PMID- 34029274
OWN - NLM
STAT- MEDLINE
DCOM- 20220504
LR  - 20230829
IS  - 1536-5166 (Electronic)
IS  - 1070-8022 (Print)
IS  - 1070-8022 (Linking)
VI  - 42
IP  - 1
DP  - 2022 Mar 1
TI  - Exploration of Rapid Automatized Naming and Standard Visual Tests in Prodromal 
      Alzheimer Disease Detection.
PG  - 79-87
LID - 10.1097/WNO.0000000000001228 [doi]
AB  - BACKGROUND: Visual tests in Alzheimer disease (AD) have been examined over the 
      last several decades to identify a sensitive and noninvasive marker of the 
      disease. Rapid automatized naming (RAN) tasks have shown promise for detecting 
      prodromal AD or mild cognitive impairment (MCI). The purpose of this 
      investigation was to determine the capacity for new rapid image and number naming 
      tests and other measures of visual pathway structure and function to distinguish 
      individuals with MCI due to AD from those with normal aging and cognition. The 
      relation of these tests to vision-specific quality of life scores was also 
      examined in this pilot study. METHODS: Participants with MCI due to AD and 
      controls from well-characterized NYU research and clinical cohorts performed high 
      and low-contrast letter acuity (LCLA) testing, as well as RAN using the Mobile 
      Universal Lexicon Evaluation System (MULES) and Staggered Uneven Number test, and 
      vision-specific quality of life scales, including the 25-Item National Eye 
      Institute Visual Function Questionnaire (NEI-VFQ-25) and 10-Item Neuro-Ophthalmic 
      Supplement. Individuals also underwent optical coherence tomography scans to 
      assess peripapillary retinal nerve fiber layer and ganglion cell/inner plexiform 
      layer thicknesses. Hippocampal atrophy on brain MRI was also determined from the 
      participants' Alzheimer disease research center or clinical data. RESULTS: 
      Participants with MCI (n = 14) had worse binocular LCLA at 1.25% contrast 
      compared with controls (P = 0.009) and longer (worse) MULES test times (P = 
      0.006) with more errors in naming images (P = 0.009) compared with controls (n = 
      16). These were the only significantly different visual tests between groups. 
      MULES test times (area under the receiver operating characteristic curve [AUC] = 
      0.79), MULES errors (AUC = 0.78), and binocular 1.25% LCLA (AUC = 0.78) showed 
      good diagnostic accuracy for distinguishing MCI from controls. A combination of 
      the MULES score and 1.25% LCLA demonstrated the greatest capacity to distinguish 
      (AUC = 0.87). These visual measures were better predictors of MCI vs control 
      status than the presence of hippocampal atrophy on brain MRI in this cohort. A 
      greater number of MULES test errors (rs = -0.50, P = 0.005) and worse 1.25% LCLA 
      scores (rs = 0.39, P = 0.03) were associated with lower (worse) NEI-VFQ-25 
      scores. CONCLUSIONS: Rapid image naming (MULES) and LCLA are able to distinguish 
      MCI due to AD from normal aging and reflect vision-specific quality of life. 
      Larger studies will determine how these easily administered tests may identify 
      patients at risk for AD and serve as measures in disease-modifying therapy 
      clinical trials.
CI  - Copyright (c) 2021 by North American Neuro-Ophthalmology Society.
FAU - Wu, Shirley Z
AU  - Wu SZ
AD  - Departments of Neurology (SZW, RNK, NM, LH, BJ, AC, JCR, SLG, TMW, AVM, and LJB), 
      Population Health (RNK and LJB), and Ophthalmology (SZW, JCR, SLG, and LJB), New 
      York University Grossman School of Medicine, New York, New York.
FAU - Nolan-Kenney, Rachel
AU  - Nolan-Kenney R
FAU - Moehringer, Nicholas J
AU  - Moehringer NJ
FAU - Hasanaj, Lisena F
AU  - Hasanaj LF
FAU - Joseph, Binu M
AU  - Joseph BM
FAU - Clayton, Ashley M
AU  - Clayton AM
FAU - Rucker, Janet C
AU  - Rucker JC
FAU - Galetta, Steven L
AU  - Galetta SL
FAU - Wisniewski, Thomas M
AU  - Wisniewski TM
FAU - Masurkar, Arjun V
AU  - Masurkar AV
FAU - Balcer, Laura J
AU  - Balcer LJ
LA  - eng
GR  - P30 AG008051/AG/NIA NIH HHS/United States
GR  - P30 AG066512/AG/NIA NIH HHS/United States
GR  - UL1 TR001445/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20210517
PL  - United States
TA  - J Neuroophthalmol
JT  - Journal of neuro-ophthalmology : the official journal of the North American 
      Neuro-Ophthalmology Society
JID - 9431308
SB  - IM
MH  - *Alzheimer Disease/diagnosis
MH  - Atrophy
MH  - Humans
MH  - Pilot Projects
MH  - *Quality of Life
MH  - Vision Tests
PMC - PMC8595455
MID - NIHMS1668438
COIS- J. C. Rucker is on the Editorial Board of the Journal of Neuro-Ophthalmology. S. 
      L. Galetta has been a consultant to Biogen. A. V. Masurkar is on the Council of 
      the Alzheimer's Association International Research Grants Program, the Steering 
      Committee of the Alzheimer's Disease Cooperative Study, and on the Advisory Board 
      of the Journal of Neuro-Ophthalmology. L. J. Balcer is Editor-in-Chief of the 
      Journal of Neuro-Ophthalmology. The remaining authors report no conflicts of 
      interest.
EDAT- 2021/05/25 06:00
MHDA- 2022/05/06 06:00
PMCR- 2023/03/01
CRDT- 2021/05/24 17:17
PHST- 2021/05/25 06:00 [pubmed]
PHST- 2022/05/06 06:00 [medline]
PHST- 2021/05/24 17:17 [entrez]
PHST- 2023/03/01 00:00 [pmc-release]
AID - 00041327-202203000-00012 [pii]
AID - 10.1097/WNO.0000000000001228 [doi]
PST - ppublish
SO  - J Neuroophthalmol. 2022 Mar 1;42(1):79-87. doi: 10.1097/WNO.0000000000001228. 
      Epub 2021 May 17.