Moulinet Inès, Touron Edelweiss, Mézenge Florence, Dautricourt Sophie, De La Sayette Vincent, Vivien Denis, Marchant Natalie L, Poisnel Géraldine, Chételat Gaël
Physiopathology and Imaging of Neurological Disorders (PhIND), Institut National de la Santé et de la Recherche Médicale, Blood and Brain @ Caen-Normandie, GIP Cyceron, Université de Caen Normandie, Caen, France.
CHU de Caen, Service de Neurologie, Caen, France.
Front Aging Neurosci. 2022 Jun 20;14:899158. doi: 10.3389/fnagi.2022.899158. eCollection 2022.
Depressive and anxiety symptoms are frequent in Alzheimer's disease and associated with increased risk of developing Alzheimer's disease in older adults. We sought to examine their relationships to Alzheimer's disease biomarkers across the preclinical and clinical stages of the disease.
Fifty-six healthy controls, 35 patients with subjective cognitive decline and 56 amyloid-positive cognitively impaired patients on the Alzheimer's continuum completed depression and anxiety questionnaires, neuropsychological tests and neuroimaging assessments. We performed multiple regressions in each group separately to assess within group associations of depressive and anxiety symptoms with either cognition (global cognition and episodic memory) or neuroimaging data (gray matter volume, glucose metabolism and amyloid load).
Depressive symptoms, but not anxiety, were higher in patients with subjective cognitive decline and cognitively impaired patients on the Alzheimer's continuum compared to healthy controls. Greater depressive symptoms were associated with higher amyloid load in subjective cognitive decline patients, while they were related to higher cognition and glucose metabolism, and to better awareness of cognitive difficulties, in cognitively impaired patients on the Alzheimer's continuum. In contrast, anxiety symptoms were not associated with brain integrity in any group.
These data show that more depressive symptoms are associated with greater Alzheimer's disease biomarkers in subjective cognitive decline patients, while they reflect better cognitive deficit awareness in cognitively impaired patients on the Alzheimer's continuum. Our findings highlight the relevance of assessing and treating depressive symptoms in the preclinical stages of Alzheimer's disease.
抑郁和焦虑症状在阿尔茨海默病中很常见，并且与老年人患阿尔茨海默病的风险增加相关。我们试图研究在该疾病的临床前和临床阶段，这些症状与阿尔茨海默病生物标志物之间的关系。
56名健康对照者、35名主观认知下降患者以及56名处于阿尔茨海默病连续体上的淀粉样蛋白阳性认知障碍患者完成了抑郁和焦虑问卷、神经心理学测试以及神经影像学评估。我们在每组中分别进行多元回归分析，以评估抑郁和焦虑症状与认知（整体认知和情景记忆）或神经影像学数据（灰质体积、葡萄糖代谢和淀粉样蛋白负荷）之间的组内关联。
与健康对照者相比，主观认知下降患者以及处于阿尔茨海默病连续体上的认知障碍患者的抑郁症状较高，但焦虑症状并非如此。在主观认知下降患者中，更严重的抑郁症状与更高的淀粉样蛋白负荷相关，而在处于阿尔茨海默病连续体上的认知障碍患者中，抑郁症状与更高的认知水平、葡萄糖代谢以及对认知困难的更好认知相关。相比之下，焦虑症状在任何组中均与脑完整性无关。
这些数据表明，在主观认知下降患者中，更多的抑郁症状与更大的阿尔茨海默病生物标志物相关，而在处于阿尔茨海默病连续体上的认知障碍患者中，抑郁症状反映了对认知缺陷的更好认知。我们的研究结果凸显了在阿尔茨海默病临床前阶段评估和治疗抑郁症状的重要性。
