Department of Clinical Neurological Sciences, Robarts Research Institute and University of Western Ontario, London, Ontario, Canada.
Gait and Brain Lab, Parkwood Institute and Lawson Health Research Institute, London, Ontario, Canada.
Alzheimers Dement. 2022 Sep;18(9):1662-1666. doi: 10.1002/alz.12637. Epub 2022 Feb 25.
Apathy, gait disturbances, and executive dysfunction (AGED) often occur together. Although they can arise independently, the presence of one might portend another. This recognition suggests the possible etiology. We focus on the most common, the vascular. We explain the AGED vascular mechanism through the ambibaric brain concept. The brain contains two complementary blood pressure systems: One high in the primitive brain (brainstem, basal ganglia, and thalamus) and a low-pressure system in the Homo sapiens brain (cerebral hemispheres). Hypertension inflicts the most damage on the primitive brain. The frontal systems connect to the basal ganglia, then the thalamus and back to the cortex. Many connections converge on the primitive brain where they are damaged by vascular disease. We need methods of determining optimal, individual blood pressures. Although the AGED triad can result from other causes, it should first signal a vascular etiology, the most prevalent, treatable, and preventable one.
淡漠、步态障碍和执行功能障碍（AGED）常同时发生。虽然它们可以独立出现，但一种的存在可能预示着另一种的存在。这种认识提示了可能的病因。我们专注于最常见的血管性病因。我们通过常压脑概念解释 AGED 血管机制。大脑包含两个互补的血压系统：一个位于原始脑（脑干、基底节和丘脑）中的高压力系统，以及一个位于智人脑（大脑半球）中的低压力系统。高血压对原始脑造成的损害最大。额叶系统连接到基底节，然后连接到丘脑，再回到大脑皮层。许多连接汇聚在原始脑，在那里它们会被血管疾病破坏。我们需要确定最佳个体血压的方法。尽管 AGED 三联征可能由其他原因引起，但它首先应该提示血管性病因，这是最常见、可治疗和可预防的病因。
