The cross-sectional association between amyloid burden and white matter hyperintensities in older adults without cognitive impairment: A systematic review and meta-analysis.
The cross-sectional association between amyloid burden and white matter hyperintensities in older adults without cognitive impairment: A systematic review and meta-analysis.
复制标题
无认知障碍老年人淀粉样蛋白负荷与白质高信号之间的横断面关联：系统评价和荟萃分析。
DOI：
10.1016/j.arr.2023.101952
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发表时间：
2023
影响因子：
13.1
通讯作者：
Geerlings,MirjamI
中科院分区：
文献类型：
--
作者：
Twait,EmmaL;Min,Britt;Beran,Magdalena;Vonk,JetMJ;Geerlings,MirjamI
阿尔茨海默病 (AD) 是痴呆症最常见的原因，其特征是淀粉样蛋白 (Aβ) 聚集成斑块。 AD 患者经常表现出混合病理，通常由脑小血管疾病 (CSVD) 引起，导致白质高信号 (WMH) 等病变。当前的系统评价和荟萃分析调查了无客观认知障碍的老年人中淀粉样蛋白负荷与 WMH 之间的横断面关系。在 PubMed、Embase 和 PsycINFO 中进行的系统检索产生了 13 项符合条件的研究。使用 PET、CSF 或血浆测量来评估 Aβ。进行了两项荟萃分析：一项针对 Cohen d 指标，一项针对相关系数。荟萃分析显示，CSF 中的总体加权小到中 Cohen d 为 0.55（95% CI：0.31-0.78），CSF 中的总体相关性为 0.31（0.09-0.50），PET 中大 Cohen d 为 0.96（95% CI：0.66-1.27）。只有两项研究评估了血浆中的这种关系，效应大小为 - 0.20（95% CI：-0.75 至 0.34）。这些发现表明 PET 和 CSF 认知正常成人中淀粉样蛋白和血管病理之间存在关系。未来的研究应该评估血液β-淀粉样蛋白和 WMH 之间可能的关系，以便更广泛地识别在临床前阶段表现出混合病理的高危个体。
Alzheimer’s disease (AD) is the most common cause of dementia, characterized by the aggregation of amyloid-beta (Aβ) proteins into plaques. Individuals with AD frequently show mixed pathologies, often caused by cerebral small vessel disease (CSVD), resulting in lesions such as white matter hyperintensities (WMH). The current systematic review and meta-analysis investigated the cross-sectional relationship between amyloid burden and WMH in older adults without objective cognitive impairment. A systematic search performed in PubMed, Embase, and PsycINFO yielded 13 eligible studies. Aβ was assessed using PET, CSF, or plasma measurements. Two meta-analyses were performed: one on Cohen’s d metrics and one on correlation coefficients. The meta-analyses revealed an overall weighted small-to-medium Cohen’s d of 0.55 (95% CI: 0.31–0.78) in CSF, an overall correlation of 0.31 (0.09–0.50) in CSF, and a large Cohen’s d of 0.96 (95% CI: 0.66–1.27) in PET. Only two studies assessed this relationship in plasma, with an effect size of − 0.20 (95% CI: −0.75 to 0.34). These findings indicate a relationship between both amyloid and vascular pathologies in cognitively normal adults in PET and CSF. Future studies should assess the possible relationship of blood amyloid-beta and WMH for broader identification of at risk individuals showing mixed pathology in preclinical stages.