Jefferson-George Kyra S, Wolk David A, Lee Edward B, McMillan Corey T
Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Alzheimers Dement. 2017 Sep;13(9):1048-1053. doi: 10.1016/j.jalz.2017.01.028. Epub 2017 Mar 16.
Primary age-related tauopathy (PART) is a neuropathological diagnosis characterized by tau neurofibrillary tangles (NFTs) in the absence of amyloid plaque pathology. Although most individuals over 50 years of age have evidence of NFTs, the clinical and cognitive consequences of PART are not known.
We evaluated 226 neuropathologically confirmed PART cases from the National Alzheimer's Coordinating Center database who participated in a total of 846 longitudinal neuropsychological assessments from the Alzheimer's Disease Center program's Uniform Data Set. Mixed-effects statistical models tested whether cognitive decline was associated with Braak stage NFT burden.
Higher stages of NFT burden in PART, with no evidence or minimal evidence of amyloid pathology, were associated with more rapid decline on tasks involving episodic and semantic memory along with tests of processing speed and attention.
We conclude that PART has cognitive consequences that should be considered in the context of emerging tau-targeted therapies in age-associated neurodegenerative diseases.
原发性年龄相关性tau蛋白病（PART）是一种神经病理学诊断，其特征是存在tau神经原纤维缠结（NFTs），但无淀粉样斑块病理改变。尽管大多数50岁以上的个体都有NFTs的证据，但PART的临床和认知后果尚不清楚。
我们评估了来自国家阿尔茨海默病协调中心数据库的226例经神经病理学确诊的PART病例，这些病例参与了阿尔茨海默病中心项目统一数据集的总共846次纵向神经心理学评估。混合效应统计模型测试了认知衰退是否与Braak阶段NFT负担相关。
在无淀粉样病理证据或仅有极少淀粉样病理证据的PART中，更高阶段的NFT负担与涉及情景记忆和语义记忆任务以及处理速度和注意力测试的更快衰退相关。
我们得出结论，在年龄相关性神经退行性疾病中新兴的以tau蛋白为靶点的治疗背景下，应考虑PART的认知后果。
