Nakase Taizen, Tatewaki Yasuko, Takano Yumi, Nomura Shuko, Baek Hae Woon, Taki Yasuyuki
Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo Machi, Sendai 980-8575, Miyagi, Japan.
Int J Mol Sci. 2025 Mar 5;26(5):2325. doi: 10.3390/ijms26052325.
Dementia blood biomarkers are becoming increasingly important. Various factors, such as ischemic lesions and inflammation, can influence the pathomechanism of dementia. We aimed to evaluate the effects of past stroke lesions on blood biomarkers (BMs). Following approval from the institutional ethics committee, patients who were admitted to the memory clinic and were consented to written documents were enrolled ( = 111, average [standard deviation] age: 74.5 [9.1] years-old). Brain magnetic resonance imaging, cognitive function, and neuropsychological symptoms were analyzed. The amyloid-β 42 (Aβ42)/Aβ40 ratio, phosphorylated tau181 (p-tau181), glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), and Aβ42/p-tau181 ratio were assessed as plasma BMs. The patients were diagnosed with Alzheimer's disease ( = 45), mild cognitive impairment ( = 56), depression ( = 8), and subjective cognitive impairment ( = 4). Bivariate analysis exhibited that all measured BM indicators were significantly associated with cognitive decline in patients without past stroke lesions. Whereas the patients with stroke lesions presented a significant association only between GFAP and cognitive decline ( = 0.0011). Multiple regression analysis showed that NfL significantly correlated with cognitive decline only in patients without stroke lesions (r = 0.4988, = 0.0003) and with delusion only in those with stroke lesions (r = 0.5492, = 0.0121). Past stroke lesions should be addressed in the assessment of the correlation between blood biomarkers and cognitive decline in dementia patients.
痴呆症血液生物标志物正变得越来越重要。各种因素,如缺血性病变和炎症,会影响痴呆症的发病机制。我们旨在评估既往中风病变对血液生物标志物(BMs)的影响。经机构伦理委员会批准后,招募了入住记忆门诊并签署书面同意书的患者(n = 111,平均[标准差]年龄:74.5 [9.1]岁)。对脑磁共振成像、认知功能和神经心理症状进行了分析。评估了血浆淀粉样β42(Aβ42)/Aβ40比值、磷酸化tau181(p-tau181)、胶质纤维酸性蛋白(GFAP)、神经丝轻链(NfL)以及Aβ42/p-tau181比值作为血浆BMs。患者被诊断为阿尔茨海默病(n = 45)、轻度认知障碍(n = 56)、抑郁症(n = 8)和主观认知障碍(n = 4)。双变量分析显示,在没有既往中风病变的患者中,所有测量的BM指标均与认知功能下降显著相关。而有中风病变的患者仅在GFAP与认知功能下降之间存在显著关联(p = 0.0011)。多元回归分析表明,NfL仅在没有中风病变的患者中与认知功能下降显著相关(r = 0.4988,p = 0.0003),而仅在有中风病变的患者中与妄想显著相关(r = 0.5492,p = 0.0121)。在评估痴呆症患者血液生物标志物与认知功能下降之间的相关性时,应考虑既往中风病变。