Cerebral amyloid angiopathy and its co-occurrence with Alzheimer's disease and other cerebrovascular neuropathologic changes.
Cerebral amyloid angiopathy and its co-occurrence with Alzheimer's disease and other cerebrovascular neuropathologic changes.
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脑淀粉样蛋白血管病及其与阿尔茨海默氏病和其他脑血管神经病理学变化的共同发生。
DOI：
10.1016/j.neurobiolaging.2015.06.028
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发表时间：
2015-10
影响因子：
4.2
通讯作者：
Kukull WA
中科院分区：
文献类型：
--
作者：
Brenowitz WD;Nelson PT;Besser LM;Heller KB;Kukull WA
我们在一个大型多中心尸检样本中研究了脑淀粉样血管病（CAA）、阿尔茨海默病神经病理学变化（ADNC）、其他血管性脑病理学和认知之间的关系。数据来自国家阿尔茨海默氏症协调中心（National Alzheimer's Coordinating Center），该中心对2005年至2012年期间死亡的尸检受试者（N= 3，976）进行了尸检。描述性统计和多变量回归模型估计CAA和其他病理之间的关联，以及CAA严重程度和接近死亡的认知测试分数之间的关联。CAA倾向于与ADNC同时发生，但有相当一部分病例存在差异。22%（n= 520）的频繁神经炎斑块受试者不存在CAA，但20.9%（n=91）的无神经炎斑块受试者存在CAA。在无/稀疏神经炎斑块的受试者中，非出血性脑梗死在CAA病理学患者中比无CAA病理学患者更常见（P= 0.007）。在没有APOE ε4等位基因的受试者中，CAA严重程度与死亡附近的认知能力降低相关，并考虑了其他病理因素。CAA在非AD患者中的存在可能表明一种独特的脑血管疾病。
We examined the relationship between cerebral amyloid angiopathy (CAA), Alzheimer’s disease neuropathologic changes (ADNC), other vascular brain pathologies, and cognition in a large multi-center autopsy sample. Data was obtained from the National Alzheimer’s Coordinating Center on autopsied subjects (N=3,976) who died between 2005 and 2012. Descriptive statistics and multivariable regression models estimated the associations between CAA and other pathologies, and between CAA severity and cognitive test scores proximal to death. CAA tended to co-occur with ADNC but a substantial minority of cases were discrepant. CAA was absent in 22% (n= 520) of subjects with frequent neuritic plaques but present in 20.9% (n=91) of subjects with no neuritic plaques. In subjects with no/sparse neuritic plaques, non-hemorrhagic brain infarcts were more common in those with CAA pathology than without (P= 0.007). In subjects without the APOE ε4 allele, CAA severity was associated with lower cognition proximal to death, factoring in other pathologies. The presence of CAA in non-AD patients may indicate a distinct cerebrovascular condition.