Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.
Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.
J Alzheimers Dis. 2021;80(1):113-132. doi: 10.3233/JAD-200840.
It has been proposed that amyloid-β (Aβ) plays a causal role in Alzheimer's disease (AD) by triggering a series of pathologic events-possibly including neuroinflammation-which culminate in progressive brain atrophy. However, the interplay between the two pathological molecular events and how both are associated with neurodegeneration is still unclear.
We aimed to estimate the spatial inter-relationship between neurodegeneration, neuroinflammation and Aβ deposition in a cohort of 20 mild AD patients and 17 healthy controls (HC).
We resorted to magnetic resonance imaging to measure cortical atrophy, using the radiotracer 11C-PK11195 PET to measure neuroinflammation levels and 11C-PiB PET to assess Aβ levels. Between-group comparisons were computed to explore AD-related changes in the three types of markers. To examine the effects of each one of the molecular pathologic mechanisms on neurodegeneration we computed: 1) ANCOVAs with the anatomic data, controlling for radiotracer uptake differences between groups and 2) voxel-based multiple regression analysis between-modalities. In addition, associations in anatomically defined regions of interests were also investigated.
We found significant differences between AD and controls in the levels of atrophy, neuroinflammation, and Aβ deposition. Associations between Aβ aggregation and brain atrophy were detected in AD in a widely distributed pattern, whereas associations between microglia activation and structural measures of neurodegeneration were restricted to few anatomically regions.
In summary, Aβ deposition, as opposed to neuroinflammation, was more associated with cortical atrophy, suggesting a prominent role of Aβ in neurodegeneration at a mild stage of the AD.
有人提出,淀粉样蛋白-β(Aβ)通过触发一系列病理事件(可能包括神经炎症)导致进行性脑萎缩,从而在阿尔茨海默病(AD)中起因果作用。然而,这两种病理分子事件之间的相互作用以及两者如何与神经退行性变相关联尚不清楚。
我们旨在估计 20 名轻度 AD 患者和 17 名健康对照者(HC)队列中神经退行性变、神经炎症和 Aβ沉积之间的空间相互关系。
我们借助磁共振成像来测量皮质萎缩,使用放射性示踪剂 11C-PK11195 PET 来测量神经炎症水平,并用 11C-PiB PET 来评估 Aβ水平。进行组间比较以探索三种标志物与 AD 相关的变化。为了研究每种分子病理机制对神经退行性变的影响,我们计算了:1)ANCOVA,将解剖数据与组间放射性示踪剂摄取差异进行对照;2)模态间基于体素的多元回归分析。此外,还研究了在解剖定义的感兴趣区域中的关联。
我们发现 AD 患者和对照组之间在萎缩、神经炎症和 Aβ沉积水平方面存在显著差异。在 AD 中,Aβ聚集与脑萎缩之间存在广泛分布的关联,而小胶质细胞激活与神经退行性变的结构测量值之间的关联仅限于少数几个解剖区域。
总之,与神经炎症相比,Aβ沉积与皮质萎缩的相关性更高,这表明在 AD 的轻度阶段,Aβ在神经退行性变中起着重要作用。