondo eyisikhombisa: isiphathimandla, ukuqamba amagama, ukunaka, ulimi, ukukhipha, inkumbulo/ukukhumbula ukubambezeleka, kanye nesimo. Inkumbulo yesizinda/ukulibaziseka kokukhumbula kanye nokuma kwe-MoCA phambilini kukhonjwe njengezinto ezizwela kakhulu ekulimaleni kwengqondo kohlobo lwe-Alzheimer, okwaholela emcabangweni wokuthi ukubhala ngekhodi inkumbulo kwakuyisici esibalulekile esihlaselwe inqubo ye-neuropathological ye-AD. Ngakho-ke, ethuluzini lomtholampilo lokuhlolwa kokukhubazeka kwengqondo okuhlotshaniswa ne-AD, inkumbulo iyisici esiyinhloko sokucabanga okufanele icatshangelwe, kuyilapho okunye ukukhubazeka, okuhlanganisa i-aphasia, i-apraxia, i-agnosia, nokungasebenzi kahle kwe-executive, nakuba ngokuvamile kuphazanyiswa i-AD, kungase kuhlotshaniswe. ekungasebenzini kwezindlela zokucubungula inkumbulo ye-neuroplastic ezindaweni ezisekelayo ze-neocortical.

Nakuba i-MoCA isetshenziswa kabanzi ukuhlola i-MCI, ukuphathwa kwe-MoCA kwenziwa ubuso nobuso, okudla isikhathi futhi kudinga ukuhlangana nomtholampilo futhi ngenxa yalokho kudinga izindleko ezinkulu zokuphatha ngakunye. Ngesikhathi sokuhlola, isikhathi esidingekayo sokuphatha ukuhlolwa kwandisa ukunemba kokuhlola, ngakho ukuthuthukiswa kwesikhathi esizayo kufanele kucabangele lobu budlelwano ukuze kuthuthukiswe ukuhlola okusebenza kahle kakhulu.

Udaba olubalulekile kule ndawo imfuneko yokuhlolwa kwengqondo ngokuhamba kwesikhathi. Ukuhlolwa izinguquko ngokuhamba kwesikhathi kukhona kubalulekile ukuhlonza kanye nokunquma ukuqhubeka kokonakala, ukusebenza kahle kokwelashwa, kanye nokuhlolwa kokungenelela kocwaningo lokwelapha. Amathuluzi amaningi anjalo atholakalayo awafanele futhi awaklanyelwe amazinga aphezulu okunemba futhi awakwazi ukulawulwa kalula njalo. Isixazululo sokuthuthukisa ukuhlola kwengqondo kuye kwaphakanyiswa ukuthi kube ukwenza ikhompuyutha, kodwa imizamo eminingi enjalo iye yanikeza okungaphezu kokwenziwa ngekhompyutha kokuhlolwa kwe-neuropsychology okuvame ukusetshenziswa, futhi ayizange ithuthukiswe ukuze ibhekane ngokuqondile nezinkinga ezibucayi zokuhlola kwengqondo okudingekayo ukuze kuqondwe kusenesikhathi. ukuwohloka komqondo kanye nokuqhubeka kwayo. Ngakho-ke, amathuluzi amasha okuhlola okuqonda kufanele enziwe ikhompuyutha futhi asekelwe emthonjeni ongenamkhawulo wokuhlola okuqhathanisekayo, okungakhawulelwe ngolimi noma isiko, okunikeza amazinga okunemba, ukunemba, nokwethembeka okungathuthukiswa kancane kancane. Ukwengeza, ukuhlolwa okunjalo kufanele kube mnandi futhi kuhlanganyele, ukuze ukuhlolwa okuphindaphindiwe kuzobhekwa njengento enhle kunokuba isipiliyoni esinzima. Ukuhlola ku-inthanethi, ikakhulukazi, kunikeza amandla okufeza lesi sidingo, kuyilapho kunikeza ukuqoqwa okusheshayo nokuhlaziywa kwedatha, futhi kunikeza impendulo esheshayo kubantu ababambe iqhaza, odokotela, nabacwaningi.

Ucwaningo lwamanje lwaklanyelwe ukuhlola ukusetshenziswa kokujwayela ku-inthanethi kwepharadigm yokuqashelwa okuqhubekayo (CRT), ukuze kuhlolwe ukusebenza kwengqondo esixukwini sabantu abahlala emphakathini ababengahlonzwanga njengabanokuwohloka komqondo. I-paradigm ye-CRT isetshenziswa kabanzi kwezemfundo izifundo zenkumbulo izindlela. Indlela ye-CRT yaqala ukusetshenziswa njengethuluzi lokubonisa izethameli elihlinzeka ngedatha ngabantu abathile ababenentshisekelo kubo izinkinga zenkumbulo. Kamuva, lokhu kuhlolwa kwasetshenziswa ku-inthanethi yinkampani yaseFrance (HAPPYneuron, Inc.); yinkampani ezinze e-US, i-MemTrax, LLC (http://www.memtrax.com); ngoBrain Impilo Irejista eyenziwe nguDkt. Michael Weiner, UCSF, kanye nethimba lakhe ukusekela ukubuthwa kwezifundo zokukhubazeka kwengqondo; kanye nenkampani yaseShayina i-SJN Biomed, LTD). Lokhu kuhlolwa, kusukela ngoJuni 2018, kuthole idatha kubasebenzisi abangaphezu kuka-200,000, futhi kusesivivinyweni emazweni amaningana.

Ocwaningweni lwamanje, i-MemTrax (MTX), ukuhlolwa okusekelwe ku-CRT, yasetshenziswa ngokubambisana ne-MoCA kubantu asebekhulile abaphila ngokuzimela enyakatho yeNetherlands. Injongo yalolu cwaningo bekuwukunquma ubudlelwano phakathi kokusebenza kulokhu kuqaliswa kwe-CRT kanye ne-MoCA. Umbuzo wawuwukuthi ingabe i-MTX ingaba usizo yini ekulinganiseni imisebenzi yengqondo ehlolwe yi-MoCA, engabonisa ukusebenza komtholampilo okungaba khona.

IZIMPAHLA NEZINDLELA

Isifundo sabantu

Phakathi kuka-Okthoba 2015 noMeyi 2016, ucwaningo oluhlukene lwenziwa phakathi kwabadala abahlala emphakathini enyakatho ye-Netherlands. Izifundo (≥75y) zabuthwa ngokusatshalaliswa kwamaflaya nangesikhathi semihlangano yeqembu ehlelelwe abantu abadala. Izifundo okungenzeka zivakashelwe ekhaya ukuze kuhlolwe indlela yokunquma yokufakwa nokukhishwa ngaphambi kokuthi zibhaliswe kulolu cwaningo. Izifundo ezihlaselwe ukuwohloka komqondo (okubikiwe) noma ababenokubona kahle kakhulu noma ukuzwa okungaba nomthelela ekuphathweni kokuhlolwa kwengqondo abazange bavunyelwe ukubamba iqhaza kulolu cwaningo. Ngaphezu kwalokho, izifundo kwakudingeka zikwazi ukukhuluma futhi ziqonde ulimi lwesiDashi futhi zingafundile. Ucwaningo lwenziwe ngokwesimemezelo sase-Helsinki sango-1975 futhi bonke ababambiqhaza basayina isivumelwano. imvume enolwazi ifomu ngemva kokuthola incazelo eningiliziwe yocwaningo.

