Department of Neurology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Dement Geriatr Cogn Disord. 2019;47(4-6):306-314. doi: 10.1159/000500718. Epub 2019 Jul 16.
BACKGROUND/AIMS: Alzheimer's disease (AD) is the most common cause of dementia worldwide. Interestingly, muscle mass (MM) and muscle strength (MS) are related to AD. In addition to the muscle profile, brain atrophy is also a prominent feature of AD. There is substantial evidence showing an association between muscle profile and dementia, but the role of the muscle profile and cerebral cortical atrophy within this association is less well understood. The objective of this study was to determine if there is any association between muscle profile and brain regional volume in AD. A secondary objective was to determine whether this relationship continues as the clinical stage of AD progresses.
We recruited 28 patients with probable AD without weakness. We assessed the patients' basic demographic characteristics, Mini-Mental State Examination score, and brain magnetic resonance images. MM was measured using body dual-energy X-ray absorptiometry. MS was assessed in Nm/kg with an isokinetic knee extensor using an isokinetic device at an angular velocity of 60°/s. An automatic analysis program was used for brain regional volumetric measurements. Dementia was divided into two stages: mild and moderate.
MS was related to left hippocampal volume ratio. After adjusting for age and cognitive status, the relationship remained. MS did not demonstrate any relationship to any brain regional volume ratio in the mild stage; however, in the moderate stage, it was positively related to both the right and the left hippocampal volume ratio.
Our findings imply a shared underlying pathology relating MS and brain volume and suggest cognitive functional declines through the muscle-brain axis. Further longitudinal studies are needed to find possible and related causes of reduced MS and cortical atrophy in patients with dementia.
背景/目的：阿尔茨海默病（AD）是全球最常见的痴呆症病因。有趣的是，肌肉量（MM）和肌肉力量（MS）与 AD 相关。除了肌肉特征外，脑萎缩也是 AD 的一个显著特征。有大量证据表明肌肉特征与痴呆之间存在关联，但肌肉特征与大脑皮质萎缩在这种关联中的作用还不太清楚。本研究的目的是确定 AD 患者的肌肉特征与大脑区域体积之间是否存在关联。次要目的是确定这种关系是否会随着 AD 临床阶段的进展而继续。
我们招募了 28 名没有肌无力的疑似 AD 患者。我们评估了患者的基本人口统计学特征、简易精神状态检查评分和脑部磁共振成像。使用体双能 X 射线吸收仪测量 MM。使用等速膝关节伸展器以 60°/s 的角速度评估 Nm/kg 的 MS。使用自动分析程序进行大脑区域容积测量。将痴呆分为轻度和中度两个阶段。
MS 与左侧海马体积比相关。在调整年龄和认知状态后，这种关系仍然存在。MS 在轻度阶段与任何大脑区域体积比均无关系；然而，在中度阶段，它与右侧和左侧海马体积比均呈正相关。
我们的研究结果表明 MS 和大脑体积之间存在共同的潜在病理联系，并提示通过肌肉-大脑轴认知功能下降。需要进一步的纵向研究来寻找可能与痴呆患者 MS 和皮质萎缩相关的原因。
