Autonomic Nervous System Dysfunctions as a Basis for a Predictive Model of Risk of Neurological Disorders in Subjects with Prior History of Traumatic Brain Injury: Implications in Alzheimer's Disease.
Autonomic Nervous System Dysfunctions as a Basis for a Predictive Model of Risk of Neurological Disorders in Subjects with Prior History of Traumatic Brain Injury: Implications in Alzheimer's Disease.
复制标题
DOI：
10.3233/jad-160948
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Pasinetti GM
中科院分区：
文献类型：
--
作者：
Ho L;Legere M;Li T;Levine S;Hao K;Valcarcel B;Pasinetti GM
自主神经功能障碍在痴呆症患者中非常常见，它的存在也可能有助于痴呆症亚型的鉴别诊断。阿尔茨海默病(AD)影响的各种中枢神经系统结构也与中枢自主神经系统(ANS)调节有关。例如，AD的中枢胆碱能功能缺陷可能导致自主神经功能障碍。我们最近开发了一种简单、易于应用的评估方法，用于监测创伤性脑损伤(TBI)的ANS障碍。这种监测脑损伤的能力可以检测并有针对性地预防脑损伤引起的长期、有害的大脑反应，这些反应会导致神经退行性疾病，如阿尔茨海默病。我们从使用ANS评估方案进行评估的受试者中随机选择并提取未识别的病历信息。使用机器学习策略分析来自个体的信息以及ANS评估方案组件的组合，我们确定了一种新的预测模型，该模型有效地正确区分了有或没有记录的脑损伤暴露史的病例。我们的研究结果支持创伤诱发的ANS功能障碍可能与临床脑外伤的特征有关的假说。由于自主神经功能障碍在AD患者中非常常见，因此脑外伤也可能通过这些新的机制促进AD和/或其他形式的痴呆。这项研究提供了一种新的预测模型来生理学地评估有脑外伤病史的受试者发生临床脑损伤并发症的可能性，如AD。
Autonomic dysfunction is very common in patients with dementia, and its presence might also help in differential diagnosis among dementia subtypes. Various central nervous system structures affected in Alzheimer’s disease (AD) are also implicated in the central autonomic nervous system (ANS) regulation. For example, deficits in central cholinergic function in AD could likely lead to autonomic dysfunction. We recently developed a simple, readily applicable evaluation for monitoring ANS disturbances in response to traumatic brain injury (TBI). This ability to monitor TBI allows for the possible detection and targeted prevention of long-term, detrimental brain responses caused by TBI that lead to neurodegenerative diseases such as AD. We randomly selected and extracted de-identified medical record information from subjects who have been assessed using the ANS evaluation protocol. Using machine learning strategies in the analysis of information from individual as well as a combination of ANS evaluation protocol components, we identified a novel prediction model that is effective in correctly segregating between cases with or without a documented history of TBI exposure. Results from our study support the hypothesis that trauma-induced ANS dysfunctions may contribute to clinical TBI features. Because autonomic dysfunction is very common in AD patients it is possible that TBI may also contribute to AD and/or other forms of dementia through these novel mechanisms. This study provides a novel prediction model to physiologically assess the likelihood of subjects with prior history of TBI to develop clinical TBI complications, such as AD.