Ecology of the aging human brain.
Ecology of the aging human brain.
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DOI：
10.1001/archneurol.2011.157
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发表时间：
2011-08
影响因子：
--
通讯作者：
Montine, Thomas J.
中科院分区：
文献类型：
--
作者：
Sonnen, Joshua A.;Cruz, Karen Santa;Hemmy, Laura S.;Woltjer, Randall;Leverenz, James B.;Montine, Kathleen S.;Jack, Clifford R.;Kaye, Jeffrey;Lim, Kelvin;Larson, Eric B.;White, Lon;Montine, Thomas J.
在以社区或人群为基础的研究中，阿尔茨海默病（AD）、脑血管脑损伤（VBI）和等皮质路易体病（LBD）是导致痴呆的主要因素：成人思维变化（ACT）研究、檀香山-亚洲老龄化研究（HAAS）、Nun研究（NS）和俄勒冈脑衰老研究（OBAS）。然而，这些疾病在认知正常（CN）成人中临床沉默形式的患病率尚不清楚。我们评估了来自ACT、HAAS、NS和OBAS的1672例脑尸检，其中424例符合CN标准。其中，336例患者进行了神经斑块（NP）密度、神经原纤维缠结（nft）的Braak分期、路易体（LB）分布和脑微梗死（CMIs）数量的综合神经病理学检查。47%的CN病例有中度或频繁NP密度；其中6%的人也有brakv或VI期的nft。CN病例中15%为髓性LBD；8%的人还患有神经性LBD， 4%的人患有等皮质性LBD。33%的CN患者存在CMIs， 10%的CN患者存在高水平CMIs。每个个体的总体病变负担及其合并症在每项研究中差异很大，但研究之间是相似的。这些数据表明，老年CN成人大脑中亚临床疾病的复杂收敛性存在个体差异。认识到这一生态应该有助于指导未来的生物标志物或神经影像学研究，以及以社区或人群为基础的临床试验。
Alzheimer’s disease (AD), cerebral vascular brain injury (VBI), and isocortical Lewy body (LB) disease (LBD) are the major contributors to dementia in community- or population-based studies: Adult Changes in Thought (ACT) study, Honolulu-Asia Aging Study (HAAS), Nun Study (NS), and Oregon Brain Aging Study (OBAS). However, the prevalence of clinically silent forms of these diseases in cognitively normal (CN) adults is less clear. We evaluated 1672 brain autopsies from ACT, HAAS, NS, and OBAS of which 424 met criteria for CN. Of these, 336 cases had a comprehensive neuropathologic examination of neuritic plaque (NP) density, Braak stage for neurofibrillary tangles (NFTs), Lewy body (LB) distribution, and number of cerebral microinfarcts (CMIs). 47% of CN cases had moderate or frequent NP density; of these 6% also had Braak stage V or VI for NFTs. 15% of CN cases had medullary LBD; 8% also had nigral and 4% isocortical LBD. The presence of any CMIs was identified in 33% and high level CMIs in 10% of CN individuals. Overall burden of lesions in each individual and their co-morbidity varied widely within each study but were similar among studies. These data show an individually varying complex convergence of subclinical diseases in the brain of older CN adults. Appreciating this ecology should help guide future biomarker or neuroimaging studies as well as clinical trials that focus on community- or population-based cohorts.
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影响因子：
--
作者：
Massoud, F;Devi, G;Mayeux, R
通讯作者：
Mayeux, R
影响因子：
120.7
作者：
Snowdon, DA;Kemper, SJ;Markesbery, WR
通讯作者：
Markesbery, WR
影响因子：
6.4
作者：
Leverenz, James B.;Hamilton, Ronald;Montine, Thomas J.
通讯作者：
Montine, Thomas J.
影响因子：
4.2
作者：
Price, Joseph L.;McKeel, Daniel W., Jr.;Buckles, Virginia D.;Roe, Catherine M.;Xiong, ChengJie;Grundman, Michael;Hansen, Lawrence A.;Petersen, Ronald C.;Parisi, Joseph E.;Dickson, Dennis W.;Smith, Charles D.;Davis, Daron G.;Schmitt, Frederick A.;Markesbery, William R.;Kaye, Jeffrey F.;Kurlan, Roger;Hulette, Christine;Kurland, Brenda F.;Higdon, Roger;Kukull, Walter;Morris, John C.
通讯作者：
Morris, John C.
影响因子：
9.9
作者：
Schmitt, FA;Davis, DG;Markesbery, WR
通讯作者：
Markesbery, WR