经颅磁刺激(TMS)产生的短传入抑制可区分无痴呆症老年人的认知状态。
TMS-derived short afferent inhibition discriminates cognitive status in older adults without dementia.
作者信息
Sundman Mark H, Green Jacob M, Fuglevand Andrew J, Chou Ying-Hui
机构信息
Brain Imaging and TMS Laboratory, Department of Psychology, University of Arizona, Tucson, AZ 85721, USA.
Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ 85721, USA.
出版信息
Aging Brain. 2024 Jul 19;6:100123. doi: 10.1016/j.nbas.2024.100123. eCollection 2024.
Aging is a complex and diverse biological process characterized by progressive molecular, cellular, and tissue damage, resulting in a loss of physiological integrity and heightened vulnerability to pathology. This biological diversity corresponds with highly variable cognitive trajectories, which are further confounded by genetic and environmental factors that influence the resilience of the aging brain. Given this complexity, there is a need for neurophysiological indicators that not only discern physiologic and pathologic aging but also closely align with cognitive trajectories. Transcranial Magnetic Stimulation (TMS) may have utility in this regard as a non-invasive brain stimulation tool that can characterize features of cortical excitability. Particularly, as a proxy for central cholinergic function, short-afferent inhibition (SAI) dysfunction is robustly associated with cognitive deficits in the latter stages of Alzheimer's Disease and Related Dementia (ADRD). In this study, we evaluated SAI in healthy young adults and older adults who, though absent clinical diagnoses, were algorithmically classified as cognitively normal (CN) or cognitively impaired (CI) according to the Jak/Bondi actuarial criteria. We report that SAI is preserved in the Old-CN cohort relative to the young adults, and SAI is significantly diminished in the Old-CI cohort relative to both young and CN older adults. Additionally, diminished SAI was significantly associated with impaired sustained attention and working memory. As a proxy measure for central cholinergic deficits, we discuss the potential value of SAI for discerning physiological and pathological aging.
衰老是一个复杂多样的生物学过程,其特征是分子、细胞和组织逐渐受损,导致生理完整性丧失,对疾病的易感性增加。这种生物学多样性与高度可变的认知轨迹相对应,而遗传和环境因素进一步混淆了这些轨迹,这些因素会影响衰老大脑的恢复力。鉴于这种复杂性,需要神经生理学指标,不仅要能够区分生理性和病理性衰老,还要与认知轨迹密切相关。经颅磁刺激(TMS)作为一种非侵入性脑刺激工具,可用于表征皮质兴奋性特征,在这方面可能具有实用性。特别是,作为中枢胆碱能功能的替代指标,短传入抑制(SAI)功能障碍与阿尔茨海默病及相关痴呆症(ADRD)后期的认知缺陷密切相关。在本研究中,我们评估了健康年轻人和老年人的SAI,这些人虽然没有临床诊断,但根据Jak/Bondi精算标准,通过算法被分类为认知正常(CN)或认知受损(CI)。我们报告称,相对于年轻人,老年CN队列中的SAI得以保留,而相对于年轻人和CN老年人群体,老年CI队列中的SAI显著降低。此外,SAI降低与持续注意力和工作记忆受损显著相关。作为中枢胆碱能缺陷的替代指标,我们讨论了SAI在区分生理性和病理性衰老方面的潜在价值。