Neuropathologic Outcome of Mild Cognitive Impairment Following Progression to Clinical Dementia

作者：Gregory A. Jicha, Joseph E. Parisi, Dennis W. Dickson, Kris Johnson, Ruth Cha, Robert J. Ivnik, Eric G. Tangalos, Bradley F. Boeve, David S. Knopman, Heiko Braak, Ronald Carl Petersen · 发表于：Archives of Neurology · 年份：2006 · DOI：10.1001/archneur.63.5.674 · 被引用次数：400 · 研究领域：Dementia and Cognitive Impairment Research、Alzheimer's disease research and treatments、Neurological Disease Mechanisms and Treatments

BACKGROUND: The pathologic outcome of patients diagnosed with mild cognitive impairment (MCI) following progression to dementia is poorly understood. OBJECTIVE: To determine the pathologic substrates of dementia in cases with prior diagnosis of amnestic MCI. DESIGN AND SETTING: Community-based cohort. PATIENTS: Thirty-four subjects followed up prospectively as part of a community-based study who were diagnosed with amnestic MCI, progressed to clinical dementia, and underwent subsequent postmortem brain analysis. MAIN OUTCOME MEASURES: Neuropathologic analyses resulted in assignment of a primary pathologic diagnosis and included staging of Alzheimer pathologic abnormalities and identification of contributing vascular disease, Lewy bodies, and argyrophilic grains. RESULTS: Although the majority of subjects progressed both clinically and pathologically to Alzheimer disease (AD), 10 (29%) of them developed non-AD primary pathologic abnormalities. All of the cases were found to have sufficient pathologic abnormalities in mesial temporal lobe structures to account for their amnestic symptoms regardless of the cause. Most subjects were found to have secondary contributing pathologic abnormalities in addition to primary pathologic diagnoses. No significant differences between subjects with and without neuropathologically proven AD were detected in demographic variables, apolipoprotein E genotype, or cognitive test measures at onset of MCI, onset of dementia, or last clinical evaluati...