Neuropsychiatric Epidemiology Unit, Section for Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.
Neurobiol Aging. 2012 Jul;33(7):1186-93. doi: 10.1016/j.neurobiolaging.2011.01.011. Epub 2011 Mar 21.
We aimed to examine whether total intracranial volume (TICV), a marker of premorbid brain size, modified the impact of the apolipoprotein E (apoE) e4 phenotype and ischemic white matter lesions (WMLs) on odds for dementia. The study comprised a population-based sample of 104 demented and 135 nondemented 85-year-olds, and included physical and neuropsychiatric examinations, and head computerized tomography (CT). Dementia disorders were defined according to standard criteria. TICV and WMLs were rated on computerized tomography. Using the highest group as reference, the risk for dementia, Alzheimer's disease (AD), and vascular dementia (VaD) was increased in those with the smallest half, tertile, and quartile of TICV. Smaller TICV increased the odds of dementia, Alzheimer's disease, and vascular dementia in participants with WMLs. WMLs were not associated with increased odds of dementia in those with the largest TICV. The interaction term WMLs*TICV was also significant. TICV did not modify the odds of dementia in those with the apolipoprotein e4 phenotype. Our results suggest that the impact of brain pathology on the risk of dementia is modified by premorbid brain size.
我们旨在研究全脑容量（TICV），即脑大小的一种潜在标志物，是否会改变载脂蛋白 E（apoE）e4 表型和缺血性脑白质病变（WML）对痴呆症发病风险的影响。该研究纳入了一个基于人群的样本，包括 104 名痴呆症患者和 135 名 85 岁非痴呆症患者，这些患者接受了身体和神经精神检查以及头部计算机断层扫描（CT）。根据标准标准定义了痴呆症障碍。TICV 和 WML 在计算机断层扫描上进行了评分。使用最高组作为参考，TICV 最小半、三分位和四分位的参与者发生痴呆症、阿尔茨海默病（AD）和血管性痴呆（VaD）的风险增加。较小的 TICV 增加了 WML 参与者发生痴呆症、阿尔茨海默病和血管性痴呆的几率。WML 与 TICV 最大者的痴呆症发病风险增加无关。WML*TICV 的交互项也具有显著性。TICV 并未改变载脂蛋白 E 表型患者的痴呆症发病风险。我们的结果表明，脑病理学对痴呆症风险的影响受脑大小的影响。
