KORELASI NILAI VOLUMETRIK KORTEKS ENTORHINAL DENGAN NILAI MOCA-INA PENDERITA DEMENSIA DI KLINIK MEMORI RSUP DR SARDJITO

AGUS NUR SALIM W, Dr. dr. Astuti, Sp.S(K); dr. Rusdy Ghazali Malueka, Ph.D, Sp.S(K)

2021 | Tesis-Spesialis | NEUROLOGI

Demensia merupakan penyakit tidak menular yang angka kejadiannya semakin meningkat. Akurasi diagnosis masih menjadi tantangan hingga saat ini. Selain pemeriksaan neuropsikologi seperti MoCA-Ina, telah dikembangkan berbagai pemeriksaan biomarker untuk menunjang diagnosis, salah satunya MRI kepala. Korteks entorhinal (KER) merupakan salah satu fokus anatomi di otak sebagai bahan analisis karena merupakan tempat paling awal proses demensia terjadi bahkan sebelum mencapai hipokampus. Tujuan penelitian ini adalah untuk mengetahui korelasi nilai volumetrik KER dengan nilai MoCA-Ina penderita demensia di Klinik Memori RSUP Dr Sardjito. Metode penelitian adalah dengan rancangan analitik observasional dengan pendekatan potong lintang berbasis rumah sakit. Penelitian dilakukan antara bulan Oktober 2020 hingga Juni 2021 dengan total 40 subjek pasien demensia. Hasil penelitian didapatkan mayoritas pasien terdiagnosis demensia Alzheimer (32,5%), rerata usia 67,87 �± 9,72 tahun, berjenis kelamin laki-laki (65%), tingkat pendidikan SMA (32,5%), median lama pendidikan 12 (9-18) tahun, menikah (87,5%), dan sudah tidak aktif bekerja (77,5%). Analisis bivariat terdapat korelasi bermakna dengan kekuatan korelasi kategori sedang (r=0,413, p=0,008) antara variabel ketebalan KER dekstra dengan nilai MoCA-Ina. Analisis multivariat menunjukkan ketebalan KER dekstra dan status pekerjaan secara independen berkorelasi signifikan terhadap nilai MoCA-Ina. Kesimpulan penelitian yaitu terdapat korelasi positif antara ketebalan KER dekstra dengan nilai MoCA-Ina pada penderita demensia.

Dementia is a non-communicable disease whose incidence is increasing. The accuracy of the diagnosis is still a challenge until now. In addition to neuropsychological examinations such as MoCA-Ina, various biomarker examinations have been developed to support the diagnosis, one of which is head MRI. The entorhinal cortex (ERC) is one of the anatomical foci in the brain for analysis because it is the earliest place for the dementia process to occur even before reaching the hippocampus. The aim of this study was to determine the correlation between the volumetric value of ERC and the value of MoCA-Ina in patients with dementia at the Memory Clinic, Dr. Sardjito General Hospital. The research method is an observational analytic design with a hospital-based cross-sectional approach. The study was conducted between October 2020 to June 2021 with a total of 40 dementia patients. The results showed that the majority of patients diagnosed with Alzheimer's dementia (32.5%), mean age 67.87 �± 9.72 years, male (65%), high school education level (32.5%), median length of education 12 (9-18) years, married (87.5%), and not actively working (77.5%). Bivariate analysis showed a significant correlation with moderate strength of correlation (r=0.413, p=0.008) between the right ERC thickness and the MoCA-Ina value. Multivariate analysis showed that the right ERC thickness and employment status were independently significantly correlated with the value of MoCA-Ina. The conclusion of the study is that there is a positive correlation between the thickness of the right KER and the value of MoCA-Ina in people with dementia

Kata Kunci : korteks entorhinal, demensia, MoCA-Ina