Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Krembil Discovery Tower, 60 Leonard Avenue, 6th floor 6KD-407, Toronto, ON, M5T 2S8, Canada.
L.C. Campbell Cognitive Neurology Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Alzheimers Res Ther. 2023 Jun 20;15(1):114. doi: 10.1186/s13195-023-01257-y.
Neuropsychiatric symptoms (NPS) are a core feature of most neurodegenerative and cerebrovascular diseases. White matter hyperintensities and brain atrophy have been implicated in NPS. We aimed to investigate the relative contribution of white matter hyperintensities and cortical thickness to NPS in participants across neurodegenerative and cerebrovascular diseases.
Five hundred thirteen participants with one of these conditions, i.e. Alzheimer's Disease/Mild Cognitive Impairment, Amyotrophic Lateral Sclerosis, Frontotemporal Dementia, Parkinson's Disease, or Cerebrovascular Disease, were included in the study. NPS were assessed using the Neuropsychiatric Inventory - Questionnaire and grouped into hyperactivity, psychotic, affective, and apathy subsyndromes. White matter hyperintensities were quantified using a semi-automatic segmentation technique and FreeSurfer cortical thickness was used to measure regional grey matter loss.
Although NPS were frequent across the five disease groups, participants with frontotemporal dementia had the highest frequency of hyperactivity, apathy, and affective subsyndromes compared to other groups, whilst psychotic subsyndrome was high in both frontotemporal dementia and Parkinson's disease. Results from univariate and multivariate results showed that various predictors were associated with neuropsychiatric subsyndromes, especially cortical thickness in the inferior frontal, cingulate, and insula regions, sex(female), global cognition, and basal ganglia-thalamus white matter hyperintensities.
In participants with neurodegenerative and cerebrovascular diseases, our results suggest that smaller cortical thickness and white matter hyperintensity burden in several cortical-subcortical structures may contribute to the development of NPS. Further studies investigating the mechanisms that determine the progression of NPS in various neurodegenerative and cerebrovascular diseases are needed.
神经精神症状（NPS）是大多数神经退行性和脑血管疾病的核心特征。脑白质高信号和脑萎缩与 NPS 有关。我们旨在研究脑白质高信号和皮质厚度对神经退行性和脑血管疾病患者 NPS 的相对贡献。
本研究纳入了 513 名患有以下疾病的参与者，包括阿尔茨海默病/轻度认知障碍、肌萎缩侧索硬化症、额颞叶痴呆、帕金森病或脑血管病。使用神经精神病学问卷-问卷评估 NPS，并将其分为活动过度、精神病性、情感和淡漠亚综合征。使用半自动分割技术量化脑白质高信号，使用 FreeSurfer 皮质厚度测量区域灰质丢失。
尽管 NPS 在五个疾病组中均很常见，但与其他组相比，额颞叶痴呆患者的活动过度、淡漠和情感亚综合征发生率最高，而精神病性亚综合征在额颞叶痴呆和帕金森病中均较高。单变量和多变量结果表明，各种预测因子与神经精神亚综合征相关，特别是额下回、扣带回和脑岛等皮质下区域的皮质厚度、性别（女性）、整体认知和基底节-丘脑白质高信号。
在患有神经退行性和脑血管疾病的患者中，我们的结果表明，几个皮质下结构的皮质厚度较小和白质高信号负担可能导致 NPS 的发展。需要进一步研究探讨决定各种神经退行性和脑血管疾病中 NPS 进展的机制。
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