基于OCT-RNFL的MCI-AD个体化筛查模型的建立和验证

项目名称： 基于OCT-RNFL的MCI-AD个体化筛查模型的建立和验证

项目编号： No.81200833

项目类型： 青年科学基金项目

立项/批准年度： 2013

项目学科： 神经系统疾病、精神疾病

项目作者： 申远

作者单位： 同济大学

项目金额： 23万元

中文摘要： 早期诊断轻度认知功能损害中罹患老年性痴呆（AD）风险高的个体（MCI-AD）是痴呆二级预防的关键。光学相干断层扫描（OCT）对视神经纤维层（RNFL）结构的识别能反映AD的神经病理状态，且快速无创，适于社区大样本的筛查。基于我们前期证实的MCI RNFL厚度较对照组显著减少的研究基础，本研究进一步开展RNFL参数对MCI-AD敏感性的前瞻性分析。利用受试者工作特征曲线广义线性模型建立基于OCT-RNFL的MCI-AD的最优个体化筛查模型，并在18个月随访期内动态检验该模型对MCI-AD判别的敏感性和可靠性。同时对筛查获得MCI-AD个体的视神经纤维形态与视皮质/皮质网络功能的相关性进行深入分析，初步研究"视神经-视皮质-视空间网络"通路在MCI-AD神经病理机制中的作用，探索基于OCT-RNFL的个体化模型有效筛查MCI-AD的科学依据。

中文关键词： 阿尔茨海默病；轻度认知功能障碍；光学相干断层扫描；视神经纤维层厚度；生物标记物

英文摘要： Early screening of subjects who suffering high risks of deteriorating to Alzheimer's disease (AD) in MCI (MCI-AD) is the key point of prevention for dementia. Retinal nerve fiber layer (RNFL) through optical coherence tomography (OCT) may reflect neuropathological change of AD in a rapid and non-invasive way, which in applicable in community screening. Our preliminary investigation showed that thickness of RNFL decreased significantly in MCI than cognitively normal subjects. The value of RNFL in screening MCI-AD need to be further investigated through prospective study. We use reciever operating characteristic (ROC) curve generalized lineat model to build the best individualized model based on OCT-RNFL index for screening MCI-AD. The validity and reliability of this OCT-RNFL based model in judging MCI-AD is dynamically inspected via correlation between model and cognitive-behavior as well brain imaging index in 18 months' follow-up period. This model may be one of sensitive,reliable and practicable measure of screening high-risk sbjects of AD in community. And the role of optic nurve-visual cortex-visual spatial network pathyway in the neural machanisms of MCI-AD will be futher investigated. It may help to provide scientific prove of this model in screening MCI-AD subjects.

英文关键词： Alzheimer's disease；mild cognitive impairment；optical coherence tomography；retinal nerve fiber layer；biomarker