Inqubo yokufunda

Ngemva kokubhalisa ocwaningweni, kwasetshenziswa uhlu lwemibuzo olujwayelekile, olwaluhlanganisa imibuzo emayelana nezici zezibalo zabantu, njengeminyaka neminyaka yokufunda (kusukela esikoleni samabanga aphansi), umlando wezokwelapha, kanye nokuphuzwa kotshwala. Ngemva kokuphothulwa kohlu lwemibuzo, ukuhlolwa kwe-MoCA kanye ne-MTX kwenziwa ngokungahleliwe.

I-MemTrax - Research Medical Center

Njengezilokotho ze-MemTrax, LLC (Redwood City, CA, USA), izinguqulo zamahhala ezigcwele zokuhlolwa kwe-MTX zanikezwa. Kulokhu kuhlolwa, uchungechunge lwezithombe ezingu-50 luboniswa kufika kumasekhondi amathathu ngayinye. Lapho kuvela isithombe esiphindiwe ncamashi (25/50), izihloko zaziyalelwe ukuthi zisabele esithombeni esiphindaphindiwe ngokushesha ngangokunokwenzeka ngokucindezela ibha yesikhala (eyayiboniswa ngeteyipu enombala obomvu). Lapho isihloko siphendula isithombe, isithombe esilandelayo saboniswa ngokushesha. Ngemva kokuphothula ukuhlolwa, uhlelo lubonisa iphesenti lezimpendulo ezifanele (MTXkulungile) kanye nesilinganiso sesikhathi sokusabela kumasekhondi ezithombeni eziphindaphindiwe, okubonisa isikhathi esidingekayo ukuze ucindezele ibha yesikhala lapho ubona isithombe esiphindaphindiwe. Ukufanisa ubukhulu balezi zinyathelo ezimbili, isikhathi sokusabela siguqulelwe kusivinini sokuphendula (MTXijubane) ngokuhlukanisa u-1 ngesikhathi sokusabela (okungukuthi, 1/MTXisikhathi sokuphendula). Umlando wokuhlola wawo wonke amaphuzu e-MemTrax angawodwana kanye nokuba semthethweni kwawo kulondolozwe ngokuzenzakalelayo ku-inthanethi ku-akhawunti yokuhlola. Ukufaneleka kwazo zonke izivivinyo ezenziwe kwahlolwa, okudinga izimpendulo ezinhle ezingamanga ezingu-5 noma ezimbalwa, ukuqashelwa okuyi-10 noma ngaphezulu okulungile, kanye nesikhathi sokuqashelwa esimaphakathi phakathi kwamasekhondi angu-0.4 namasekhondi angu-2, futhi ukuhlola okuvumelekile kuphela kufakwe ekuhlaziyeni.

Ngaphambi kokuhlolwa kwangempela kwe-MTX, ukuhlolwa kwachazwa ngokuningiliziwe futhi ukuhlolwa kokusebenza kwanikezwa ezifundweni. Lokhu kwakuhlanganisa hhayi kuphela ukuhlolwa ngokwayo, kodwa futhi imiyalelo kanye namakhasi abale-phansi ukuvumela umhlanganyeli ukuthi ajwayele ukuhlelwa kwesayithi kanye nezenzo zokuqala ezidingekayo, ngaphambi kokuqala kokuhlolwa. Ukuze ugweme ukuphindaphinda kwezithombe phakathi nokuhlolwa kwangempela, izithombe ezingafakiwe ku-database ye-MemTrax zasetshenziselwa ukuhlolwa kokuzijwayeza.

Ukuhlolwa kwengqondo kweMontreal ithuluzi

Imvume itholwe ku-MoCA Institute & Clinique (Quebec, Canada) yokusebenzisa i-MoCA kulolu cwaningo. I-Dutch MoCA itholakala ngezinguqulo ezintathu, ezinikezwe ngokungahleliwe ezifundweni. Isikolo se-MoCA siyisamba sokusebenza esizindeni somqondo ngasinye esihloliwe futhi sinamaphuzu aphezulu angama-30. Njengokwezincomo ezisemthethweni, iphuzu elingeziwe lingeziwe uma umhlanganyeli enemfundo engu-≤12 (uma <amaphuzu angama-30). Iziqondiso zokuhlola ezisemthethweni zasetshenziswa njengesiqondiso phakathi nokuphathwa kokuhlolwa. Izivivinyo zenziwa abacwaningi abathathu abaqeqeshiwe futhi ukuphathwa kokuhlolwa okukodwa kuthathe cishe imizuzu eyi-10 kuye kweyi-15.

Ukuhlaziywa kwedatha ye-MemTrax

Ngokusekelwe emiphumeleni ye-MoCA, eyalungiselelwa imfundo, izifundo zihlukaniswe ngamaqembu amabili esimo sokuqonda: i-normal cognition (NC) ngokumelene nokukhubazeka kokucabanga okuncane (MCI). Isikolo se-MoCA esingama-23 sisetshenziswe njengesinqamuleli se-MCI (amaphuzu angu-22 nangaphansi ayebhekwa njenge-MCI), njengoba kwaboniswa ukuthi leli phuzu libonise ‘ukunemba okungcono kakhulu kokuxilonga kulo lonke uhla lwamapharamitha” uma kuqhathaniswa nenani elinconywe ekuqaleni 26 noma amanani angu-24 noma angu-25. Kukho konke ukuhlaziya, amaphuzu e-MoCA alungisiwe asetshenzisiwe njengoba lesi sikolo sisetshenziswa kuzilungiselelo zomtholampilo.

Ukuhlolwa kwe-MTX kunikeza imiphumela emibili, okuyi-MTXisikhathi sokuphendula, eyaguqulelwa ku-MTXijubane ngo-1/MTXisikhathi sokuphendula, kanye ne-MTXkulungile.

Ukuhlaziywa kwezibalo kwenziwe kusetshenziswa i-R (inguqulo 1.0.143, Ithimba le-Rstudio, 2016). Okujwayelekile kuhlolwe zonke iziguquko ngokuhlolwa kwe-Shapiro-Wilk. Okuguquguqukayo kwaso sonke isibalo socwaningo, kanye namaqembu e-NC kanye ne-MCI, kubikwe njengokuchezuka okulinganiselwe ± okujwayelekile (SD), uhla lwe-median ne-interquartile (IQR) noma njengenombolo namaphesenti. Ukuhlolwa kwesampula okuzimele kwe-T kanye nokuhlolwa kwe-Wilcoxon Sum Rank kokuhlukahluka okuqhubekayo nokuhlolwa kwe-Chi-squared yokuhlukahluka kwezigaba kwenziwa ukuze kuqhathaniswe izici zeqembu le-NC ne-MCI. Ukuhlolwa kwe-Kruskal-Wallis okungeyona ingxenye yepharamitha yasetshenziswa ukuze kutholwe ukuthi ingabe izinguqulo ezintathu ze-MoCA kanye nabalawuli abathathu bayithintile yini imiphumela ye-MoCA. Ukwengeza, ukuhlolwa kwe-T okuzimele noma ukuhlolwa kwe-Wilcoxon Sum Rank kwenziwa ukuze kutholwe ukuthi ukuhleleka kokuphathwa kwe-MoCA ne-MTX kube nomthelela emiphumeleni yokuhlolwa (isb., isikolo se-MoCA, i-MTXkulungile, kanye ne-MTXijubane). Lokhu kwenziwa ngokunquma ukuthi amaphuzu asho ahlukile yini ezifundweni ezithole kuqala i-MoCA bese kuba i-MemTrax noma abathole kuqala i-MTX bese kuba yi-MoCA.

