Neurology and psychiatry department, Assiut university hospital, Assiut, Egypt.
Medical physiology department, faculty of medicine, Assiut university, Assiut, Egypt.
Neurophysiol Clin. 2020 Jul;50(3):185-193. doi: 10.1016/j.neucli.2020.05.001. Epub 2020 Jun 23.
The aim of the present study was to identify neurophysiologic markers to differentiate between Alzheimer dementia (AD), Vascular dementia (VaD), and Parkinson's disease dementia (PDD), and to examine their relationship to levels of transforming growth factor β1 (TGFβ1).
The study included 15 patients with each type of dementia (AD, VaD, PDD) and 25 control subjects. Dementia patients were diagnosed according to the DiagnosticandStatisticalManualofMentalDisorders4thedition-revised(DSM-IV-R). Modified Mini Mental State Examination (MMMSE), motor cortex excitability including resting and active motor thresholds (rMT, aMT), input-output (I/O) curve, contralateral and ipsilateral silent periods (cSP, iSP), short-interval intracortical inhibition (SICI) at 1,2 and 4ms, and serum levels of TGFβ1 were examined.
There were no significant differences between groups with regards to age, sex, education or socioeconomic level. There was significant neuronal hyperexcitability in the form of reduced rMT and aMT and a shallower I/O curve in all three groups of dementia compared with the control group. The durations of cSP and iSP were longer in AD and PDD groups compared with the control group, whereas there were no significant differences in VaD. SICI was less effective in the three dementia groups than in the control group at intervals of 4ms. Serum levels of TGFβ1 were significantly elevated in all dementia groups in comparison with the control group. There was a significant negative correlation between serum level of TGFβ1 and cSP, iSP, and SICI across all patients and a significant negative correlation between serum level of TGFβ1 and iSP duration in AD.
Although motor thresholds were reduced in all patients, measures of SICI, cSP and iSP could distinguish between dementia groups. Serum level of TGFβ1 negatively correlated with iSP specifically in the AD group. This suggests that levels of TGFβ1 may relate to GABAergic dysfunction in dementia.
本研究旨在寻找神经生理标记物以区分阿尔茨海默病（AD）、血管性痴呆（VaD）和帕金森病痴呆（PDD），并研究其与转化生长因子β1（TGFβ1）水平的关系。
本研究纳入了 15 例每种类型的痴呆患者（AD、VaD、PDD）和 25 例对照。痴呆患者的诊断符合《精神障碍诊断与统计手册》第 4 版修订版（DSM-IV-R）。采用改良简易精神状态检查量表（MMMSE）、运动皮质兴奋性包括静息和活动运动阈值（rMT、aMT）、输入-输出（I/O）曲线、对侧和同侧静息期（cSP、iSP）、短程抑制性内抑制（SICI）1、2、4ms，以及血清 TGFβ1 水平。
各组在年龄、性别、教育程度或社会经济水平方面均无显著差异。与对照组相比，所有三组痴呆患者的 rMT 和 aMT 均显著降低，I/O 曲线明显变浅，表现为神经元过度兴奋。与对照组相比，AD 和 PDD 组的 cSP 和 iSP 持续时间较长，而 VaD 组无显著差异。与对照组相比，在 4ms 的间隔内，SICI 在三组痴呆患者中的作用较弱。与对照组相比，所有痴呆组的血清 TGFβ1 水平均显著升高。所有患者的血清 TGFβ1 水平与 cSP、iSP 和 SICI 呈显著负相关，AD 患者的血清 TGFβ1 水平与 iSP 持续时间呈显著负相关。
虽然所有患者的运动阈值均降低，但 SICI、cSP 和 iSP 的测量可区分痴呆组。AD 组患者的血清 TGFβ1 水平与 iSP 呈负相关。这表明 TGFβ1 水平可能与痴呆患者的 GABA 能功能障碍有关。
