Projects / Programmes
Subjective Cognitive Complaint: Defining the entity and the determination of markers
predictive of progression to Mild Cognitive Impairment and Dementia
| Code |
Science |
Field |
Subfield |
| 3.03.00 |
Medical sciences |
Neurobiology |
|
| Code |
Science |
Field |
| B640 |
Biomedical sciences |
Neurology, neuropsychology, neurophysiology |
| Code |
Science |
Field |
| 3.01 |
Medical and Health Sciences |
Basic medicine |
subjective cognitive decline, neurodegenerative disorder, multimodal research, EEG, MRI, analysis of gait and balance
Researchers (18)
Organisations (2)
Abstract
Disorders of cognition a represent an important social and public health challenge. Efforts to develop successful treatments require early diagnosis, which also helps provide important clinical predictions to patients and their families. Elderly individuals with subjective cognitive decline (SCD) are a recently identified population that express concern about their cognitive abilities fading. They are classified as normal using currently valid clinical and neuropsychological criteria, but harbour increased risk for later progression to dementia. SCD represent the earliest possible stage of cognitive impairment and a clinically relevant population that might require early identification and diagnosis of those who might progress to dementia.
Little is known about the pathogenic mechanisms of early cognitive decline, the compensatory processes that might help maintain normal cognition at this stage and the mechanisms of insight into cognitive abilities fading. Previous studies primarily aimed to characterise this population and follow it longitudinally, thus demonstrating SCD to represent a pre-dementia stage of Alzheimer’s disease. By using multi-modal approaches, we aim to provide a more comprehensive account of the structural and functional alterations occurring in SCD, with a particular focus on detailed neuropsychological characterisation and assessment of network alterations. Our goal is to identify early pathogenic changes, as well as potential compensatory processes that maintain objectively normal cognitive function. By combining different investigative approaches, we also aim to develop new behavioral and neurophysiological markers specific for cognitive decline in the earliest stages. We will use neuropsychological tests to characterise the population, and neuroimaging methods which can demonstrate structural and functional changes. We will also use an advanced computational assessment of gait and balance, which provide complementary information, as gait can be affected subclinically at an early stage of cognitive decline.
To explore the mechanisms in play, we propose to use established state-of-the-art methods of studying structural and functional connectivity of the brain. We plan a prospective observational study of elderly individuals expressing subjective complaints about cognitive decline, and matched controls, in the period of 2.5 years. They will undergo clinical and neuropsychological investigation, analysis of balance and gait, quantitative EEG recordings, and structural and functional MRI. As part of the examination, we will use our recently developed paradigm to engage flexible cognitive control in participants with SCD and matched controls.
The proposed project would significantly advance our understanding of the concept of SCD, as well as the mechanisms responsible for the earliest stages of cognitive decline. Our results would be relevant for patients and their caregivers, who could prepare for the challenges of caring for a patient with dementia in the future. It would also be provide valuable information for future studies of treatment, which have been flawed in the past due to recruitment of inhomogeneous populations. It also opens the door for prevention and non-pharmacological management approaches, such as cognitive training and non-invasive brain stimulation.
Our proposed study on SCD is the first offering an ambitious prospective observation of a larger sample using neurophysiological markers, which would be potentially relevant also for quick and repeatable follow up of the rate of cognitive decline in different stages of neurodegenerative disorders. The proposed use of the methods will also enable a significant progress in the field of analyses of various neurophysiological signals and thus enabling the progress in understanding basic mechanisms of the brain function.
Significance for science
The concept of subjective cognitive complaint may prove to be an important milestone in prevention and early diagnosis of cognitive decline. Results would be highly important for public health system, for directing activities in early diagnosis of dementia, in planning management across the health and social system. Establishment of the entity and subjects with SCC opens the door for prevention and non-pharmacological management approaches (cognitive training, biological stimulation of the brain). Results would be very relevant for carers and families, who could prepare for challenges of caring for a chronic patient. Our proposed study on SCC is the first offering an ambitious prospective observation of a larger sample using neurophysiological markers, which would be potentially relevant also for quick and repeatable follow up of the rate of cognitive decline in different stages of neurodegenerative disorders. The proposed use of the methods will also enable a significant
progress in the field of analyses of various neurophysiological signals thus enabling the progress in understanding basic mechanisms of the brain function.
Significance for the country
The proposed project would significantly advance our understanding of the concept of SCD, as well as the mechanisms responsible for the earliest stages of cognitive decline. Our results would be relevant for patients and their caregivers, who could prepare for the challenges of caring for a patient with dementia in the future. It would also be provide valuable information for future studies of treatment, which have been flawed in the past due to recruitment of inhomogeneous populations. It also opens the door for prevention and non-pharmacological management approaches, such as cognitive training and non-invasive brain stimulation.
Most important scientific results
Interim report,
final report
Most important socioeconomically and culturally relevant results
Interim report,
final report
