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白质病变分级对慢性酒精依赖患者认知功能的影响。

Effects of white matter lesion grading on the cognitive function of patients with chronic alcohol dependence.

作者信息

Ren Yuhang, Meng Keyan, Sun Yuting, Wu Meini, Li Siou, Zhao Weina, Sun Yanli, Zhu Xiaofeng, Yin Changhao

机构信息

Department of Neurology, Hongqi Hospital Affiliated to Mudanjiang Medical University Mudanjiang 157000, Heilongjiang, China.

Heilongjiang Key Laboratory of Ischemic Stroke Prevention and Treatment Mudanjiang 157000, Heilongjiang, China.

出版信息

Am J Transl Res. 2023 Feb 15;15(2):1129-1139. eCollection 2023.

Abstract

BACKGROUND

Alcohol dependence has become a major problem that poses a serious threat to public health. Long-term heavy alcohol consumption can lead to brain functional disorders. This study aimed to investigate the relationship of the severity of cerebral white matter lesions (WMLs), serum neurofilament light (NfL) and inflammatory factors, tumour necrosis factor alpha (TNF-α) and Interleukin-1β (IL-1β), with the cognitive function of patients with alcohol dependence.

METHODS

A total of 118 patients were enrolled in this prospective study, and divided into alcohol-dependent and non-alcohol-dependent groups. The severity of WMLs was assessed using the Fazekas scale based on magnetic resonance imaging analysis. The expression levels of NfL, TNF-α and IL-1β in the serum of the subjects were measured by enzyme-linked immunosorbent assay. The cognitive function and psychological status of the patients were assessed using the Minimum Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA). The severity of WMLs and the expression levels of serum NfL, TNF-α and IL-1β in alcohol-dependent patients were analysed for their influence on cognitive function. This clinical trial was approved by China Clinical Trials Registry, and the trial number is ChiCTR2200066057 (http://www.chictr.org.cn/searchproj.aspx).

RESULTS

The score of Fazekas scale was higher, and the MMSE score and MoCA score were lower in the alcohol-dependent group than those in the non-alcohol-dependent group. Moreover, the Fazekas score of the alcohol-dependent group was negatively correlated with the MMSE and MoCA scores. The serum NfL, TNF-α and IL-1β levels were higher in the alcohol-dependent group than in the non-alcohol-dependent group, and the serum NfL, TNF-α and IL-1β levels in the alcohol-dependent group were negatively correlated with the MMSE and MoCA scores.

CONCLUSION

Alcohol-dependent patients have more severe cerebral WMLs and significant cognitive impairment, particularly in visuospatial and executive functions, attention, calculation, abstraction, delayed recall and orientation. Serum NfL, TNF-α and IL-1β may be used as biomarkers to assess alcohol related cognitive decline.

摘要

背景

酒精依赖已成为对公众健康构成严重威胁的主要问题。长期大量饮酒会导致脑功能障碍。本研究旨在探讨脑白质病变(WMLs)的严重程度、血清神经丝轻链(NfL)以及炎症因子肿瘤坏死因子α(TNF-α)和白细胞介素-1β(IL-1β)与酒精依赖患者认知功能之间的关系。

方法

本前瞻性研究共纳入118例患者,分为酒精依赖组和非酒精依赖组。基于磁共振成像分析,使用 Fazekas 量表评估 WMLs 的严重程度。采用酶联免疫吸附测定法测量受试者血清中 NfL、TNF-α 和 IL-1β 的表达水平。使用简易精神状态检查表(MMSE)、蒙特利尔认知评估量表(MoCA)、汉密尔顿抑郁量表(HAMD)和汉密尔顿焦虑量表(HAMA)评估患者的认知功能和心理状态。分析酒精依赖患者中 WMLs 的严重程度以及血清 NfL、TNF-α 和 IL-1β 的表达水平对认知功能的影响。本临床试验已获得中国临床试验注册中心批准,试验编号为 ChiCTR2200066057(http://www.chictr.org.cn/searchproj.aspx)。

结果

酒精依赖组的 Fazekas 量表评分较高,MMSE 评分和 MoCA 评分低于非酒精依赖组。此外,酒精依赖组的 Fazekas 评分与 MMSE 和 MoCA 评分呈负相关。酒精依赖组的血清 NfL、TNF-α 和 IL-1β 水平高于非酒精依赖组,且酒精依赖组的血清 NfL、TNF-α 和 IL-1β 水平与 MMSE 和 MoCA 评分呈负相关。

结论

酒精依赖患者存在更严重的脑 WMLs 和明显的认知障碍,尤其是在视觉空间和执行功能、注意力、计算、抽象、延迟回忆和定向方面。血清 NfL、TNF-α 和 IL-1β 可作为评估酒精相关认知衰退的生物标志物。

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