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慢性低灌注由于颅内大动脉狭窄与脑β淀粉样蛋白沉积和脑萎缩无关。

Chronic hypoperfusion due to intracranial large artery stenosis is not associated with cerebral β-amyloid deposition and brain atrophy.

机构信息

Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.

Institute of Brain and Intelligence, Third Military Medical University, Chongqing, 400038, China.

出版信息

Chin Med J (Engl). 2022 Jan 4;135(5):591-597. doi: 10.1097/CM9.0000000000001918.

Abstract

BACKGROUND

Insufficient cerebral perfusion is suggested to play a role in the development of Alzheimer disease (AD). However, there is a lack of direct evidence indicating whether hypoperfusion causes or aggravates AD pathology. We investigated the effect of chronic cerebral hypoperfusion on AD-related pathology in humans.

METHODS

We enrolled a group of cognitively normal patients (median age: 64 years) with unilateral chronic cerebral hypoperfusion. Regions of interest with the most pronounced hypoperfusion changes were chosen in the hypoperfused region and were then mirrored in the contralateral hemisphere to create a control region with normal perfusion. 11C-Pittsburgh compound-positron emission tomography standard uptake ratios and brain atrophy indices were calculated from the computed tomography images of each patient.

RESULTS

The median age of the 10 participants, consisting of 4 males and 6 females, was 64 years (47-76 years). We found that there were no differences in standard uptake ratios of the cortex (volume of interest [VOI]: P = 0.721, region of interest [ROI]: P = 0.241) and grey/white ratio (VOI: P = 0.333, ROI: P = 0.445) and brain atrophy indices (Bicaudate, Bifrontal, Evans, Cella, Cella media, and Ventricular index, P > 0.05) between the hypoperfused regions and contralateral normally perfused regions in patients with unilateral chronic cerebral hypoperfusion.

CONCLUSION

Our findings suggest that chronic hypoperfusion due to large vessel stenosis may not directly induce cerebral β-amyloid deposition and neurodegeneration in humans.

摘要

背景

脑灌注不足被认为在阿尔茨海默病(AD)的发展中起作用。然而,目前缺乏直接证据表明灌注不足是导致还是加重 AD 病理的原因。我们研究了慢性大脑灌注不足对人类 AD 相关病理的影响。

方法

我们纳入了一组认知正常的单侧慢性大脑灌注不足患者(中位年龄:64 岁)。在灌注不足区域中选择灌注变化最明显的感兴趣区(ROI),然后在对侧半球镜像相同区域以创建具有正常灌注的对照区。从每位患者的 CT 图像中计算 11C-匹兹堡化合物正电子发射断层扫描标准摄取值比和脑萎缩指数。

结果

10 名参与者(4 名男性和 6 名女性)的中位年龄为 64 岁(47-76 岁)。我们发现,皮质的标准摄取值比(VOI:P=0.721,ROI:P=0.241)和灰质/白质比值(VOI:P=0.333,ROI:P=0.445)以及脑萎缩指数(双尾体、双额、Evans、Cella、Cella media 和脑室指数,P>0.05)在单侧慢性大脑灌注不足患者的灌注不足区域和对侧正常灌注区域之间没有差异。

结论

我们的研究结果表明,大动脉狭窄引起的慢性灌注不足可能不会直接导致人类大脑β-淀粉样蛋白沉积和神经退行性变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ad8/8920433/838ce3147252/cm9-135-591-g001.jpg

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