ObjectiveTo obverse the changes of macular choroidal thickness (CT) in patients with mild to moderate Alzheimer’s disease (AD).MethodsThis was a case-control study. Twenty-one patients with mild to moderate AD confirmed by Neurology Department of Jinhua Central Hospital from November 2016 to June 2018 and 21 age-matched control subjects were concluded in the study. There was no significant difference in age (t=0.128), intraocular pressure (t=0.440) and axial length (t=1.202) between the two groups (P＞0.05). There was significant difference in mini-mental state examination score (t=8.608, P＜0.05). CT was measured by OCT with enhanced depth imaging technique in the subfoveal choroid, at 0.5 mm and 1.0 mm from the center of the fovea nasal (NCT0.5, 1.0 mm), temporal (TCT0.5, 1.0 mm), superior (SCT0.5, 1 .0 mm), and inferior (ICT0.5, 1.0 mm). Independent-samples t test was used to compare the results obtained from these two groups.ResultsSFCT (t=2.431), NCT0.5, 1.0 mm (t=3.341, 2.640), TCT0.5, 1.0 mm (t=3.340, 2.899), SCT0.5, 1.0 mm (t=3.576, 3.751) and ICT0.5, 1.0 mm (t=2.897, 2.903) were significantly thinner in AD eyes than those in control eyes.ConclusionCompared with healthy subjects, patients with mild to moderate AD showed a significant reduction in CT.
Alzheimer's disease is a common neuro-degenerative disease. The clinical diagnosis mainly depends on the patient's complaint, the score of mini-mental state examination and Montreal cognitive assessment scale, and the comprehensive judgment of MRI and other imaging examinations. Retina is homologous to brain tissue, and their vascular systems have similar physiological characteristics to small blood vessels in the brain. Numerous studies found that the thickness of retinal nerve fiber layer, visual function, retinal blood vessels and retinal oxygen saturation were changed in AD patients to different degrees. To explore the formation mechanism and significance of ocular fundus changes in AD patients will be helpful to select specific, sensitive and simple methods for early observation and evaluation of AD.
This study aims to explore the diagnosis in patients with Alzheimer's disease (AD) based on magnetic resonance (MR) images, and to compare the differences of bilateral hippocampus in classification and recognition. MR images were obtained from 25 AD patients and 25 normal controls (NC) respectively. Three-dimensional texture features were extracted from bilateral hippocampus of each subject. The texture features that existed significant differences between AD and NC were used as the features in a classification procedure. Back propagation (BP) neural network model was built to classify AD patients from healthy controls. The classification accuracy of three methods, which were principal components analysis, linear discriminant analysis and non-linear discriminant analysis, was obtained and compared. The correlations between bilateral hippocampal texture parameters and Mini-Mental State Examination (MMSE) scores were calculated. The classification accuracy of nonlinear discriminant analysis with a neural network model was the highest, and the classification accuracy of right hippocampus was higher than that of the left. The bilateral hippocampal texture features were correlated to MMSE scores, and the relative of right hippocampus was higher than that of the left. The neural network model with three-dimensional texture features could recognize AD patients and NC, and right hippocampus might be more helpful to AD diagnosis.
ObjectiveTo conduct a meta-analysis comparing the accuracy of artificial intelligence (AI)-assisted diagnostic systems based on 18F-fluorodeoxyglucose PET/CT (18F-FDG PET/CT) and structural MRI (sMRI) in the diagnosis of Alzheimer's disease (AD). MethodsOriginal studies dedicated to the development or validation of AI-assisted diagnostic systems based on 18F-FDG PET/CT or sMRI for AD diagnosis were retrieved from the Web of Science, PubMed, and Embase databases. Studies meeting the inclusion criteria were collected, and the risk of bias and clinical applicability of the included studies were assessed using the PROBAST checklist. The pooled sensitivity, specificity, and area under the summary receiver operating characteristic (SROC) curve (AUC) were calculated using a bivariate random-effects model. ResultsTwenty-six studies met the inclusion criteria, yielding a total of 38 2×2 contingency tables related to diagnostic performance. Specifically, 24 contingency tables were based on 18F-FDG PET/CT to distinguish AD patients from normal cognitive (NC) controls, and 14 contingency tables were based on sMRI for the same purpose. The meta-analysis results showed that for 18F-FDG PET/CT, the AI-assisted diagnostic systems had a pooled sensitivity, specificity, and SROC-AUC of 89% (95%CI 88% to 91%), 93% (95%CI 91% to 94%), and 0.96 (95%CI 0.93 to 0.97), respectively. For sMRI, the AI-assisted diagnostic systems had a pooled sensitivity, specificity, and SROC-AUC of 88% (95%CI 85% to 90%), 90% (95%CI 87% to 92%), and 0.94 (95%CI 0.92 to 0.96), respectively. ConclusionAI-assisted diagnostic systems based on either 18F-FDG PET/CT or sMRI demonstrated similar performance in the diagnosis of AD, with both showing high accuracy.
