Cui Liang, Zhang Zhen, Huang Chu-Chung, Yuan Cheng-Yi, Tu You-Yi, Wang Min, Guan Yi-Hui, Li Yue-Hua, Xie Fang, Guo Qi-Hao
Department of Gerontology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Key Laboratory of Brain Functional Genomics (Ministry of Education), Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.
Alzheimers Dement. 2025 May;21(5):e70253. doi: 10.1002/alz.70253.
This study aims to establish a multi-phase visual staging system based on amyloid-beta (Aβ) deposition to more precisely assess the stages of Aβ accumulation in Alzheimer's disease (AD), and to validate the cognitive function, neurodegeneration, and blood biomarker characteristics at different stages.
A total of 1002 participants from the Chinese Preclinical Alzheimer's Disease Study (C-PAS) cohort were included. Aβ deposition was assessed using positron emission tomography (PET) imaging, and three multi-phase Aβ deposition grading systems were established. Participants underwent neuropsychological testing, peripheral blood biomarker collection, and multimodal neuroimaging data acquisition.
Cognitive function, peripheral blood biomarkers, default mode network (DMN) function, and hippocampal volumes showed stage-dependent changes across different Aβ deposition stages. Different grading systems revealed varying clinical manifestations and biomarker sensitivity.
Region-based multi-phase Aβ deposition systems demonstrate practical utility in detecting early pathological changes, understanding disease progression, and informing early diagnosis and intervention strategies for AD.
Developed and validated visual multi-phase Aβ deposition staging systems for AD progression. Revealed stage-specific cognitive, neurodegenerative, and biomarker characteristics in AD. Demonstrated the sensitivity of visual methods to detect early, regional Aβ deposition. Highlighted differential strengths of Villeneuve, Grothe, and Mattsson staging systems. Proposed multi-phase systems as tools for personalized AD diagnosis and intervention strategies.
本研究旨在建立一种基于β淀粉样蛋白（Aβ）沉积的多阶段视觉分期系统，以更精确地评估阿尔茨海默病（AD）中Aβ积累的阶段，并验证不同阶段的认知功能、神经退行性变和血液生物标志物特征。
纳入了来自中国临床前阿尔茨海默病研究（C-PAS）队列的1002名参与者。使用正电子发射断层扫描（PET）成像评估Aβ沉积，并建立了三种多阶段Aβ沉积分级系统。参与者接受了神经心理学测试、外周血生物标志物采集和多模态神经影像数据采集。
认知功能、外周血生物标志物、默认模式网络（DMN）功能和海马体积在不同的Aβ沉积阶段呈现出阶段依赖性变化。不同的分级系统显示出不同的临床表现和生物标志物敏感性。
基于区域的多阶段Aβ沉积系统在检测早期病理变化、理解疾病进展以及为AD的早期诊断和干预策略提供信息方面具有实际应用价值。
开发并验证了用于AD进展的视觉多阶段Aβ沉积分期系统。揭示了AD中特定阶段的认知、神经退行性变和生物标志物特征。证明了视觉方法检测早期区域Aβ沉积的敏感性。突出了维勒纽夫、格罗特和马特松分期系统的不同优势。提出多阶段系统作为个性化AD诊断和干预策略的工具。
