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自我报告的认知混乱与全脑和区域性β-淀粉样蛋白有关:来自女性健康老龄化项目的数据。

Self-reported confusion is related to global and regional β-amyloid: data from the Women's healthy ageing project.

机构信息

Centre for Medical Research, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia.

Department of Medicine, University of Melbourne, Parkville, VIC, 3050, Australia.

出版信息

Brain Imaging Behav. 2018 Feb;12(1):78-86. doi: 10.1007/s11682-016-9668-5.

Abstract

Disease-modifying treatments for Alzheimer's disease (AD) may require implementation during early stages of β-amyloid accumulation, well before patients have objective cognitive decline. In this study we aimed to assess the clinical value of subjective cognitive impairment (SCI) by examining the cross-sectional relationship between β-amyloid load and SCI. Cerebral β-amyloid and SCI was assessed in a cohort of 112 cognitively normal subjects. Subjective cognition was evaluated using specific questions on memory and cognition and the MAC-Q. Participants had cerebral β-amyloid load measured with F-Florbetaben Positron Emission Tomography (PET). No associations were found between measures of subjective memory impairment and cerebral β-amyloid. However, by self-reported confusion was predictive of a higher global β-amyloid burden (p = 0.002), after controlling for confounders. Regional analysis revealed significant associations of confusion with β-amyloid in the prefrontal region (p = 0.004), posterior cingulate and precuneus cortices (p = 0.004) and the lateral temporal lobes (p = 0.001) after controlling for confounders. An in vivo biomarker for AD pathology was associated with SCI by self-reported confusion on cross-sectional analysis. Whilst there has been a large body of research on SMC, our results indicate more research is needed to explore symptoms of confusion.

摘要

阿尔茨海默病(AD)的疾病修饰治疗可能需要在β-淀粉样蛋白积累的早期阶段实施,远早于患者出现客观认知能力下降。在这项研究中,我们旨在通过检查β-淀粉样蛋白负荷与主观认知障碍(SCI)的横断面关系来评估主观认知障碍的临床价值。在 112 名认知正常的受试者队列中评估了大脑β-淀粉样蛋白和 SCI。使用关于记忆和认知的特定问题和 MAC-Q 评估主观认知。参与者使用 F-Florbetaben 正电子发射断层扫描(PET)测量大脑β-淀粉样蛋白负荷。在控制混杂因素后,未发现主观记忆障碍测量值与大脑β-淀粉样蛋白之间存在关联。然而,自我报告的困惑与β-淀粉样蛋白总负荷呈正相关(p=0.002)。在控制混杂因素后,区域分析显示,困惑与前额叶(p=0.004)、后扣带回和楔前叶皮质(p=0.004)和外侧颞叶(p=0.001)的β-淀粉样蛋白之间存在显著关联。在横断面分析中,AD 病理的体内生物标志物与 SCI 相关,这与自我报告的困惑有关。虽然关于 SMC 的研究已经很多,但我们的结果表明,需要进一步研究来探索困惑的症状。

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