Gibson Lucy L, Gonzalez Maria C, Ashton Nicholas J, Tovar-Rios Diego, Blanc Frédéric, Pilotto Andrea, Lemstra Afina, Paquet Claire, Ballard Clive, Zetterberg Henrik, Aarsland Dag
Centre for Healthy Brain Ageing, Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
Alzheimers Dement. 2025 Feb;21(2):e14434. doi: 10.1002/alz.14434. Epub 2024 Dec 28.
Neuropsychiatric symptoms (NPSs) are common in dementia with Lewy bodies (DLB) but their neurobiological mechanisms are poorly understood.
NPSs and cognition were assessed annually in participants (DLB n = 222; Alzheimer's disease [AD] n = 125) from the European DLB (E-DLB) Consortium, and plasma phosphorylated tau-181 (p-tau181) and p-tau231 concentrations were measured at baseline.
Hallucinations, delusions, and depression were more common in DLB than in AD and, in a subgroup with longitudinal follow-up, persistent hallucinations and NPSs were associated with lower p-tau181 and p-tau231 in DLB. In adjusted linear mixed-effects models, hallucinations at baseline were associated with greater longitudinal cognitive impairment in DLB, with a significant interaction with p-tau231.
Higher p-tau181 and p-tau231 levels were associated with a lower longitudinal risk of NPSs and hallucinations in early-stage DLB. However, the interaction between hallucinations and p-tau231 suggests that when AD co-pathology and hallucinations do co-exist in DLB that they may synergistically exacerbate cognitive decline.
Neuropsychiatric symptoms (NPSs) were more common in dementia with Lewy bodies (DLB) than in Alzheimer's disease (AD). Lower plasma phosphorylated tau-231 (p-tau231) and p-tau181 levels were associated with persistent hallucinations in DLB. Lower plasma p-tau231 and p-tau181 levels were associated with an increased risk of persistent NPSs in early DLB. Hallucinations at baseline were associated with greater cognitive dysfunction in DLB, and there was an interaction with p-tau231.
神经精神症状（NPSs）在路易体痴呆（DLB）中很常见，但其神经生物学机制尚不清楚。
欧洲DLB（E-DLB）联盟的参与者（DLB组n = 222；阿尔茨海默病[AD]组n = 125）每年接受NPSs和认知功能评估，并在基线时测量血浆磷酸化tau-181（p-tau181）和p-tau231浓度。
幻觉、妄想和抑郁在DLB中比在AD中更常见，在纵向随访的亚组中，持续性幻觉和NPSs与DLB中较低的p-tau181和p-tau231相关。在调整后的线性混合效应模型中，基线时的幻觉与DLB中更大的纵向认知障碍相关，与p-tau231有显著交互作用。
较高的p-tau181和p-tau231水平与早期DLB中NPSs和幻觉的较低纵向风险相关。然而，幻觉与p-tau231之间的交互作用表明，当AD共病病理和幻觉在DLB中同时存在时，它们可能会协同加剧认知衰退。
神经精神症状（NPSs）在路易体痴呆（DLB）中比在阿尔茨海默病（AD）中更常见。较低的血浆磷酸化tau-231（p-tau231）和p-tau181水平与DLB中的持续性幻觉相关。较低的血浆p-tau231和p-tau181水平与早期DLB中持续性NPSs的风险增加相关。基线时的幻觉与DLB中更大的认知功能障碍相关，且与p-tau231存在交互作用。
