Centre for Medical Research, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia.
Department of Medicine, University of Melbourne, Parkville, VIC, 3050, Australia.
Brain Imaging Behav. 2018 Feb;12(1):78-86. doi: 10.1007/s11682-016-9668-5.
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.
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。