Abstract
In patients with Alzheimer’s disease (AD), synaptic plasticity seems to be involved in cognitive improvement induced by cognitive training. The platelet amyloid precursor protein (APP) ratio (APPr), i.e., the ratio between two APP isoforms, may be a useful peripheral biomarker to investigate synaptic plasticity pathways. This study evaluates the changes in neuropsychological/cognitive performance and APPr induced by cognitive training in AD patients participating in the “My Mind Project”. Neuropsychological/cognitive variables and APPr were evaluated in the trained group (n = 28) before a two-month experimental protocol, immediately after its termination at follow-up 1 (FU1), after 6 months at follow-up 2 (FU2), and after 24 months at follow-up 3 (FU3). The control group (n = 31) received general psychoeducational training for two months. Some memory and attention parameters were significantly improved in trained vs. control patients at FU1 and FU2 compared to baseline (Δ values). At FU3, APPr and Mini Mental State Examination (MMSE) scores decreased in trained patients. Δ APPr correlated significantly with the Δ scores of (i) MMSE at FU1, (ii) the prose memory test at FU2, and (iii) Instrumental Activities of Daily Living (IADL), the semantic word fluency test, Clinical Dementia Rating (CDR), and the attentive matrices test at FU3. Our data demonstrate that the platelet APPr correlates with key clinical variables, thereby proving that it may be a reliable biomarker of brain function in AD patients.
Highlights
Over the past few years, a growing number of studies showed that cognitive stimulation, cognitive training, and cognitive rehabilitation programs improve the cognitive state of dementia patients [1,2,3]
APP ratio (APPr) correlates with Mini Mental State Examination (MMSE) scores and was successfully applied to monitor the effects of acetylcholinesterase inhibitors donepezil and galantamine in Alzheimer’s disease (AD) patients [28,29,30]
The platelet APPr was evaluated in AD patients participating in the “My Mind Project”, which investigates the effects of a comprehensive cognitive training program on cognitive performances and peripheral blood biomarkers [31,32,33,34,35], to test the hypothesis that it reflects central changes induced by the intervention and that such changes correlate with cognitive and/or neuropsychological test scores
Summary
Over the past few years, a growing number of studies showed that cognitive stimulation, cognitive training, and cognitive rehabilitation programs improve the cognitive state of dementia patients [1,2,3] This is interesting given that current pharmacological treatments provide only temporary relief of clinical symptoms and are unable to alter disease progression [4]. The platelet APPr was evaluated in AD patients participating in the “My Mind Project”, which investigates the effects of a comprehensive cognitive training program on cognitive performances and peripheral blood biomarkers [31,32,33,34,35], to test the hypothesis that it reflects central changes induced by the intervention and that such changes correlate with cognitive and/or neuropsychological test scores
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