认知无症状成年人中抗血小板药物、口服抗凝剂的使用与Aβ负荷和脑微出血之间的关系。
Relationship between use of anti-platelet agents, oral anti-coagulants, and Aβ burden with cerebral microhemorrhages in cognitively asymptomatic adults.
作者信息
Gay Marcus D, Baldaranov Dobri, Donohue Michael C, Jack Clifford R, Sperling Reisa A, Aisen Paul S, Rafii Michael S
机构信息
Alzheimer's Therapeutic Research Institute, Keck School of Medicine, San Diego, California, USA.
Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
出版信息
Alzheimers Dement. 2025 May;21(5):e70167. doi: 10.1002/alz.70167.
INTRODUCTION
Cerebral microhemorrhages (CMHs) are detectable by magnetic resonance imaging (MRI). CMHs in deep brain regions are linked to hypertensive vasculopathy, while those in lobar regions with amyloid beta (Aβ) deposition in blood vessels. This study aims to determine the association between anti-thrombotic treatment and CMH prevalence among cognitively asymptomatic adults, and to assess the role of Aβ markers, apolipoprotein E (APOE) ε4 carrier status, and cardiovascular risk factors in CMH development.
METHODS
Using baseline data from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) and Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) studies, we examined CMH presence via 3T MRI, along with medication use, APOE ε4 carrier status, medical history, and blood pressure.
RESULTS
Our analysis showed a significantly higher prevalence of CMHs in the A4 cohort (17.3%) compared to the LEARN cohort (2.6%).
DISCUSSION
Factors such as male sex, age, Aβ markers, and APOE ε4 status were significantly associated with higher CMH prevalence in the A4 cohort. However, anti-thrombotic treatment did not show association with overall CMHs.
HIGHLIGHTS
Male sex, age > 75, amyloid beta (Aβ) burden, and apolipoprotein E (APOE) ε4 homozygosity are significantly associated with higher prevalence of CMHs (cerebral microhemorrhages) in a cohort of cognitively asymptomatic individuals. Male sex, age > 75, Aβ burden, and APOE ε4 homozygosity are significantly associated with higher prevalence of lobar CMHs in a cohort of cognitively asymptomatic individuals. Anti-platelet or anti-coagulant usage were not associated with an increased prevalence of CMHs in either brain location or overall, in a cohort of cognitively asymptomatic individuals. History of a lipid disorder is associated with a higher prevalence of lobar CMHs in a cohort of cognitively asymptomatic individuals.
引言
脑微出血（CMHs）可通过磁共振成像（MRI）检测到。深部脑区的CMHs与高血压性血管病变有关，而叶区的CMHs与血管中淀粉样β蛋白（Aβ）沉积有关。本研究旨在确定抗血栓治疗与认知无症状成年人中CMH患病率之间的关联，并评估Aβ标志物、载脂蛋白E（APOE）ε4携带者状态和心血管危险因素在CMH发生中的作用。
方法
利用无症状阿尔茨海默病抗淀粉样蛋白治疗（A4）和淀粉样蛋白风险与神经退行性变纵向评估（LEARN）研究的基线数据，我们通过3T MRI检查CMH的存在情况，以及药物使用、APOE ε4携带者状态、病史和血压。
结果
我们的分析显示，A4队列中CMHs的患病率（17.3%）显著高于LEARN队列（2.6%）。
讨论
男性、年龄、Aβ标志物和APOE ε4状态等因素与A4队列中较高的CMH患病率显著相关。然而，抗血栓治疗与总体CMHs并无关联。
要点
在认知无症状个体队列中，男性、年龄>75岁、淀粉样β蛋白（Aβ）负荷和载脂蛋白E（APOE）ε4纯合性与较高的脑微出血（CMHs）患病率显著相关。在认知无症状个体队列中，男性、年龄>75岁、Aβ负荷和APOE ε4纯合性与较高的叶性CMHs患病率显著相关。在认知无症状个体队列中，使用抗血小板或抗凝药物与脑内任何位置或总体CMHs患病率增加均无关联。在认知无症状个体队列中，脂质紊乱病史与较高的叶性CMHs患病率相关。
Zotero 插件