Impact of atrial fibrillation on the cognitive decline in Alzheimer's disease.
Impact of atrial fibrillation on the cognitive decline in Alzheimer's disease.
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DOI：
10.1186/s13195-023-01165-1
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发表时间：
2023-01-13
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影响因子：
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心房颤动（AF）是阿尔茨海默病（AD）的一个强有力的危险因素，独立于缺血性卒中。然而，AF对AD严重程度的临床病理学影响尚未得到很好的阐明。我们的目的是通过影像学数据研究有AF和无AF的痴呆患者之间的临床差异。在获得机构伦理委员会批准后，对新诊断的AD或遗忘型轻度认知障碍（aMCI）患者进行回顾性筛选（n = 170，79.5 ± 7.4岁）。认知功能评估采用简易精神状态检查（MMSE）。根据MRI数据，评价脑体积、脑微出血（CMB）、脑室周围白色病变（WML）和深部WML。用123 I-IMP SPECT测定局部脑血流量（rCBF）。在这些患者中，分别有14例（8.2%）和156例（91.8%）房颤（房颤组）和窦性心律（SR组）。AF组的MMSE评分显著低于SR组（平均值[标准差（SD）]：分别为19.4 [4.4]和22.0 [4.4]; p = 0.0347）。两组之间的脑容量和CMB没有差异。AF组的室周WML（而非深部WML）显著大于SR组（平均值[SD] mL：分别为6.85 [3.78]和4.37 [3.21]; p = 0.0070）。但在与AD病理相关的区域，两组的rCBF无显著差异。AD和aMCI伴AF患者表现出更严重的认知功能下降，沿着更大的室周WML，与SR患者相比，尽管AF和SR患者的rCBF减少没有差异。在AF痴呆患者中，白色病变可能是比脑血流受损更重要的病理。未来需要更大规模的研究来证实我们的发现。在线版本包含补充材料，可通过10.1186/s13195-023-01165-1获得。
Atrial fibrillation (AF) is a strong risk factor for Alzheimer’s disease (AD) independent of ischemic stroke. However, the clinicopathological impact of AF on the severity of AD has not been well elucidated. We aimed to investigate the clinical differences between dementia patients with AF and those without AF by means of imaging data. Following approval from the institutional ethics committee, patients with newly diagnosed AD or amnestic mild cognitive impairment (aMCI) were retrospectively screened (n = 170, 79.5 ± 7.4 years old). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Based on the MRI data, the cerebral volume, cerebral microbleeds (CMBs), periventricular white matter lesions (WMLs), and deep WMLs were evaluated. The regional cerebral blood flow (rCBF) was measured using 123I-IMP SPECT. Of the patients, 14 (8.2%) and 156 (91.8%) had AF (AF group) and sinus rhythm (SR group), respectively. The AF group had significantly lower MMSE scores than the SR group (average [standard deviation (SD)]: 19.4 [4.4] and 22.0 [4.4], respectively; p = 0.0347). Cerebral volume and CMBs did not differ between the two groups. The periventricular WMLs, but not the deep WMLs, were significantly larger in the AF group than in the SR group (mean [SD] mL: 6.85 [3.78] and 4.37 [3.21], respectively; p = 0.0070). However, there was no significant difference in rCBF in the areas related to AD pathology between the two groups. AD and aMCI patients with AF showed worse cognitive decline along with larger periventricular WMLs compared to those with SR, although the reduction of rCBF was not different between patients with AF and SR. The white matter lesions may be a more important pathology than the impairment of cerebral blood flow in dementia patients with AF. A larger study is needed to confirm our findings in the future. The online version contains supplementary material available at 10.1186/s13195-023-01165-1.
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DOI：
10.1016/j.jalz.2016.12.002
发表时间：
2017-07
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
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作者：
Sposato LA;Ruíz Vargas E;Riccio PM;Toledo JB;Trojanowski JQ;Kukull WA;Cipriano LE;Nucera A;Whitehead SN;Hachinski V
通讯作者：
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DOI：
10.1016/j.jalz.2011.03.005
发表时间：
2011-05
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
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影响因子：
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