Department of Neurology, Inje University Sanggye Paik Hospital, Seoul, South Korea.
Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
J Alzheimers Dis. 2023;94(3):1133-1144. doi: 10.3233/JAD-230187.
Clinical significance of additional occipital amyloid-β (Aβ) plaques in Alzheimer's disease (AD) remains unclear.
In this study, we investigated the effect of regional Aβ deposition on cognition in patients on the AD continuum, especially in the occipital region.
We retrospectively reviewed the medical record of 208 patients with AD across the cognitive continuum (non-dementia and dementia). Multivariable linear regression analyses were performed to determine the effect of regional Aβ deposition on cognitive function. A linear mixed model was used to assess the effect of regional deposition on longitudinal changes in Mini-Mental State Examination (MMSE) scores. Additionally, the patients were dichotomized according to the occipital-to-global Aβ deposition ratio (ratio ≤1, Aβ-OCC- group; ratio >1, Aβ-OCC+ group), and the same statistical analyses were applied for between-group comparisons.
Regional Aβ burden itself was not associated with baseline cognitive function. In terms of Aβ-OCC group effect, the Aβ-OCC+ group exhibited a poorer cognitive performance on language function compared to the Aβ-OCC- group. High Aβ retention in each region was associated with a rapid decline in MMSE scores, only in the dementia subgroup. Additionally, Aβ-OCC+ individuals exhibited a faster annual decline in MMSE scores than Aβ-OCC- individuals in the non-dementia subgroup (β= -0.77, standard error [SE] = 0.31, p = 0.013).
The present study demonstrated that additional occipital Aβ deposition was associated with poor baseline language function and rapid cognitive deterioration in patients on the AD continuum.
阿尔茨海默病（AD）患者额外的枕叶淀粉样蛋白-β（Aβ）斑块的临床意义尚不清楚。
本研究旨在探讨 AD 连续体患者（包括非痴呆和痴呆患者）中，区域性 Aβ沉积对认知功能的影响，尤其是在枕叶区域。
我们回顾性分析了 208 例 AD 连续体患者（非痴呆和痴呆）的病历。采用多变量线性回归分析来确定区域性 Aβ沉积对认知功能的影响。采用线性混合模型来评估区域性沉积对简易精神状态检查（MMSE）评分纵向变化的影响。此外，根据枕叶与全脑 Aβ沉积比值（比值≤1，Aβ-OCC-组；比值>1，Aβ-OCC+组）将患者进行二分法，并对组间差异进行相同的统计分析。
区域性 Aβ负担本身与基线认知功能无关。就 Aβ-OCC 组效应而言，与 Aβ-OCC-组相比，Aβ-OCC+组的语言功能认知表现更差。每个区域的 Aβ 保留量与 MMSE 评分的快速下降相关，仅在痴呆亚组中。此外，与 Aβ-OCC-个体相比，Aβ-OCC+个体在非痴呆亚组中的 MMSE 评分下降速度更快（β=-0.77，标准误[SE]=0.31，p=0.013）。
本研究表明，在 AD 连续体患者中，额外的枕叶 Aβ 沉积与基线时较差的语言功能和认知快速恶化有关。
