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脑脊液与正电子发射断层扫描成像的β-淀粉样蛋白不一致显示出不同的空间tau模式。

β-Amyloid discordance of cerebrospinal fluid and positron emission tomography imaging shows distinct spatial tau patterns.

作者信息

Jiang Chenyang, Wang Qingyong, Xie Siwei, Chen Zhicheng, Fu Liping, Peng Qiyu, Liang Ying, Guo Hongbo, Guo Tengfei

机构信息

Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen 518132, China.

Department of Neurology, University of Chinese Academy of Sciences-Shenzhen Hospital, Shenzhen 518107, China.

出版信息

Brain Commun. 2022 Mar 31;4(2):fcac084. doi: 10.1093/braincomms/fcac084. eCollection 2022.

Abstract

Extracellular β-amyloid plaques and intracellular neurofibrillary tau tangles are the primary hallmarks of Alzheimer's disease. β-Amyloid pathology can be directly quantified by positron emission tomography imaging or indirectly by measuring the decrease of cerebrospinal fluid β-amyloid/β-amyloid ratio. Although these two β-amyloid biomarkers may be considered interchangeable, they sometimes show discordance, particularly in early stage of Alzheimer's disease. Individuals with cerebrospinal fluid β-amyloid positive only or β-amyloid positron emission tomography positive only may be at early amyloidosis stage compared to those who are cerebrospinal fluid β-amyloid negative and β-amyloid positron emission tomography negative orcerebrospinal fluid β-amyloid positive and β-amyloid positron emission tomography positive. Besides, β-amyloid pathology may play an initiating role in Alzheimer's disease onset, leading to subsequent tau increases. However, it is still unclear whether individuals with different β-amyloid pathways have distinct spatial patterns of cortical tau tangles in early amyloidosis stage. In this study, we analyzed 238 cognitively unimpaired and 77 mild cognitive impairment individuals with concurrent (interval of acquisition <1 year) F-flortaucipir tau positron emission tomography, β-amyloid (F-florbetapir or F-florbetaben) positron emission tomography and cerebrospinal fluid β-amyloid and β-amyloid and cerebrospinal fluid p-Tau and divided them into four different cerebrospinal fluid/positron emission tomography groups based on the abnormal status of cerebrospinal fluid β-amyloid/β-amyloid (cerebrospinal fluid±) and β-amyloid positron emission tomography (±). We determined the cortical regions with significant tau elevations of different cerebrospinal fluid/positron emission tomography groups and investigated the region-wise and voxel-wise associations of tau positron emission tomography images with cerebrospinal fluid β-amyloid/β-amyloid, β-amyloid positron emission tomography and cerebrospinal fluid p-Tau/β-amyloid in early (cerebrospinal fluid positive/positron emission tomography negative and cerebrospinal fluid negative/positron emission tomography positive) and late (cerebrospinal fluid positive/positron emission tomography positive) amyloidosis stages. By compared to the cerebrospinal fluid negative/positron emission tomography negative individuals (Ref) without evidence of tau increase measured by cerebrospinal fluid or positron emission tomography, cerebrospinal fluid positive/positron emission tomography negative individuals showed higher tau in entorhinal but not in Braak and Braak, whereas cerebrospinal fluid negative/positron emission tomography positive individuals had significant tau elevations in Braak but not in entorhinal and Braak. In contrast, cerebrospinal fluid positive/positron emission tomography positive individuals showed significant tau increases in all the cortical regions than the Ref group. The voxel-wise analyses provided further evidence that lower cerebrospinal fluid β-amyloid/β-amyloid was associated with higher tau in entorhinal, whilst higher β-amyloid positron emission tomography was related to higher tau in Braak regions in early amyloidosis stage. Both lower cerebrospinal fluid β-amyloid/β-amyloid and higher β-amyloid positron emission tomography were correlated with tau aggregation in all the Braak stages regions in late amyloidosis stage. These findings provide novel insights into the spatial patterns of cortical tau tangles in different amyloidosis stages of Alzheimer's disease, suggesting cerebrospinal fluid β-amyloid and β-amyloid positron emission tomography discordant groups may have distinct characteristics of cortical tau tangles in early amyloidosis stage.