Pearson ukuhlobana ukuhlolwa kubalwe ukuze kuhlolwe ubudlelwano phakathi kwe-MTX ne-MoCA naphakathi kokubili kwe-MemTrax imiphumela yokuhlolwa, isb, i-MTXspeed ne-MTXcorrect. Isibalo sesayizi yesampula esake sasetshenziswa sabonisa ukuthi ekuhlolweni kokulinganisa kwe-Pearson enomsila owodwa (amandla = 80 % , α = 0.05), ngokucatshangwa kosayizi womphumela ophakathi (r = 0.3), usayizi omncane wesampula we-n = 67 wawudingeka. Ukuhlolwa kokudidiyelwa kwe-Polyserial kubalwe ukuhlola ubudlelwano phakathi kwemiphumela yokuhlolwa kwe-MTX nezizinda ezihlukene ze-MoCA kusetshenziswa iphakheji yengqondo ku-R.

Isikolo esilinganayo se-MoCA samaphuzu e-MemTrax anikeziwe abalwe ngokubala isilinganiso samaphuzu e-MemTrax kumphumela ngamunye ongaba khona we-MoCA kanye nokuhlehliswa komugqa kwenziwa ukuze kulinganiswe izibalo ezihambisana nalezi zilinganiso. Ngaphezu kwalokho, ukuze kunqunywe amanani anqamule ohlolo lwe-MemTrax ye-MCI elinganiswa nge-MoCA, kanye nokuzwela okuhambisanayo namanani acacisiwe, ukuhlaziya kwe-Receiver Operator Characteristic (ROC) kwenziwa kusetshenziswa iphakheji ye-pROC ku-R. Non-parametric stratified bootstrapping (n = 2000) yasetshenziswa ukuze kuqhathaniswe indawo engaphansi kwamajika (AUCs) kanye nezikhawu zokuzethemba ezihambisanayo. Isilinganiso esilungile sokunqanyulwa sibalwa ngendlela ye-Youden, ekhulisa amaphozithivu eqiniso kuyilapho inciphisa amaphuzu angamanga.

Kukho konke ukuhlaziya kwezibalo, inani le-p elizinhlangothi ezimbili lika-<0.05 lithathwe njengomkhawulo wokubaluleka kwezibalo, ngaphandle kokuhlaziywa kokuhlola ubudlelwano phakathi kwe-MTX ne-MoCA (okungukuthi, ukuhlaziywa kokuhlobana kanye nokuhlehla komugqa okulula) lapho- inani elingu-p elisemaceleni elingu-<0.05 lithathwe njengelibalulekile.

I-MemTrax IMIPHUMELA

Tifundvo letifundvwa

Sezizonke izifundo eziyi-101 zifakiwe kulolu cwaningo. Idatha yabantu abangu-19 ayizange ifakwe ekuhlaziyweni, njengoba imiphumela yokuhlolwa ye-MemTrax evela ezifundweni ezingu-12 ayizange ilondolozwe uhlelo, izifundo ezingu-6 zazinemiphumela yokuhlolwa ye-MemTrax engavumelekile, futhi isifundo esisodwa sasinamaphuzu we-MoCA amaphuzu angu-8, okubonisa ukukhubazeka okukhulu kwengqondo umbandela wokukhishwa. Ngakho-ke, idatha evela ezifundweni ze-82 ifakiwe ekuhlaziyweni. Akukho mehluko obalulekile emiphumeleni yokuhlolwa ye-MoCA etholwe phakathi kwezinguqulo ezihlukene ze-MoCA naphakathi kwabalawuli. Ngaphezu kwalokho, i-oda lokulawulwa kokuhlolwa alibanga namphumela obalulekile kunoma imaphi amaphuzu okuhlola (MoCA, MTXijubane, MTXkulungile). Ngokusekelwe emiphumeleni yokuhlolwa ye-MoCA, izihloko zafakwa eqenjini le-NC noma le-MCI (isb, i-MoCA ≥ 23 noma i-MoCA <23, ngokulandelanayo). Izici zesihloko zengqikithi yenani locwaningo, kanye namaqembu e-NC kanye ne-MCI ethulwa kuThebula 1. Akukho mehluko omkhulu obekhona phakathi kwamaqembu, ngaphandle kwamaphuzu amaphakathi e-MoCA (25 (IQR: 23 – 26) uma kuqhathaniswa nama-21 (IQR: 19 – 22 ) amaphuzu, Z = -7.7, p <0.001).

Ithebula 1

Izici zezihloko

Isamba sabantu bokufunda (n = 82) I-NC (n = 45) I-MCI (n = 37) p
Iminyaka yobudala (y) I-83.5 ± 5.2 I-82.6 ± 4.9 I-84.7 ± 5.4 0.074
Owesifazane, Cha. (%) 55 (67) 27 (60) 28 (76) 0.133
Imfundo (y) I-10.0 (8.0 - 13.0) I-11.0 (8.0 - 14.0) I-10.0 (8.0 - 12.0) 0.216
Ukuphuza utshwala (# izingilazi/iviki) I-0 (0 - 4) I-0 (0 - 3) I-0 (0 - 5) 0.900
Isikolo se-MoCA (# amaphuzu) I-23 (21 - 25) I-25 (23 - 26) I-21 (19 - 22) na

Amanani avezwa ngokuthi ± sd, i-median (IQR) noma njengenombolo enamaphesenti.

Isimo somqondo silinganiswa yi-MemTrax

Isimo sokuqonda silinganiswa ngokuhlolwa kwe-MTX. Umfanekiso 1 ukhombisa imiphumela ye ukuhlolwa kwengqondo imiphumela yezifundo ze-NC kanye ne-MCI. Isilinganiso samaphuzu e-MTX (isb, i-MTXijubane kanye ne-MTXkulungile) ayehluke kakhulu phakathi kwamaqembu amabili. Izifundo ze-NC (0.916 ± 0.152 s-1) ibe nesivinini esikhulu sokusabela esisheshayo uma kuqhathaniswa nezihloko ze-MCI (0.816 ± 0.146 s-1); t(80) = 3.01, p = 0.003) (Fig. 1A). Ngaphezu kwalokho, izifundo ze-NC zibe namaphuzu angcono ku-MTXkulungile ukuhlukahluka kunezifundo ze-MCI (91.2 ± 5.0% uma kuqhathaniswa no-87.0 ± 7.7% ngokulandelana; tw (59) = 2.89, p = 0.005) (Fig. 1B).

I-Fig.1

Amabhokisi emiphumela yokuhlolwa kwe-MTX ye-NC kanye namaqembu e-MCI. A) MTXijubane umphumela wokuhlolwa kanye no-B) MTXkulungile umphumela wokuhlolwa. Kokubili okuguquguqukayo kwemiphumela yokuhlolwa kwe-MTX kuphansi kakhulu eqenjini le-MCI uma kuqhathaniswa ne-NC. Umbala ompunga okhanyayo ubonisa izifundo ze-NC, kanti umbala ompunga omnyama ubonisa izifundo ze-MCI.

ukuhlolwa kokuqonda kwe-Montreal, ukuhlolwa kwenkumbulo ku-inthanethi, ukuhlolwa kwengqondo, ukuhlolwa kobuchopho, isifo se-Alzheimers kanye nokuwohloka komqondo, i-MemTrax

Amabhokisi emiphumela yokuhlolwa kwe-MTX ye-NC kanye namaqembu e-MCI. A) Umphumela wokuhlolwa kwesivinini se-MTX kanye no-B) Umphumela wokuhlolwa olungile we-MTX. Kokubili okuguquguqukayo kwemiphumela yokuhlolwa kwe-MemTrax kuphansi kakhulu eqenjini le-MCI uma kuqhathaniswa ne-NC. Umbala ompunga okhanyayo ubonisa izifundo ze-NC, kanti umbala ompunga omnyama ubonisa izifundo ze-MCI.

