淀粉样蛋白-β或tau 在存在严重脑血管疾病的情况下对认知变化的影响。

The Impact of Amyloid-β or Tau on Cognitive Change in the Presence of Severe Cerebrovascular Disease.

机构信息

Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.

出版信息

J Alzheimers Dis. 2020;78(2):573-585. doi: 10.3233/JAD-200680.

DOI:10.3233/JAD-200680

PMID:33016911

Abstract

BACKGROUND

As Alzheimer's disease (AD) and cerebral small vessel disease (CSVD) commonly coexist, the interaction between two has been of the considerable interest.

OBJECTIVE

We determined whether the association of Aβ and tau with cognitive decline differs by the presence of significant CSVD.

METHODS

We included 60 subcortical vascular cognitive impairment (SVCI) from Samsung Medical Center and 82 Alzheimer's disease-related cognitive impairment (ADCI) from ADNI, who underwent Aβ (florbetaben or florbetapir) and tau (flortaucipir, FTP) PET imaging. They were retrospectively assessed for 5.0±3.9 and 5.6±1.9 years with Clinical Dementia Rating-sum of boxes (CDR-SB)/Mini-Mental State Examination (MMSE). Mixed effects models were used to investigate the interaction between Aβ/tau and group on CDR-SB/MMSE changes.

RESULTS

The frequency of Aβ positivity (45% versus 54.9%, p = 0.556) and mean global FTP SUVR (1.17±0.21 versus 1.16±0.17, p = 0.702) were not different between the two groups. We found a significant interaction effect of Aβ positivity and SVCI group on CDR-SB increase/MMSE decrease (p = 0.013/p < 0.001), and a significant interaction effect of global FTP uptake and SVCI group on CDR-SB increase/MMSE decrease (p < 0.001 and p = 0.030). Finally, the interaction effects of regional tau and group were prominent in the Braak III/IV (p = 0.001) and V/VI (p = 0.003) not in Braak I/II region (p = 0.398).

CONCLUSION

The association between Aβ/tau and cognitive decline is stronger in SVCI than in ADCI. Therefore, our findings suggested that Aβ positivity or tau burden (particularly in the Braak III/IV or V/VI regions) and CSVD might synergistically affect cognitive decline.

摘要

背景

由于阿尔茨海默病（AD）和脑小血管病（CSVD）通常同时存在，因此两者之间的相互作用引起了相当大的关注。

目的

我们旨在确定 Aβ 和 tau 与认知能力下降的相关性是否因存在明显的 CSVD 而有所不同。

方法

我们纳入了来自三星医疗中心的 60 例皮质下血管性认知障碍（SVCI）患者和来自 ADNI 的 82 例 AD 相关认知障碍（ADCI）患者，他们接受了 Aβ（florbetaben 或 florbetapir）和 tau（flortaucipir，FTP）PET 成像。通过临床痴呆评定量表总和分-盒式测验（CDR-SB）/简易精神状态检查（MMSE）对他们进行了回顾性评估，随访时间为 5.0±3.9 年和 5.6±1.9 年。采用混合效应模型来研究 Aβ/tau 与组之间的相互作用对 CDR-SB/MMSE 变化的影响。

结果

两组之间 Aβ 阳性率（45%比 54.9%，p=0.556）和平均全脑 FTP SUVR（1.17±0.21 比 1.16±0.17，p=0.702）没有差异。我们发现 Aβ 阳性率和 SVCI 组对 CDR-SB 增加/MMSE 下降的交互作用有显著影响（p=0.013/p<0.001），而全球 FTP 摄取和 SVCI 组对 CDR-SB 增加/MMSE 下降的交互作用有显著影响（p<0.001 和 p=0.030）。最后，区域 tau 与组之间的交互作用在 Braak III/IV（p=0.001）和 V/VI（p=0.003）区显著，而在 Braak I/II 区不显著（p=0.398）。