Evaluation of glymphatic system activity by diffusion tensor image analysis along the perivascular space (DTI-ALPS) in dementia patients
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Objectives: Dementia is a clinical syndrome caused by multiple etiologies, usually manifests with progressive and diffuse brain dysfunction. The activity of the human glymphatic system was evaluated in cases of dementia by the diffusion tensor image analysis along the perivascular space (DTI-ALPS). Methods: We recruited 28 healthy subjects and 77 patients, including 38 with Alzheimer’s disease (AD),18 with mild cognitive impairment (MCI), 28 with normal controls (NC) and 21 with vascular cognitive impairment (VCI). All participants underwent DTI scanning. Diffusivities in the X, Y and Z axes were obtained in the lateral ventricle body plane of all subjects. We assessed the diffusivity along the perivascular spaces, as well as projection fibers and association fibers, respectively, in order to acquire an DTI-ALPS-index and correlated them with mini mental state examination (MMSE) and montreal cognitive assessment (MOCA) scores using partial correlation which the influence of age was controlled. Results: The AD, MCI, and VCI patients showed significantly lower DTI-ALPS-index (p < 0.001) compared to the NC. Besides, the VCI group had significantly higher DTI-ALPS-index than the AD group (p = 0.007). There was a significant positive correlation between DTI-ALPS-index and MMSE and MOCA scores (the effect of age was controlled), showing that lower water diffusivity along the perivascular spaces associated with dementia.The higher Dzassoc led to the reduced DTI-ALPS-index in VCI, while lower Dxassoc contributed to the decrease of DTI-ALPS-index in AD. Conclusion: The evaluation of DTI-ALPS demonstrates impairment of the glymphatic system in dementia patients by decreased DTI-ALPS-index. Different from AD, the VCI patients show glymphatic drainage disorder rather than glymphatic system impairment. Advances in knowledge: This article comprehensively covers several types of dementia and performs the comparison of VCI, AD and MCI in glymphatic system dysfunction.Keywords:
Montreal Cognitive Assessment
Our aim was to compare the utility and accuracy of the Chinese Version of Montreal Cognitive Assessment Basic (MoCA-BC) and the Montreal Cognitive Assessment-Beijing Version (MoCA-BJ) in the identification of mild cognitive impairment (MCI) under different education levels. A sample of individuals with MCI (n = 295), Alzheimer's disease (AD; n = 254), and normal controls (NC; n = 259) at 2 Memory Clinics and communities was administered the MoCA-BC, MoCA-BJ, Mini-Mental State Examination (MMSE), and other neuropsychological tests. The discriminant validity of the MoCA-BC and MoCA-BJ as diagnostic instruments was ascertained. The overall discriminant validity for detection of MCI from NC (receiver operating characteristic area under the curve [95% confidence interval]) was that the MoCA-BC (0.95 [0.93, 0.97]) had better sensitivity and accuracy than MoCA-BJ (0.87 [0.84, 0.90]). In addition, we provide an easy to use table that enables the conversion of MoCA-BC to the MoCA-BJ scores or to MMSE scores. The MoCA-BC and MoCA-BJ provided good diagnostic accuracy when compared to MMSE. The MoCA-BC, which was proved to be an appropriate tool when screening for MCI among elderly subjects, can now be compared directly with the MoCA-BJ.
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The Montreal Cognitive Assessment (MoCA) is one of the most common screening instruments for mild cognitive impairment. However, the standard MoCA is approximately two times longer to administer than the Mini-Mental State Examination. A total of 699 Czech and 175 American participants received the standard MoCA Czech and English versions and in the clinical part, a sample of 102 nondemented patients with Parkinson's disease (PD). We created a validated Czech short version (s-MoCA-CZ) from the original using item response theory. As expected, s-MoCA-CZ scores were highly correlated with the standard version (Pearson
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Objective To study the effect of Motreal cognitive assessment(MoCA)(Chinese version) in diagnosing the amnestic mild cognitive impairment.Methods A total of 61 persons were chosen from the outpatient section of Beijing Hospital(2009-05-2010-03),including 31 patients who meeting the criteria of MCI-Revised(MCI-R) and 30 normal controls(NC) for comparing the sensitivity and specificity of the mini-mental state examination(MMSE) and MoCA in diagnosing the aMCI and analysing the effect and characteristics of MoCA in diagnosing the aMCI.Results When using the cut off score of 26,the sensitivity of MMSE and MoCA are 9.68% and 87.10% separately,the specificity are 93.33% and 73.33%.Conclusions MoCA might play an important role in screening aMCI and the other cognitive impairments due to the better sensitivity of MoCA and its wide cover of multiple cognitive district.
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The Montreal Cognitive Assessment （MoCA） は軽度認知障害のスクリーニング検査であり，合計得点の算出時に教育年数を考慮する特徴がある。先行研究では，MoCAの下位指標の一つである言語領域得点において教育年数の影響が報告されているが，日本においてMoCAの各認知領域得点と教育年数との関連は明らかになっていない。そこで本研究では，教育年数がMoCAの各認知領域に与える影響を評価するため，60歳以上の健常高齢者104名に対し日本語版MoCAおよび教育年数の聴取を行い，教育年数で2群（低群：12年以下，37名；高群：13年以上，67名）に分け，各認知領域得点についてWelch’s t-testを行った。その結果，先行研究で報告されている言語領域得点（t（76.0）＝－2.114, p＝0.038）に加え，注意領域得点（t（62.8）＝－2.075, p＝0.042）においても，教育年数高群の方が低群よりも有意に高かった。以上より，日本では教育年数がMoCAの言語領域だけでなく注意領域にも影響を与えることが示唆された。
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Objective To investigate the feasibility of application of Montreal Cognitive Assessment Scale(MoCA) chinese version to the assessment of global cognition in the patients with vascular mild cognitive impairment(vMCI).Methods Fifty vMCI patients and fifty healthy normal subjects were included in the study.Their cognitive functions were assessed with MoCA and Mini-Mental State Examination(MMSE),and the results were analyzed and compared.Results There was a significant correlation between the MMSE and the MoCA scores in both groups(P0.05),and MoCA scores were significantly lower than MMSE scores(P0.05).The significant differences presented between vMCI group and control group in the comparison of sub-item score and total score in MoCA.The MoCA had the sensitivity of 84.0% and the specificity of 76.0% for detecting vMCI,the sensitivity and the specificity of MMSE was 46.0% and 98%,respectively.Conclusion The MoCA has higher sensitivity than the MMSE for cognitive assessment in the patients with vMCI.
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The Montreal Cognitive Assessment (MoCA; Nasreddine et al., JAGS 2005) is a brief measure of global cognitive function used worldwide and validated as a reliable tool for the detection of cognitive impairment in several neurodegenerative diseases and medical conditions. Our objective was to investigate the validity of the German MoCA alternate forms for the purpose of longitudinal clinical and research applications.
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