Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
Cognitive Impairment and Movement Disorders Unit, Neurology Department, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
J Alzheimers Dis. 2023;92(4):1303-1321. doi: 10.3233/JAD-220930.
Neuropsychological assessments are essential to define the cognitive profile and contribute to the diagnosis of Alzheimer's disease (AD). The progress in knowledge about the pathophysiological process of the disease has allowed conceptualizing AD through biomarkers as a biological continuum that encompasses different clinical stages.
To explore the association between cerebrospinal fluid (CSF) biomarkers of AD and cognition using the NEURONORMA battery, in a sample of cognitively unimpaired (CU), mild cognitive impaired (MCI), and mild dementia of the Alzheimer type (DAT) subjects, and to characterize the cognitive profiles in MCI subjects classified by A/T/N system.
42 CU, 35 MCI, and 35 mild DAT were assessed using the NEURONORMA battery. Core AD biomarkers [amyloid-β42 (Aβ42) peptide, total tau (t-tau), and phosphorylated tau 181 (p-tau181)] proteins were measured in CSF. Correlation coefficients, multivariate regression, and effect sizes were calculated. We explored the age- and education-adjusted cognitive profiles by A/T/N variants within the MCI group.
Cognitive outcomes were directly associated with CSF Aβ42 and inversely with CSF tau measures. We found differences in both biomarkers and cognitive outcomes comparing all pairs except for CSF measures between cognitively impaired groups. The highest effect size was in memory tasks and biomarkers ratios. Lower performances were in memory and executive domains in MCI subjects with AD pathology (A+T+N±) compared to those with normal levels of AD biomarkers (A- T- N).
This study provides further evidence of the validity of Spanish NEURONORMA cognitive battery to characterize cognitive impairment in the AD pathological continuum.
神经心理学评估对于定义认知特征并有助于阿尔茨海默病（AD）的诊断至关重要。对疾病病理生理过程的认识的进步使得 AD 可以通过生物标志物进行概念化，作为一个包含不同临床阶段的生物学连续体。
使用 NEURONORMA 电池探索 AD 的脑脊液（CSF）生物标志物与认知之间的关联，该样本包括认知正常（CU）、轻度认知障碍（MCI）和轻度 AD 痴呆（DAT）受试者，并对根据 A/T/N 系统分类的 MCI 受试者的认知特征进行描述。
42 名 CU、35 名 MCI 和 35 名轻度 DAT 受试者使用 NEURONORMA 电池进行评估。在 CSF 中测量 AD 核心生物标志物[β淀粉样蛋白 42（Aβ42）肽、总 tau（t-tau）和磷酸化 tau 181（p-tau181）]蛋白。计算相关系数、多元回归和效应大小。我们在 MCI 组内通过 A/T/N 变体探索了年龄和教育调整后的认知特征。
认知结果与 CSF Aβ42 直接相关，与 CSF tau 测量值呈负相关。我们发现除了认知障碍组之间的 CSF 测量值外，所有配对之间的生物标志物和认知结果都存在差异。在记忆任务和生物标志物比值中，效应量最大。与 AD 生物标志物水平正常（A- T- N）的 MCI 受试者相比，具有 AD 病理（A+T+N±）的 MCI 受试者在记忆和执行域的表现较差。
本研究进一步证明了西班牙 NEURONORMA 认知电池用于描述 AD 病理连续体中认知障碍的有效性。
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