From the Divisions of Epidemiology (M.M.Mielke, R.O.R., R.C.P., Y.E.G.) and Biomedical Statistics and Informatics (H.J.W., S.D.W.), Department of Health Sciences Research; Departments of Neurology (R.S., D.S.K., R.O.R, R.C.P.), Psychiatry and Psychology (M.M.Machulda), and Radiology (P.V., V.J.L, C.R.J.), Mayo Clinic, Rochester, MN; and Departments of Psychiatry, Psychology, and Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
Neurology. 2014 Jan 7;82(1):70-6. doi: 10.1212/01.wnl.0000438229.56094.54. Epub 2013 Dec 26.
We determined whether head trauma was associated with amyloid deposition and neurodegeneration among individuals who were cognitively normal (CN) or had mild cognitive impairment (MCI).
Participants included 448 CN individuals and 141 individuals with MCI from the Mayo Clinic Study of Aging who underwent Pittsburgh compound B (PiB)-PET, fluorodeoxyglucose-PET, and MRI. Head trauma was defined as a self-reported brain injury with at least momentary loss of consciousness or memory. Regression models examined whether head trauma was associated with each neuroimaging variable (assessed as continuous and dichotomous measures) in both CN and MCI participants, controlling for age and sex.
Among 448 CN individuals, 74 (17%) self-reported a head trauma. There was no difference in any neuroimaging measure between CN subjects with and without head trauma. Of 141 participants with MCI, 25 (18%) self-reported a head trauma. MCI participants with a head trauma had higher amyloid levels (by an average 0.36 standardized uptake value ratio units, p = 0.002).
Among individuals with MCI, but not CN individuals, self-reported head trauma with at least momentary loss of consciousness or memory was associated with greater amyloid deposition, suggesting that head trauma may be associated with Alzheimer disease-related neuropathology. Differences between CN individuals and individuals with MCI raise questions about the relevance of head injury-PET abnormality findings in those with MCI.
我们旨在确定头部创伤是否与认知正常(CN)或轻度认知障碍(MCI)个体的淀粉样蛋白沉积和神经退行性变有关。
参与者包括来自梅奥诊所衰老研究的 448 名认知正常个体和 141 名轻度认知障碍个体,他们接受了匹兹堡化合物 B(PiB)-PET、氟脱氧葡萄糖-PET 和 MRI 检查。头部创伤的定义为自我报告的脑损伤,至少有瞬间意识丧失或记忆丧失。回归模型检查了头部创伤是否与 CN 和 MCI 参与者的每个神经影像学变量(连续和二分变量评估)相关,同时控制了年龄和性别。
在 448 名认知正常个体中,有 74 名(17%)自我报告头部创伤。有头部创伤的 CN 个体与无头部创伤的个体之间,任何神经影像学测量均无差异。在 141 名轻度认知障碍参与者中,有 25 名(18%)自我报告头部创伤。有头部创伤的 MCI 参与者的淀粉样蛋白水平更高(平均标准化摄取比值单位增加 0.36,p = 0.002)。
在 MCI 个体中,但在认知正常个体中,自我报告的至少有瞬间意识丧失或记忆丧失的头部创伤与更大的淀粉样蛋白沉积相关,这表明头部创伤可能与阿尔茨海默病相关的神经病理学有关。认知正常个体和 MCI 个体之间的差异提出了关于 MCI 个体中头部损伤-PET 异常发现的相关性问题。