Sorbonne Universités, UPMC Univ Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM) - Hôpital Pitié-Salpêtrière, Paris, France.
AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département de Neurologie, Institut de la mémoire et de la maladie d'Alzheimer, Paris, France.
Alzheimers Res Ther. 2020 May 14;12(1):57. doi: 10.1186/s13195-020-00626-1.
Lack of awareness of cognitive decline (ACD) has been described at the preclinical and prodromal stages of Alzheimer's disease (AD). In this study, we introduced a meta-memory ratio (MMR) and explored how it is associated with neuroimaging AD biomarkers in asymptomatic individuals at risk for AD.
Four hundred forty-eight cognitively healthy participants from two cohorts of subjective memory complainers (INSIGHT-PreAD and ADNI) were included. Regression models were used to assess the impact of AD biomarkers on the MMR.
In both cohorts, there was a significant quadratic effect of cerebral amyloidosis on the MMR value. In particular, participants had a high ACD up to the amyloid positivity threshold, above which a decrease of ACD was eventually observed as the amyloid load increased.
This nonlinear evolution of ACD in very early AD must be taken into account in clinical care and for trial enrollment as well.
在阿尔茨海默病（AD）的临床前和前驱期，已经描述了对认知能力下降（ACD）的认识不足。在这项研究中，我们引入了元记忆比（MMR），并探讨了它与无症状 AD 风险个体的神经影像学 AD 生物标志物之间的关系。
共纳入来自两个主观记忆抱怨者队列（INSIGHT-PreAD 和 ADNI）的 448 名认知健康的参与者。回归模型用于评估 AD 生物标志物对 MMR 的影响。
在两个队列中，脑淀粉样蛋白对 MMR 值的影响呈显著二次方效应。具体来说，参与者在淀粉样蛋白阳性阈值之前的 ACD 较高，而随着淀粉样蛋白负荷的增加，最终观察到 ACD 下降。
在临床护理和试验入组中，必须考虑到非常早期 AD 中 ACD 的这种非线性演变。
