认知正常老年人脑脊液 Aβ42 和 Aβ40 水平降低与脑白质病变有关。
Low Cerebrospinal Fluid Aβ42 and Aβ40 are Related to White Matter Lesions in Cognitively Normal Elderly.
机构信息
Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Department of Psychiatry and Neurochemistry, Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
出版信息
J Alzheimers Dis. 2018;62(4):1877-1886. doi: 10.3233/JAD-170950.
BACKGROUND
Low cerebrospinal fluid (CSF) levels of Aβ42 may be the earliest manifestation of Alzheimer's disease (AD). Knowledge on how CSF Aβ interacts with different brain pathologies early in the disease process is limited. We examined how CSF Aβ markers relate to brain atrophy and white matter lesions (WMLs) in octogenarians with and without dementia to explore the earliest pathogenetic pathways of AD in the oldest old.
OBJECTIVE
To study CSF amyloid biomarkers in relation to brain atrophy and WMLs in 85-year-olds with and without dementia.
METHODS
53 octogenarians took part in neuropsychiatric examinations and underwent both a lumbar puncture and a brain CT scan. CSF levels of Aβ42 and Aβ40 were examined in relation to cerebral atrophy and WMLs. Dementia was diagnosed.
RESULTS
In 85-year-olds without dementia, lower levels of both CSF Aβ42 and CSF Aβ40 were associated with WMLs. CSF Aβ42 also correlated with measures of central atrophy, but not with cortical atrophy. In participants with dementia, lower CSF levels of Aβ42 were related to frontal, temporal, and parietal cortical atrophy but not to WMLs.
CONCLUSIONS
Our findings may suggest that there is an interrelationship between Aβ and subcortical WMLs in older persons without dementia. After onset of dementia, low CSF Aβ42, probably representing amyloid deposition in plaques, is associated with cortical atrophy. WMLs may be an earlier manifestation of Aβ deposition than cortical degeneration.
背景
脑脊液（CSF）中 Aβ42 水平低可能是阿尔茨海默病（AD）的最早表现。关于 CSF Aβ 如何在疾病早期与不同的脑部病变相互作用的知识有限。我们研究了在患有和不患有痴呆症的 80 多岁老年人中，CSF Aβ 标志物与脑萎缩和白质病变（WML）之间的关系，以探索最年长老年人 AD 的最早发病途径。
目的
研究认知正常和认知障碍的 85 岁老年人 CSF 淀粉样蛋白生物标志物与脑萎缩和 WML 的关系。
方法
53 名 80 多岁的老年人参加了神经精神病学检查，并进行了腰椎穿刺和脑 CT 扫描。研究了 CSF Aβ42 和 Aβ40 水平与脑萎缩和 WML 之间的关系。诊断了痴呆症。
结果
在认知正常的 85 岁老年人中，CSF Aβ42 和 CSF Aβ40 水平较低与 WML 有关。CSF Aβ42 还与中央萎缩的测量值相关，但与皮质萎缩无关。在患有痴呆症的参与者中，较低的 CSF Aβ42 水平与额叶、颞叶和顶叶皮质萎缩有关，但与 WML 无关。
结论
我们的研究结果可能表明，在认知正常的老年人中，Aβ 与皮质下 WML 之间存在相互关系。在痴呆症发作后，CSF Aβ42 水平较低，可能代表斑块中淀粉样蛋白沉积，与皮质萎缩有关。WML 可能是 Aβ 沉积的早期表现，而不是皮质变性。
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