Page 48 - MaquetaFundCIEN-2019-ENG

48
Annual Report 2019
than with objective cognitive performance in neuropsychological tests.
• Not all cognitive complaints have the same specific weight when differentiat- ing between cognitively healthy people and patients with Mild Cognitive Impair- ment (MCI). More specifically, complaints related to forgetting recent events, with things that we must remember in the future or with the ability to manage ourselves effectively on a day-to-day basis, allow us to differentiate between
those two groups.
• Using the criteria of the International SCI Working Group, it is possible to classify
individuals in preclinical stages of AD into three groups: non-SCI, SCI and SCI -Plus. This last group is considered the one with the highest risk of conversion based on a series of evidence-based parameters. Our results support the clin- ical interest of the classification proposed by the International Working Group: SCI -Plus has a 4 times higher risk of developing MCI in just one year compared to non- SCI. Although there are no significant differences between non- SCI and SCI, there is a higher conversion rate in SCI. Perhaps the one-year follow-up is not enough to show greater differences.
• A comprehensive protocol proposal for collecting SCI -related information has been described and published. An operational definition has also been provided to classify individuals into the above three groups, namely non- SCI, SCI and SCI Plus.
• An opinion paper has been published related to the need to demonstrate that the SCI classification is stable over time. This is a prerequisite to be able to con- sider SCI as a variable of interest in the field of early detection of MCI.
• Our results have shown that when an assessment protocol is used systemat- ically and rigorous operational criteria are employed, the SCI classification is sufficiently stable.
• After analyzing the temporal dynamics of the DCS groups during 3 years, the fol- lowing sequential transition is observed that fits perfectly with the hypothesis of the different stages of AD: non-SCI SCI SCI-Plus MCI. The risk of developing MCI therefore increases progressively in the SCI and SCI-Plus groups respectively.
• In the future, although we have not yet been allowed access to neuroimaging data, our interest is to combine the available cognitive data with fMRI data. The objective is to determine if there are significant differences between con- trol subjects and individuals with SCI-Plus with respect to the pattern of brain connectivity (a greater hyperconnectivity associated with SCI-Plus would be expected, as the literature has already shown in later phases of mild cognitive impairment).
1.2. Usefulness of various cognitive parameters as early markers
Numerous studies have shown that there are certain cognitive variables that al- low the identification of subjects at higher risk of developing Alzheimer’s disease years before their diagnosis. With this idea in mind, we investigate whether certain parameters of the neuropsychological protocol, in the context of a longitudinal research project such as the Vallecas Project, are useful to identify individuals at risk of cognitive impairment. These parameters are analyzed in an evolutionary way together with the rest of clinical and genetic information of each volunteer in