DYSPRAXIA AND AUTONOMIC CONTROL IN VERY EARLY AD

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 阿尔茨海默氏痴呆症只是一个跨越数十年的心理过程的最后阶段。 在临床医生能够检测到痴呆症之前，AD病理可能已经到达岛叶皮层，这与心率和血压的自主控制有关。 岛叶病变，尤其是右侧岛叶病变，与缓慢性心律失常、心率变异性降低和死亡率增加有关。 临床前AD应被视为非痴呆老年人心血管/跌倒相关发病率和死亡率的可能解释。 该研究将在三个认知障碍水平上检查右半球功能障碍和自主控制之间的关系。 所有受试者均无严重心脏病。 将通过结构性实践的测量和通过功能性MRI的局部脑血流量来评估右半球功能。 将通过对24份霍尔特记录的HRV进行统计分析，并辅以选定心律失常的频率和严重程度、直立性血压和症状自我报告，评估自主神经控制。 受试者将是年龄在75岁或以上的男性和女性非住院老年人。 将纳入正常对照、符合“轻度认知障碍”（MCI）标准的认知障碍受试者和轻度AD病例。 受试者将接受解剖和功能MRI。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Alzheimer's dementia is merely the final stage of a psychological process that spans decades. Before clinicians can detect dementia, AD pathology may have already reached the insular cortex, which is related to autonomic control of heart rate and blood pressure. Insular lesions, particularly on the right, are associated with bradyarrhythmias, decreased heart rate variability and increased mortality. Preclinical AD should be considered as a possible explanation for cardiovascular/fall related morbidity and mortality in non-demented elderly persons. The study will examine the association between right hemisphere dysfunction and autonomic control at three levels of cognitive impairment. All subject will be free of significant cardiac disease. Right hemisphere function will be assessed by measures of constructional praxis, and regional cerebral blood flow by functional MRI. Autonomic control will be assessed by statistical analyses of HRV derived from 24 Holter records, supplemented by the frequency and severity of selected cardiac arrhythmias, orthostatic blood pressure, and symptom self-reports. Subjects will be male and female non-institutionalized elderly persons, aged 75 years or older. Normal controls, cognitively impaired subjects meeting criteria for "Mild Cognitive Impairment" (MCI), and cases with mild AD will be included. Subjects will have anatomical and functional MRI.