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通过 11C-PiB PET 测量的淀粉样蛋白-β 病理学的皮质下和皮质区域与记忆门诊患者的认知功能和疾病阶段呈不同相关。

Subcortical and Cortical Regions of Amyloid-β Pathology Measured by 11C-PiB PET Are Differentially Associated with Cognitive Functions and Stages of Disease in Memory Clinic Patients.

机构信息

Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.

Theme Aging, Karolinska University Hospital, Stockholm, Sweden.

出版信息

J Alzheimers Dis. 2021;81(4):1613-1624. doi: 10.3233/JAD-201612.

Abstract

BACKGROUND

The effect of regional brain amyloid-β (Aβ) pathology on specific cognitive functions is incompletely known.

OBJECTIVE

The relationship between Aβ and cognitive functions was investigated in this cross-sectional multicenter study of memory clinic patients.

METHODS

The participants were patients diagnosed with Alzheimer's disease (AD, n = 83), mild cognitive impairment (MCI, n = 60), and healthy controls (HC, n = 32), who had been scanned by 11C-PiB PET in 13 brain regions of both hemispheres and who had been assessed by cognitive tests covering seven domains.

RESULTS

Hierarchic multiple regression analyses were performed on each cognitive test as dependent variable, controlling for demographic characteristics and APOE status (block 1) and PiB measures in 13 brain regions (block 2) as independent variables. The model was highly significant for each cognitive test and most strongly for tests of episodic memory (learning and retention) versus PiB in putamen, visuospatially demanding tests (processing and retention) versus the occipital lobe, semantic fluency versus the parietal lobe, attention versus posterior gyrus cinguli, and executive function versus nucleus accumbens. In addition, education had a positively and APOE status a negatively significant effect on cognitive tests.

CONCLUSION

Five subcortical and cortical regions with Aβ pathology are differentially associated with cognitive functions and stages of disease in memory clinic patients.

摘要

背景

区域脑淀粉样蛋白-β(Aβ)病理学对特定认知功能的影响尚不完全清楚。

目的

本研究通过对记忆门诊患者的横断面多中心研究,探讨 Aβ与认知功能之间的关系。

方法

研究对象为经 11C-PiB PET 在双侧半球 13 个脑区扫描、并接受涵盖 7 个领域的认知测试评估的阿尔茨海默病(AD,n=83)、轻度认知障碍(MCI,n=60)和健康对照(HC,n=32)患者。

结果

对每个认知测试作为因变量进行层次多重回归分析,控制人口统计学特征和 APOE 状态(块 1)和 13 个脑区的 PiB 测量值(块 2)作为自变量。该模型对每个认知测试均具有高度显著性,对纹状体中情节记忆(学习和保持)与 PiB 的测试、枕叶中对视觉空间要求高的测试(处理和保持)、顶叶中语义流畅性、后扣带回皮质中的注意力以及伏隔核中的执行功能与 PiB 的测试最为显著。此外,教育程度对认知测试有积极影响,而 APOE 状态有消极影响。

结论

5 个皮质下和皮质区域的 Aβ 病理学与记忆门诊患者的认知功能和疾病阶段有差异相关。

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