Читать книгу Anti-Aging Therapeutics Volume XVI - A4M American Academy - Страница 28

Dementia is the sixth leading cause of death in the United States, increasing in incidence and prevalence as the “Baby Boomer” generation ages along with longer life expectancies.¹ With the economic burden of dementia consistently rising,² early identification of cognitive decline in primary care settings is imperative.³ Decades of research involving brain electrophysiology have shown that delayed latency in the P300 brain wave (the positive spike in an EEG wave 300 ms after a stimulus) and a lower amplitude in the voltage of the P300 wave, occur in both normal aging, and even more so, in dementia.⁴ However, little is known about the relation of electrophysiological parameters (P300), HM of the brain, and MCI/Alzheimer’s disease (AD) markers such as tau proteins, C-reactive protein, and hippocampal atrophy.^5-7 If a patient diagnosed with clinical MCI is positive for these markers, prodromal AD should be considered. Magnetic resonance imaging or angiogram (MRI, MRA) and PET are useful techniques that permit us to track abnormalities that may be markers of MCI or AD.^8-11 Both P300 and PET can detect early functional changes in MCI before anatomical damage becomes evident on MRI/MRA or neuropsychological profiles. There is also a paucity of information linking scores on the Mini-Mental State Examination (MMSE)¹² and brain HM in early cognitive decline.^13,14 Finally, there are no studies to our knowledge that have evaluated the validation ability of 3 common assessment tools for revealing brain HM: Central Nervous System Vital Signs Memory Test (CNSM); Test of Variables of Attention (TOVA); and Wechsler Memory Scale-III (WMS). Our hypothesis is that evoked potentials and neuropsychological tests can validate PET brain metabolism and MCI, or early stages of Alzheimer’s disease.¹⁵ Therefore, the current retrospective study systematically examined the sensitivity and specificity of using P300, TOVA, and memory tests (WMS, CNSM, and MMSE) as early indicators of HM as measured by PET, in a cohort of patients with amnestic and non-amnestic cognitive impairments presenting to a large medical practice.¹⁶