Ukuxhumana phakathi kweMemTrax ne-MOCA

Ukuhlangana phakathi kwamaphuzu okuhlolwa kwe-MTX ne-MoCA kuboniswa ku-Fig. 2. Kokubili okuguquguqukayo kwe-MTX kwakuhlotshaniswa kahle ne-MoCA. I-MTXijubane futhi i-MoCA ibonise ukuhlobana okubalulekile kwe-r = 0.39 (p = 0.000), kanye nokuhlobana phakathi kwe-MTXkulungile futhi i-MoCA yayingu-r = 0.31 (p = 0.005). Kwakungekho ukuhlangana phakathi kwe-MTXijubane kanye ne-MTXkulungile.

I-Fig.2

Izinhlangano phakathi kwe-A) MTXijubane kanye ne-MoCA; B) MTXkulungile kanye ne-MoCA; C) MTXkulungile kanye ne-MTXijubane. Izihloko ze-NC ne-MCI zikhonjiswe ngamachashazi nonxantathu ngokulandelanayo. Ekhoneni elingezansi kwesokudla legrafu ngayinye inani elithi rho kanye ne-p elihambisanayo liboniswa ukuhlobana phakathi kwalokhu okuguquguqukayo okubili.

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Izinhlangano phakathi kwe-A) i-MTXspeed ne-MoCA; B) I-MTXcorrect ne-MoCA; C) I-MTXcorrect ne-MTXspeed. Izihloko ze-NC ne-MCI zikhonjiswe ngamachashazi nonxantathu ngokulandelanayo. Ekhoneni elingezansi kwesokudla legrafu ngayinye inani elithi rho kanye ne-p elihambisanayo liboniswa ukuhlobana phakathi kwalokhu okuguquguqukayo okubili.

Izinhlangano phakathi kwe-A) i-MTXspeed ne-MoCA; B) I-MTXcorrect ne-MoCA; C) I-MTXcorrect ne-MTXspeed. Izihloko ze-NC ne-MCI zikhonjiswe ngamachashazi nonxantathu ngokulandelanayo. Ekhoneni elingezansi kwesokudla legrafu ngayinye inani elithi rho kanye nenani elingu-p liboniswa lokuhlobana phakathi kwezinto ezimbili eziguquguqukayo.[/caption]

Ukuxhumana kwe-Polyserial kubalwe phakathi kwezikolo zokuhlola ze-MemTrax nezizinda ze-MoCA ukuze kunqunywe ukuhlotshaniswa kwesizinda ngasinye namamethrikhi e-MemTrax. Ukuhlobana kwe-polyserial kukhonjisiwe kuThebula 2. Izizinda eziningi ze-MoCA zazihlotshaniswa kakhulu ne-MTX.isivinini .  Isizinda esithi "abstraction" sibonise ukuhlobana okuphezulu kakhulu, nakuba kulinganiselwe, ne-MTXijubane (r = 0.35, p = 0.002). Izizinda "ukuqamba" kanye "nolimi" zibonise ukuhlangana okubalulekile okubuthakathaka kuya kokulinganisela ne-MTXijubane (r = 0.29, p = 0.026 kanye no-r = 0.27, p = 0.012, ngokulandelana). I-MTXkulungile ayizange ihlotshaniswe kakhulu nezizinda ze-MoCA, ngaphandle kokuxhumana okubuthakathaka nesizinda esithi “visuospatial” (r = 0.25, p = 0.021).

Ithebula 2

Ukuxhumana kwe-Polyserial kwemiphumela yokuhlolwa kwe-MTX ngezizinda ze-MoCA

I-MTXijubane I-MTXkulungile
r p r p
I-Visuospatial 0.22 0.046 0.25 0.021
Ukuqamba igama 0.29 0.026 0.24 0.063
Attention 0.24 0.046 0.09 0.477
Ulimi 0.27 0.012 0.160 0.165
Abstraction 0.35 0.002 0.211 0.079
Khumbula 0.15 0.159 0.143 0.163
UkuJayela 0.21 0.156 0.005 0.972

Qaphela: Ukuhlobana okubalulekile kukhonjiswe ngokugqamile.

Izikolo ze-MemTrax kanye namanani alinganiselwe wokunqamuka we-MCI

Ukuze kunqunywe amaphuzu ahambisanayo e-MemTrax ne-MoCA, amaphuzu e-MemTrax wesikolo ngasinye se-MoCA alinganisiwe futhi ukuhlehla komugqa kubalwe ukuze kubikezelwe ubudlelwano nezibalo ezihambisanayo. Imiphumela yokuhlehla komugqa ibonise ukuthi i-MTXijubane ichaze u-55% womehluko ku-MoCA (R2 = 0.55, p = 0.001). Ukushintsha kwe-MTXkulungile ichaze u-21% womehluko ku-MoCA (R2 = 0.21, p = 0.048). Ngokusekelwe ezilinganisweni zalobu budlelwano, izikolo ezilinganayo ze-MoCA zibalwe kumaphuzu e-MTX anikeziwe, aboniswa kuThebula 3. Ngokusekelwe kulezi zibalo, amanani ahambisanayo anqamule (isb, amaphuzu we-MoCA wamaphoyinti angu-23) we-MTX.ijubane kanye ne-MTXkulungile awu 0.87s-1 futhi 90%. Ngaphezu kwalokho, ukuhlehliswa komugqa okuningi kuzo zombili iziguquguquko ze-MemTrax kwenziwa, kodwa i-MTX eguquguqukayokulungile ayizange inikele kakhulu kumodeli ngakho-ke imiphumela ayiboniswa.

Ithebula 3

Kuphakanyiswe isikolo esilinganayo se-MoCA sezikolo ze-MemTrax ezinikeziwe

I-MoCA (amaphuzu) I-MTX efanayoijubane (s-1)a I-CI yokubikezela nge-MTXijubane (amaphuzu) I-MTX efanayokulungile (%)b I-CI yokubikezela nge-MTXkulungile (amaphuzu)
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

aIsibalo esisetshenzisiwe: 1.1 + 25.2 *MTXijubane; b Isibalo esisetshenzisiwe: -9.7 + 0.36 *MTXkulungile.

Ngaphezu kwalokho, amanani we-MTX cutoff kanye nokuzwela okuhambisanayo nokucaciswa kwanqunywa ngokuhlaziywa kwe-ROC. Amajika e-ROC ezinto eziguquguqukayo ze-MemTrax zethulwe ku-Fig. 3. Ama-AUC e-MTXijubane kanye ne-MTXkulungile kukhona, ngokulandelana, i-66.7 (CI: 54.9 - 78.4) kanye ne-66.4% (CI: 54.1 - 78.7). Ama-AUC wezinto eziguquguqukayo ze-MemTrax ezisetshenziselwa ukuhlola i-MCI esungulwe yi-MoCA ayengahlukanga kakhulu. Ithebula lesi-4 libonisa ukuzwela kanye nokucaciswa kwamaphoyinti ahlukene wokunqamuka wezinto eziguquguqukayo ze-MemTrax. Amaphuzu aphelele anqunyiwe, akhulise amaphozithi eqiniso ngenkathi enciphisa amaphuzu angamanga, we-MTXijubane kanye ne-MTXkulungile ibe 0.91s-1 (ukuzwela = 48.9% ukucaciswa = 78.4%) kanye ne-85% (ukuzwela = 43.2%; ukucaciswa = 93.3%), ngokulandelanayo.

