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正常眼压性青光眼患者、阿尔茨海默病患者及健康对照者的脑灌注压、血流动力学参数与认知测试值之间的关联

Associations Between Cerebral Perfusion Pressure, Hemodynamic Parameters, and Cognitive Test Values in Normal-Tension Glaucoma Patients, Alzheimer's Disease Patients, and Healthy Controls.

作者信息

Stoskuviene Akvile, Chaleckas Edvinas, Grusauskiene Evelina, Bartusis Laimonas, Celikkaya Guven, Januleviciene Ingrida, Vaitkus Antanas, Ragauskas Arminas, Hamarat Yasin

机构信息

Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.

Eye Clinic, Lithuanian University of Health Sciences, Eiveniu Str. 2, LT-50161 Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2025 May 24;61(6):972. doi: 10.3390/medicina61060972.

Abstract

: Glaucoma and Alzheimer's disease (AD) are neurodegenerative conditions with vascular underpinnings. This study aimed to explore the relationship between blood pressure parameters such as mean arterial pressure (MAP), pulse pressure (PP), and cerebral perfusion pressure (CPP) and cognitive performance in patients with AD, normal-tension glaucoma (NTG), and healthy controls. We hypothesized that NTG patients, like those with mild cognitive impairment (MCI), may experience subtle cognitive changes related to vascular dysregulation. : Ninety-eight participants (35 NTG, 17 AD, 46 controls) were assessed for CPP, MAP, OPP, and cognitive performance. Statistical analyses compared groups and examined correlations. : AD patients showed lower CPP and MAP ( < 0.001), indicating systemic vascular dysfunction, while NTG patients had higher ocular perfusion pressure (OPP) ( = 0.008), suggesting compensatory mechanisms. CPP correlated with visuospatial abilities in AD (r = 0.492, = 0.045). MAP correlated with the Clock drawing test (CDT) scores in the NTG group (r = 0.378, = 0.025). PP negatively correlated with cognition in AD (r = -0.527, = 0.016 for CDT scores) and controls (r = -0.440, = 0.002 for verbal fluency and r = -0.348, = 0.019 for total ACE scores). : The study highlights distinct hemodynamic profiles: systemic dysfunction in AD and localized dysregulation in NTG. These findings emphasize the role of vascular dysregulation in neurodegeneration, with implications for personalized treatment approaches targeting vascular health in neurodegenerative conditions.

摘要

青光眼和阿尔茨海默病(AD)是具有血管基础的神经退行性疾病。本研究旨在探讨平均动脉压(MAP)、脉压(PP)和脑灌注压(CPP)等血压参数与AD患者、正常眼压性青光眼(NTG)患者及健康对照者认知功能之间的关系。我们假设,NTG患者与轻度认知障碍(MCI)患者一样,可能会经历与血管调节异常相关的细微认知变化。

98名参与者(35名NTG患者、17名AD患者、46名对照者)接受了CPP、MAP、眼灌注压(OPP)和认知功能评估。统计分析对各组进行了比较并检验了相关性。

AD患者的CPP和MAP较低(<0.001),表明存在全身血管功能障碍,而NTG患者的眼灌注压(OPP)较高(=0.008),提示存在代偿机制。CPP与AD患者的视觉空间能力相关(r=0.492,=0.045)。MAP与NTG组的画钟试验(CDT)得分相关(r=0.378,=0.025)。PP与AD患者的认知呈负相关(CDT得分r=-0.527,=0.016),与对照组的认知也呈负相关(语言流畅性r=-0.440,=0.002;ACE总分r=-0.348,=0.019)。

该研究突出了不同的血液动力学特征

AD患者存在全身功能障碍,NTG患者存在局部调节异常。这些发现强调了血管调节异常在神经退行性变中的作用,对针对神经退行性疾病中血管健康的个性化治疗方法具有启示意义。

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