进展为阿尔茨海默病痴呆高风险的轻度认知障碍（MCI-HR-AD）：Souvenaid治疗对认知及F-FDG PET扫描的影响
Mild Cognitive Impairment with a High Risk of Progression to Alzheimer's Disease Dementia (MCI-HR-AD): Effect of Souvenaid Treatment on Cognition and F-FDG PET Scans.
作者信息
Manzano Palomo Maria Sagrario, Anaya Caravaca Belen, Balsa Bretón Maria Angeles, Castrillo Sergio Muñiz, Vicente Asuncion de la Morena, Castro Arce Eduardo, Alves Prez María Teresa
机构信息
Department of Neurology, Infanta Leonor Hospital, Madrid, Spain.
Behavioral Neurology and Dementia Group of the Spanish Society of Neurology, Barcelona, Spain.
出版信息
J Alzheimers Dis Rep. 2019 May 3;3(1):95-102. doi: 10.3233/ADR-190109.
BACKGROUND
Previous studies have shown that Souvenaid (medical food) can have benefits on memory, cognition, and function in early Alzheimer's disease (AD) and mild cognitive impairment (MCI).
OBJECTIVE
Demonstrate that Souvenaid could improve or maintain cognition and has an effect on neurodegeneration biomarkers.
METHODS
This cohort study was carried out from June 2015 through December 2016 in the Neurology Department, Infanta Cristina Hospital, Madrid, Spain. MCI-HR-AD were recruited using Petersen criteria, neuropsychology (NPS), and F-FDG PET scans to confirm the high risk of progression to dementia with one year of follow-up. Age, sex, vascular risk factors (VRF), and NPS values (Barcelona brief version) were analyzed. F-FDG PET scans were analyzed as a visual procedure. The study was approved by the Research Committee of ICH. Statistical analysis was made with SPSS 22.0 version.
RESULTS
Subjects included 43 MCI patients (58.5% women; mean age 69.78±7.89): 17 receiving Souvenaid treatment (ST), 24 receiving no treatment (WT) and 2 who withdrew. No differences were seen in VRF, only hypercholesterolemia, and were less prevalent in the ST group ( = 0.002). The rate of progression to dementia was 48.8% (no differences between groups, = 0.654). A second round of F-FDG PET scans showed a significance worsening of glucose metabolism in WT ( = 0.001) versus ST, in which it was low ( = 0.050). For NPS testing, there was a significant worsening in memory performance in the WT group ( = 0.011) and a stabilization in ST ( = 0.083), as well as in executive functions and attention (worsening in WT, = 0.014). For the Subjective Changing Scale (SCS), caregivers indicated a stabilization/improvement in ST ( = 0.017).
CONCLUSION
Souvenaid had a significant effect on several cognitive domains, and on SCS in patients with MCI-HR-AD. Its intervention had an impact on preservation on F-FDG PET scans.
背景
既往研究表明，Souvenaid（医用食品）对早期阿尔茨海默病（AD）和轻度认知障碍（MCI）患者的记忆力、认知能力及功能有益。
目的
证明Souvenaid可改善或维持认知功能，并对神经退行性变生物标志物产生影响。
方法
本队列研究于2015年6月至2016年12月在西班牙马德里Infanta Cristina医院神经科开展。采用彼得森标准、神经心理学（NPS）及F-FDG PET扫描招募MCI-HR-AD患者，随访1年以确认进展为痴呆的高风险。分析年龄、性别、血管危险因素（VRF）及NPS值（巴塞罗那简短版）。F-FDG PET扫描作为一种视觉检查方法进行分析。本研究经ICH研究委员会批准。采用SPSS 22.0版进行统计分析。
结果
研究对象包括43例MCI患者（女性占58.5%；平均年龄69.78±7.89岁）：17例接受Souvenaid治疗（ST组），24例未接受治疗（WT组），2例退出研究。VRF方面未见差异，仅高胆固醇血症在ST组中患病率较低（P = 0.002）。进展为痴呆的比例为48.8%（组间无差异，P = 0.654）。第二轮F-FDG PET扫描显示，与ST组相比，WT组葡萄糖代谢显著恶化（P = 0.001），ST组葡萄糖代谢较低（P = 0.050）。NPS测试方面，WT组记忆表现显著恶化（P = 0.011），ST组保持稳定（P = 0.083），执行功能和注意力方面也是如此（WT组恶化，P = 0.014）。对于主观变化量表（SCS），照料者表示ST组病情稳定/改善（P = 0.017）。
结论
Souvenaid对MCI-HR-AD患者的多个认知领域及SCS有显著影响。其干预对F-FDG PET扫描结果的维持有作用。
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