Alzheimer's disease (AD) is the most common type of dementia and a neurodegenerative disease with progressive cognitive dysfunction as the main feature. How to identify the early changes of cognitive dysfunction and give appropriate treatments is of great significance to delay the onset of dementia. Some other researches have shown that AD is associated with abnormal changes of brain networks. To study human brain functional connectivity characteristics in AD, 16 channels electroencephalogram (EEG) were recorded under resting and eyes-closed condition in 15 AD patients and 15 subjects in the control group. The synchronization likelihood of the full-band and alpha-band (8-13 Hz) data were evaluated, which resulted in the synchronization likelihood coefficient matrices. Considering a threshold T, the matrices were converted into binary graphs. Then the graphs of two groups were measured by topological parameters including the clustering coefficient and global efficiency. The results showed that the global efficiency of the network in full-band EEG was significantly smaller in AD group for the values of T=0.06 and T=0.07, but there was no statistically significant difference in the clustering coefficients between the two groups for the values of T (0.05-0.07). However, the clustering coefficient and global efficiency were significantly lower in AD patients at alpha-band for the same threshold range than those of subjects in the control group. It suggests that there may be decreases of the brain connectivity strength in AD patients at alpha-band of the resting-state EEG. This study provides a support for quantifying functional brain state of AD from the brain network perspective.
ObjectivesTo systematically review the efficacy of seven types of cognitive interventions for older adults with mild to moderate Alzheimer's Disease (AD).MethodsWe searched The Cochrane Library, PubMed, EMbase, CNKI, WanFang Data, VIP and CBM databases to collect randomized controlled trials on cognitive interventions for mild to moderate Alzheimer's Disease (AD) from inception to January 2018. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. STATA 14.0 software was then used to perform a meta-analysis.ResultsA total of 49 randomized controlled trials (RCTs) were included. The results of network meta-analysis revealed that each cognitive intervention had significantly improved the cognitive ability of AD patients. Specifically, nursing intervention (NI) (MD=3.01, 95%CI 1.70 to 4.50, P<0.005) was the most effective enhancer of cognitive ability, followed by music therapy (MT) (MD=2.60, 95%CI 0.96 to 4.30, P<0.001), physical exercise (PE) (MD=2.4, 95%CI 1.0 to 3.9, P<0.001), cognitive rehabilitation (CR) (MD=2.3, 95% CI 0.92 to 3.7, P=0.013), cognitive simulation (CS) (MD=1.7, 95%CI 1.2 to 2.3, P=0.037), computerized cognitive training (CCT) (MD=1.6, 95%CI 0.42 to 2.8, P<0.001), and pharmacological therapies (PT) (MD=1.5, 95%CI 0.24 to 2.8, P=0.041).ConclusionsThe seven types of cognitive interventions are helpful in improving the cognitive ability of Alzheimer's patients, and nursing intervention is the most effective cognitive intervention. Moreover, non-pharmacological therapies may be better than pharmacological therapies.
