Bruno Dubois

Claire Meyniel, Dalila Samri, Farah Stefano et al.

We evaluated the cognitive status of visually impaired patients referred to low vision rehabilitation (LVR) based on a standard cognitive battery and a new evaluation tool, named the COGEVIS, which can be used to assess patients with severe visual deficits. We studied patients aged 60 and above, referred to the LVR Hospital in Paris. Neurological and cognitive evaluations were performed in an expert memory center. Thirty-eight individuals, 17 women and 21 men with a mean age of 70.3 $\pm$ 1.3 years and a mean visual acuity of 0.12 $\pm$ 0.02, were recruited over a one-year period. Sixty-three percent of participants had normal cognitive status. Cognitive impairment was diagnosed in 37.5% of participants. The COGEVIS score cutoff point to screen for cognitive impairment was 24 (maximum score of 30) with a sensitivity of 66.7% and a specificity of 95%. Evaluation following 4 months of visual rehabilitation showed an improvement of Instrumental Activities of Daily Living (p = 0 004), National Eye Institute Visual Functioning Questionnaire (p = 0 035), and Montgomery-Åsberg Depression Rating Scale (p = 0 037). This study introduces a new short test to screen for cognitive impairment in visually impaired patients.

Emilie Gerardin, Gaël Chételat, Marie Chupin et al.

We describe a new method to automatically discriminate between patients with Alzheimer's disease (AD) or mild cognitive impairment (MCI) and elderly controls, based on multidimensional classification of hippocampal shape features. This approach uses spherical harmonics (SPHARM) coefficients to model the shape of the hippocampi, which are segmented from magnetic resonance images (MRI) using a fully automatic method that we previously developed. SPHARM coefficients are used as features in a classification procedure based on support vector machines (SVM). The most relevant features for classification are selected using a bagging strategy. We evaluate the accuracy of our method in a group of 23 patients with AD (10 males, 13 females, age $\pm$ standard-deviation (SD) = 73 $\pm$ 6 years, mini-mental score (MMS) = 24.4 $\pm$ 2.8), 23 patients with amnestic MCI (10 males, 13 females, age $\pm$ SD = 74 $\pm$ 8 years, MMS = 27.3 $\pm$ 1.4) and 25 elderly healthy controls (13 males, 12 females, age $\pm$ SD = 64 $\pm$ 8 years), using leave-one-out cross-validation. For AD vs controls, we obtain a correct classification rate of 94%, a sensitivity of 96%, and a specificity of 92%. For MCI vs controls, we obtain a classification rate of 83%, a sensitivity of 83%, and a specificity of 84%. This accuracy is superior to that of hippocampal volumetry and is comparable to recently published SVM-based whole-brain classification methods, which relied on a different strategy. This new method may become a useful tool to assist in the diagnosis of Alzheimer's disease.