Rolstad S, Nordlund A, Eckerström C, Gustavsson M H, Zetterberg H, Wallin A
Institute of Neuroscience and Physiology, Sahlgrenska Academy at Goteborg University, Mölndal, Sweden.
Dement Geriatr Cogn Disord. 2009;28(2):110-5. doi: 10.1159/000234912. Epub 2009 Aug 13.
The concept of the cognitive reserve (CR) hypothesizes that premorbid factors such as education enable compensation for the manifestation of brain pathology. Accordingly, pathology should be more prominent in individuals with higher CR before becoming clinically apparent. Previously, we found that patients subsequently converting to dementia with higher CR had lower concentrations of amyloid beta 42 (abeta42) as compared to patients with lower CR. However, the interaction between time, biomarkers, neuropsychological performance and CR is yet to be established.
To study the relation between biomarkers, neuropsychological performance and CR longitudinally.
A mixed between-within subject analysis of variance was performed for longitudinal analysis. Paired t tests were used for within group comparisons.
Patients with higher CR (n = 15) had significantly lower concentrations of abeta42 at both time points compared to those with medium (n = 23) and lower CR (n = 28). Also, abeta42 concentrations decreased significantly from baseline to follow-up in patients with higher and medium CR. Groups performed comparably on neuropsychological tests.
This study provides further support for the applicability of abeta42 as a substitute for pathology in relation to CR. Also, abeta42 reflects the disease progression in patients with higher and medium CR.
认知储备(CR)的概念假设,诸如教育程度等病前因素能够对脑病理学表现起到代偿作用。因此,在临床症状出现之前,病理学改变在认知储备较高的个体中应更为显著。此前,我们发现,与认知储备较低的患者相比,随后转变为痴呆症的认知储备较高的患者,其β淀粉样蛋白42(Aβ42)浓度更低。然而,时间、生物标志物、神经心理学表现和认知储备之间的相互作用尚未明确。
纵向研究生物标志物、神经心理学表现与认知储备之间的关系。
采用组间和组内混合方差分析进行纵向分析。配对t检验用于组内比较。
与中度认知储备(n = 23)和低度认知储备(n = 28)的患者相比,高度认知储备(n = 15)的患者在两个时间点的Aβ42浓度均显著更低。此外,高度和中度认知储备的患者从基线到随访时,Aβ42浓度均显著下降。各组在神经心理学测试中的表现相当。
本研究进一步支持了Aβ42作为与认知储备相关的病理学替代指标的适用性。此外,Aβ42反映了高度和中度认知储备患者的疾病进展。