Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, California, USA.
Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.
Alzheimers Dement. 2023 Mar;19(3):884-895. doi: 10.1002/alz.12712. Epub 2022 Jun 29.
Epidemiological studies report an association between traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) and clinically diagnosed Alzheimer's disease (AD). We examined the association between TBI/PTSD and biomarker-defined AD.
We identified 289 non-demented veterans with TBI and/or PTSD and controls who underwent clinical evaluation, cerebrospinal fluid (CSF) collection, magnetic resonance imaging (MRI), amyloid beta (Aβ) and tau positron emission tomography, and apolipoprotein E testing. Participants were followed for up to 5.2 years.
Exposure groups (TBI, PTSD, and TBI + PTSD) had higher prevalence of mild cognitive impairment (MCI: P < .0001) and worse Mini-Mental State Examination scores (PTSD: P = .008; TBI & PTSD: P = .009) than controls. There were no significant differences in other cognitive scores, MRI volumes, Aβ or tau accumulation, or in most longitudinal measures.
TBI and/or PTSD were not associated with elevated AD biomarkers. The poorer cognitive status of exposed veterans may be due to other comorbid pathologies.
流行病学研究报告称，创伤性脑损伤（TBI）与创伤后应激障碍（PTSD）以及临床上诊断的阿尔茨海默病（AD）之间存在关联。我们研究了 TBI/PTSD 与生物标志物定义的 AD 之间的关联。
我们确定了 289 名无痴呆的创伤性脑损伤和/或创伤后应激障碍退伍军人以及接受临床评估、脑脊液（CSF）采集、磁共振成像（MRI）、β淀粉样蛋白（Aβ）和 tau 正电子发射断层扫描以及载脂蛋白 E 检测的对照组。参与者的随访时间最长为 5.2 年。
暴露组（TBI、PTSD 和 TBI+PTSD）的轻度认知障碍（MCI：P<0.0001）和简易精神状态检查评分（PTSD：P=0.008；TBI+PTSD：P=0.009）较对照组更高。其他认知评分、MRI 容积、Aβ或 tau 积累或大多数纵向指标均无显著差异。
TBI 和/或 PTSD 与升高的 AD 生物标志物无关。暴露退伍军人认知状态较差可能是由于其他共病病理。
