轻度认知障碍中阿尔茨海默病的生物标志物：来自拉丁美洲记忆诊所的经验。

Biomarkers of Alzheimer's disease in mild cognitive impairment: Experience in a memory clinic from Latin America.

机构信息

Servicio de Neurología Cognitiva, Neuropsiquiatría y Neuropsicología, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina; Departamento de Neurociencias, Universidad de la Costa (CUC), Barranquilla, Colombia; Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Argentina.

Servicio de Neurología Cognitiva, Neuropsiquiatría y Neuropsicología, Instituto de Investigaciones Neurológicas Raúl Carrea (FLENI), Buenos Aires, Argentina.

出版信息

Neurologia (Engl Ed). 2021 Apr;36(3):201-208. doi: 10.1016/j.nrl.2017.12.011. Epub 2018 Apr 7.

DOI:10.1016/j.nrl.2017.12.011

PMID:29636288

Abstract

OBJECTIVE

This study aimed to investigate the role and prognosis of Alzheimer disease biomarkers in patients with mild cognitive impairment (MCI) at a memory clinic in Latin America.

METHODS

We studied 89 patients with MCI, 43 with Alzheimer-type dementia, and 18 healthy controls (matched for age, sex, and educational level) at our memory clinic (Instituto FLENI) in Buenos Aires, Argentina. Patients and controls underwent an extensive demographic, neurological, and neuropsychological assessment. All subjects underwent a brain MRI scan; FDG-PET scan; amyloid PET scan; apolipoprotein E genotyping; and cerebrospinal fluid concentrations of Aβ, tau, and phosphorylated tau. Patients were categorised as positive or negative for the presence of amyloid pathology and neurodegeneration.

RESULTS

Amyloid pathology was observed in cerebrospinal fluid results in 18% of controls, 64% of patients with MCI, and 92% of patients with Alzheimer-type dementia. Suspected non-Alzheimer disease pathophysiology was found in 11% of controls, 6% of patients with MCI, and 8% of patients with Alzheimer-type dementia. At 30 months of follow-up, 45% of amyloid-positive patients with MCI and 20% of amyloid-negative patients with MCI showed progression to dementia.

CONCLUSIONS

This study demonstrates biomarker-based MCI prognosis and supports its role in clinical decision-making in daily practice.

摘要

目的

本研究旨在探讨拉丁美洲某记忆诊所轻度认知障碍（MCI）患者中阿尔茨海默病生物标志物的作用和预后。

方法

我们研究了在阿根廷布宜诺斯艾利斯的 FLENI 研究所的记忆诊所中，89 名 MCI 患者、43 名阿尔茨海默病型痴呆患者和 18 名健康对照者（年龄、性别和教育程度匹配）。患者和对照者接受了广泛的人口统计学、神经学和神经心理学评估。所有受试者均接受了脑 MRI 扫描、FDG-PET 扫描、淀粉样蛋白 PET 扫描、载脂蛋白 E 基因分型以及 Aβ、tau 和磷酸化 tau 的脑脊液浓度检测。患者根据是否存在淀粉样蛋白病理和神经退行性变进行分类。

结果

在 18%的对照组、64%的 MCI 患者和 92%的阿尔茨海默病型痴呆患者中观察到脑脊液中淀粉样蛋白病理。在 11%的对照组、6%的 MCI 患者和 8%的阿尔茨海默病型痴呆患者中发现了疑似非阿尔茨海默病病理生理学。在 30 个月的随访中，45%的 MCI 患者中淀粉样蛋白阳性和 20%的 MCI 患者中淀粉样蛋白阴性出现了向痴呆的进展。