两个独立前瞻性队列中的急性肾损伤概况分类

ATN profile classification across two independent prospective cohorts.

作者信息

Peretti Débora E, Ribaldi Federica, Scheffler Max, Mu Linjing, Treyer Valerie, Gietl Anton F, Hock Christoph, Frisoni Giovanni B, Garibotto Valentina

机构信息

Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Faculty of Medicine, Geneva University Neurocenter, University of Geneva, Geneva, Switzerland.

Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.

出版信息

Front Med (Lausanne). 2023 Jul 25;10:1168470. doi: 10.3389/fmed.2023.1168470. eCollection 2023.

DOI:10.3389/fmed.2023.1168470

PMID:37559930

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10407659/

Abstract

BACKGROUND

The ATN model represents a research framework used to describe in subjects the presence or absence of Alzheimer's disease (AD) pathology through biomarkers. The aim of this study was to describe the prevalence of different ATN profiles using quantitative imaging biomarkers in two independent cohorts, and to evaluate the pertinence of ATN biomarkers to identify comparable populations across independent cohorts.

METHODS

A total of 172 subjects from the Geneva Memory Clinic and 113 volunteers from a study on healthy aging at the University Hospital of Zurich underwent amyloid (A) and tau (T) PET, as well as T1-weigthed MRI scans using site-specific protocols. Subjects were classified by cognition (cognitively unimpaired, CU, or impaired, CI) based on clinical assessment by experts. Amyloid data converted into the standardized centiloid scale, tau PET data normalized to cerebellar uptake, and hippocampal volume expressed as a ratio over total intracranial volume ratio were considered as biomarkers for A, T, and neurodegeneration (N), respectively. Positivity for each biomarker was defined based on previously published thresholds. Subjects were then classified according to the ATN model. Differences among profiles were tested using Kruskal-Wallis ANOVA, and between cohorts using Wilcoxon tests.

RESULTS

Twenty-nine percent of subjects from the Geneva cohorts were classified with a normal (A-T-N-) profile, while the Zurich cohort included 64% of subjects in the same category. Meanwhile, 63% of the Geneva and 16% of the Zurich cohort were classified within the AD continuum (being A+ regardless of other biomarkers' statuses). Within cohorts, ATN profiles were significantly different for age and mini-mental state examination scores, but not for years of education. Age was not significantly different between cohorts. In general, imaging A and T biomarkers were significantly different between cohorts, but they were no longer significantly different when stratifying the cohorts by ATN profile. N was not significantly different between cohorts.

CONCLUSION

Stratifying subjects into ATN profiles provides comparable groups of subjects even when individual recruitment followed different criteria.

摘要

背景

ATN模型是一个研究框架，用于通过生物标志物描述受试者是否存在阿尔茨海默病（AD）病理特征。本研究的目的是使用定量成像生物标志物描述两个独立队列中不同ATN特征的患病率，并评估ATN生物标志物在识别不同独立队列中可比人群方面的相关性。

方法

来自日内瓦记忆诊所的172名受试者和苏黎世大学医院一项健康老龄化研究的113名志愿者接受了淀粉样蛋白（A）和tau蛋白（T）PET检查，以及使用特定部位方案的T1加权MRI扫描。根据专家的临床评估，受试者按认知情况（认知未受损，CU，或受损，CI）进行分类。转化为标准化百分等级量表的淀粉样蛋白数据、以小脑摄取量进行归一化的tau PET数据以及表示为与总颅内体积之比的海马体积分别被视为A、T和神经退行性变（N）的生物标志物。每个生物标志物的阳性定义基于先前公布的阈值。然后根据ATN模型对受试者进行分类。使用Kruskal-Wallis方差分析检验不同特征之间的差异，使用Wilcoxon检验检验不同队列之间的差异。

结果

日内瓦队列中有29%的受试者被分类为正常（A-T-N-）特征，而苏黎世队列中有64%的受试者属于同一类别。同时，日内瓦队列的63%和苏黎世队列的16%被分类为AD连续体（无论其他生物标志物状态如何，均为A+）。在队列内部，ATN特征在年龄和简易精神状态检查得分方面存在显著差异，但在受教育年限方面无显著差异。队列之间的年龄无显著差异。总体而言，成像A和T生物标志物在队列之间存在显著差异，但按ATN特征对队列进行分层时，它们不再有显著差异。队列之间的N无显著差异。