Tsai Hsin-Hsi, Liu Chia-Ju, Lee Bo-Ching, Chen Ya-Fang, Yen Ruoh-Fang, Jeng Jiann-Shing, Tsai Li-Kai
Department of Neurology, National Taiwan University Hospital, Taipei 100225, Taiwan.
Department of Nuclear Medicine, National Taiwan University Hospital, Taipei 100225, Taiwan.
Brain Commun. 2024 Mar 12;6(2):fcae086. doi: 10.1093/braincomms/fcae086. eCollection 2024.
Tau, a hallmark of Alzheimer's disease, is poorly characterized in cerebral amyloid angiopathy. We aimed to assess the clinico-radiological correlations between tau positron emission tomography scans and cerebral amyloid angiopathy. We assessed cerebral amyloid and hyperphosphorylated tau in patients with probable cerebral amyloid angiopathy ( = 31) and hypertensive small vessel disease ( = 27) using C-Pittsburgh compound B and F-T807 positron emission tomography. Multivariable regression models were employed to assess radio-clinical features related to cerebral tau pathology in cerebral amyloid angiopathy. Cerebral amyloid angiopathy exhibited a higher cerebral tau burden in the inferior temporal lobe [1.25 (1.17-1.42) versus 1.08 (1.05-1.22), < 0.001] and all Braak stage regions of interest ( < 0.05) than hypertensive small vessel disease, although the differences were attenuated after age adjustment. Cerebral tau pathology was significantly associated with cerebral amyloid angiopathy-related vascular markers, including cortical superficial siderosis ( = 0.12, 95% confidence interval 0.04-0.21) and cerebral amyloid angiopathy score ( = 0.12, 95% confidence interval 0.03-0.21) after adjustment for age, ApoE4 status and whole cortex amyloid load. Tau pathology correlated significantly with cognitive score (Spearman's =-0.56, = 0.001) and hippocampal volume (-0.49, = 0.007), even after adjustment. In conclusion, tau pathology is more frequent in sporadic cerebral amyloid angiopathy than in hypertensive small vessel disease. Cerebral amyloid angiopathy-related vascular pathologies, especially cortical superficial siderosis, are potential markers of cerebral tau pathology suggestive of concomitant Alzheimer's disease.
tau蛋白是阿尔茨海默病的一个标志性特征，在脑淀粉样血管病中的特征尚不明确。我们旨在评估tau正电子发射断层扫描与脑淀粉样血管病之间的临床-放射学相关性。我们使用C-匹兹堡化合物B和F-T807正电子发射断层扫描评估了可能患有脑淀粉样血管病（n = 31）和高血压小血管病（n = 27）患者的脑淀粉样蛋白和过度磷酸化tau蛋白。采用多变量回归模型评估与脑淀粉样血管病中脑tau病理学相关的放射学临床特征。与高血压小血管病相比，脑淀粉样血管病在颞下叶[1.25（1.17 - 1.42）对1.08（1.05 - 1.22），P < 0.001]和所有Braak分期感兴趣区域（P < 0.05）表现出更高的脑tau负荷，尽管在年龄调整后差异有所减弱。在调整年龄、载脂蛋白E4状态和全皮质淀粉样蛋白负荷后，脑tau病理学与脑淀粉样血管病相关的血管标志物显著相关，包括皮质表面铁沉积（β = 0.12，95%置信区间0.04 - 0.21）和脑淀粉样血管病评分（β = 0.12，95%置信区间0.03 - 0.21）。即使在调整后，tau病理学与认知评分（Spearman相关系数r = -0.56，P = 0.001）和海马体积（r = -0.49，P = 0.007）也显著相关。总之，散发性脑淀粉样血管病中tau病理学比高血压小血管病更常见。脑淀粉样血管病相关的血管病变，尤其是皮质表面铁沉积，是提示合并阿尔茨海默病的脑tau病理学的潜在标志物。