I-Fig.3

Amajika e-ROC wemiphumela yokuhlolwa kwe-MTX ukuhlola i-MCI elinganiselwe yi-MoCA. Umugqa wamachashazi ubonisa i-MTXijubane kanye nomugqa oqinile we-MTXkulungile. Umugqa ompunga umele umugqa wereferensi ongu-0.5.

ukuhlolwa okuku-inthanethi kokuhlolwa kwezempilo kokulahlekelwa inkumbulo ongakwenza ekhaya ukubaluleka kokuhlolwa kwempilo yobuchopho

Amajika e-ROC wemiphumela yokuhlolwa kwe-MTX ukuhlola i-MCI elinganiselwe yi-MoCA. Ulayini onamachashazi ubonisa i-MTXspeed kanye nomugqa oqinile othi MTXcorrect. Umugqa ompunga umele umugqa wereferensi ongu-0.5.

Ithebula 4

I-MTXijubane kanye ne-MTXkulungile amaphuzu anqunyiwe kanye nokucaciswa okuhambisanayo nokuzwela

Iphuzu lokunqamula Tp (#) tn (#) Fp (#) Fn (#) Ukucaciswa (%) Ukuzwela (%)
I-MTXijubane 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
I-MTXkulungile 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

i-tp, i-positive yangempela; tn, negative kweqiniso; fp, iphozithivu yamanga; fn, i-negative yamanga.

UKUKHULUMA

Lolu cwaningo lwasungulwa ukuze luphenye ithuluzi le-MemTrax eku-inthanethi, ukuhlolwa okusekelwe ku-CRT, kusetshenziswa i-MoCA njengereferensi. I-MoCA ikhethwe ngoba lolu hlolo okwamanje lusetshenziswa kabanzi ukuhlolela i-MCI. Kodwa-ke, izindawo zokusika ezifanele ze-MoCA azikacaciswanga kahle [28]. Ukuqhathaniswa kwezilinganiso zomuntu ngamunye ze-MemTrax ne-MoCA kubonisa ukuthi ukuhlola okulula, okufushane, okuku-inthanethi kungathatha ingxenye enkulu yomehluko ekusebenzeni kwengqondo kanye nokukhubazeka kwengqondo. Kulokhu kuhlaziywa, umphumela onamandla kakhulu ubonakale wesilinganiso sejubane. Isilinganiso sokunemba sibonise ubudlelwano obuqinile kancane. Ukuthola okubalulekile kwaba ukuthi akukho ukuhlobana okubonwe phakathi kwejubane le-MTX nezinyathelo zokulunga, okubonisa ukuthi lezi ziguquko zikala izingxenye ezihlukene zesisekelo. umsebenzi wokucubungula ubuchopho. Ngakho-ke, akukho nkomba yokuhweba ngokunemba kwejubane okutholwe kuzo zonke izifundo. Ngaphezu kwalokho, kusetshenziswe izindlela ezimbili ezihlukene ukulinganisa amanani e-cutoff ohlolo lwenkumbulo ye-MemTrax ukuze kutholwe i-MCI. Lezi zindlela zibonise ukuthi ngesivinini semiphumela nokunemba, amaphuzu angaphansi kobubanzi obuyi-0.87 – 91 s.-1 futhi ama-85 – 90% ayinkomba yokuthi abantu abathola amaphuzu angaphansi kwelilodwa lalawa mabanga maningi amathuba okuba babe ne-MCI. "Ukuhlaziywa kokufaneleka kwezindleko" kuzobonisa ukuthi kunini lapho umuntu okufanele elulekwe khona ukuthi abonane nodokotela mayelana nokwenza izivivinyo ezibanzi ukuze ahlole i-MCI [8-35].

Ocwaningweni lwamanje, kutholwe ukuthi izizinda “ukuqamba”, “ulimi”, kanye “nokungafinyeleli” okukalwe yi-MoCA kunokuhlobana okuphezulu kakhulu nomunye wemiphumela ye-MemTrax, nakuba ukuhlobana bekubuthakathaka ukuze kulinganiselwe. Lokhu kuphambene nalokho obekulindelekile, njengoba izifundo ezedlule zabonisa ekuhloleni Ukuhlolwa Kwesimo Sengqondo Esincane kusetshenziswa I-Item Response Theory, ukuthi izizinda "inkumbulo/inkumbulo ebambezelekile" kanye "nokuqondisa" bekuzwela kakhulu ekuqaleni kwe-AD [12]. Kulokhu ekuqaleni yokungasebenzi kahle kwengqondo, kubonakala sengathi izinkomba ze-MoCA zokukhubazeka okucashile ekuqanjweni kwamagama, ulimi, nokukhipha zizwela kakhulu ku-MCI kunezilinganiso zenkumbulo nokumayo, ngokuhambisana nokutholwe kwangaphambilini ku-Item Response Theory analysis of the MoCA [36]. Ngaphezu kwalokho, i- Isilinganiso se-MemTrax sesivinini sokubonwa sibonakala sibonisa lokhu konakala ngaphambi kwesikhathi ngaphambi kwenkumbulo yokubonwa njengoba kulinganiswa i-MTX (enomphumela obalulekile wophahla). Lo mlaza we imiphumela iphakamisa ukuthi izici eziyinkimbinkimbi ze-pathology ebangela i-MCI zibonisa ubuchopho bokuqala izinguquko obekunzima ukuzicabangela ngezindlela ezilula ze-neurocognitive futhi empeleni zingase zibonise ukuqhubeka kwe-neuropathology eyisisekelo [37].

Amaphuzu aqinile ocwaningweni lwamanje ukuthi usayizi wesampula (n = 82) wawungaphezu kokwanele ukuthola ukuhlobana phakathi kwe-MoCA ne-MTX kulesi sibalo esidala uma kuqhathaniswa. Ngaphezu kwalokho, ukuhlolwa kokuprakthiza kwenziwa kuzo zonke izifundo, ukuze abantu asebekhulile ababengajwayele ukusebenzisa ikhompyutha bathole ithuba lokujwayela indawo yokuhlola kanye nemishini. Uma kuqhathaniswa ne-MoCA, izifundo zibonise ukuthi i-MemTrax ibijabulisa kakhulu ukuyenza, kanti i-MoCA izwakale njengesivivinyo. Iminyaka yezifundo kanye nokuzimela komphakathi wazo kukhawulele ukugxila kokuhlaziywa kuleli qembu elikhethiwe labantu abasebenza kakhulu, kodwa leli qembu liphakathi kwalawo anzima kakhulu ekuhlonzeni ukonakala.

