Chen Qianyun, Abrigo Jill, Liu Wanting, Han Elyia Yixun, Yeung David Ka Wai, Shi Lin, Au Lisa Wing Chi, Deng Min, Chen Sirong, Leung Eric Yim Lung, Ho Chi Lai, Mok Vincent Chung Tong, Chu Winnie Chiu Wing
Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China.
Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China.
Brain Sci. 2022 May 31;12(6):722. doi: 10.3390/brainsci12060722.
Alzheimer’s disease (AD) was recently defined as a biological construct to reflect neuropathologic status, and both abnormal amyloid and tau are required for a diagnosis of AD. We aimed to determine the proton MR spectroscopic (1H-MRS) patterns of the posterior cingulate in biologically defined AD. A total of 68 participants were included in this study, comprising 37 controls, 16 early AD, and 15 late AD, who were classified according to their amyloid and tau status and presence of hippocampal atrophy. Compared with controls, early AD showed lower N-acetylaspartate (NAA)/creatine (Cr) (p = 0.003), whereas late AD showed lower NAA/Cr and higher myoInositol (mI)/Cr (all with p < 0.05). Lower NAA/Cr correlated with a greater global amyloid load (r = −0.47, p < 0.001) and tau load (r = −0.51, p < 0.001) and allowed a discrimination of early AD from controls (p < 0.001). Subgroup analysis showed that NAA/Cr also allowed a differentiation of early AD from controls in the cognitively unimpaired subjects, with an area under the receiver operating characteristics curve, sensitivity, and specificity of 0.96, 100%, and 83.8%, respectively. Lower posterior cingulate NAA levels may help to inform underlying neuropathologic changes in the early stage of AD.
阿尔茨海默病（AD）最近被定义为一种反映神经病理状态的生物学概念，AD的诊断需要同时存在异常的淀粉样蛋白和tau蛋白。我们旨在确定生物学定义的AD患者扣带回后部的质子磁共振波谱（1H-MRS）模式。本研究共纳入68名参与者，包括37名对照者、16名早期AD患者和15名晚期AD患者，他们根据淀粉样蛋白和tau蛋白状态以及海马萎缩情况进行分类。与对照者相比，早期AD患者的N-乙酰天门冬氨酸（NAA）/肌酸（Cr）较低（p = 0.003），而晚期AD患者的NAA/Cr较低，肌醇（mI）/Cr较高（均p < 0.05）。较低的NAA/Cr与更高的整体淀粉样蛋白负荷（r = -0.47，p < 0.001）和tau蛋白负荷（r = -0.51，p < 0.001）相关，并且能够区分早期AD与对照者（p < 0.001）。亚组分析表明，NAA/Cr也能够在认知未受损的受试者中区分早期AD与对照者，受试者工作特征曲线下面积、敏感性和特异性分别为0.96、100%和83.8%。扣带回后部较低的NAA水平可能有助于了解AD早期潜在的神经病理变化。