摘要

细胞外β-淀粉样蛋白斑块和细胞内神经原纤维缠结是阿尔茨海默病的主要标志。β-淀粉样蛋白病理学可通过正电子发射断层扫描成像直接定量,或通过测量脑脊液β-淀粉样蛋白/β-淀粉样前体蛋白比值间接定量。尽管这两种β-淀粉样蛋白生物标志物可能被认为是可互换的,但它们有时会出现不一致,尤其是在阿尔茨海默病的早期阶段。与脑脊液β-淀粉样蛋白阴性且β-淀粉样蛋白正电子发射断层扫描阴性或脑脊液β-淀粉样蛋白阳性且β-淀粉样蛋白正电子发射断层扫描阳性的个体相比,仅脑脊液β-淀粉样蛋白阳性或仅β-淀粉样蛋白正电子发射断层扫描阳性的个体可能处于早期淀粉样变性阶段。此外,β-淀粉样蛋白病理学可能在阿尔茨海默病发病中起启动作用,导致随后的tau蛋白增加。然而,尚不清楚不同β-淀粉样蛋白途径的个体在早期淀粉样变性阶段是否具有不同的皮质tau缠结空间模式。在本研究中,我们分析了238名认知未受损和77名轻度认知障碍个体,这些个体同时(采集间隔<1年)进行了F-氟代tau蛋白正电子发射断层扫描、β-淀粉样蛋白(F-氟代贝他吡或F-氟代贝他宾)正电子发射断层扫描以及脑脊液β-淀粉样蛋白和β-淀粉样前体蛋白以及脑脊液p-Tau检测,并根据脑脊液β-淀粉样蛋白/β-淀粉样前体蛋白(脑脊液±)和β-淀粉样蛋白正电子发射断层扫描(±)的异常状态将他们分为四个不同的脑脊液/正电子发射断层扫描组。我们确定了不同脑脊液/正电子发射断层扫描组tau蛋白显著升高的皮质区域,并研究了早期(脑脊液阳性/正电子发射断层扫描阴性和脑脊液阴性/正电子发射断层扫描阳性)和晚期(脑脊液阳性/正电子发射断层扫描阳性)淀粉样变性阶段tau蛋白正电子发射断层扫描图像与脑脊液β-淀粉样蛋白/β-淀粉样前体蛋白、β-淀粉样蛋白正电子发射断层扫描以及脑脊液p-Tau/β-淀粉样前体蛋白的区域和体素水平关联。与脑脊液阴性/正电子发射断层扫描阴性个体(参照组)相比,脑脊液阳性/正电子发射断层扫描阴性个体在内嗅区的tau蛋白水平较高,但在Braak 1和Braak 2区不高,而脑脊液阴性/正电子发射断层扫描阳性个体在Braak 1和Braak 2区有显著的tau蛋白升高,但在内嗅区不高。相比之下,脑脊液阳性/正电子发射断层扫描阳性个体在所有皮质区域的tau蛋白均比参照组有显著增加。体素水平分析进一步证明,在早期淀粉样变性阶段,脑脊液β-淀粉样蛋白/β-淀粉样前体蛋白水平较低与内嗅区较高的tau蛋白相关,而较高的β-淀粉样蛋白正电子发射断层扫描与Braak区较高的tau蛋白相关。在晚期淀粉样变性阶段,脑脊液β-淀粉样蛋白/β-淀粉样前体蛋白水平较低和β-淀粉样蛋白正电子发射断层扫描较高均与所有Braak分期区域的tau蛋白聚集相关。这些发现为阿尔茨海默病不同淀粉样变性阶段皮质tau缠结的空间模式提供了新的见解,表明脑脊液β-淀粉样蛋白和β-淀粉样蛋白正电子发射断层扫描不一致的组在早期淀粉样变性阶段可能具有不同的皮质tau缠结特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/824b/9014538/0155e6a99a86/fcac084ga1.jpg

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