认知受损老年人的神经精神症状与脑淀粉样蛋白沉积之间的关联

Associations between Neuropsychiatric Symptoms and Cerebral Amyloid Deposition in Cognitively Impaired Elderly People.

作者信息

Bensamoun David, Guignard Renaud, Furst Ansgar J, Derreumaux Alexandre, Manera Valeria, Darcourt Jacques, Benoit Michel, Robert Philippe H, David Renaud

机构信息

Centre Memoire de Ressources et de Recherche, Institut Claude Pompidou, EA CoBTek, University of Nice Sophia Antipolis, Nice, France.

Department of Nuclear Medicine, Hôpital de La Tour, Meyrin, GE, Switzerland.

出版信息

J Alzheimers Dis. 2016;49(2):387-98. doi: 10.3233/JAD-150181.

DOI:10.3233/JAD-150181

PMID:26484900

Abstract

BACKGROUND

Neuropsychiatric symptoms, also known as behavioral and psychological symptoms of dementia (BPSD), affect the majority of patients with dementia, and result in a greater cognitive and functional impairment.

OBJECTIVE

To investigate associations between BPSD and amyloid cerebral deposition as measured by 18F-Florbetapir-PET quantitative uptake in elderly subjects with and without cognitive impairment.

METHODS

Participants with cognitive impairment [mild cognitive impairment (MCI) or Alzheimer's disease (AD)] and healthy controls (HC) from the ADNI cohort (Alzheimer Disease Neuroimaging Initiative) who underwent an 18F-florbetapir PET scan between May 2010 and March 2014 were included. Clinical assessments included the Clinical Dementia Rating, the Mini-Mental State Examination (MMSE), and the Neuropsychiatric Inventory. Freesurfer software was used to extract PET counts based on T1-based structural ROI (frontal, cingulate, parietal, and temporal). Spearman's partial correlation scores between BPSD severity and regional amyloid uptake were calculated.

RESULTS

Data for 657 participants [age = 72.6 (7.19); MMSE = 27.4 (2.67)] were analyzed, including 230 HC [age = 73.1 (6.02); MMSE = 29 (1.21)], 308 MCI [age = 71.5 (7.44); MMSE = 28.0 (1.75)], and 119 AD subjects [age = 74.7 (8.05); MMSE = 23.1 (2.08)]. Considering all diagnostic groups together, positive significant correlations were found between anxiety and 18F-florbetapir uptake in the frontal (r = 0.102; p = 0.009), cingulate (r = 0.083; p = 0.034), and global cerebral uptake (r = 0.099; p = 0.011); between irritability and frontal (r = 0.089; p = 0.023), cingulate (r = 0.085; p = 0.030), parietal (r = 0.087; p = 0.025), and global cerebral uptake (r = 0.093; p = 0.017); in the MCI subgroup, between anxiety and frontal (r = 0.126; p = 0.03) and global uptake (r = 0.14; p = 0.013); in the AD subgroup, between irritability and parietal uptake (r = 0.201; p = 0.03).

CONCLUSION

Anxiety and irritability are associated with greater amyloid deposition in the neurodegenerative process leading to AD.

摘要

背景

神经精神症状，也称为痴呆的行为和心理症状（BPSD），影响大多数痴呆患者，并导致更大的认知和功能损害。

目的

研究在有和没有认知障碍的老年受试者中，通过18F-氟代贝他吡正电子发射断层扫描（PET）定量摄取测量的BPSD与脑淀粉样蛋白沉积之间的关联。

方法

纳入2010年5月至2014年3月期间接受18F-氟代贝他吡PET扫描的阿尔茨海默病神经影像学倡议（ADNI）队列中的认知障碍参与者[轻度认知障碍（MCI）或阿尔茨海默病（AD）]和健康对照（HC）。临床评估包括临床痴呆评定量表、简易精神状态检查表（MMSE）和神经精神科问卷。使用Freesurfer软件基于基于T1的结构感兴趣区（额叶、扣带回、顶叶和颞叶）提取PET计数。计算BPSD严重程度与区域淀粉样蛋白摄取之间的斯皮尔曼偏相关分数。

结果

分析了657名参与者的数据[年龄=72.6（7.19）；MMSE=27.4（2.67）]，包括230名HC[年龄=73.1（6.02）；MMSE=29（1.21）]、308名MCI[年龄=71.5（7.44）；MMSE=28.0（1.75）]和119名AD受试者[年龄=74.7（8.05）；MMSE=23.1（2.08）]。将所有诊断组综合考虑，发现焦虑与额叶（r=0.102；p=0.009）、扣带回（r=0.083；p=0.034）和全脑摄取（r=0.099；p=0.011）的18F-氟代贝他吡摄取之间存在显著正相关；易激惹与额叶（r=0.089；p=0.023）、扣带回（r=0.085；p=0.030）、顶叶（r=0.087；p=0.025）和全脑摄取（r=0.093；p=0.017）之间存在显著正相关；在MCI亚组中，焦虑与额叶（r=0.126；p=0.03）和全脑摄取（r=0.14；p=0.013）之间存在显著正相关；在AD亚组中，易激惹与顶叶摄取（r=0.201；p=0.03）之间存在显著正相关。