Application value of structural MRI combined with computerized cognitive assessment based on VR eye-tracking technology in early diagnosis of Alzheimer's disease
Objective: To explore the clinical application value of structural MRI in conjunction with computerized cognitive assessment based on VR eye-tracking technology in early diagnosis of Alzheimer's disease (AD). Materials and Methods: Seventy-seven patients with early AD and fifty-eight cognitively unimpaired (CU) participants underwent the traditional neuropsychological scale assessment [including Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)], a 5-minute VR eye-tracking technology-based cognitive assessment, and 3D T1-weighted MRI. The hippocampal volume (HV) was quantified using an automatic structural analysis tool. Receiver operating characteristic (ROC) curves were constructed to analyze the diagnostic effectiveness of the single index (HV) and the combined index (HV along with the total score from the VR eye-tracking technology-based cognitive assessment) for AD.Results: (1) The area under ROC curve (AUC) of early AD diagnosed by HV was 0.629 (95％ CI:0.542-0.711). When combining HV with the VR eye-tracking cognitive assessment, the AUC increased to 0.825 (95％ CI: 0.751-0.885). The DeLong test results indicated a significant difference between the two methods (P<0.001). (2) The HV in the early AD group was significantly lower than that in the CU group (Z=-2.565, P=0.010). (3) The total score of VR eye-tracking cognitive assessment was positively correlated with MMSE score and MoCA score (r=0.531, 0.627, P<0.001). Conclusions: Combining computerized cognitive assessment using VR eye-tracking technology significantly enhances the diagnostic value of hippocampal volume in the early detection of AD.
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