Weng Xiaofen, Liu Shanwen, Li Meng, Zhang Yingchun, Zhu Jiangtao, Liu Chunfeng, Hu Hua
Department of Neurology, The Second Affiliated Hospital of Soochow University, 1055 San Xiang Road, Suzhou, 215004, Jiangsu, China.
Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, China.
Eur Geriatr Med. 2023 Oct;14(5):1037-1047. doi: 10.1007/s41999-023-00818-6. Epub 2023 Jun 18.
Alzheimer's disease (AD) has been reported to be associated with sarcopenia. White matter hyperintensities (WMH) are common in AD patients. However, the effect of WMH on sarcopenia in AD remains unclear. We hence aimed to investigate the possible association between regional WMH volumes and sarcopenic parameters in AD.
57 mild to moderate AD patients and 22 normal controls (NC) were enrolled. Sarcopenic parameters were assessed, including appendicular skeletal mass index (ASMI), grip strength, 5-times sit-to-stand (5-STS) time, and gait speed. The volumes of periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH) were quantified using 3D-slicer software.
AD subjects exhibited a lower ASMI, a slower gait speed, an increased 5-STS time, and larger volumes of PVH and DWMH than those in the NC group. In AD subjects, total WMH and PVH volumes were related to cognitive impairment, particularly executive function decline. Moreover, total WMH volume and PVH volume were negatively correlated with gait speed across various clinical stages of AD. Multiple linear regression analysis showed that PVH volume was independently associated with 5-STS time and gait speed, whereas DWMH volume was only independently associated with gait speed.
WMH volume was associated with cognitive decline and various sarcopenic parameters. It thereby suggested that WMH may serve as the connection between sarcopenia and cognitive dysfunction in AD. Further studies are needed to confirm these findings and to determine whether sarcopenia interventions reduce WMH volume and improve cognitive function in AD.
据报道，阿尔茨海默病（AD）与肌肉减少症有关。白质高信号（WMH）在AD患者中很常见。然而，WMH对AD患者肌肉减少症的影响仍不清楚。因此，我们旨在研究AD患者局部WMH体积与肌肉减少症参数之间可能存在的关联。
纳入57例轻度至中度AD患者和22例正常对照（NC）。评估肌肉减少症参数，包括四肢骨骼肌质量指数（ASMI）、握力、5次坐立试验（5-STS）时间和步速。使用3D Slicer软件对脑室周围高信号（PVH）和深部白质高信号（DWMH）的体积进行量化。
与NC组相比，AD患者的ASMI较低，步速较慢，5-STS时间增加，PVH和DWMH体积较大。在AD患者中，总的WMH和PVH体积与认知障碍有关，尤其是执行功能下降。此外，在AD的各个临床阶段，总的WMH体积和PVH体积与步速呈负相关。多元线性回归分析表明，PVH体积与5-STS时间和步速独立相关，而DWMH体积仅与步速独立相关。
WMH体积与认知功能下降和各种肌肉减少症参数有关。因此表明，WMH可能是AD患者肌肉减少症与认知功能障碍之间的联系。需要进一步的研究来证实这些发现，并确定肌肉减少症干预措施是否能减少AD患者的WMH体积并改善认知功能。
