Reader response: Practice guideline update summary: MCI
GangWang, Neurologist, Ruijin Hospital, Shanghai Jiaotong University (Shanghai, China)
Hai-lunCui, Graduate Student, Ruijin Hospital, Shanghai Jiaotong University (Shanghai, China)
Submitted January 14, 2018
The updated American Academy of Neurology guidelines on mild cognitive impairment (MCI) is essential both for clinical and research settings. [1] Dramatic changes in the definition of MCI over the past decades require a more dynamic and on-limits attitude towards newly-proposed diagnostic and treating methods, which lead to a few concerns that demand further explanation:
The guidelines mentioned a 14.4-55.6 percent reverting rate for patients with MCI to rehabilitate to normal cognitive status based on multiple Class-I studies. Could any subtle differences in clinical presentation be found during the course of disease among each subtype of MCI? For example, between MCI and MCI due to Alzheimer disease. If so, predicting prognosis could be made at an early stage. Further, we deem a more specific and detailed recommendation on nonpharmacologic treatments, which may include a variety of choices that were studied and validated throughout different research teams across the world (especially some unique and traditional types of exercise such as Tai Chi Chuan practice. [2-4] Meanwhile, since no cut-off points for diverse biomarkers, such as Amyloid beta and tau concentration in CSF, have been officially proposed, the documented value of these biomarkers in differential diagnosis remains uncertain. [5]
1. Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2018;90:126-135.
2. Tao J, Chen X, Egorova N, et al. Tai Chi Chuan and Baduanjin practice modulates functional connectivity of the cognitive control network in older adults. Sci Rep 2017;7:41581.
3. Tao J, Liu J, Liu W, et al. Tai Chi Chuan and Baduanjin Increase Grey Matter Volume in Older Adults: A Brain Imaging Study. J Alzheimers Dis 2017;60:389-400.
4. Brasure M, Desai P, Davila H, et al. Physical Activity Interventions in Preventing Cognitive Decline and Alzheimer-Type Dementia: A Systematic Review. Ann Intern Med 2018;168:30-38.
5. Petersen RC, Caracciolo B, Brayne C, et al. Mild cognitive impairment: a concept in evolution. J Intern Med 2014;275:214-228.
The updated American Academy of Neurology guidelines on mild cognitive impairment (MCI) is essential both for clinical and research settings. [1] Dramatic changes in the definition of MCI over the past decades require a more dynamic and on-limits attitude towards newly-proposed diagnostic and treating methods, which lead to a few concerns that demand further explanation:
The guidelines mentioned a 14.4-55.6 percent reverting rate for patients with MCI to rehabilitate to normal cognitive status based on multiple Class-I studies. Could any subtle differences in clinical presentation be found during the course of disease among each subtype of MCI? For example, between MCI and MCI due to Alzheimer disease. If so, predicting prognosis could be made at an early stage. Further, we deem a more specific and detailed recommendation on nonpharmacologic treatments, which may include a variety of choices that were studied and validated throughout different research teams across the world (especially some unique and traditional types of exercise such as Tai Chi Chuan practice. [2-4] Meanwhile, since no cut-off points for diverse biomarkers, such as Amyloid beta and tau concentration in CSF, have been officially proposed, the documented value of these biomarkers in differential diagnosis remains uncertain. [5]
1. Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2018;90:126-135.
2. Tao J, Chen X, Egorova N, et al. Tai Chi Chuan and Baduanjin practice modulates functional connectivity of the cognitive control network in older adults. Sci Rep 2017;7:41581.
3. Tao J, Liu J, Liu W, et al. Tai Chi Chuan and Baduanjin Increase Grey Matter Volume in Older Adults: A Brain Imaging Study. J Alzheimers Dis 2017;60:389-400.
4. Brasure M, Desai P, Davila H, et al. Physical Activity Interventions in Preventing Cognitive Decline and Alzheimer-Type Dementia: A Systematic Review. Ann Intern Med 2018;168:30-38.
5. Petersen RC, Caracciolo B, Brayne C, et al. Mild cognitive impairment: a concept in evolution. J Intern Med 2014;275:214-228.
For disclosures, please contact the editorial office at journal@neurology.org.