Dadar Mahsa, Camicioli Richard, Duchesne Simon, Collins D Louis
CERVO Brain Research Center Centre intégré universitaire santé et services sociaux de la Capitale Nationale Québec Quebec Canada.
Department of Medicine, Division of Neurology University of Alberta Edmonton Alberta Canada.
Alzheimers Dement (Amst). 2020 Oct 13;12(1):e12091. doi: 10.1002/dad2.12091. eCollection 2020.
Cognitive decline in Alzheimer's disease is associated with amyloid beta (Aβ) accumulation, neurodegeneration, and cerebral small vessel disease, but the temporal relationships among these factors is not well established.
Data included white matter hyperintensity (WMH) load, gray matter (GM) atrophy and Alzheimer's Disease Assessment Scale-Cognitive-Plus (ADAS13) scores for 720 participants and cerebrospinal fluid amyloid (Aβ1-42) for 461 participants from the Alzheimer's Disease Neuroimaging Initiative. Linear regressions were used to assess the relationships among baseline WMH, GM, and Aβ1-42 to changes in WMH, GM, Aβ1-42, and cognition at 1-year follow-up.
Baseline WMHs and Aβ1-42 predicted WMH increase and GM atrophy. Baseline WMHs and Aβ1-42 predicted worsening cognition. Only baseline Aβ1-42 predicted change in Aβ1-42.
Baseline WMHs lead to greater future GM atrophy and cognitive decline, suggesting that WM damage precedes neurodegeneration and cognitive decline. Baseline Aβ1-42 predicted WMH increase, suggesting a potential role of amyloid in WM damage.
阿尔茨海默病中的认知衰退与β淀粉样蛋白（Aβ）积累、神经退行性变和脑小血管疾病相关，但这些因素之间的时间关系尚未明确确立。
数据包括来自阿尔茨海默病神经影像倡议的720名参与者的白质高信号（WMH）负荷、灰质（GM）萎缩以及阿尔茨海默病评估量表-认知增强版（ADAS13）评分，以及461名参与者的脑脊液淀粉样蛋白（Aβ1-42）。采用线性回归评估基线时的WMH、GM和Aβ1-42与1年随访时WMH、GM、Aβ1-42和认知变化之间的关系。
基线时的WMH和Aβ1-42可预测WMH增加和GM萎缩。基线时的WMH和Aβ1-42可预测认知功能恶化。只有基线时的Aβ1-42可预测Aβ1-42的变化。
基线时的WMH会导致未来更严重的GM萎缩和认知衰退，这表明白质损伤先于神经退行性变和认知衰退。基线时的Aβ1-42可预测WMH增加，提示淀粉样蛋白在白质损伤中可能发挥作用。
