Abstract Details

Title Exploring Rapid Automatized Naming and Standard Visual Tests for Detection of Early Alzheimer’s Disease

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) Neuro-ophthalmology/Neuro-otology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 012

Background

Visual markers of AD are well-studied and can be sensitive and non-invasive. RAN tasks have shown promise in detecting mild cognitive impairment and should be further examined with other visual measures for early disease detection.

Objective

To evaluate new rapid automatized naming (RAN) tests and measures of visual pathway structure and function for distinguishing mild cognitive impairment (MCI) due to Alzheimer’s disease (AD) from cognitively normal individuals. To examine how visual measures correlate with vision-specific quality of life.

Design/Methods

Well-characterized MCI and cognitively normal participants performed rapid automatized naming using the Mobile Universal Lexicon Evaluation System (MULES) and Staggered Uneven Number (SUN) test, high and low-contrast letter acuity (LCLA) testing, 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. Qualitative assessment of hippocampal atrophy on MRI was also determined from participants’ research/clinical data.

Results

MCI participants (n=14) had worse 1.25% LCLA (p=0.009) and worse MULES time (p=0.006) with more errors naming pictures (p=0.009) than controls (n=16). The two groups did not differ in other tests. MULES time (AUC=0.79), MULES errors (AUC 0.78), and 1.25% LCLA (AUC=0.78) had good diagnostic accuracy for differentiating MCI versus controls, with combined MULES time and 1.25% LCLA demonstrating best accuracy (AUC=0.87). These visual tests were better predictors of MCI versus control status than hippocampal atrophy on MRI. Greater MULES errors (r_s= -0.50, P=0.005) and worse 1.25% LCLA scores (r_s=0.39, P=0.03) were associated with worse NEI-VFQ-25 scores.

Conclusions

Rapid picture naming (MULES) and LCLA distinguish MCI due to AD from normal aging and reflect vision-specific quality of life. These easily-administered tests may identify patients at risk for AD dementia and serve as measures in disease-modifying therapy clinical trials.

Authors/Disclosures
Shirley Z. Wu (NYU School of Medicine) PRESENTER	Miss Wu has nothing to disclose.
Rachel Nolan (NYU Langone Medical Center)	Ms. Nolan has nothing to disclose.
Nicholas Moehringer	Mr. Moehringer has nothing to disclose.
Lisena Hasanaj (NYU Langone Medical Center)	Ms. Hasanaj has nothing to disclose.
	No disclosure on file
Ashley Clayton (NYU Langone Medical Center)	Ms. Clayton has nothing to disclose.
Janet C. Rucker, MD	Dr. Rucker has nothing to disclose.
Steven Galetta, MD, FAAN (NYU Langone Medical Center)	Dr. Galetta has nothing to disclose.
Thomas M. Wisniewski, MD (New York University School of Medicine)	Dr. Wisniewski has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Aging Neuroscience. The institution of Dr. Wisniewski has received research support from the National Institute of Aging. Dr. Wisniewski has received intellectual property interests from a discovery or technology relating to health care.
Arjun V. Masurkar, MD (NYU Langone Medical Center)	The institution of Dr. Masurkar has received research support from NIH. The institution of Dr. Masurkar has received research support from Alzheimer's Association. The institution of Dr. Masurkar has received research support from BrightFocus Foundation. Dr. Masurkar has received personal compensation in the range of $500-$4,999 for serving as a IRGP Advisory Council Member with Alzheimer's Association. Dr. Masurkar has a non-compensated relationship as a Steering Committee Member with Alzheimer's Disease Cooperative Study that is relevant to AAN interests or activities.
Laura J. Balcer, MD, MSCE, FAAN (NYU Grossman School of Medicine)	An immediate family member of Dr. Balcer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Children's Hospital of Philadelphia. Dr. Balcer has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for North American Neuro-Ophthalmology Society.