低水平和高水平 Aβ 和 tau 沉积对皮质厚度的独特和共同影响。

Distinct and joint effects of low and high levels of Aβ and tau deposition on cortical thickness.

机构信息

Quantitative Neuroimaging Laboratory, Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, NY, United States.

Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, NY, United States.

出版信息

Neuroimage Clin. 2023;38:103409. doi: 10.1016/j.nicl.2023.103409. Epub 2023 Apr 19.

Abstract

Alzheimer's disease (AD) is defined by the presence of Amyloid-β (Aβ),tau, and neurodegeneration (ATN framework) in the human cerebral cortex. Yet, prior studies have suggested that Aβ deposition can be associated with both cortical thinning and thickening. These contradictory results are attributed to small sample sizes, the presence versus absence of tau, and limited detectability in the earliest phase of protein deposition, which may begin in young adulthood and cannot be captured in studies enrolling only older subjects. In this study, we aimed to find the distinct and joint effects of Aβ andtau on neurodegeneration during the progression from normal to abnormal stages of pathologies that remain elusive. We usedF-MK6240 and F-Florbetaben/F-Florbetapir positron emission tomography (PET) and magnetic resonance imaging (MRI) to quantify tau, Aβ, and cortical thickness in 590 participants ranging in age from 20 to 90. We performed multiple regression analyses to assess the distinct and joint effects of Aβ and tau on cortical thickness using 590 healthy control (HC) and mild cognitive impairment (MCI) participants (141 young, 394 HC elderlies, 52 MCI). We showed thatin participants with normal levels of global Aβdeposition, Aβ uptakewassignificantly associated with increasedcortical thickness regardless of tau (e.g., left entorhinal cortex with t > 3.241, p < 0.0013). The relationship between tau deposition and neurodegeneration was more complex: in participants with abnormal levels of global tau, tau uptake was associated with cortical thinning in several regions of the brain (e.g., left entorhinal with t < -2.80, p < 0.0096 and left insula with t-value < -4.284, p < 0.0001), as reported on prior neuroimaging and neuropathological studies. Surprisingly, in participants with normal levels of global tau, tau was found to be associated with cortical thickening. Moreover, in participants with abnormal levels of global Aβandtau, theresonancebetween them, defined as their correlation throughout the cortex, wasassociated strongly with cortical thinning even when controlling for a direct linear effect. We confirm prior findings of an association between Aβ deposition and cortical thickening and suggest this may also be the case in the earliest stages of deposition in normal aging. We also illustrate that resonance between high levels of Aβ and tau uptake is strongly associated with cortical thinning, emphasizing the effects of Aβ/tau synergy inAD pathogenesis.

摘要

阿尔茨海默病(AD)的定义是在人类大脑皮层中存在淀粉样蛋白-β(Aβ)、tau 和神经退行性变(ATN 框架)。然而,先前的研究表明,Aβ 沉积与皮质变薄和增厚都有关。这些相互矛盾的结果归因于样本量小、tau 的存在与否以及在蛋白质沉积的最早阶段的检测能力有限,该阶段可能始于成年早期,在仅招募老年受试者的研究中无法捕捉到。在这项研究中,我们旨在寻找 Aβ 和 tau 在从正常到异常病理阶段的进展过程中对神经退行性变的独特和共同影响,而这些病理阶段仍然难以捉摸。我们使用 F-MK6240 和 F-Florbetaben/F-Florbetapir 正电子发射断层扫描(PET)和磁共振成像(MRI)来定量评估 590 名年龄在 20 至 90 岁之间的参与者的 tau、Aβ 和皮质厚度。我们进行了多项回归分析,使用 590 名健康对照组(HC)和轻度认知障碍(MCI)参与者(141 名年轻人,394 名 HC 老年人,52 名 MCI)来评估 Aβ 和 tau 对皮质厚度的独特和共同影响。我们表明,在具有正常水平的全局 Aβ 沉积的参与者中,无论 tau 如何,Aβ 摄取都与皮质厚度增加显著相关(例如,左侧内嗅皮质 t>3.241,p<0.0013)。tau 沉积与神经退行性变之间的关系更为复杂:在具有异常水平的全局 tau 的参与者中,tau 摄取与大脑中几个区域的皮质变薄有关(例如,左侧内嗅皮质 t<-2.80,p<0.0096 和左侧岛叶 t 值<-4.284,p<0.0001),如先前的神经影像学和神经病理学研究报告的那样。令人惊讶的是,在具有正常水平的全局 tau 的参与者中,tau 与皮质增厚有关。此外,在具有异常水平的全局 Aβ 和 tau 的参与者中,它们之间的共振(即整个皮质中它们的相关性)与皮质变薄强烈相关,即使在控制直接线性效应时也是如此。我们证实了先前关于 Aβ 沉积与皮质增厚之间存在关联的发现,并表明在正常衰老的早期沉积阶段也可能如此。我们还表明,高水平的 Aβ 和 tau 摄取之间的共振与皮质变薄强烈相关,这强调了 Aβ/tau 协同作用在 AD 发病机制中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0db/10165160/a03ef38223ac/gr1.jpg

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