Okuqaphelekayo, nakuba kubhekwa njengokuhlolwa okujwayelekile kokuhlola, i-MoCA iyisivivinyo kuphela sokukhombisa ukuba khona okungenzeka kwe-MCI, hhayi ithuluzi lokuxilonga noma isilinganiso esiphelele sokungasebenzi kahle kwengqondo. Ngakho-ke, ngokufanelekile, ukuqhathaniswa kwe-MoCA ne-MTX kuyahlobene, futhi kungenzeka ukuthi kuthwebule ukwehluka okuzimele ekukhombeni kwe-MCI. Ngakho-ke, inkinga ebalulekile ezincwadini kube ngumzamo wokuchaza usizo lwe-MoCA [38], ukuqinisekiswa kwayo [39], ukusungulwa kwamaphuzu ajwayelekile [40], ukuqhathanisa nokunye ukuhlola okufushane kwengqondo [41-45] , kanye nokusetshenziswa kwayo njengethuluzi lokuhlola le-MCI [46] (ibuyekezwe uCarson et al., 2017 [28]), kanye nokusebenziseka kwenguqulo ye-elekthronikhi [47]. Ukuhlaziya okunjalo kuhilela ukuhlolwa kokuzwela nokucaciswa, ngokuvamile kusetshenziswa ukuhlaziywa kwe-ROC ngesilinganiso "sendawo engaphansi kwejika", kanye nezincomo zokunqanyulwa "kokuxilongwa". Kodwa-ke, uma ingekho indlela yokunquma ngokuphelele lapho umuntu elele khona ekuqhubekeni kokukhubazeka okuncane, kanye nokuhlukahluka okukhulu kwesisekelo. imisebenzi yobuchopho okunikela kulokho konakala, wonke amathuluzi anjalo anganikeza kuphela isilinganiso esingenzeka. Ukunikeza ukuhlobana phakathi kwezinyathelo ezihlukene kukhombisa kuphela ukuthi isimo esiyisisekelo sisingathwa ngendlela efanele, kodwa isimo sangempela sebhayoloji asikwazi ukuchazwa ngokunembile ngale ndlela. Nakuba ukuhlaziya kwezinga eliphezulu kungase kube usizo esimweni somtholampilo, ukusungulwa kwalolu hlelo kudinga ukucatshangelwa okwengeziwe kwezici ezine: ukusabalala kwesimo kubantu; izindleko zokuhlolwa, izindleko zemiphumela engelona iqiniso, kanye nenzuzo ebonakalayo yokuxilongwa kweqiniso kweqiniso [8, 35].

Okuyinhloko ingxenye yenkinga ekuhloleni i-AD kanye nokukhubazeka kwayo kwengqondo okuhlobene ukuthi akukho okwangempela "izigaba" [48], kodwa kunalokho ukuqhubeka kwesikhashana kokuqhubeka [8, 17, 49]. Umehluko "ojwayelekile" ku-MCI empeleni unzima kakhulu kunokuhlukanisa noma iyiphi yalezi zimo kwezincane. ukuwohloka komqondo okuhlobene ngo-AD [50, 51]. Kusetshenziswa umqondo wokuthi "Ithiyori Yokuhlola Yesimanje", inkinga iba ukunquma ukuthi kuphi lapho okuqhubekayo umuntu angase abe phakathi kwebanga elithile lesikhawu sokuzithemba, uma kubhekwa amaphuzu athile okuhlolwa. Ukuze wenze izinqumo ezinjalo, ukuhlola okunembe kakhudlwana kuyadingeka kunalokho okunikezwa ukuhlolwa okuningi okufushane kwengqondo, kodwa okuhlinzekwa yi-MTX. Ukunemba okwengeziwe nokususwa kokuchema kwezibukeli ngokuhlolwa kwekhompuyutha kuyisiqondiso esithembisayo. Futhi, ukuhlolwa kwekhompuyutha, njenge-MemTrax, kunikeza ithuba lenombolo engenamkhawulo yokuhlola okuqhathanisekayo, okunciphisa kakhulu ukuhluka kwesilinganiso sokonakala. Ngaphezu kwalokho, ngokomthetho, ukuhlolwa kwekhompuyutha kungahlola izizinda eziningi ezihlobene nenkumbulo ezithintwa i-AD. Lolu cwaningo aluzange luqhathanise i-MTX nezinye izivivinyo eziningi zekhompiyutha ezidaliwe (bheka isingeniso), kodwa azikho ezitholakalayo kuze kube manje ezisebenzisa indlela enamandla ehlinzekwa yi-CRT. Ukuthuthukiswa okuqhubekayo kokuhlolwa kwekhompuyutha kuyindawo ebalulekile ukuze kubhekwe nokusekelwa okwengeziwe. Ekugcineni, ukuqeqeshwa imiphumela zingafakwa ekuhlaziyeni.

Ngalesi sikhathi, ukuhlolwa kwe-inthanethi ngekhompyutha akuyona indlela emisiwe yoku isikrini sokuwohloka komqondo, hlola ukukhubazeka kwengqondo, noma wenze noma yikuphi ukuxilonga emtholampilo. Kodwa-ke, amandla namandla ale ndlela, ikakhulukazi ukusetshenziswa kwe-CRT, ukuhlola inkumbulo ye-episodic (yesikhashana), kukhulu futhi kungase kubaluleke kakhulu ekusetshenzisweni kwesikhathi esizayo kokuhlola kwengqondo, okuhlanganisa. ukuhlolwa kokuwohloka komqondo kanye nokuhlola, ukuqapha kokudideka kwangemva kokuhlinzwa, ukusungulwa kwamandla engqondo okwenza izinqumo, ukuthola ukushoda kwangemva kokungqubuzana, kanye nesilinganiso sokonakala okungaba khona ukuze uvikeleke ekushayeleni. Kulolu cwaningo, kuboniswa ukuthi i-MemTrax ingathwebula ingxenye enkulu yokuhluka kokukhubazeka kwengqondo. Ukwengeza, amanani anqamule ethulwa okuguquguqukayo kwe-MTX alingana nesikolo se-MoCA cutoff se-MCI. Ocwaningweni lwangomuso, kuphakanyiswa ukuthi kuphenywe ngezibalo ezinkulu, ezichazwe ngokucacile ukuze kusungulwe i-MemTrax njengethuluzi lokuhlola le-MCI. Isibalo esinjalo kufanele sifake amasampula omtholampilo lapho izinkinga zokuxilonga zingachazwa ngokunembile ngangokunokwenzeka futhi izihloko zingalandelwa ngokuhamba kwesikhathi nge-MTX nokunye ukuhlola kwengqondo. Ukuhlaziywa okunjalo kunganquma ukuhlukahluka emigudwini yokuncipha kwengqondo, okuhlobene kokubili ukuguga okuvamile kanye nezimo ezihlukahlukene ze-pathological. Njengoba ukuhlolwa kwekhompuyutha kanye nokubhaliswa kukhula, ulwazi olwengeziwe mayelana namazinga we impilo izotholakala futhi ngokungangabazeki izoholela ekuthuthukisweni okukhulu ekunakekelweni kwezempilo futhi ngethemba izindlela zokuvimbela izimo ezifana ne-AD.

Ukuvuma

Sithanda ukubonga u-Anne van der Heijden, u-Hanneke Rasing, u-Esther Sinnema, no-Melinda Lodders ngomsebenzi wabo kulolu cwaningo. Ngaphezu kwalokho, sithanda ukubonga i-MemTrax, LLC ngokunikeza izinguqulo zamahhala ezigcwele zokuhlolwa kwe-MemTrax. Lo msebenzi uyingxenye yohlelo locwaningo, oluxhaswe ngezimali yiSifundazwe saseFryslân (01120657), Netherlands kanye ne-Alfasigma Nederland BV (umnikelo oqondile enombolweni yesibonelelo 01120657). Kushicilelwe: 12 February 2019

