Genomic Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Cleveland Clinic Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, Ohio, USA.
Alzheimers Dement. 2024 Jan;20(1):549-562. doi: 10.1002/alz.13398. Epub 2023 Sep 23.
The National Institute on Aging - Alzheimer's Association (NIA-AA) ATN research framework proposes to use biomarkers for amyloid (A), tau (T), and neurodegeneration (N) to stage individuals with AD pathological features and track changes longitudinally. The overall aim was to utilize this framework to characterize pre-mortem ATN status longitudinally in a clinically diagnosed cohort of dementia with Lewy bodies (DLB) and to correlate it with the post mortem diagnosis.
The cohort was subtyped by cerebrospinal fluid (CSF) ATN category. A subcohort had longitudinal data, and a subgroup was neuropathologically evaluated.
We observed a significant difference in Aβ after 12 months in the A+T- group. Post mortem neuropathologic analyses indicated that most of the p-Tau 181 positive (T+) cases also had a high Braak stage.
This suggests that DLB patients who are A+ but T- may need to be monitored to determine whether they remain A+ or ever progress to T positivity.
Some A+T- DLB subjects transition from A+ to negative after 12-months. Clinically diagnosed DLB with LBP-AD (A+T+) maintain their positivity. Clinically diagnosed DLB with LBP-AD (A+T+) maintain their positivity. Monitoring of the A+T- sub-type of DLB may be necessary.
美国国家老龄化研究所-阿尔茨海默病协会（NIA-AA）的 ATN 研究框架提议使用淀粉样蛋白（A）、tau（T）和神经退行性变（N）的生物标志物对具有 AD 病理特征的个体进行分期，并进行纵向跟踪。总体目标是利用该框架对临床诊断为路易体痴呆（DLB）的队列进行预先死亡 ATN 状态的纵向特征描述，并将其与死后诊断相关联。
该队列通过脑脊液（CSF）ATN 类别进行亚型分类。一个亚队列具有纵向数据，一个亚组进行了神经病理学评估。
我们观察到 A+T-组在 12 个月后 Aβ 有显著差异。死后神经病理学分析表明，大多数 p-Tau 181 阳性（T+）病例也具有较高的 Braak 分期。
这表明，A+但 T-的 DLB 患者可能需要进行监测，以确定他们是否仍然为 A+，或者是否会进展为 T 阳性。
一些 A+T-的 DLB 患者在 12 个月后从 A+转为阴性。临床诊断为 DLB 且 LBP-AD（A+T+）的患者保持其阳性。对 DLB 的 A+T-亚型进行监测可能是必要的。
