Accelerating Cortical Thinning: Unique to Dementia or Universal in Aging?
Accelerating Cortical Thinning: Unique to Dementia or Universal in Aging?
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DOI：
10.1093/cercor/bhs379
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发表时间：
2014-04-01
期刊：
影响因子：
3.7
通讯作者：
Walhovd, Kristine B.
中科院分区：
文献类型：
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作者：
Fjell, Anders M.;Westlye, Lars T.;Walhovd, Kristine B.
衰老中的皮质加速萎缩，特别是在易患早期阿尔茨海默病(AD)的区域，是否明确地标志着神经退行性疾病，或者它是否可能是正常衰老的一部分？我们通过三种方式解决了这个问题。首先，横断面(n=1100)和纵向(n=207)描绘了皮质厚度的年龄轨迹。其次，通过将样本与极轻至中度AD患者的样本混合来模拟未检测到的AD对年龄轨迹的影响。第三，根据2年神经心理稳定性、脑脊液A(1-42)水平和载脂蛋白4阴性，在早期AD概率非常低的老年人中，检查了AD易损区的萎缩。在大多数区域可以看到稳步下降，但在各组中观察到内嗅皮层加速变薄。非常低风险的老年人有类似于其他健康老年人的纵向内嗅觉萎缩率，这种萎缩是记忆变化的预测。虽然皮质厚度的稳步下降是衰老的常态，但AD易发区域的加速并不是神经退行性疾病的唯一标志，而是健康衰老的一部分。内脏变化和记忆表现变化之间的关系表明，易患AD的区域的非AD机制可能仍然是认知能力下降的原因。
Does accelerated cortical atrophy in aging, especially in areas vulnerable to early Alzheimers disease (AD), unequivocally signify neurodegenerative disease or can it be part of normal aging? We addressed this in 3 ways. First, age trajectories of cortical thickness were delineated cross-sectionally (n 1100) and longitudinally (n 207). Second, effects of undetected AD on the age trajectories were simulated by mixing the sample with a sample of patients with very mild to moderate AD. Third, atrophy in AD-vulnerable regions was examined in older adults with very low probability of incipient AD based on 2-year neuropsychological stability, CSF A(1-42) levels, and apolipoprotein ?4 negativity. Steady decline was seen in most regions, but accelerated cortical thinning in entorhinal cortex was observed across groups. Very low-risk older adults had longitudinal entorhinal atrophy rates similar to other healthy older adults, and this atrophy was predictive of memory change. While steady decline in cortical thickness is the norm in aging, acceleration in AD-prone regions does not uniquely signify neurodegenerative illness but can be part of healthy aging. The relationship between the entorhinal changes and changes in memory performance suggests that non-AD mechanisms in AD-prone areas may still be causative for cognitive reductions.