Cognitive profile of amyloid burden and white matter hyperintensities in cognitively normal older adults.
Cognitive profile of amyloid burden and white matter hyperintensities in cognitively normal older adults.
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DOI：
10.1523/jneurosci.2462-12.2012
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发表时间：
2012-11-14
期刊：
影响因子：
--
通讯作者：
Rentz DM
中科院分区：
文献类型：
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作者：
Hedden T;Mormino EC;Amariglio RE;Younger AP;Schultz AP;Becker JA;Buckner RL;Johnson KA;Sperling RA;Rentz DM
淀粉样蛋白负荷和白质高强度（WMH）是老年神经退行性变的两个常见标志。每一个都代表了影响认知的与年龄相关的神经系统疾病的潜在早期指标。在相当一部分认知正常的老年人中观察到淀粉样蛋白的存在，但关于非痴呆人群中的淀粉样蛋白是否对认知有害，文献仍然模棱两可。同样，在许多非痴呆的老年人中检测到WMH，并且有大量证据表明WMH与执行功能和其他认知领域的下降有关。目前的研究调查了65至86岁临床正常老年人（N=168）的淀粉样蛋白负担和WMH，并检查了每种生物标志物与情景记忆、执行功能和处理速度的认知领域的关系。每个领域的因素都是在理论基础上从神经心理学电池中得出的，没有参考认知和生物标志物之间的关系。淀粉样蛋白负荷与WMH无相关性。年龄与所有认知领域的较低表现有关，而较高的语言智力与所有领域的较高表现有关。假设驱动的测试显示，淀粉样蛋白负担和WMH具有不同的认知特征，淀粉样蛋白负担对情景记忆有特定的影响，而WMH主要与执行功能相关，但对其他领域有广泛（但较小）的影响。这些发现表明，即使在临床损害之前，淀粉样蛋白负担和WMH可能代表具有不同病因和对认知的可分离影响的神经病理级联反应。
Amyloid burden and white matter hyperintensities (WMH) are two common markers of neurodegeneration present in advanced aging. Each represents a potential early indicator of an age-related neurological disorder that impacts cognition. The presence of amyloid is observed in a substantial subset of cognitively normal older adults, but the literature remains equivocal regarding whether amyloid in nondemented populations is deleterious to cognition. Similarly, WMH are detected in many nondemented older adults and there is a body of evidence indicating that WMH are associated with decreased executive function and other cognitive domains. The current study investigated amyloid burden and WMH in clinically normal older adult humans aged 65 to 86 (N=168) and examined each biomarker’s relation with cognitive domains of episodic memory, executive function, and speed of processing. Factors for each domain were derived from a neuropsychological battery on a theoretical basis without reference to the relation between cognition and the biomarkers. Amyloid burden and WMH were not correlated with one another. Age was associated with lower performance in all cognitive domains, while higher estimated verbal intelligence was associated with higher performance in all domains. Hypothesis-driven tests revealed that amyloid burden and WMH had distinct cognitive profiles, with amyloid burden having a specific influence on episodic memory and WMH being primarily associated with executive function but having broad (but lesser) effects on the other domains. These findings suggest that even prior to clinical impairment, amyloid burden and WMH likely represent neuropathological cascades with distinct etiologies and dissociable influences on cognition.