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早发性阿尔茨海默病的进展是否快于晚发性阿尔茨海默病?一项临床进展和脑脊液生物标志物的病例对照研究。

Does Alzheimer's disease with early onset progress faster than with late onset? A case-control study of clinical progression and cerebrospinal fluid biomarkers.

机构信息

Department of Neurology, University Hospital of Copenhagen, Roskilde Hospital, Køgevej 7–13, Roskilde, Denmark.

出版信息

Dement Geriatr Cogn Disord. 2012;33(2-3):111-7. doi: 10.1159/000337386. Epub 2012 Apr 12.

Abstract

BACKGROUND

Early-onset Alzheimer's disease (EOAD) is generally thought to have a more rapid course compared to late-onset Alzheimer's disease (LOAD). The faster progression of EOAD observed in some studies has also been thought to correlate with cerebrospinal fluid (CSF) biomarkers. Our clinical experience has not been suggestive of any difference in disease progression; therefore, we decided to investigate whether differences in clinical progression and CSF biomarkers between EOAD and LOAD could be demonstrated.

METHODS

Case-control study with 42 patients, 21 EOAD and 21 matched LOAD patients. Rates of progression were calculated and these, as well as CSF biomarker levels, were statistically compared.

RESULTS

There were no statistically significant differences in clinical progression between the EOAD group and the LOAD group. There was no significant difference in the absolute values of CSF biomarkers, but a tendency towards lower levels of β-amyloid in patients with EOAD was observed.

CONCLUSIONS

Our findings did not converge with results from the majority of previous studies, which have been suggestive of a faster clinical progression in EOAD. Possibly, the very strict algorithm by which our patients were matched explains our findings. However, the findings should be repeated in a larger study population.

摘要

背景

早发性阿尔茨海默病(EOAD)通常被认为比晚发性阿尔茨海默病(LOAD)具有更快的病程。一些研究中观察到的 EOAD 更快的进展也被认为与脑脊液(CSF)生物标志物相关。我们的临床经验并未提示疾病进展有任何差异;因此,我们决定研究 EOAD 和 LOAD 之间的临床进展和 CSF 生物标志物是否存在差异。

方法

对 42 例患者进行病例对照研究,其中 21 例为 EOAD,21 例为匹配的 LOAD。计算进展率,并对这些进展率以及 CSF 生物标志物水平进行统计学比较。

结果

EOAD 组和 LOAD 组之间的临床进展无统计学差异。CSF 生物标志物的绝对值没有显著差异,但在 EOAD 患者中观察到 β-淀粉样蛋白水平有降低的趋势。

结论

我们的发现与大多数先前研究的结果不一致,这些研究表明 EOAD 的临床进展更快。可能是我们的患者匹配非常严格的算法解释了我们的发现。然而,这一发现应该在更大的研究人群中重复。

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