10 / 11
Page 60
conferenceseries
.com
10
th
International Conference on
February 22-23, 2018 | Paris, France
Vascular Dementia
Volume 8
Journal of Alzheimers Disease & Parkinsonism
ISSN: 2161-0460
Vascular Dementia 2018
February 22-23, 2018
Corneal confocal microscopy: An imaging surrogate end point for mild cognitive impairment and dementia
Hamad Almuhannadi
Weill Cornell Medicine-Qatar, Qatar
Background:
The risk of dementia in people over 60 is 1 in 10. Imaging biomarkers of neurodegeneration could facilitate early
diagnosis of dementia. Corneal confocal microscopy (CCM), a non-invasive ophthalmic technique may act as an imaging end
point for neurodegeneration in patients with mild cognitive impairment (MCI) and dementia.
Aim:
Aim of the study is to evaluate the diagnostic ability of CCM for MCI and dementia and determine the association
between corneal nerve fiber loss and cognitive and physical impairment.
Methods:
79 patients with MCI (n=32), dementia (n=26) and age matched cognitively healthy controls (n=21) underwent
clinical examination, neuropsychological testing, neuroimaging and CCM. Corneal nerve pathology was quantified by
measuring corneal nerve fiber density (CNFD), branch density (CNBD) and length (CNFL).
Results:
Comparing cognitively healthy controls to patients with MCI and dementia, there was a significant reduction in
CNFD, CNBD and CNFL (P<0.01 and P<0.0001, respectively). CNFL was significantly different between controls vs. MCI vs.
dementia (25.67 [SD 5.85] mm/mm2 vs. 19.61 [SD 5.85] mm/mm2, P<0.01 vs. 15.65 [SD 7.19] mm/mm2, P=0.04, respectively).
The AUC/sensitivity and specificity of CNFL for identifying patients with MCI were 0.75, 95% CI 0.66-0.90/72%/71% and
for dementia 0.85, 95% CI 0.70-0.95/81%/81%, with a cut-off point of <21 mm/mm2 for optimal diagnostic accuracy for
dementia. Adjusted for confounders, corneal nerve fiber loss was associated with declining cognitive function (P<0.01-<0.001)
and increased physical disability (P=0.03- <0.01).
Conclusion:
This original research advocates CCM as a surrogate end point for neurodegeneration in patients with MCI and
dementia, as the diagnostic accuracy of CCM for the detection of dementia is comparable to established Alzheimer’s disease
biomarkers. Furthermore, we show a strong association between corneal nerve fiber loss with cognitive decline and physical
disability.
J Alzheimers Dis Parkinsonism 2018, Volume 8
DOI: 10.4172/2161-0460-C1-037