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ORIGINAL RESEARCH article

Front. Neurosci.

Sec. Neurodegeneration

Volume 19 - 2025 | doi: 10.3389/fnins.2025.1558448

This article is part of the Research Topic Advancing personalized diagnosis and treatment in Parkinson's Disease: Integrating biomarkers, neuroimaging, and artificial intelligence View all 4 articles

Differential Cognitive Functioning in the Digital Clock Drawing Test in AD-MCI and PD-MCI Populations

Provisionally accepted
  • 1 School of Medical Technology and lnformation Engineering, Zhejiang Chinese Medical University, Hangzhou, Jiangsu Province, China
  • 2 School of Information Engineering, Hangzhou Medical College, Hangzhou, Jiangsu Province, China
  • 3 Zhejiang Engineering Research Center for Brain Cognition and Brain Diseases Digital Medical Instruments, Hangzhou Medical College, Hangzhou, Jiangsu Province, China
  • 4 Department of Neurology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China

The final, formatted version of the article will be published soon.

    Mild cognitive impairment (MCI) is common in Alzheimer's disease (AD) and Parkinson's disease (PD), but there are differences in pathogenesis and cognitive performance between Mild cognitive impairment due to Alzheimer's disease (AD-MCI) and Parkinson's disease with Mild cognitive impairment (PD-MCI) populations. Studies have shown that assessments based on the digital clock drawing test (dCDT) can effectively reflect cognitive deficits. Based on this, we proposed the following research hypothesis: there is a difference in cognitive functioning between AD-MCI and PD-MCI populations in the CDT, and the two populations can be effectively distinguished based on this feature. To test this hypothesis, we designed the dCDT to extract digital biomarkers that can characterize and quantify cognitive function differences between AD-MCI and PD-MCI populations. We enrolled a total of 40 AD-MCI patients, 40 PD-MCI patients, 41 PD with normal cognition (PD-NC) patients and 40 normal cognition (NC) controls. Through a cross-sectional study, we revealed a difference in cognitive function between AD-MCI and PD-MCI populations in the dCDT, which distinguished AD-MCI from PD-MCI patients, the area under the roc curve (AUC) = 0.923, 95% confidence interval (CI) = 0.866 -0.983. The AUC for effective differentiation between AD-MCI and PD-MCI patients with high education (≥ 12 years of education) was 0.968, CI = 0.927 -1.000. By correlation analysis, we found that the overall plotting of task performance score (VFDB1) correlated with the [visuospatial/executive] subtest score on the Montreal Cognitive Assessment (MoCA) scale (Spearman rank correlation coefficient [R] = 0.472, p < 0.001). Thus, the dCDT is a tool that can rapidly and accurately characterize and quantify differences in cognitive functioning in AD-MCI and PD-MCI populations.

    Keywords: Alzheimer's disease, Parkinson's disease, Mild Cognitive Impairment, digital clock drawing test, Cognitive Function, digital biomarkers

    Received: 10 Jan 2025; Accepted: 26 Feb 2025.

    Copyright: © 2025 Wang, Li, Huang, Liu, Li, Tu, Wang, Zhang, Luo and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Kai Li, School of Information Engineering, Hangzhou Medical College, Hangzhou, Jiangsu Province, China
    Tong Chen, Department of Neurology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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