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Mild Cognitive Impairment – the Gøteborg-Oslo (GO) project. Early diagnosis and treatment of dementing illnesses is a major goal of modern clinical neuroscience. Mild cognitive impairment is a symptom associated with increased risk of developing dementia, but itself too unspecific to lead to a diagnosis. When impairment is supported by thorough clinical assessment or neuropsychological evidence, the likelihood of a dementing illness is considerably increased, but causal mechanisms and prognosis is still uncertain.
The main goal of the GO-MCI project is to assign non-demented patients seeking clinical assessment for perceived cognitive deficit to one of 3 groups, a. No dementing illness, b. Vascular cognitive impairment c. Alzheimer disease. We aim to do this by developing a common data base of patients investigated in memory clinics in Oslo and Gøteborg and to follow these patients with bi-annual investigations. The study started in 2006 and as of October 2007 about 50 patients have been recruited from each study site.
The data base includes information from clinical assessment, from neuropsychological tests, MR-scans, PET-scanning, and from analysis of cerebrospinal fluid (CSF). The study protocol allows application of the recently proposed revised research criteria for Alzheimer disease (DuBois et al 2007) which demand evidence of memory impairment from neuropsychological tests combined with at least one pathological biomarker (CSF, MR or PET) for positive diagnosis. CSF is central in the study protocol because of the documented high sensitivity and specificity of CSF-markers for Alzheimer disease and the fact that the Gøteborg group are world leaders in methods of CSF analysis.
The Oslo study cohort is recruited from Akershus Universitetssykehus (AHUS), Department of Neurology, and researchers at Center for Study of Human Cognition are responsible for the neuropsychological protocol (Ivar Reinvang, Thomas Espeseth) and for the MR-morphometric studies (Kristine B. Walhovd, Anders M. Fjell). An independent study of association of APOE polymorhisms and attention will be performed on a subset of participants (see separate project description). The data available on the first 50 participants have resulted in some preliminary findings.
A case study by Stenset et al (2007) demonstrates that combining MR and PET derived structural and metabolic information is important in explaining a vascular clinical syndrome. The MR scan shows a small thalamic infarction, whereas the PET image shows extensive metabolic reduction in parts of the frontal lobe known to have fiber connection with the lesioned thalamic nucleus. |
