患阿尔茨海默病遗传风险的成年人的脑储备概况。
A profile of brain reserve in adults at genetic risk of Alzheimer's disease.
作者信息
Coughlan Gillian, Zhukovsky Peter, Voineskos Aristotle, Grady Cheryl
机构信息
Rotman Research Institute Baycrest Toronto Canada.
Kimel Family Translational Imaging Genetics Laboratory Centre for Addiction and Mental Health Toronto Canada.
出版信息
Alzheimers Dement (Amst). 2021 Jun 9;13(1):e12208. doi: 10.1002/dad2.12208. eCollection 2021.
INTRODUCTION
The apolipoprotein E () ε4 allele is the greatest genetic risk factor for Alzheimer's disease (AD). Our aim was to identify the structural brain measures that mitigate the negative effect of ε4 on cognition, which would have implications for AD diagnosis and treatment trial selection.
METHODS
A total of 742 older adults (mean age: 70.1 ± 8.7 years) were stratified by status and classified as cognitively normal (CDR 0) or with very mild dementia (CDR 0.5). Regional brain volume and cognitive performance were measured.
RESULTS
There were significant interactions between and CDR on the left precuneus and on bilateral superior frontal volumes. These regions were preserved in CDR-0 ε3/ε4 and ε4/ε4 carriers but were reduced in CDR-0.5 ε3/ε4 and ε4/ε4 carriers, compared to their respective ε3/ε3 counterparts. Educational attainment predicted greater brain reserve.
DISCUSSION
This pattern of preserved brain structure in cognitively normal ε4 carriers with comprised medial temporal volume is consistent with the theory of brain reserve.
引言
载脂蛋白E（ApoE）ε4等位基因是阿尔茨海默病（AD）最大的遗传风险因素。我们的目的是确定能够减轻ε4对认知负面影响的脑结构测量指标，这将对AD诊断和治疗试验选择具有重要意义。
方法
总共742名老年人（平均年龄：70.1±8.7岁）根据ApoE状态进行分层，并分为认知正常（CDR 0）或极轻度痴呆（CDR 0.5）。测量了脑区体积和认知表现。
结果
在左侧楔前叶和双侧额上回体积方面，ApoE与CDR之间存在显著交互作用。与各自的ε3/ε3携带者相比，这些脑区在CDR-0的ε3/ε4和ε4/ε4携带者中得以保留，但在CDR-0.5的ε3/ε4和ε4/ε4携带者中减小。受教育程度预示着更大的脑储备。
讨论
认知正常的含ε4等位基因且内侧颞叶体积正常的携带者中这种脑结构保留模式与脑储备理论一致。
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