IZINDAWO ZOLWAZI

[1] Jorm AF, Jolley D (1998) Izehlakalo zokuwohloka komqondo: i-meta-analysis. I-Neurology 51, 728-733.
[2] Hebert LE , Weuve. J , Scherr PA , Evans DA (2013) Isifo i-Alzheimer e-United States (2010-2050) kulinganiselwa kusetshenziswa ukubalwa kwabantu kuka-2010. I-Neurology 80, 1778-1783.
[3] Weuve. J , Hebert LE , Scherr PA , Evans DA (2015) Ukusabalala kwe Isifo i-Alzheimer emazweni ase-US. I-Epidemiology 26, e4–6.
[4] Brookmeyer R , Abdalla N , Kawas CH , Corrada MM (2018) Ukubikezela ukusabalala kwe-preclinical kanye nomtholampilo Isifo i-Alzheimer e-United States. I-Alzheimers Dement 14, 121-129.
[5] Borson S , Frank L , Bayley PJ , Boustani M , Dean M , Lin PJ , McCarten JR , Morris JC , Salmon DP , Schmitt FA , Stefanacci RG , Mendiondo MS , Peschin S , Hall EJ , Fillit H , Ashford JW (2013) Ukuthuthukisa ukunakekelwa kokuwohloka komqondo: the indima yokuhlola kanye nokutholwa kokukhubazeka kwengqondo. I-Alzheimers Dement 9, 151-159.
[6] I-Loewenstein DA , Curiel RE , Duara R , Buschke H (2018) Amapharadigmu engqondo anoveli we ukutholwa kokukhubazeka kwenkumbulo ku-preclinical Alzheimer's disease. Ukuhlola 25, 348–359.
[7] Thyrian JR , Hoffmann W , Eichler T (2018) Umhleli: Ukuqashelwa kokuqala kokuwohloka komqondo ezindabeni zokunakekelwa okuyinhloko-zamanje kanye nemiqondo. I-Curr Alzheimer Res 15, 2–4.
[8] I-Ashford JW (2008) Ukuhlolwa kokuphazamiseka kwenkumbulo, ukuwohloka komqondo, kanye Isifo i-Alzheimer. Impilo yokuguga 4, 399–432.
[9] Yokomizo JE , Simon SS , Bottino CM (2014) Ukuhlolwa kwengqondo kwe ukuwohloka komqondo ekunakekelweni okuyinhloko: ukubuyekezwa okuhlelekile. I-Psychogeriatr 26, 1783-1804.
[10] Bayley PJ , Kong JY , Mendiondo M , Lazzeroni LC , Borson S , Buschke H , Dean M , Fillit H , Frank L , Schmitt FA , Peschin S , Finkel S , Austen M , Steinberg C , Ashford JW (2015) Okutholakele ku- Ukuhlolwa Kwenkumbulo Kazwelonke Uhlelo losuku. J Am Geriatr Soc 63, 309–314.
[11] I-Nasreddine ZS , Phillips NA , Bedirian V , Charbonneau S , Whitehead V , Collin I , Cummings JL , Chertkow H (2005) I-Montreal Cognitive Assessment, i-MoCA: ithuluzi lokuhlola elifushane lokukhubazeka kwengqondo okuncane. J Am Geriatr Soc 53, 695–699.
[12] Ashford JW , Kolm P , Colliver JA , Bekian C , Hsu LN (1989) Ukuhlolwa kwesiguli se-Alzheimer kanye nesimo sengqondo esincane: ukuhlaziywa kwejika lento. J Gerontol 44, P139–P146.
[13] Ashford JW , Jarvik L (1985) Isifo i-Alzheimer's: Ingabe i-neuron plasticity ibeka phambili ekuwohlokeni kwe-axonal neurofibrillary? N Engl J Med 313, 388–389.
[14] Ashford JW (2015) Ukwelashwa kwe Isifo i-Alzheimer's: ifa le-cholinergic hypothesis, neuroplasticity, nezikhombisi-ndlela zesikhathi esizayo. J Alzheimers Dis 47, 149-156.
[15] I-Larner AJ (2015) Ingqondo esekelwe ekusebenzeni amathuluzi okuhlola: ukuhlaziya okunwetshiwe kwesikhathi ngokumelene nokunemba kokuhwebelana. Ukuxilongwa (Basel) 5, 504–512.
[16] Ashford JW , Shan M , Butler S , Rajasekar A , Schmitt FA (1995) Ukulinganisa kwesikhashana Isifo i-Alzheimer ubulukhuni: imodeli 'yenkomba yesikhathi'. Ukuwohloka komqondo 6, 269–280.
[17] Ashford JW , Schmitt FA (2001) Ukumodela inkambo yesikhathi ye Ukuwohloka komqondo kwe-Alzheimer. Curr Psychiatry Rep 3, 20–28.
[18] U-Li K , Chan W , Doody RS , Quinn J , Luo S (2017) Ukubikezelwa kokuguqulwa kube Isifo i-Alzheimer ngezilinganiso ze-longitudinal kanye nedatha yesikhathi somcimbi. J Alzheimers Dis 58, 361-371.
[19] I-Dede E , Zalonis I , Gatzonis S , Sakas D (2015) Ukuhlanganiswa kwamakhompyutha ekuhloleni kwengqondo kanye nezinga lokuqonda okuphelele kwamabhethri ekhompuyutha asetshenziswa njalo. I-Neurol Psychiatry Brain Res 21, 128-135.
[20] Siraly E , Szabo A , Szita B , Kovacs V , Fodor Z , Marosi C , Salacz P , Hidasi Z , Maros V , Hanak P , Csibri E , Csukly G (2015) Monitoring the izimpawu zokuqala ukwehla kwengqondo kubantu asebekhulile ngemidlalo yekhompiyutha: isifundo se-MRI. I-PLoS One 10, e0117918.
[21] Gates NJ , Kochan NA (2015) Ukuhlolwa kwe-neuropsychological kwekhompyutha kanye ne-inthanethi kokuqaphela isikhathi sekwephuzile kanye nokuphazamiseka kwe-neurocognitive: ingabe sisekhona? I-Curr Opin Psychiatry 28, 165–172.
[22] Zygouris S , Tsolaki M (2015) Ukuhlolwa kwengqondo okusekhompyutheni kwe abantu abadala: isibuyekezo. Am J Alzheimers Dis Other Demen 30, 13-28.
[23] Possin KL , Moskowitz T , Erlhoff SJ , Rogers KM , Johnson ET , Steele NZR , Higgins JJ , Stiver. J , Alioto AG , Farias ST , Miller BL , Rankin KP (2018) The Brain Health Ukuhlolwa kokuthola nokuxilongwa kwezinkinga ze-neurocognitive. J Am Geriatr Soc 66, 150–156.
[24] Shepard RN , Teghtsoonian M (1961) Ukugcinwa kolwazi ngaphansi kwezimo ezisondela esimweni esizinzile. J Exp Psychol 62, 302–309.
[25] Wixted JT , Goldinger SD , ​​Squire LR , Kuhn JR , Papesh MH , Smith KA , Treiman DM , Steinmetz PN (2018) Ukubhalwa kwekhodi kwenkumbulo yesiqephu ku womuntu i-hippocampus. I-Proc Natl Acad Sci USA 115, 1093–1098.
[26] Ashford JW , Gere E , Bayley PJ (2011) Ukukala inkumbulo kuzilungiselelo zeqembu elikhulu kusetshenziswa uhlolo lokuqaphela okuqhubekayo. J Alzheimers Dis 27, 885-895.
[27] Weiner MW , Nosheny R , Camacho M , Truran-Sacrey D , Mackin RS , Flenniken D , Ulbricht A , Insel P , Finley S , Fockler J , Veitch D (2018) The Brain Health I-Registry: Inkundla esekwe ku-inthanethi yokuqasha, ukuhlola, nokuqapha isikhathi eside ababambiqhaza ezifundweni ze-neuroscience. I-Alzheimers Dement 14, 1063-1076.
