Fu Pan, Zhu Bihong, Huang Yangping
Department of Neurology, Taizhou First People's Hospital, Taizhou, Zhejiang, People's Republic of China.
Neuropsychiatr Dis Treat. 2021 May 26;17:1659-1666. doi: 10.2147/NDT.S291020. eCollection 2021.
Emerging studies have suggested that tumor necrosis factor-alpha (TNF-α) is implicated in the pathogenesis of Alzheimer's disease (AD), and that cerebral glucose hypometabolism is a key feature of AD. However, the association of CSF TNF-α levels with changes in cerebral glucose metabolism has not been studied among non-demented older people.
At baseline, there were a total of 214 non-demented older people from Alzheimer's Disease Neuroimaging Initiative (ADNI) study. We examined the cross-sectional and longitudinal associations of CSF TNF-α with global cognition (as assessed by mini-mental state examination), verbal memory (as assessed by Rey Auditory Verbal Learning Test-total learning score), and cerebral glucose metabolism (as measured by FDF-PET). Linear mixed-effects models were used to examine the longitudinal association of CSF TNF- α with change in each outcome over time with adjustment of age, educational level, gender, and APOE4 status.
In the cross-sectional study, CSF TNF-α was negatively associated with MMSE scores, but not verbal memory or FDG-PET. In the longitudinal study, higher CSF TNF- α at baseline was associated with a faster decline in cerebral glucose metabolism, but not MMSE scores or RAVLT total learning scores.
Higher CSF TNF-α levels were associated with a steeper decline in cerebral glucose metabolism among non-demented older people.
新出现的研究表明，肿瘤坏死因子-α（TNF-α）与阿尔茨海默病（AD）的发病机制有关，且脑葡萄糖代谢减退是AD的一个关键特征。然而，在非痴呆老年人中，脑脊液TNF-α水平与脑葡萄糖代谢变化之间的关联尚未得到研究。
在基线时，共有来自阿尔茨海默病神经影像学倡议（ADNI）研究的214名非痴呆老年人。我们研究了脑脊液TNF-α与整体认知（通过简易精神状态检查评估）、言语记忆（通过雷伊听觉词语学习测验-总学习得分评估）和脑葡萄糖代谢（通过FDF-PET测量）之间的横断面和纵向关联。使用线性混合效应模型来研究脑脊液TNF-α与每个结局随时间变化之间的纵向关联，并对年龄、教育水平、性别和APOE4状态进行调整。
在横断面研究中，脑脊液TNF-α与MMSE评分呈负相关，但与言语记忆或FDG-PET无关。在纵向研究中, 基线时较高的脑脊液TNF-α与脑葡萄糖代谢更快下降有关，但与MMSE评分或RAVLT总学习得分无关。
在非痴呆老年人中，较高的脑脊液TNF-α水平与脑葡萄糖代谢更急剧下降有关。
