Hessen Erik, Nordlund Arto, Stålhammar Jacob, Eckerström Marie, Bjerke Maria, Eckerström Carl, Göthlin Mattias, Fladby Tormod, Reinvang Ivar, Wallin Anders
Department of Neurology, Akershus University Hospital, Oslo, Norway.
Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway.
J Alzheimers Dis. 2015;47(3):619-28. doi: 10.3233/JAD-150109.
There is a need to find very early markers for pre-clinical Alzheimer's disease as interventions early in the disease process are thought to be most effective.
The present study aimed to address the potential relation between cerebrospinal fluid (CSF) biomarkers and reduced cognitive function in a relatively young cohort of memory clinic patients with subjective cognitive decline.
122 patients (mean age 63 years) with subjective cognitive decline were recruited from two university memory clinics and followed for two years.
The main finding was that the subgroup with objective memory decline during the study period had significantly higher T-tau at baseline than the group with improved memory. Baseline CSF variables showed a trend toward more pathological values in the patients with memory decline compared to those who improved or remained stable. The baseline memory score of those who declined was significantly better than the baseline score of those who improved over two years. The general trend for the whole group was improved memory and executive test scores. There were no differences in cognitive scores based on CSF quartiles at baseline, nor were there differences in cognitive outcome for patients with early amnestic mild cognitive impairment versus average cognitive function at baseline.
The main finding that T-tau rather than amyloid-β was associated with memory decline do not support the prevailing opinion about the chain of events assumed to take place in Alzheimer's disease. In addition, memory decline was not associated with poor baseline memory score. Thus, a memory cut-off indicating low baseline memory would not would have identified the declining group.
由于认为在疾病进程早期进行干预最为有效,因此需要找到临床前阿尔茨海默病的极早期标志物。
本研究旨在探讨脑脊液(CSF)生物标志物与相对年轻的主观认知下降记忆门诊患者认知功能减退之间的潜在关系。
从两家大学记忆门诊招募了122名主观认知下降患者(平均年龄63岁),并随访两年。
主要发现是,在研究期间有客观记忆下降的亚组在基线时的总tau蛋白(T-tau)显著高于记忆改善的亚组。与记忆改善或保持稳定的患者相比,记忆下降患者的基线脑脊液变量呈现出更具病理性值的趋势。记忆下降患者的基线记忆评分显著高于两年内记忆改善患者的基线评分。整个组的总体趋势是记忆和执行测试评分有所改善。基线时基于脑脊液四分位数的认知评分没有差异,基线时早期遗忘型轻度认知障碍患者与平均认知功能患者的认知结果也没有差异。
主要发现是总tau蛋白而非淀粉样β蛋白与记忆下降相关,这一发现不支持关于阿尔茨海默病假定发生事件链的主流观点。此外,记忆下降与基线记忆评分不佳无关。因此,表明基线记忆低的记忆临界值并不能识别出记忆下降组。