Supplementary Material for: Visual Evaluation of Medial Temporal Lobe Atrophy as a Clinical Marker of Conversion from Mild Cognitive Impairment to Dementia and for Predicting Progression in Patients with Mild Cognitive Impairment and Mild Alzheimer's Disease

<b><i>Background/Aims:</i></b> To evaluate whether visual assessment of medial temporal lobe atrophy (vaMTA) can predict 2-year conversion from mild cognitive impairment (MCI) to dementia and progression of MCI and Alzheimer's disease dementia as measured by the Clinical Dementia Rating Scale Sum of Boxes score (CDR-SB). <b><i>Methods:</i></b> vaMTA was performed in 94 patients with MCI according to the Winblad criteria and in 124 patients with AD according to ICD-10 and NINCDS-ADRDA criteria. Demographic data, the Consortium to Establish a Registry for Alzheimer's Disease 10-word delayed recall, APOE ɛ4 status, Cornell Scale for Depression in Dementia, and comorbid hypertension were used as covariates. <b><i>Results:</i></b> vaMTA was associated with MCI conversion in an unadjusted model but not in an adjusted model (<i>p</i> = 0.075), where delayed recall and APOE ɛ4 status were significant predictors. With CDR-SB change as the outcome, an interaction between vaMTA and diagnosis was found, but in the adjusted model only delayed recall and age were significant predictors. For vaMTA below 2, the association between vaMTA and CDR-SB change differed between diagnostic groups. Similar results were found based on a trajectory analysis. <b><i>Conclusion:</i></b> In adjusted models, memory function, APOE ɛ4 status and age were significant predictors of disease progression, not vaMTA. The association between vaMTA and CDR-SB change was different in patients with MCI and Alzheimer's disease dementia.

背景与目的：评估内侧颞叶萎缩视觉评估(vaMTA)能否预测轻度认知障碍(MCI)向痴呆的2年转化率，以及以临床痴呆评定量表总框分(CDR-SB)为评估指标的MCI与阿尔茨海默病(AD)痴呆的疾病进展情况。
方法：本研究按照Winblad标准对94例MCI患者、符合国际疾病分类第10版(ICD-10)及美国国立神经系统疾病与卒中研究所-阿尔茨海默病及相关疾病协会(NINCDS-ADRDA)标准的124例AD患者进行vaMTA评估。协变量纳入人口学资料、阿尔茨海默病登记联盟10词延迟回忆测试得分、载脂蛋白E ε4(APOE ɛ4)状态、康奈尔痴呆抑郁量表得分以及合并高血压情况。
结果：在未校正模型中，vaMTA与MCI转化存在相关性，但在校正模型中无显著关联（p=0.075），此时延迟回忆得分与APOE ɛ4状态为显著预测因子。以CDR-SB变化为结局指标时，发现vaMTA与诊断类型存在交互作用，但在校正模型中仅延迟回忆得分与年龄为显著预测因子。当vaMTA评分低于2分时，不同诊断组间vaMTA与CDR-SB变化的相关性存在差异。轨迹分析也得到了一致的结果。
结论：在校正模型中，记忆功能、APOE ɛ4状态与年龄是疾病进展的显著预测因子，而vaMTA并非如此。MCI患者与AD痴呆患者中，vaMTA与CDR-SB变化的关联存在显著差异。