PROGRESSIONE DA MILD COGNITIVE IMPAIRMENT A MALATTIA DI ALZHEIMER: IDENTIFICAZIONE DI PROFILI NEUROCOGNITIVI PREDITTIVI E CORRELAZIONE CON BIOMARCATORI LIQUORALI

Objective: To correlate neuropsychological testing with cerebrospinal fluid Amyloid beta (AD), tau and Ptau levels in patients with Mild Cognitive Impairment (MCI) Background: Principal diagnostic instrument to define global cognitive state is the Mini Mental State Examination (MMSE). Cognitive domains that best predict progression from amnestic MCI to AD are episodic memory and executive functioning. Were selected two neuropsychological tests for both domains: Story Recall Test (SRT) and Paired-Associate Learning (PAL) to examine episodic verbal memory, and Coloured Progressive Matrices of Raven (CPMR) and Clock Drawing Test (CDT) to investigate executive functioning. Methods: Forty subjects with amnestic MCI were recruited. All of them underwent neurological exam, neuropsychological testing and lumbar puncture at time of diagnosis. Cognition were explored by MMSE (global cognitive functioning), CPMR and CDT (executive functions), SRT and PAL (episodic verbal memory). Statistical analysis was carried out by using t-test and Spearman test for correlations. Results: In the whole population, no significant correlation between cognitive and biological markers was observed. Considering CSF biomarker level of amiloidβ, thirteen subjects showed an altered pattern and converted to AD after few months, the other subjects whit a normal profile did not convert. MMSE show a significant difference between converters/no converters groups (26.4 versus 27.6 p=0.066). Also CDT and SRT had a significant difference between two groups (3 versus 5 p= 0.003 and 5.85 versus 8.32, p=0.03). Conclusion: According to these results, MMSE value is lower in converters, in according to patological biomarkers profile. PAL and CDT are more specific to predict conversion from MCI to AD.