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轻度认知障碍作为认知正常个体中阿尔茨海默病病理和临床进展的标志物。

Subtle cognitive impairment as a marker of Alzheimer's pathologies and clinical progression in cognitively normal individuals.

作者信息

Shen Xue-Ning, Kuo Kevin, Yang Yu-Xiang, Li Hong-Qi, Chen Shi-Dong, Cui Mei, Tan Lan, Dong Qiang, Yu Jin-Tai

机构信息

Department of Neurology and Institute of Neurology Huashan Hospital, Shanghai Medical College Fudan University Shanghai China.

Department of Neurology Qingdao Municipal Hospital Qingdao University Qingdao China.

出版信息

Alzheimers Dement (Amst). 2021 May 27;13(1):e12198. doi: 10.1002/dad2.12198. eCollection 2021.

DOI:10.1002/dad2.12198
PMID:34095433
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8158163/
Abstract

INTRODUCTION

Subtle cognitive impairment (SCI) may appear before pathological changes surpass thresholds for abnormality. We aimed to investigate whether SCI could predict Alzheimer's pathologies and advancement.

METHODS

A total of 816 cognitively normal individuals were enrolled to assess the longitudinal neuropathological and clinical correlates of baseline SCI, via linear mixed-effects and Cox proportional-hazard models. Cross-lagged panel models were used in specific time waves.

RESULTS

SCI individuals had a faster increase in brain amyloid burden and a higher risk of conversion. They also showed greater rates of cerebrospinal fluid (CSF) phosphorylated tau (p-tau) increase and glucose metabolism decrease. In addition, baseline SCI predicted worse clinical progression, whereas multi-domain SCI advanced faster compared to the single domain group.

DISCUSSION

Baseline SCI could be an imperative prediction indicator of clinical and pathological progression. It enables cognitive measures to be informative at a very early stage and provided objective criteria for high-risk population screening.

摘要

引言

轻微认知障碍（SCI）可能在病理变化超过异常阈值之前就已出现。我们旨在研究SCI是否能够预测阿尔茨海默病的病理变化及进展情况。

方法

共纳入816名认知正常个体，通过线性混合效应模型和Cox比例风险模型评估基线SCI的纵向神经病理学和临床相关性。在特定时间波中使用交叉滞后面板模型。

结果

SCI个体的脑淀粉样蛋白负担增加更快且转化风险更高。他们还表现出脑脊液（CSF）磷酸化tau（p-tau）增加和葡萄糖代谢降低的速率更高。此外，基线SCI预示着更差的临床进展，而多领域SCI与单领域组相比进展更快。

讨论

基线SCI可能是临床和病理进展的重要预测指标。它使认知测量在非常早期阶段就具有信息价值，并为高危人群筛查提供了客观标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd0/8158163/0937361d0994/DAD2-13-e12198-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd0/8158163/3f577291bced/DAD2-13-e12198-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd0/8158163/53b817e3c3ad/DAD2-13-e12198-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd0/8158163/72b05c788c65/DAD2-13-e12198-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd0/8158163/0937361d0994/DAD2-13-e12198-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd0/8158163/3f577291bced/DAD2-13-e12198-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd0/8158163/53b817e3c3ad/DAD2-13-e12198-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd0/8158163/72b05c788c65/DAD2-13-e12198-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbd0/8158163/0937361d0994/DAD2-13-e12198-g002.jpg

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