de Godoy Laiz Laura, Alves Cesar Augusto Pinheiro Ferreira, Saavedra Juan Sebastian Martin, Studart-Neto Adalberto, Nitrini Ricardo, da Costa Leite Claudia, Bisdas Sotirios
The National Hospital of Neurology and Neurosurgery, University College London, London, UK.
Department of Radiology and Oncology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
Neuroradiology. 2021 May;63(5):663-683. doi: 10.1007/s00234-020-02562-1. Epub 2020 Sep 30.
Superagers are older adults presenting excellent memory performance that may reflect resilience to the conventional pathways of aging. Our contribution aims to shape the evidence body of the known distinctive biomarkers of superagers and their connections with the Brain and Cognitive Reserve and Brain Maintenance concepts.
We performed a systematic literature search in PubMed and ScienceDirect with no limit on publication date for studies that evaluated potential biomarkers in superagers classified by validated neuropsychological tests. Methodological quality was assessed using the QUADAS-2 tool.
Twenty-one studies were included, the majority in neuroimaging, followed by histological, genetic, cognition, and a single one on blood plasma analysis. Superagers exhibited specific regions of cortical preservation, rather than global cortical maintenance, standing out the anterior cingulate and hippocampus regions. Both superagers and controls showed similar levels of amyloid deposition. Moreover, the functional oscillation patterns in superagers resembled those described in young adults. Most of the quality assessment for the included studies showed medium risks of bias.
This systematic review supports selective cortical preservation in superagers, comprehending regions of the default mode, and salience networks, overlapped by stronger functional connectivity. In this context, the anterior cingulate cortex is highlighted as an imaging and histologic signature of these subjects. Besides, the biomarkers included pointed out that the Brain and Cognitive Reserve and Brain Maintenance concepts are independent and complementary in the superagers' setting.
超级老人是指记忆表现出色的老年人，这可能反映出他们对传统衰老途径具有恢复力。我们的研究旨在梳理有关超级老人已知独特生物标志物及其与大脑和认知储备以及大脑维持概念之间联系的证据。
我们在PubMed和ScienceDirect上进行了系统的文献检索，对通过验证的神经心理学测试分类的超级老人中评估潜在生物标志物的研究，不设出版日期限制。使用QUADAS-2工具评估方法学质量。
纳入了21项研究，大多数是神经影像学研究，其次是组织学、遗传学、认知方面的研究，还有一项血浆分析研究。超级老人表现出特定的皮质保存区域，而非整体皮质维持，突出表现在前扣带回和海马体区域。超级老人和对照组的淀粉样蛋白沉积水平相似。此外，超级老人的功能振荡模式与年轻人中描述的相似。纳入研究的大多数质量评估显示存在中等偏倚风险。
本系统评价支持超级老人存在选择性皮质保存，包括默认模式和突显网络区域，且具有更强的功能连接重叠。在此背景下，前扣带回皮质被视为这些受试者的影像学和组织学特征。此外，所纳入的生物标志物表明，在超级老人的情况下，大脑和认知储备以及大脑维持概念是独立且互补的。
