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Background: Visual rating of medial temporal lobe atrophy (MTA) is an accepted structural neuroimaging marker of Alzheimer’s disease. Corneal confocal microscopy (CCM) is a non-invasive ophthalmic technique that detects neuronal loss in peripheral and central neurodegenerative disorders. Objective: To determine the diagnostic accuracy of CCM for mild cognitive impairment (MCI) and dementia compared to medial temporal lobe atrophy (MTA) rating on MRI. Methods: Subjects aged 60–85 with no cognitive impairment (NCI), MCI, and dementia based on the ICD-10 criteria were recruited. Subjects underwent cognitive screening, CCM, and MTA rating on MRI. Results: 182 subjects with NCI (n = 36), MCI (n = 80), and dementia (n = 66), including AD (n = 19, 28.8%), VaD (n = 13, 19.7%), and mixed AD (n = 34, 51.5%) were studied. CCM showed a progressive reduction in corneal nerve fiber density (CNFD, fibers/mm2) (32.0±7.5 versus 24.5±9.6 and 20.8±9.3, p

This study compared the capability of corneal confocal microscopy (CCM) with magnetic resonance imaging (MRI) brain volumetry for the diagnosis of mild cognitive impairment (MCI) and dementia.In this cross-sectional study, participants with no cognitive impairment (NCI), MCI, and dementia underwent assessment of Montreal Cognitive Assessment (MoCA), MRI brain volumetry, and CCM.Two hundred eight participants with NCI (n = 42), MCI (n = 98), and dementia (n = 68) of comparable age and gender were studied. For MCI, the area under the curve (AUC) of CCM (76% to 81%), was higher than brain volumetry (52% to 70%). For dementia, the AUC of CCM (77% to 85%), was comparable to brain volumetry (69% to 93%). Corneal nerve fiber density, length, branch density, whole brain, hippocampus, cortical gray matter, thalamus, amygdala, and ventricle volumes were associated with cognitive impairment after adjustment for confounders (AllThe diagnostic capability of CCM compared to brain volumetry is higher for identifying MCI and comparable for dementia, and abnormalities in both modalities are associated with cognitive impairment.

IntroductionThis study assessed the association of cerebral ischemia with neurodegeneration in mild cognitive impairment (MCI) and dementia.MethodsSubjects with MCI, dementia and controls underwent assessment of cognitive function, severity of brain ischemia, MRI brain volumetry and corneal confocal microscopy.ResultsOf 63 subjects with MCI (n = 44) and dementia (n = 19), 11 had no ischemia, 32 had subcortical ischemia and 20 had both subcortical and cortical ischemia. Brain volume and corneal nerve measures were comparable between subjects with subcortical ischemia and no ischemia. However, subjects with subcortical and cortical ischemia had a lower hippocampal volume (P < 0.01), corneal nerve fiber length (P < 0.05) and larger ventricular volume (P < 0.05) compared to those with subcortical ischemia and lower corneal nerve fiber density (P < 0.05) compared to those without ischemia.DiscussionCerebral ischemia was associated with cognitive impairment, brain atrophy and corneal nerve loss in MCI and dementia.

BackgroundThe prevalence of cerebral ischemia increases with age and is a risk factor for cognitive impairment and dementia. This study assessed the association of brain ischemic lesions with the severity of neurodegeneration utilizing brain volumetric MRI and corneal confocal microscopy (CCM) in patients with mild cognitive impairment (MCI) and dementia.MethodsSubjects with MCI and dementia without diabetes underwent cognitive screening, CCM, assessment of ischemic lesions and quantitative brain MRI.ResultsOf 63 subjects with MCI (n=44) and dementia (n=19), 11 had no ischemia, 32 had subcortical ischemia and 20 had both cortical and subcortical ischemia. Subjects with MCI and dementia had comparable percentage of cerebral ischemia (P=0.25). Global cognitive function was significantly impaired in subjects with both cortical and subcortical ischemia (P

Background: Visual rating of medial temporal lobe atrophy (MTA) is an accepted biomarker of Alzheimer’s disease. Corneal confocal microscopy (CCM) is a non-invasive ophthalmic imaging biomarker of neurodegeneration. We sought to determine the diagnostic accuracy of CCM to distinguish mild cognitive impairment (MCI) and dementia from no cognitive impairment (NCI) in relation to MTA rating.Methods: Subjects aged 60-85 with NCI, MCI and dementia were recruited from the geriatric and memory clinic in Rumailah Hospital, Doha, Qatar between 18/09/16 and 31/07/19. The diagnosis of MCI and dementia were based on the International Classification of Diseases (ICD-10) criteria. Subjects underwent cognitive screening using the Montreal Cognitive Assessment (MoCA), CCM and MTA rating on MRI. Statistical tests used were ANOVA with Bonferroni’s post hoc test, kappa statistics and receiver operating characteristic (ROC) curve analysis. A two-tailed P value of ≤0.05 was considered significant.Results: 182 subjects with NCI (n=36), MCI (n=80) and dementia (n=66), including AD (n=19, 28.8%), VaD (n=13, 19.7%) and combined AD (n=34, 51.5%) were studied. CCM showed a progressive reduction in corneal nerve fiber density (CNFD, fibers/mm2) (32.0±7.5 vs 24.5±9.6 vs 20.8±9.3, p2) (90.9±46.5 vs 59.3±35.7 vs 53.9±38.7, p2) (22.9±6.1 vs 17.2±6.5 vs 15.8±7.4, pConclusions: The diagnostic accuracy of CCM, a non-invasive ophthalmic biomarker of neurodegeneration was high and comparable with MTA rating for dementia and superior to MTA rating for MCI.

Objectives Corneal confocal microscopy (CCM) is a noninvasive ophthalmic technique that identifies corneal nerve degeneration in a range of peripheral neuropathies and in patients with multiple sclerosis, Parkinson's disease, and amyotrophic lateral sclerosis. We sought to determine whether there is any association of corneal nerve fiber measures with cognitive function and functional independence in patients with MCI and dementia. Methods In this study, 76 nondiabetic participants with MCI (n = 30), dementia (n = 26), and healthy age‐matched controls (n = 20) underwent assessment of cognitive and physical function and CCM. Results There was a progressive reduction in corneal nerve fiber density (CNFD), branch density (CNBD), and fiber length (CNFL) (P