Immunological and Neuroanatomical Markers for the Dynamics of Predementia Cognitive Disorders during Neurorehabilitation

Objectives. To study the relationship between measures of immunity and systemic inflammation and structural magnetic resonance imaging (MRI) indicators in patients with pre-dementia cognitive disorders (pre CI) during neurocognitive rehabilitation with the aim of identifying candidate markers for the efficacy of this rehabilitation. Materials and methods. The study group consisted of 49 patients with preMCI with memory impairments; patients were aged 60 years and older and underwent five-week neurorehabilitation courses. The control group consisted of 19 volunteers of similar age without cognitive disorders or immune-inflammatory disorders. Measures of cellular and humoral immunity and inflammatory markers were determined and structural MRI was performed. Results. preMCI was found to be associated with an elevated content of activated natural killers (NK cells) (0.63 ± 0.12% versus 0.22 ± 0.07% in the control group, p = 2.2 10^–7). Immunoglobulin G (IgG) levels of <12.5 g/liter in patients with preMCI and scores of <22 on the Montreal Cognitive Assessment (MoCA) were associated with decreases in the volume of the right nucleus accumbens (376 ± 35 mm³ with IgG <12.5 g/liter (p = 0.0013), 429 ± 40 mm³ at IgG >12.5 g/liter, and 480 ± 44 mm³ in the control group), as well as the thickness and volume of some other cortical areas. A logistic regression model (R² = 0.57; p < 1 10^–5; standard error of estimate 2.93) was built, including immunoglobulin G, NK cells, CD8⁺ NK cell levels, and the volume of the right amygdala, which predicted MoCA scores six months after rehabilitation courses. Conclusions. These studies provide the first demonstration that immune parameters in combination with socio-demographic data and brain morphometric indexes are highly significant as potential prognostic markers reflecting the response to neurorehabilitation.