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阿尔茨海默病连续谱中认知障碍患者的性别差异的多模态神经影像学:女性tau-PET 保留更多。

Multimodal neuroimaging of sex differences in cognitively impaired patients on the Alzheimer's continuum: greater tau-PET retention in females.

机构信息

Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.

Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA.

出版信息

Neurobiol Aging. 2021 Sep;105:86-98. doi: 10.1016/j.neurobiolaging.2021.04.003. Epub 2021 Apr 22.

Abstract

We assessed sex differences in amyloid- and tau-PET retention in 119 amyloid positive patients with mild cognitive impairment or Alzheimer's disease (AD) dementia. Patients underwent 3T-MRI, C-PIB amyloid-PET and F-Flortaucipir tau-PET. Linear ordinary least squares regression models tested sex differences in Flortaucipir-PET SUVR in a summary temporal region of interest as well as global PIB-PET. No sex differences were observed in demographics, Clinical Dementia Rating Sum of Boxes (CDR-SoB), Mini-Mental State Exam (MMSE), raw episodic memory scores, or cortical thickness. Females had higher global PIB SUVR (η²=.043, p=.025) and temporal Flortaucipir SUVR (η²=.070, p=.004), adjusting for age and CDR-SoB. Sex differences in temporal Flortaucipir-PET remained significant when controlling additionally for PIB SUVR and APOE4 status (η²=.055, p=.013), or when using partial volume-corrected data. No sex differences were present in areas of known Flortaucipir off-target binding. Overall, females demonstrated greater AD regional tau-PET burden than males despite clinical comparability. Further characterization of sex differences will provide insight into AD pathogenesis and support development of personalized therapeutic strategies.

摘要

我们评估了 119 名轻度认知障碍或阿尔茨海默病 (AD) 痴呆症的淀粉样蛋白阳性患者中淀粉样蛋白和 tau-PET 保留的性别差异。患者接受了 3T-MRI、C-PIB 淀粉样蛋白-PET 和 F-Flortaucipir tau-PET 检查。线性普通最小二乘回归模型测试了 Flortaucipir-PET SUVR 在时间汇总感兴趣区域以及全球 PIB-PET 中的性别差异。在人口统计学、临床痴呆评定量表总和评分 (CDR-SoB)、简易精神状态检查 (MMSE)、原始情节记忆评分或皮质厚度方面,未观察到性别差异。女性的全球 PIB SUVR 更高 (η²=.043, p=.025) 和颞部 Flortaucipir SUVR (η²=.070, p=.004),调整了年龄和 CDR-SoB。当控制 PIB SUVR 和 APOE4 状态 (η²=.055, p=.013) 或使用部分体积校正数据时,颞部 Flortaucipir-PET 的性别差异仍然显著。在已知 Flortaucipir 脱靶结合的区域不存在性别差异。总的来说,尽管临床可比性,女性表现出比男性更大的 AD 区域 tau-PET 负担。进一步表征性别差异将深入了解 AD 的发病机制,并支持个性化治疗策略的发展。

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