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      Perfil clínico neuropsicológico del deterioro cognitivo subtipo posible Alzheimer Translated title: Clinical and Neuropsychological Profile of Possible Alzheimer subtype neurocognitive disorder

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          Abstract

          RESUMEN Introducción: La enfermedad de Alzheimer se presenta con diferentes fenotipos neuropsicológicos y se considera que el deterioro de la memoria es su afectación más sobresaliente; no obstante, estudios recientes sugieren que los trastornos en las funciones ejecutivas pueden constituir marcadores muy tempranos de la enfermedad. Objetivos: Caracterizar los perfiles clínicos y neuropsicológicos que constituyen marcadores fenotípicos de los trastornos neurocognitivos subtipo posible Alzheimer. Métodos: Se realizó un estudio descriptivo y transversal de 39 enfermos con edades comprendidas entre 57-85 años, clasificados según los criterios del DSM-5, con deterioro cognitivo leve y mayor, catalogados desde el punto de vista etiológico en el subtipo posible Alzheimer. Se evaluaron múltiples dominios cognitivos (atención compleja, memoria y aprendizaje, funciones ejecutivas, lenguaje, funciones motoras y perceptuales) y se hizo una evaluación detallada de las funciones ejecutivas mediante un grupo de test neuropsicológicos específicos. Resultados: El análisis estadístico demostró que entre los dos grupos de estudio con deterioro cognitivo existen diferencias significativas en cuanto al nivel de funcionamiento cognitivo en todos los dominios explorados, excepto en la percepción y funciones motoras. Así mismo, los resultados demostraron que el nivel de rendimiento para cada función evaluada dentro del dominio de las funciones ejecutivas es significativamente diferente entre ambos grupos con deterioro cognitivo, excepto para la orientación espacial. Conclusiones: El perfil neuropsicológico del deterioro cognitivo subtipo posible Alzheimer se caracterizó por una afectación en múltiples dominios, con predominio de la disfunción ejecutiva focalizada en las áreas de la flexibilidad mental e inhibición de automatismos.

          Translated abstract

          ABSTRACT Introduction: Alzheimer disease is presented with different neuropsychological phenotypes and it is considered that the memory disorder is its most important one; however, recent studies suggest that the dysfunctions in the executive functions can constitute very early markers of the disease. Objectives: To characterize the clinical and neuropsychological profiles that constitutes phenotypical markers of the neurocognitive disorders possible Alzheimer subtype. Methods: A descriptive and cross-sectional study of 39 sick persons with ages between 57-85 years, classified according to the DSM-5 criteria, with cognitive mild and major disorder, classified from the etiological point of view in the possible Alzheimer subtype was carried out. Multiple cognitive domains were evaluated (complex attention, memory and learning, executive functions, language, motor and perceptual functions) and a detailed evaluation of the executive functions was made by means of a group of specific neuropsychological tests. Results: The statistical analysis demonstrated that comparing the two study groups with cognitive disorder, significant differences exist as for the level of cognitive performance in all the explored domains, except in the perception and motor functions. Likewise, the results demonstrated that the yielding level for each function evaluated within the domain of the executive functions is significantly different between both groups with cognitive disorder, except for the space orientation. Conclusions: The neuropsychological profile of the cognitive disorder Alzheimer possible subtype was characterized by a disorder in multiple domains, with predominance of the focused executive dysfunction in the areas of the mental flexibility and inhibition of automatisms.

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          Classification of Single Normal and Alzheimer's Disease Individuals from Cortical Sources of Resting State EEG Rhythms

