Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA.
Section of Biomedical Image Analysis, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.
Neurobiol Aging. 2022 Dec;120:34-42. doi: 10.1016/j.neurobiolaging.2022.08.004. Epub 2022 Aug 17.
Although liver dysfunction has been implicated in Alzheimer's disease (AD), it remains unknown how liver disease may influence the trajectory of brain and cognitive changes in older adults. We related self-reported liver disease to longitudinal measures of brain structure and cognition, as well as baseline measures of plasma AD/neurodegeneration biomarkers in the Baltimore Longitudinal Study of Aging. Liver disease was identified using ICD-9 classification codes. Brain volume and cognition were assessed serially using 3T-MRI and a cognitive battery. 1008, 2157, and 780 participants were included in the MRI, cognitive, and plasma biomarker analysis, respectively. After adjustment for confounders, liver disease was associated with accelerated decline in total brain and white matter volume, but not total gray matter or AD signature region volume. Although liver disease showed no relationship with domain-specific cognitive decline or plasma biomarkers, participants with a history of hepatitis demonstrated accelerated decline in verbal fluency and elevated neurofilament light. Results suggest all-cause liver disease may accelerate brain volume loss but does not appear to promote AD-specific neurocognitive changes.
尽管肝功能障碍与阿尔茨海默病（AD）有关，但尚不清楚肝脏疾病如何影响老年人的大脑和认知变化轨迹。我们将自我报告的肝脏疾病与大脑结构和认知的纵向测量以及巴尔的摩老龄化纵向研究中的基线 AD/神经退行性变生物标志物测量相关联。肝脏疾病使用 ICD-9 分类代码确定。使用 3T-MRI 和认知成套测验对脑容量和认知进行连续评估。分别有 1008、2157 和 780 名参与者纳入 MRI、认知和血浆生物标志物分析。在调整混杂因素后，肝脏疾病与总脑和白质体积的加速下降相关，但与总灰质或 AD 特征区域体积无关。尽管肝脏疾病与特定领域的认知下降或血浆生物标志物没有关系，但患有肝炎病史的参与者在言语流畅性方面表现出加速下降，神经丝轻链水平升高。结果表明，所有原因的肝脏疾病可能会加速脑容量的减少，但似乎不会促进 AD 特异性的神经认知变化。
