Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, 33 Fruit Street, Boston, MA 02114, USA.
Ann Neurol. 2010 Mar;67(3):353-64. doi: 10.1002/ana.21904.
To determine whether amyloid deposition is associated with impaired neuropsychological (NP) performance and whether cognitive reserve (CR) modifies this association.
In 66 normal elderly controls and 17 patients with Alzheimer disease (AD), we related brain retention of Pittsburgh Compound B (PiB) to NP performance and evaluated the impact of CR using education and American National Adult Reading Test intelligence quotient as proposed proxies.
We found in the combined sample of subjects that PiB retention in the precuneus was inversely related to NP performance, especially in tests of memory function, but also in tests of working memory, semantic processing, language, and visuospatial perception. CR significantly modified the relationship, such that at progressively higher levels of CR, increased amyloid deposition was less or not at all associated with poorer neuropsychological performance. In a subsample of normal controls, both the main effect of amyloid deposition of worse memory performance and the interaction with CR were replicated using a particularly challenging memory test.
Amyloid deposition is associated with lower cognitive performance both in AD patients and in the normal elderly, but the association is modified by CR, suggesting that CR may be protective against amyloid-related cognitive impairment.
确定淀粉样蛋白沉积是否与神经认知表现受损有关，以及认知储备（CR）是否会改变这种关联。
在 66 名正常老年对照者和 17 名阿尔茨海默病（AD）患者中，我们将匹兹堡化合物 B（PiB）在大脑中的保留情况与神经认知表现相关联，并使用教育和美国国家成人阅读测试智商作为提出的替代指标来评估 CR 的影响。
我们发现，在受试者的综合样本中，扣带回后部的 PiB 保留与 NP 表现呈负相关，特别是在记忆功能测试中，但在工作记忆、语义处理、语言和视空间感知测试中也是如此。CR 显著改变了这种关系，以至于随着 CR 水平的不断提高，淀粉样蛋白沉积与较差的神经认知表现的相关性降低或不存在。在正常对照组的一个亚组中，使用一项特别具有挑战性的记忆测试，复制了淀粉样蛋白沉积对记忆表现更差的主要影响以及与 CR 的相互作用。
淀粉样蛋白沉积与 AD 患者和正常老年人的认知表现下降有关，但这种关联受到 CR 的调节，这表明 CR 可能对与淀粉样蛋白相关的认知障碍具有保护作用。
