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在阿尔茨海默病临床进展过程中蓝斑的退化:一项神经影像学随访研究。

The degeneration of locus coeruleus occurring during Alzheimer's disease clinical progression: a neuroimaging follow-up investigation.

机构信息

Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via Roma 55, Pisa, 56126, Italy.

Department of Radiology, Fondazione Toscana G. Monasterio, Pisa, Italy.

出版信息

Brain Struct Funct. 2024 Jun;229(5):1317-1325. doi: 10.1007/s00429-024-02797-1. Epub 2024 Apr 16.

Abstract

The noradrenergic nucleus Locus Coeruleus (LC) is precociously involved in Alzheimer's Disease (AD) pathology, and its degeneration progresses during the course of the disease. Using Magnetic Resonance Imaging (MRI), researchers showed also in vivo in patients the disruption of LC, which can be observed both in Mild Cognitively Impaired individuals and AD demented patients. In this study, we report the results of a follow-up neuroradiological assessment, in which we evaluated the LC degeneration overtime in a group of cognitively impaired patients, submitted to MRI both at baseline and at the end of a 2.5-year follow-up. We found that a progressive LC disruption can be observed also in vivo, involving the entire nucleus and associated with clinical diagnosis. Our findings parallel neuropathological ones, which showed a continuous increase of neuronal death and volumetric atrophy within the LC with the progression of Braak's stages for neurofibrillary pathology. This supports the reliability of MRI as a tool for exploring the integrity of the central noradrenergic system in neurodegenerative disorders.

摘要

蓝斑核(LC)是早发性涉及阿尔茨海默病(AD)病理学的区域,并且其退化在疾病过程中进展。使用磁共振成像(MRI),研究人员还在体内显示了 LC 的中断,在轻度认知障碍个体和 AD 痴呆患者中都可以观察到。在这项研究中,我们报告了神经影像学随访评估的结果,其中我们评估了一组认知障碍患者的 LC 随时间的退化,这些患者在基线和 2.5 年随访结束时都接受了 MRI 检查。我们发现,LC 的破坏也可以在体内进行,涉及整个核,并与临床诊断相关。我们的发现与神经病理学平行,神经病理学显示随着神经纤维缠结病理的 Braak 阶段的进展,LC 内神经元死亡和体积萎缩不断增加。这支持 MRI 作为探索神经退行性疾病中中枢去甲肾上腺素能系统完整性的工具的可靠性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b719/11147916/0ca2ec276bbf/429_2024_2797_Fig2_HTML.jpg

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