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皮质厚度及其与脑淀粉样血管病临床认知和神经影像学标志物的关系。

Cortical Thickness and Its Association with Clinical Cognitive and Neuroimaging Markers in Cerebral Amyloid Angiopathy.

机构信息

Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.

Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.

出版信息

J Alzheimers Dis. 2021;81(4):1663-1671. doi: 10.3233/JAD-210138.

Abstract

BACKGROUND

Cerebral amyloid angiopathy (CAA) contributes to brain neurodegeneration and cognitive decline, but the relationship between these two processes is incompletely understood.

OBJECTIVE

The purpose of this study is to examine cortical thickness and its association with cognition and neurodegenerative biomarkers in CAA.

METHODS

Data were collected from the Functional Assessment of Vascular Reactivity study and the Calgary Normative Study. In total, 48 participants with probable CAA, 72 cognitively normal healthy controls, and 24 participants with mild dementia due to AD were included. Participants underwent an MRI scan, after which global and regional cortical thickness measurements were obtained using FreeSurfer. General linear models, adjusted for age and sex, were used to compare cortical thickness globally and in an AD signature region.

RESULTS

Global cortical thickness was lower in CAA compared to healthy controls (mean difference (MD) -0.047 mm, 95% confidence interval (CI) -0.088, -0.005, p = 0.03), and lower in AD compared to CAA (MD -0.104 mm, 95% CI -0.165, -0.043, p = 0.001). In the AD signature region, cortical thickness was lower in CAA compared to healthy controls (MD -0.07 mm, 95% CI -0.13 to -0.01, p = 0.02). Within the CAA group, lower cortical thickness was associated with lower memory scores (R2 = 0.10; p = 0.05) and higher white matter hyperintensity volume (R2 = 0.09, p = 0.04).

CONCLUSION

CAA contributes to neurodegeneration in the form of lower cortical thickness, and this could contribute to cognitive decline. Regional overlap with an AD cortical atrophy signature region suggests that co-existing AD pathology may contribute to lower cortical thickness observed in CAA.

摘要

背景

脑淀粉样血管病(CAA)可导致脑神经元退行性病变和认知能力下降,但这两个过程之间的关系尚未完全阐明。

目的

本研究旨在探讨 CAA 患者皮质厚度及其与认知和神经退行性生物标志物的关系。

方法

数据来自功能评估血管反应性研究和卡尔加里正常对照研究。共纳入 48 例可能患有 CAA 的患者、72 例认知正常的健康对照者和 24 例因 AD 导致轻度痴呆的患者。所有参与者均接受 MRI 扫描,之后使用 FreeSurfer 获得全脑和局部皮质厚度测量值。采用一般线性模型,根据年龄和性别进行调整,比较 CAA 患者全脑和 AD 特征区域的皮质厚度。

结果

与健康对照者相比,CAA 患者的全脑皮质厚度较低(平均差异(MD)-0.047mm,95%置信区间(CI)-0.088,-0.005,p=0.03),且 AD 患者皮质厚度低于 CAA 患者(MD -0.104mm,95% CI -0.165,-0.043,p=0.001)。在 AD 特征区域,CAA 患者皮质厚度低于健康对照者(MD -0.07mm,95% CI -0.13 至 -0.01,p=0.02)。在 CAA 患者中,皮质厚度较低与记忆评分较低(R2=0.10;p=0.05)和脑白质高信号体积较高(R2=0.09,p=0.04)相关。

结论

CAA 可导致皮质厚度降低,从而引起神经元退行性病变,进而导致认知能力下降。与 AD 皮质萎缩特征区域的重叠表明,并存的 AD 病理可能导致 CAA 患者皮质厚度降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f073/8293635/40fb29d48a74/jad-81-jad210138-g001.jpg

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