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阿尔茨海默病和慢性肾脏病导致轻度认知障碍患者皮质神经同步化机制的不同异常:一项 EEG 研究。

Different Abnormalities of Cortical Neural Synchronization Mechanisms in Patients with Mild Cognitive Impairment due to Alzheimer's and Chronic Kidney Diseases: An EEG Study.

机构信息

Department of Physiology and Pharmacology "Vittorio Erspamer", University of Rome "La Sapienza", Rome, Italy.

Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy.

出版信息

J Alzheimers Dis. 2018;65(3):897-915. doi: 10.3233/JAD-180245.

DOI:10.3233/JAD-180245
PMID:30103322
Abstract

This study tested whether resting state alpha rhythms (8-13 Hz) may characterize mild cognitive impairment due to Alzheimer's disease (ADMCI) compared with MCI due to chronic kidney disease (CKDMCI). Clinical and resting state eyes-closed electroencephalographic (rsEEG) rhythms from 40 ADMCI, 29 CKDMCI, and 45 cognitively normal elderly (Nold) subjects were available in a national archive. Age, gender, and education were matched in the three groups, and Mini-Mental State Evaluation (MMSE) score was paired in the ADMCI and CKDMCI groups. Delta (<4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-13 Hz), beta 1 (13-20 Hz), beta 2 (20-30 Hz), and gamma (30-40 Hz) cortical sources were estimated by eLORETA freeware and classified across individuals by area under the receiver operating characteristic curve (AUROCC). Compared with Nold group, posterior alpha 1 source activities were more reduced in ADMCI than CKDMCI group. In contrast, widespread delta source activities were greater in CKDMCI than ADMCI group. These source activities correlated with the MMSE score and correctly classified between Nold and all MCI individuals (AUROCC = 0.8-0.85) and between ADMCI and CKDMCI subjects (AUROCC = 0.75). These results suggest that early AD affects cortical neural synchronization at alpha frequencies underpinning brain arousal and low vigilance in the quiet wakefulness. In contrast, CKD may principally affect cortical neural synchronization at the delta frequencies. Future prospective cross-validation studies will have to test these candidate rsEEG markers for clinical applications and drug discovery.

摘要

这项研究旨在测试静息状态下的阿尔法节律(8-13Hz)是否可以区分阿尔茨海默病导致的轻度认知障碍(ADMCI)与慢性肾脏病导致的轻度认知障碍(CKDMCI)。研究人员在国家档案中获取了 40 名 ADMCI 患者、29 名 CKDMCI 患者和 45 名认知正常的老年人(Nold)的临床和静息状态闭眼脑电图(rsEEG)数据。这三组患者的年龄、性别和教育程度相匹配,ADMCI 组和 CKDMCI 组的患者则进行了 Mini-Mental State Evaluation(MMSE)评分配对。研究人员使用 eLORETA 软件估算了皮质的 delta(<4Hz)、theta(4-8Hz)、alpha 1(8-10.5Hz)、alpha 2(10.5-13Hz)、beta 1(13-20Hz)、beta 2(20-30Hz)和 gamma(30-40Hz)脑区的源活动,并通过受试者工作特征曲线下面积(AUROCC)对个体进行分类。与 Nold 组相比,ADMCI 组的后阿尔法 1 源活动减少更为明显,而 CKDMCI 组的弥散 delta 源活动增加更为明显。这些源活动与 MMSE 评分相关,并能正确区分 Nold 组与所有 MCI 个体(AUROCC=0.8-0.85)以及 ADMCI 组与 CKDMCI 组(AUROCC=0.75)。这些结果表明,早期 AD 会影响安静觉醒时大脑唤醒和警觉性较低的阿尔法频率的皮质神经同步性。相反,CKD 可能主要影响皮质神经同步性的 delta 频率。未来的前瞻性交叉验证研究将不得不测试这些候选 rsEEG 标志物的临床应用和药物发现。

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