Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Division of Neurology, Department of Medicine, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada.
Int J Geriatr Psychiatry. 2024 Mar;39(3):e6074. doi: 10.1002/gps.6074.
Neuropsychiatric symptoms (NPS) increase risk of developing dementia and are linked to various neurodegenerative conditions, including mild cognitive impairment (MCI due to Alzheimer's disease [AD]), cerebrovascular disease (CVD), and Parkinson's disease (PD). We explored the structural neural correlates of NPS cross-sectionally and longitudinally across various neurodegenerative diagnoses.
The study included individuals with MCI due to AD, (n = 74), CVD (n = 143), and PD (n = 137) at baseline, and at 2-years follow-up (MCI due to AD, n = 37, CVD n = 103, and PD n = 84). We assessed the severity of NPS using the Neuropsychiatric Inventory Questionnaire. For brain structure we included cortical thickness and subcortical volume of predefined regions of interest associated with corticolimbic and frontal-executive circuits.
Cross-sectional analysis revealed significant negative correlations between appetite with both circuits in the MCI and CVD groups, while apathy was associated with these circuits in both the MCI and PD groups. Longitudinally, changes in apathy scores in the MCI group were negatively linked to the changes of the frontal-executive circuit. In the CVD group, changes in agitation and nighttime behavior were negatively associated with the corticolimbic and frontal-executive circuits, respectively. In the PD group, changes in disinhibition and apathy were positively associated with the corticolimbic and frontal-executive circuits, respectively.
The observed correlations suggest that underlying pathological changes in the brain may contribute to alterations in neural activity associated with MBI. Notably, the difference between cross-sectional and longitudinal results indicates the necessity of conducting longitudinal studies for reproducible findings and drawing robust inferences.
神经精神症状（NPS）增加了痴呆的发病风险，与各种神经退行性疾病有关，包括轻度认知障碍（阿尔茨海默病[AD]引起的 MCI）、脑血管病（CVD）和帕金森病（PD）。我们探索了 NPS 在各种神经退行性诊断中的横断面和纵向结构神经相关性。
本研究包括基线时患有 AD 引起的 MCI（n=74）、CVD（n=143）和 PD（n=137）的患者，以及 2 年随访时（AD 引起的 MCI，n=37、CVD n=103 和 PD n=84）。我们使用神经精神问卷评估 NPS 的严重程度。对于脑结构，我们包括与皮质边缘和额执行回路相关的预设感兴趣区域的皮质厚度和皮质下体积。
横断面分析显示，在 MCI 和 CVD 组中，食欲与两个回路均呈显著负相关，而淡漠与 MCI 和 PD 组的这两个回路均相关。纵向分析显示，MCI 组淡漠评分的变化与额执行回路的变化呈负相关。在 CVD 组中，激越和夜间行为的变化分别与皮质边缘和额执行回路呈负相关。在 PD 组中，去抑制和淡漠的变化分别与皮质边缘和额执行回路呈正相关。
观察到的相关性表明，大脑中潜在的病理变化可能导致与 MBI 相关的神经活动发生改变。值得注意的是，横断面和纵向结果之间的差异表明，为了获得可重复的结果并得出可靠的结论，有必要进行纵向研究。
