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In-Out-Test: A New Paradigm for Sorting the Wheat from the Chaff in Prodromal Alzheimer’s Disease
BACKGROUND: Assessment of hippocampal amnesia is helpful to distinguish between normal cognition and mild cognitive impairment (MCI), but not for identifying converters to dementia. Here biomarkers are useful but novel neuropsychological approaches are needed in their absence. The In-out-test assess...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
IOS Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7836051/ https://www.ncbi.nlm.nih.gov/pubmed/30530971 http://dx.doi.org/10.3233/JAD-171007 |
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author | Torrealba, Eduardo Garcia-Morales, Pilar Cejudo, Juan Carlos Diaz, Mario Rodriguez-Esparragon, Francisco Fabre, Oscar Mesa-Herrera, Fatima Marin, Raquel Sanchez-Garcia, Florentino Rodriguez-Perez, Aurelio Gramunt, Nina |
author_facet | Torrealba, Eduardo Garcia-Morales, Pilar Cejudo, Juan Carlos Diaz, Mario Rodriguez-Esparragon, Francisco Fabre, Oscar Mesa-Herrera, Fatima Marin, Raquel Sanchez-Garcia, Florentino Rodriguez-Perez, Aurelio Gramunt, Nina |
author_sort | Torrealba, Eduardo |
collection | PubMed |
description | BACKGROUND: Assessment of hippocampal amnesia is helpful to distinguish between normal cognition and mild cognitive impairment (MCI), but not for identifying converters to dementia. Here biomarkers are useful but novel neuropsychological approaches are needed in their absence. The In-out-test assesses episodic memory using a new paradigm hypothesized to avoid reliance on executive function, which may compensate for damaged memory networks. OBJECTIVE: To assess the validity of the In-out-test in identifying prodromal Alzheimer’s disease (PAD) in a clinical setting, by comparing this to the Free and Cued Selective Reminding Test (FCSRT) and cerebrospinal fluid biomarkers. METHODS: A cross-sectional study of 32 cognitively healthy, 32 MCI, and 30 progressive dementia subjects. All participants were given both the In-out-test and the FCSRT; 40 of them also received a lumbar puncture. RESULTS: Internal consistency was demonstrated using Cronbach Alpha (r = 0.81) and Inter-rater reliability with Kappa (k = 0.94). Intraclass correlation (ICC) for test-retest reliability: r = 0.57 (p = 0.57). ICC between the In-out-test and FCSRT r = 0.87 (p = 0.001). ICC between the In-out-test and Aβ(42) and P-tau/Aβ(42) for controls: 0.73 and 0.75, respectively; P-tau for MCI: 0.77 and total sample: 0.70; Aβ(42) for dementia: 0.71. All ICC measures between FCSRT and biomarkers were ≤0.264. AD diagnosis: In-out-test k = 0.71; FCSRT k = 0.49. PAD diagnosis (N = 35): In-out-test k = 0.69; FCSRT k = 0.44. CONCLUSIONS: The In-out-test detected prodromal AD with a higher degree of accuracy than a conventional hippocampal-based memory test. These results suggest that this new paradigm could be of value in clinical settings, predicting which patients with MCI will go on to develop AD. |
format | Online Article Text |
id | pubmed-7836051 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | IOS Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-78360512021-02-01 In-Out-Test: A New Paradigm for Sorting the Wheat from the Chaff in Prodromal Alzheimer’s Disease Torrealba, Eduardo Garcia-Morales, Pilar Cejudo, Juan Carlos Diaz, Mario Rodriguez-Esparragon, Francisco Fabre, Oscar Mesa-Herrera, Fatima Marin, Raquel Sanchez-Garcia, Florentino Rodriguez-Perez, Aurelio Gramunt, Nina J Alzheimers Dis Research Article BACKGROUND: Assessment of hippocampal amnesia is helpful to distinguish between normal cognition and mild cognitive impairment (MCI), but not for identifying converters to dementia. Here biomarkers are useful but novel neuropsychological approaches are needed in their absence. The In-out-test assesses episodic memory using a new paradigm hypothesized to avoid reliance on executive function, which may compensate for damaged memory networks. OBJECTIVE: To assess the validity of the In-out-test in identifying prodromal Alzheimer’s disease (PAD) in a clinical setting, by comparing this to the Free and Cued Selective Reminding Test (FCSRT) and cerebrospinal fluid biomarkers. METHODS: A cross-sectional study of 32 cognitively healthy, 32 MCI, and 30 progressive dementia subjects. All participants were given both the In-out-test and the FCSRT; 40 of them also received a lumbar puncture. RESULTS: Internal consistency was demonstrated using Cronbach Alpha (r = 0.81) and Inter-rater reliability with Kappa (k = 0.94). Intraclass correlation (ICC) for test-retest reliability: r = 0.57 (p = 0.57). ICC between the In-out-test and FCSRT r = 0.87 (p = 0.001). ICC between the In-out-test and Aβ(42) and P-tau/Aβ(42) for controls: 0.73 and 0.75, respectively; P-tau for MCI: 0.77 and total sample: 0.70; Aβ(42) for dementia: 0.71. All ICC measures between FCSRT and biomarkers were ≤0.264. AD diagnosis: In-out-test k = 0.71; FCSRT k = 0.49. PAD diagnosis (N = 35): In-out-test k = 0.69; FCSRT k = 0.44. CONCLUSIONS: The In-out-test detected prodromal AD with a higher degree of accuracy than a conventional hippocampal-based memory test. These results suggest that this new paradigm could be of value in clinical settings, predicting which patients with MCI will go on to develop AD. IOS Press 2019-01-08 /pmc/articles/PMC7836051/ /pubmed/30530971 http://dx.doi.org/10.3233/JAD-171007 Text en © 2019 – IOS Press and the authors. All rights reserved https://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License (https://creativecommons.org/licenses/by-nc/4.0/) , which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Torrealba, Eduardo Garcia-Morales, Pilar Cejudo, Juan Carlos Diaz, Mario Rodriguez-Esparragon, Francisco Fabre, Oscar Mesa-Herrera, Fatima Marin, Raquel Sanchez-Garcia, Florentino Rodriguez-Perez, Aurelio Gramunt, Nina In-Out-Test: A New Paradigm for Sorting the Wheat from the Chaff in Prodromal Alzheimer’s Disease |
title | In-Out-Test: A New Paradigm for Sorting the Wheat from the Chaff in Prodromal Alzheimer’s Disease |
title_full | In-Out-Test: A New Paradigm for Sorting the Wheat from the Chaff in Prodromal Alzheimer’s Disease |
title_fullStr | In-Out-Test: A New Paradigm for Sorting the Wheat from the Chaff in Prodromal Alzheimer’s Disease |
title_full_unstemmed | In-Out-Test: A New Paradigm for Sorting the Wheat from the Chaff in Prodromal Alzheimer’s Disease |
title_short | In-Out-Test: A New Paradigm for Sorting the Wheat from the Chaff in Prodromal Alzheimer’s Disease |
title_sort | in-out-test: a new paradigm for sorting the wheat from the chaff in prodromal alzheimer’s disease |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7836051/ https://www.ncbi.nlm.nih.gov/pubmed/30530971 http://dx.doi.org/10.3233/JAD-171007 |
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