          Previous studies have shown abnormal power and functional connectivity of resting state electroencephalographic (EEG) rhythms in groups of Alzheimer's disease (AD) compared to healthy elderly (Nold) subjects. Here we tested the best classification rate of 120 AD patients and 100 matched Nold subjects using EEG markers based on cortical sources of power and functional connectivity of these rhythms. EEG data were recorded during resting state eyes-closed condition. Exact low-resolution brain electromagnetic tomography (eLORETA) estimated the power and functional connectivity of cortical sources in frontal, central, parietal, occipital, temporal, and limbic regions. Delta (2–4 Hz), theta (4–8 Hz), alpha 1 (8–10.5 Hz), alpha 2 (10.5–13 Hz), beta 1 (13–20 Hz), beta 2 (20–30 Hz), and gamma (30–40 Hz) were the frequency bands of interest. The classification rates of interest were those with an area under the receiver operating characteristic curve (AUROC) higher than 0.7 as a threshold for a moderate classification rate (i.e., 70%). Results showed that the following EEG markers overcame this threshold: (i) central, parietal, occipital, temporal, and limbic delta/alpha 1 current density; (ii) central, parietal, occipital temporal, and limbic delta/alpha 2 current density; (iii) frontal theta/alpha 1 current density; (iv) occipital delta/alpha 1 inter-hemispherical connectivity; (v) occipital-temporal theta/alpha 1 right and left intra-hemispherical connectivity; and (vi) parietal-limbic alpha 1 right intra-hemispherical connectivity. Occipital delta/alpha 1 current density showed the best classification rate (sensitivity of 73.3%, specificity of 78%, accuracy of 75.5%, and AUROC of 82%). These results suggest that EEG source markers can classify Nold and AD individuals with a moderate classification rate higher than 80%.
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            A novel biomarker of amnestic MCI based on dynamic cross-frequency coupling patterns during cognitive brain responses

            The detection of mild cognitive impairment (MCI), the transitional stage between normal cognitive changes of aging and the cognitive decline caused by AD, is of paramount clinical importance, since MCI patients are at increased risk of progressing into AD. Electroencephalographic (EEG) alterations in the spectral content of brainwaves and connectivity at resting state have been associated with early-stage AD. Recently, cognitive event-related potentials (ERPs) have entered into the picture as an easy to perform screening test. Motivated by the recent findings about the role of cross-frequency coupling (CFC) in cognition, we introduce a relevant methodological approach for detecting MCI based on cognitive responses from a standard auditory oddball paradigm. By using the single trial signals recorded at Pz sensor and comparing the responses to target and non-target stimuli, we first demonstrate that increased CFC is associated with the cognitive task. Then, considering the dynamic character of CFC, we identify instances during which the coupling between particular pairs of brainwave frequencies carries sufficient information for discriminating between normal subjects and patients with MCI. In this way, we form a multiparametric signature of impaired cognition. The new composite biomarker was tested using data from a cohort that consists of 25 amnestic MCI patients and 15 age-matched controls. Standard machine-learning algorithms were employed so as to implement the binary classification task. Based on leave-one-out cross-validation, the measured classification rate was found reaching very high levels (95%). Our approach compares favorably with the traditional alternative of using the morphology of averaged ERP response to make the diagnosis and the usage of features from spectro-temporal analysis of single-trial responses. This further indicates that task-related CFC measurements can provide invaluable analytics in AD diagnosis and prognosis.
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              Searching for Primary Predictors of Conversion from Mild Cognitive Impairment to Alzheimer’s Disease: A Multivariate Follow-Up Study

                Author and article information

                Journal
                san
                MEDISAN
                MEDISAN
                Centro Provincial de Ciencias Médicas, Santiago de Cuba (Santiago de Cuba, , Cuba )
                1029-3019
                October 2019
                : 23
                : 5
                : 875-891
                Affiliations
                [1] Santiago de Cuba orgnameUniversidad de Ciencias Médicas orgdiv1Hospital Infantil Sur Dr. Antonio María Béguez César Cuba
                [2] Santiago de Cuba orgnameUniversidad de Ciencias Médicas orgdiv1Hospital General Docente Dr. Juan Bruno Zayas Alfonso Cuba
                Article
                S1029-30192019000500875 S1029-3019(19)02300500875
                52025025-ddef-46eb-b159-b4ffa0f7a193

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 24 August 2019
                : 07 June 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 17
                Product

                SciELO Cuba

                Categories
                ARTÍCULOS ORIGINALES

                Alzheimer,dementia,major cognitive disorder,mild cognitive disorder,demencia,deterioro cognitivo mayor,deterioro cognitivo leve

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