视网膜改变可预测神经退行性疾病的早期前驱征象。

Retinal Alterations Predict Early Prodromal Signs of Neurodegenerative Disease.

机构信息

Department of Translational Medicine and LTTA Centre, University of Ferrara, 44121 Ferrara, Italy.

Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy.

出版信息

Int J Mol Sci. 2024 Jan 30;25(3):1689. doi: 10.3390/ijms25031689.

Abstract

Neurodegenerative diseases are an increasingly common group of diseases that occur late in life with a significant impact on personal, family, and economic life. Among these, Alzheimer's disease (AD) and Parkinson's disease (PD) are the major disorders that lead to mild to severe cognitive and physical impairment and dementia. Interestingly, those diseases may show onset of prodromal symptoms early after middle age. Commonly, the evaluation of these neurodegenerative diseases is based on the detection of biomarkers, where functional and structural magnetic resonance imaging (MRI) have shown a central role in revealing early or prodromal phases, although it can be expensive, time-consuming, and not always available. The aforementioned diseases have a common impact on the visual system due to the pathophysiological mechanisms shared between the eye and the brain. In Parkinson's disease, α-synuclein deposition in the retinal cells, as well as in dopaminergic neurons of the substantia nigra, alters the visual cortex and retinal function, resulting in modifications to the visual field. Similarly, the visual cortex is modified by the neurofibrillary tangles and neuritic amyloid β plaques typically seen in the Alzheimer's disease brain, and this may reflect the accumulation of these biomarkers in the retina during the early stages of the disease, as seen in postmortem retinas of AD patients. In this light, the ophthalmic evaluation of retinal neurodegeneration could become a cost-effective method for the early diagnosis of those diseases, overcoming the limitations of functional and structural imaging of the deep brain. This analysis is commonly used in ophthalmic practice, and interest in it has risen in recent years. This review will discuss the relationship between Alzheimer's disease and Parkinson's disease with retinal degeneration, highlighting how retinal analysis may represent a noninvasive and straightforward method for the early diagnosis of these neurodegenerative diseases.

摘要

神经退行性疾病是一组越来越常见的疾病,它们在生命后期发生,对个人、家庭和经济生活都有重大影响。在这些疾病中,阿尔茨海默病(AD)和帕金森病(PD)是导致轻度至重度认知和身体功能障碍以及痴呆的主要疾病。有趣的是,这些疾病可能在中年后早期出现前驱症状。通常,这些神经退行性疾病的评估基于生物标志物的检测,其中功能和结构磁共振成像(MRI)在揭示早期或前驱阶段方面发挥了核心作用,尽管它可能昂贵、耗时且并非总是可用。由于眼睛和大脑之间存在共同的病理生理机制,上述疾病对视系统有共同的影响。在帕金森病中,视网膜细胞和黑质多巴胺能神经元中的α-突触核蛋白沉积改变了视觉皮层和视网膜功能,导致视野改变。同样,神经纤维缠结和神经原纤维缠结通常见于阿尔茨海默病大脑中的β淀粉样斑块改变了视觉皮层,这可能反映了这些生物标志物在疾病早期在视网膜中的积累,正如 AD 患者死后视网膜中所见。从这个角度来看,眼科评估视网膜神经退行性变可能成为这些疾病早期诊断的一种具有成本效益的方法,克服了深部脑功能和结构成像的局限性。这种分析在眼科实践中很常见,近年来引起了人们的兴趣。本文将讨论阿尔茨海默病和帕金森病与视网膜变性的关系,强调视网膜分析如何可能成为这些神经退行性疾病早期诊断的一种非侵入性和直接的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d81/10855697/a520aae95161/ijms-25-01689-g001.jpg

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