Yin Changhao, Chen Lingyu, Wang Jianhang, Zhao Weina
Department of Neurology, Hongqi Hospital Affiliated to Mudanjiang Medical College, 157000 Mudanjiang, Heilongjiang, China.
Department of Neurology, Hongqi Hospital Affiliated to Mudanjiang Medical College, 157000 Mudanjiang, Heilongjiang, China; Center for Mudanjiang North Medicine Resource Development and Application Collaborative Innovation, 157000 Mudanjiang, Heilongjiang, China.
Actas Esp Psiquiatr. 2025 Aug;53(4):669-682. doi: 10.62641/aep.v53i4.1936.
BACKGROUND: Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) represent early clinical manifestations of Alzheimer's disease (AD). Recent research has highlighted serum markers and changes in brain structure as promising tools for diagnosing cerebral disorders. This study investigated serum biomarkers and brain structural changes in the early clinical stage of AD affected individuals residing in a cold region. METHODS: Clinical data from patients with SCD or MCI and from normal controls, who were tested at Hongqi Hospital Affiliated to Mudanjiang Medical College from January 2018 to December 2023, were retrospectively analysed. According to clinical classification, the patients were categorised into SCD (n = 60), MCI (n = 60) and normal control groups (n = 70). The magnetic resonance imaging data, serum levels of amyloid β 1-40/42, exosomal miRNA (34a/34c/135a) and apolipoprotein E (ApoE) genotype were collected and analysed. RESULTS: The mean diffusivity values in the bilateral parahippocampal gyrus, inferior longitudinal bundle, right inferior fronto-occipital tract and posterior cingulate gyrus in the SCD group decreased relative to those of the MCI group (all p < 0.05). Conversely, the fractional anisotropy values in the bilateral parahippocampal gyrus, inferior fronto-occipital tract, inferior longitudinal tract and posterior cingulate gyrus in the SCD group increased (all p < 0.05). Compared with the normal control group, the MCI and SCD groups showed elevated levels of serum Aβ1-40 and Aβ1-42 and exosomal miRNA-34a and miRNA-34c (all p < 0.05) and decreased exosomal miRNA-135a expression (p < 0.05). The serum levels of Aβ1-40, Aβ1-42 and exosomal miRNA-34a and miRNA-34c in the SCD group were lower than those in the MCI group (all p < 0.05), whereas miRNA-135a level was higher (p < 0.05). The proportions of ApoE ε3/3 in the normal control group was the highest (62.86%), and the proportions of ApoE ε2/4, ε3/4 and ε4/4 in the MCI group were the highest (38.33%, 26.67% and 10.00%, respectively). CONCLUSION: Changes in brain structure and serum biomarkers (miRNAs and Aβ) are evident in the early stages of AD, and the proportion of ApoE alleles vary in early AD. These findings may contribute to the development of an early recognition model for AD.
背景：主观认知下降（SCD）和轻度认知障碍（MCI）是阿尔茨海默病（AD）的早期临床表现。最近的研究强调血清标志物和脑结构变化是诊断脑部疾病的有前景的工具。本研究调查了居住在寒冷地区的AD患者早期临床阶段的血清生物标志物和脑结构变化。 方法：回顾性分析2018年1月至2023年12月在牡丹江医学院附属红旗医院接受检测的SCD或MCI患者及正常对照的临床资料。根据临床分类，将患者分为SCD组（n = 60）、MCI组（n = 60）和正常对照组（n = 70）。收集并分析磁共振成像数据、血清淀粉样蛋白β1-40/42水平、外泌体微小RNA（34a/34c/135a）和载脂蛋白E（ApoE）基因型。 结果：SCD组双侧海马旁回、下纵束、右侧额枕下束和后扣带回的平均扩散率值相对于MCI组降低（均p < 0.05）。相反，SCD组双侧海马旁回、额枕下束、下纵束和后扣带回的各向异性分数值升高（均p < 0.05）。与正常对照组相比，MCI组和SCD组血清Aβ1-40和Aβ1-42水平以及外泌体miRNA-34a和miRNA-34c水平升高（均p < 0.05），外泌体miRNA-135a表达降低（p < 0.05）。SCD组血清Aβ1-40、Aβ1-42水平以及外泌体miRNA-34a和miRNA-34c水平低于MCI组（均p < 0.05），而miRNA-135a水平更高（p < 0.05）。正常对照组中ApoE ε3/3的比例最高（62.86%），MCI组中ApoE ε2/4、ε3/4和ε4/4的比例最高（分别为38.33%、26.67%和10.00%）。 结论：AD早期脑结构和血清生物标志物（微小RNA和Aβ）发生变化，且ApoE等位基因比例在AD早期有所不同。这些发现可能有助于AD早期识别模型的建立。
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