Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands.
Department of Clinical Neurophysiology/MEG Center, VU University Medical Center, Amsterdam, the Netherlands.
Ann Neurol. 2017 May;81(5):749-753. doi: 10.1002/ana.24921. Epub 2017 May 4.
We studied whether continuous lower normal cerebrospinal fluid (CSF) amyloid β1-42 (≥640pg/ml) levels were related with rate of clinical progression in a sample of 393 nondemented memory clinic patients. Lower normal levels were associated with faster clinical progression, and this depended on baseline cognitive status (subjective cognitive decline: hazard ratio [HR] = 0.57, p < 0.05; mild cognitive impairment: HR = 0.19, p < .01), indicating that normal CSF amyloid levels do not exclude incident Alzheimer disease. These findings suggest that research on preclinical markers for Alzheimer disease should take the continuum of CSF amyloid β1-42 levels within the normal range into account. Ann Neurol 2017;81:749-753.
我们研究了 393 名非痴呆记忆门诊患者的样本中，脑脊液（CSF）中持续较低的正常β淀粉样蛋白 1-42（≥640pg/ml）水平是否与临床进展速度有关。较低的正常水平与更快的临床进展有关，这取决于基线认知状态（主观认知下降：危险比[HR] = 0.57，p < 0.05；轻度认知障碍：HR = 0.19，p <.01），表明正常 CSF 淀粉样蛋白水平并不能排除阿尔茨海默病的发生。这些发现表明，针对阿尔茨海默病临床前标志物的研究应该考虑到正常范围内β淀粉样蛋白 1-42 水平的连续变化。神经病学杂志 2017;81:749-753.
