Effects of vitamin B12 on cognitive function in elderly patients
Effects of vitamin B12 on cognitive function in elderly patients
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维生素B12对老年患者认知功能的影响
DOI：
10.1002/alz.055458
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Atsushi Michael Kimura
中科院分区：
文献类型：
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作者：
福田 哲平;大西 康太;増田 真志;松崎 泰教;今野 歩;藤元 萌;大西 愛花;坂井 麻衣子;大南 博和;奥村 仙示;原 太一;平井 宏和;竹谷 豊;Atsushi Michael Kimura
研究背景建立阿尔茨海默病（Alzheimer 'sdisease，AD）的预防和治疗方法是一个亟待解决的问题.由于维生素B12（VB 12）对中枢神经系统具有神经保护作用，因此开始受到关注。最近，我们发现VB 12可以在体外抑制β-淀粉样蛋白毒性。此外，有报道称，VB 12可能有助于轻度认知障碍（MCI）患者的记忆保持。为了阐明VB 12对AD和MCI患者的影响，我们检查了VB 12对认知功能和局部脑血流量（rCBF）的影响。方法我们检查了46名在我们的记忆诊所咨询的参与者。他们被分为三组：阿尔茨海默病（AD），轻度认知障碍（MCI）和健康对照（HC），根据国家老龄化研究所阿尔茨海默病协会（NIA-AA）的诊断标准。我们使用韦氏记忆量表修订版（WMS-R）评估认知功能，并评估哪种功能退化。使用三维立体定向表面投影（3D-SSP）定量海马、丘脑和胼胝体边缘区的rCBF，这些区域与AD有明确的联系。结果在VB 12与记忆功能的相关性方面，MCI组中VB 12与视觉配对联想I/II的WMS-R评分显著相关，AD组中与言语配对联想I的WMS-R评分显著相关（均p<0.05）。此外，在HC组中，VB 12与视觉再现I、逻辑记忆I和视觉记忆广度的WMS‐R评分之间存在显著相关性（所有，p<0.05）。在VB_（12）与rCBF的相关性方面，MCI组左侧海马区VB_（12）浓度与rCBF显著相关（均p<0.05）。AD组和HC组rCBF与VB 12均无显著相关性。结论VB 12对记忆功能和rCBF有影响，在MCI中作用更明显。考虑到WMS-R和rCBF之间的关系，VB 12可能会影响痴呆的进展。早期应用VB 12干预可提高AD的治疗效果。
BackgroundEstablishing preventive and therapeutic methods for Alzheimer's disease (AD) is an urgent issue. Because Vitamin B12(VB12) has a neuroprotective effect on the central nervous system, it has begun to receive attention. Recently, we found that VB12 can suppress β‐amyloid toxicity in vitro. Besides, it has been reported that VB12 might be useful for keeping memory in Mild Cognitive Impairment (MCI). To clarify the effects of VB12 in AD and MCI patients, we examined the effects of the VB12 on cognitive function and regional cerebral blood flow (rCBF).MethodWe examined 46 participants who consulted to our memory clinic. They were divided into three groups: Alzheimer's disease (AD), mild cognitive impairment (MCI), and healthy controls (HC) based on the National Institute on Aging‐Alzheimer’s Association (NIA‐AA) diagnostic criteria. We used Wechsler Memory Scale‐Revised(WMS‐R) to assess the cognitive function and evaluate what kind of function is degraded. Three‐dimensional stereotactic surface projection(3D‐SSP)was used to quantify the rCBF of hippocampus, thalamus, and callosomarginal regions, which had a well‐established connection with AD. Multiple regression analysis was conducted to examine the correlations among serum VB12, WMS‐R, and rCBF in each group.ResultRegarding the correlations between VB12 and memory function, we found that the VB12 was significantly correlated with the WMS‐R scores of visual paired association I/II in the MCI group and the verbal paired associates I in the AD group (all, p<0.05). Besides, there were significant correlations between VB12 and WMS‐R scores of the visual reproduction I, logical memory I, and visual memory span in the HC group (all, p<0.05). Regarding the correlations between VB12 and rCBF, VB12 concentration was significantly correlated with the rCBF of the left hippocampal in the MCI group (all, p<0.05). Neither AD nor HC groups showed significant correlations between rCBF and VB12. Finally, the rCBF of the left hippocampus was positively correlated with visual paired association I/II(all, p<0.05).ConclusionThese results suggested that VB12 affects memory function and rCBF, especially in the MCI. Considering the relationship between WMS‐R and rCBF, VB12 may affect the progression of dementia. The early intervention with VB12 can be more effective in AD treatment strategies.