Cerebrovascular and amyloid pathology in predementia stages: the relationship with neurodegeneration and cognitive decline.
Cerebrovascular and amyloid pathology in predementia stages: the relationship with neurodegeneration and cognitive decline.
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DOI：
10.1186/s13195-017-0328-9
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发表时间：
2017-12-29
期刊：
影响因子：
--
通讯作者：
Vos SJB
中科院分区：
文献类型：
--
作者：
Bos I;Verhey FR;Ramakers IHGB;Jacobs HIL;Soininen H;Freund-Levi Y;Hampel H;Tsolaki M;Wallin ÅK;van Buchem MA;Oleksik A;Verbeek MM;Olde Rikkert M;van der Flier WM;Scheltens P;Aalten P;Visser PJ;Vos SJB
脑血管疾病（CVD）和β淀粉样蛋白（Aβ）经常共存，但它们对痴呆前期神经退行性变和认知的影响仍不清楚。我们研究了 CVD 和 Aβ 对非痴呆患者神经退行性标志物和认知的关联。我们纳入了来自 BioBank 阿尔茨海默病中心林堡队列 (n = 99)、LeARN (n = 50) 和 DESCRIPA (n = 122) 多中心研究的 271 名记忆诊所患者，他们患有主观或客观认知缺陷，但没有痴呆。脑脊液 Aβ1-42 和磁共振成像 (MRI) 扫描中的白质高信号 (WMH) 分别用作 Aβ 和 CVD 的测量。根据 Aβ 和 WMH 的存在（+）或不存在（-），个体被分为四组。我们使用一般线性模型研究了组间磷酸化 tau、总 tau (t-tau) 和内侧颞叶萎缩 (MTA) 的差异。我们使用线性混合模型和 Cox 比例风险模型检查了认知能力下降和痴呆的进展。所有分析均根据研究和人口统计数据进行了调整。 Aβ − WMH+、Aβ + WMH−和Aβ + WMH+组中MTA和t-tau升高。与单一病理组相比，Aβ + WMH+ 组的 MTA 最严重。 WMH 和 Aβ 都与认知能力下降有关，但同时患有这两种病症与认知能力下降速度更快无关。在本研究中，我们发现 Aβ 和 CVD 病理学与基线 MTA 存在累加关联，但与认知能力下降无关。由于我们的研究结果可能对记忆诊所患者的诊断和预后以及未来的科学研究产生影响，因此应该在更大的样本和更长时间的随访中对其进行验证。本文的在线版本 (doi:10.1186/s13195-017-0328-9) 包含补充材料，可供授权用户使用。
Cerebrovascular disease (CVD) and amyloid-β (Aβ) often coexist, but their influence on neurodegeneration and cognition in predementia stages remains unclear. We investigated the association between CVD and Aβ on neurodegenerative markers and cognition in patients without dementia. We included 271 memory clinic patients with subjective or objective cognitive deficits but without dementia from the BioBank Alzheimer Center Limburg cohort (n = 99) and the LeARN (n = 50) and DESCRIPA (n = 122) multicenter studies. CSF Aβ1–42 and white matter hyperintensities (WMH) on magnetic resonance imaging (MRI) scans were used as measures of Aβ and CVD, respectively. Individuals were classified into four groups based on the presence (+) or absence (−) of Aβ and WMH. We investigated differences in phosphorylated tau, total tau (t-tau), and medial temporal lobe atrophy (MTA) between groups using general linear models. We examined cognitive decline and progression to dementia using linear mixed models and Cox proportional hazards models. All analyses were adjusted for study and demographics. MTA and t-tau were elevated in the Aβ − WMH+, Aβ + WMH−, and Aβ + WMH+ groups. MTA was most severe in the Aβ + WMH+ group compared with the groups with a single pathology. Both WMH and Aβ were associated with cognitive decline, but having both pathologies simultaneously was not associated with faster decline. In the present study, we found an additive association of Aβ and CVD pathology with baseline MTA but not with cognitive decline. Because our findings may have implications for diagnosis and prognosis of memory clinic patients and for future scientific research, they should be validated in a larger sample with longer follow-up. The online version of this article (doi:10.1186/s13195-017-0328-9) contains supplementary material, which is available to authorized users.
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影响因子：
1.8
作者：
Hoenig, JM;Heisey, DM
通讯作者：
Heisey, DM
DOI：
10.1136/bmj.c3666
发表时间：
2010-07-26
期刊：
BMJ (Clinical research ed.)
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影响因子：
2.6
作者：
Aalten, Pauline;Ramakers, Inez H. G. B.;van der Flier, Wiesje M.
通讯作者：
van der Flier, Wiesje M.
影响因子：
9.9
作者：
Lo, Raymond Y.;Jagust, William J.
通讯作者：
Jagust, William J.