Valech Natalia, Sánchez-Benavides Gonzalo, Tort-Merino Adrià, Coll-Padrós Nina, Olives Jaume, León María, Falcon Carles, Molinuevo José Luis, Rami Lorena
Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clinic, Barcelona, Spain.
Barcelona Beta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.
J Alzheimers Dis. 2019;72(4):1287-1302. doi: 10.3233/JAD-190624.
Exploring the relationship between Alzheimer's disease (AD) biomarkers and subjective cognitive decline (SCD) is needed for better defining its clinical meaning in preclinical AD (preAD).
To assess the association between the Subjective Cognitive Decline Questionnaire (SCD-Q), gray matter (GM), and cerebrospinal fluid amyloid-β (Aβ).
56 cognitively healthy older adults and their informants answered the SCD-Q. Correlations between GM and SCD-Q scores were explored using structural voxel-based morphometry models including Aβ levels. SCD-Q*Aβ vectors were calculated with higher scores reflecting higher SCD and cerebral amyloid, simultaneously. Subjects were classified according to their perception of cognitive worsening in the last two years, exploring for GM differences between-groups.
Higher self-reported SCD-Q scores correlated with reduced GM in the right frontal lobe and increased volumes in the occipital lobe, calcarine sulcus, fusiform gyrus, and cerebellum, while higher informant's scores correlated with increased GM in the right middle temporal gyrus. Correlations were more significant for SCD-Q language items, self-complaints, and more positive than negative correlations were found. The SCD-Q*Aβ vectors were negatively associated with GM both in self and informant's reports. Finally, lower Aβ levels related to lower GM in subjects who noticed cognitive worsening, but related to higher GM in subjects who have not noticed this decline.
Our results suggest that SCD-Q scores relate with incipient brain changes that may be due to preAD. Independent studies are needed to confirm our observations.
为了更好地定义阿尔茨海默病（AD）生物标志物与主观认知下降（SCD）之间的关系，需要探索其在临床前AD（preAD）中的临床意义。
评估主观认知下降问卷（SCD-Q）、灰质（GM）和脑脊液淀粉样蛋白-β（Aβ）之间的关联。
56名认知健康的老年人及其 informant 回答了 SCD-Q。使用包括Aβ水平的基于体素的结构形态计量学模型探索GM与SCD-Q评分之间的相关性。计算SCD-Q*Aβ向量，较高的分数同时反映较高的SCD和脑淀粉样蛋白。根据他们对过去两年认知恶化的感知对受试者进行分类，探索组间GM差异。
自我报告的较高SCD-Q评分与右侧额叶GM减少以及枕叶、距状沟、梭状回和小脑体积增加相关，而 informant 较高的评分与右侧颞中回GM增加相关。SCD-Q语言项目、自我抱怨的相关性更显著，且发现正向相关性多于负向相关性。SCD-Q*Aβ向量在自我报告和 informant 报告中均与GM呈负相关。最后，在注意到认知恶化的受试者中，较低的Aβ水平与较低的GM相关，但在未注意到这种下降的受试者中与较高的GM相关。
我们的结果表明，SCD-Q评分与可能由preAD引起的早期脑变化有关。需要独立研究来证实我们的观察结果。