Objective To observe the changes of retinal nerve fiber layer (RNFL) thickness in patients with Alzheimer's disease (AD). Methods Twenty eyes of 40 patients with mild and (or) moderate AD confirmed by clinical examination (AD group) were included in the study. There were 11 males and 9 females with an average age of (72.75±8.25) years. Age and gender-matched normal 20 objectives were in the normal control group. Among them, there were 11 males and 9 females with a mean age of (71.05±7.08) years. There was no significant difference in gender composition, age and intraocular pressure between the two groups (P＞0.05). There were significant differences in visual acuity, cup disc ratio and mini-mental state examination score (P＜0.05). All eyes underwent high-resolution optical coherence tomography (OCT) examination. With a diameter of 3.4 mm and a center on the center of the optic disc, circular fast scans on optic disc were performed to obtain an average disc RNFL thickness, signal threshold ＞6. Computer image analysis system was used to measure the RNFL thickness from superior, inferior, temporal and nasal quadrants, and the average RNFL thickness. The changes of RNFL thickness between the two groups and between different eyes of the same group were compared. Results Compared with the normal control group, the average (t=5.591), superior (t=8.169, 8.053) and inferior (t=12.596, 11.377) thickness of RNFL in both eyes in AD group were thinner, the differences were significant (P＜0.05); the temporal (t=1.966, 0.838）and nasal (t=2.071, 0.916) thickness of RNFL in both eyes of AD group were thinner, but the difference was not statistically significant (P＞0.05). There was no significant difference of the mean and different quadrant RNFL thickness between different eyes in AD group and normal control group (AD group: t=0.097, 0.821, 0.059, 0.020, 0.116; normal control group: t=0.791, 1.938, 1.806, 2.058, 1.005; P＞0.05). Conclusion The RNFL thickness around the optic disc in AD patients is thinner; This occurs first in superior and inferior quadrants of the optic disc.
Wavelet entropy is a quantitative index to describe the complexity of signals. Continuous wavelet transform method was employed to analyze the spontaneous electroencephalogram (EEG) signals of mild, moderate and severe Alzheimer's disease (AD) patients and normal elderly control people in this study. Wavelet power spectrums of EEG signals were calculated based on wavelet coefficients. Wavelet entropies of mild, moderate and severe AD patients were compared with those of normal controls. The correlation analysis between wavelet entropy and MMSE score was carried out. There existed significant difference on wavelet entropy among mild, moderate, severe AD patients and normal controls (P<0.01). Group comparisons showed that wavelet entropy for mild, moderate, severe AD patients was significantly lower than that for normal controls, which was related to the narrow distribution of their wavelet power spectrums. The statistical difference was significant (P<0.05). Further studies showed that the wavelet entropy of EEG and the MMSE score were significantly correlated (r=0.601-0.799, P<0.01). Wavelet entropy is a quantitative indicator describing the complexity of EEG signals. Wavelet entropy is likely to be an electrophysiological index for AD diagnosis and severity assessment.
Alzheimer’s Disease (AD) is a progressive neurodegenerative disorder. Due to the subtlety of symptoms in the early stages of AD, rapid and accurate clinical diagnosis is challenging, leading to a high rate of misdiagnosis. Current research on early diagnosis of AD has not sufficiently focused on tracking the progression of the disease over an extended period in subjects. To address this issue, this paper proposes an ensemble model for assisting early diagnosis of AD that combines structural magnetic resonance imaging (sMRI) data from two time points with clinical information. The model employs a three-dimensional convolutional neural network (3DCNN) and twin neural network modules to extract features from the sMRI data of subjects at two time points, while a multi-layer perceptron (MLP) is used to model the clinical information of the subjects. The objective is to extract AD-related features from the multi-modal data of the subjects as much as possible, thereby enhancing the diagnostic performance of the ensemble model. Experimental results show that based on this model, the classification accuracy rate is 89% for differentiating AD patients from normal controls (NC), 88% for differentiating mild cognitive impairment converting to AD (MCIc) from NC, and 69% for distinguishing non-converting mild cognitive impairment (MCInc) from MCIc, confirming the effectiveness and efficiency of the proposed method for early diagnosis of AD, as well as its potential to play a supportive role in the clinical diagnosis of early Alzheimer's disease.
ObjectiveTo systematically review the relationship between Cadmium (Cd) level and Alzheimer's disease (AD). MethodWe searched PubMed, EMbase, CNKI, WanFang Data and CBM databases from inception to December 2014 to collect case-control studies about the relationship between Cd level and AD. Two reviewers screened literature, extracted data and evaluated the risk of bias of included studies, and then meta-analysis was performed by using RevMan 5.3 software. ResultsA total of 11 studies were included, among them 8 studies were included into final meta-analysis. Three studies including 154 patients and 141 controls reported the relationship of serum Cd concentrations and AD, and the result of meta-analysis showed that the higher serum Cd level was found in the AD group than the control group (SMD=0.36, 95%CI 0.12 to 0.59, P=0.003). Six studies including 358 patients and 423 controls reported the relationship of blood Cd concentrations and AD, and the result of meta-analysis showed that there was no significant difference of blood Cd levels between both groups (SMD=0.35, 95%CI -0.14 to 0.84, P=0.16). ConclusionSerum Cd concentrations may be associated with AD, but blood Cd concentrations not. Due to the limitation of quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.