[28] Carson N , Leach L , Murphy KJ (2018) Ukuhlolwa kabusha kwe-Montreal Cognitive Assessment (MoCA) scores cutoff. I-Int J Geriatr Psychiatry 33, 379–388.
[29] Faul F , Erdfelder E , Buchner A , Lang AG (2009) Amandla ezibalo ahlaziya kusetshenziswa i-G*Power 3.1: ukuhlolwa kokuhlobana nokuhlaziya ukwehla. I-Behav Res Izindlela 41, 1149-1160.
[30] I-Drasgow F (1986) i-Polychoric kanye ne-polyserial correlations. Ku-Encyclopedia of Statistical Sciences, Kotz S , Johnson NL , Funda CB , ed. John Wiley & Sons, New York, amakhasi 68-74.
[31] I-Revelle WR (2018) yengqondo: Izinqubo Zomuntu Nocwaningo Lwezengqondo. Northwestern University, Evanston, IL, USA.
[32] Robin X , Turck N , Hainard A , Tiberti N , Lisacek F , Sanchez JC , Muller M (2011) pROC: iphakheji yomthombo ovulekile we-R no-S+ ukuhlaziya nokuqhathanisa amajika e-ROC. I-BMC Bioinformatics 12, 77.
[33] I-Fluss R , i-Faraggi D , i-Reiser B (2005) Isilinganiso se-Youden Index kanye nephoyinti layo lokunqamula elihlobene. I-Biom J 47, 458–472.
[34] I-Youden WJ (1950) Inkomba yokulinganisa ukuhlolwa kokuxilonga. Umdlavuza 3, 32-35.
[35] UKraemer H (1992) Uhlola Ukuhlolwa Kwezokwelapha, Sage Publications, Inc., Newbury Park, CA.
[36] I-Tsai CF , Lee WJ , Wang SJ , Shia BC , Nasreddine Z , Fuh JL (2012) Psychometrics of the Montreal Cognitive Assessment (MoCA) kanye nezigatshana zayo: ukuqinisekiswa kwenguqulo ye-Taiwanese ye-MoCA kanye nokuhlaziywa kwethiyori yempendulo yento. I-Int Psychogeratr 24, 651-658.
[37] Aschenbrenner AJ , Gordon BA , Benzinger TLS , Morris JC , Hassenstab JJ (2018) Ithonya le-tau PET, i-amyloid PET, kanye nevolumu ye-hippocampal ukubonakaliswa kwesifo i-Alzheimer's. I-Neurology 91, e859–e866.
[38] Puustinen. J , Luostarinen L , Luostarinen M , Pulliainen V , Huhtala H , Soini M , Suhonen J (2016) Ukusetshenziswa kwe-MoCA nezinye izivivinyo zengqondo ekuhloleni ukukhubazeka kwengqondo ezigulini esezikhulile ezibhekene ne-arthroplasty. I-Geriatr Orthop Surg Rehabil 7, 183–187.
[39] Chen KL , Xu Y , Chu AQ , Ding D , Liang XN , Nasreddine ZS , Dong Q , Hong Z , Zhao QH , Guo QH (2016) Ukuqinisekiswa Kwenguqulo yesiShayina yaseMontreal Ukuhlola Ingqondo Okuyisisekelo ukuze kuhlolwe ukukhubazeka kwengqondo okuncane. J Am Geriatr Soc 64, e285–e290.
[40] Borland E , Nagga K , Nilsson PM , Minthon L , Nilsson ED , Palmqvist S (2017) The Montreal Cognitive Assessment: idatha evamile evela kuqoqo elikhulu labantu base-Swedish. J Alzheimers Dis 59, 893-901.
[41] Ciesielska N , Sokolowski R , Mazur E , Podhorecka M , Polak-Szabela A , Kedziora-Kornatowska K (2016) Is the Montreal Cognitive Assessment (MoCA) ifaneleka kangcono kuneMini-Mental State Examination (I-MMSE) ekutholweni kokukhubazeka kwengqondo okumaphakathi (MCI) phakathi kwabantu abaneminyaka engaphezu kuka-60? Ukuhlaziywa kwe-Meta. I-Psychiatr Pol 50, 1039–1052.
[42] U-Giebel CM , u-Challis D (2017) Ukuzwela kokuhlolwa kwe-Mini-Mental State Examination, e-Montreal Ukuhlolwa kwengqondo kanye ne-Addenbrooke's Cognitive Examination III kumsebenzi wansuku zonke ukukhubazeka kokuwohloka komqondo: ucwaningo lokuhlola. I-Int J Geriatr Psychiatry 32, 1085–1093.
[43] Kopecek M , Bezdicek O , Sulc Z , Lukavsky. J , Stepankova H (2017) I-Montreal Cognitive Assessment kanye ne-Mini-Mental State Examination izinkomba zoshintsho oluthembekile kubantu abadala abanempilo. I-Int J Geriatr Psychiatry 32, 868-875.
[44] Roalf DR , Moore TM , Mechanic-Hamilton D , Wolk DA , Arnold SE , Weintraub DA , Moberg PJ (2017) Ukuvala izivivinyo zokuhlolwa kwengqondo ezinkingeni ze-neurologic: Ukuwela phakathi kwe-Montreal Cognitive Assessment kanye ne-Mini-Mental State Examination. I-Alzheimers Dement 13, 947-952.
[45] Solomon TM , deBros GB , Budson AE , Mirkovic N , Murphy CA , Solomon PR (2014) Ukuhlaziywa okuhlobene kwezinyathelo ezi-5 ezivame ukusetshenziswa zokusebenza kwengqondo kanye isimo sengqondo: isibuyekezo. Am J Alzheimers Dis Other Demen 29, 718-722.
[46] Mellor D , Lewis M , McCabe M , Byrne L , Wang T , Wang. J , Zhu M , Cheng Y , Yang C , Dong S , Xiao S (2016) Ukunquma amathuluzi okuhlola afanelekile kanye namaphoyinti okusika okukhubazeka kwengqondo kusampula yamaShayina asebekhulile. Ukuhlolwa Kwengqondo 28, 1345-1353.
[47] U-Snowdon A , u-Hussein A , u-Kent R , u-Pino L , u-Hachinski V (2015) Ukuqhathaniswa kweThuluzi Lokuhlola Ingqondo le-Montreal elisekelwe ku-electronic nephepha. I-Alzheimer Dis Assoc Disord 29, 325-329.
[48] Eisdorfer C , Cohen D , Paveza GJ , Ashford JW , Luchins DJ , Gorelick PB , Hirschman RS , Freels SA , Levy PS , Semla TP et al. (1992) Ukuhlolwa okusebenzayo kwe-Global Deterioration Scale yesiteji Isifo i-Alzheimer. Am J Psychiatry 149, 190-194.
[49] Butler SM , Ashford JW , Snowdon DA (1996) Iminyaka yobudala, imfundo, kanye nezinguquko kuzikolo zeMini-Mental State Exam zabesifazane asebekhulile: okutholwe ocwaningweni lweNun. J Am Geriatr Soc 44, 675–681.
[50] Schmitt FA , Davis DG , Wekstein DR , Smith CD , Ashford JW , Markesbery WR (2000) AD "Preclinical" AD revisited: neuropathology of cognitively normal alast. I-Neurology 55, 370-376.
[51] Schmitt FA , Mendiondo MS , Kryscio RJ , Ashford JW (2006) Kafushane Isikrini se-Alzheimer's ukwenza umtholampilo. I-Res Pract I-Alzheimers Dis 11, 1–4.

Amagama angukhiye: Isifo i-Alzheimer's, umsebenzi oqhubekayo wokusebenza, ukuwohloka komqondo, abantu abadala, inkumbulo, ukukhubazeka okuncane kokuqonda, ukuhlolwa