Soussi Célia, Segobin Shailendra, Cabé Nicolas, Laniepce Alice, Coulbault Laurent, Boudehent Céline, de la Sayette Vincent, Chételat Gaël, Pitel Anne-Lise
Normandie Univ, UNICAEN, INSERM, U1237, PhIND 'Physiopathology and Imaging of Neurological Disorders', NeuroPresage Team, Cyceron, Caen 14000, France.
Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, Caen 14000, France.
Brain Commun. 2025 Aug 20;7(4):fcaf289. doi: 10.1093/braincomms/fcaf289. eCollection 2025.
Distinguishing aetiologies of neurocognitive disorder (NCD) between alcohol-induced pathologies (OH) and Alzheimer's disease poses a major clinical challenge while dual diagnosis may be common. We aimed to define commonalities and specificities of neurocognitive alterations in OH or Alzheimer's Disease, considering the NCD severity (mild/major). In this retrospective cross-sectional study, we included 203 participants: 50 Mild-NCD-OH patients, 18 Major-NCD-OH patients, 30 Mild-NCD-AD patients, 24 Major-NCD-AD patients, as well as 81 healthy controls. Patients were compared on a neuropsychological and multimodal neuroimaging assessment (grey/white matter density and glucose metabolism). Analyses explored commonalities and specificities of each patient group within each NCD severity. All patient groups had episodic memory impairments, medial temporal lobe damage and hypometabolism in thalami and posteromedial cortex. NCD-AD patients had more severe cognitive deficits than NCD-OH patients, and the reverse pattern was observed for brain damage. NCD-OH patients notably showed more severe thalamic and cingulate alterations. NCD-OH patients also presented cerebellar damage not observed in NCD-AD. Volume deficits in the medial temporal lobe and memory deficits were more severe in Mild-NCD-AD than Mild-NCD-OH, but similar in Major-NCD-AD and Major-NCD-OH. Common alterations are observed in NCD-OH and NCD-AD, mainly within the memory circuit. Only cerebellar damage appears to be specific to NCD-OH. The specificity of NCD-AD deficits relies on their severity since they are also present to a lesser extent in NCD-OH, reinforcing how the neurocognitive phenotypes overlap. These results reaffirm the importance of questioning alcohol consumption in NCD-AD patients and considering an Alzheimer's Disease diagnosis in NCD-OH patients.
区分酒精所致病变（OH）和阿尔茨海默病导致的神经认知障碍（NCD）病因是一项重大临床挑战，而双重诊断可能很常见。我们旨在确定OH或阿尔茨海默病神经认知改变的共性和特异性，同时考虑NCD的严重程度（轻度/重度）。在这项回顾性横断面研究中，我们纳入了203名参与者：50名轻度NCD-OH患者、18名重度NCD-OH患者、30名轻度NCD-AD患者、24名重度NCD-AD患者以及81名健康对照者。对患者进行了神经心理学和多模态神经影像学评估（灰质/白质密度和葡萄糖代谢）。分析探讨了每个NCD严重程度下各患者组的共性和特异性。所有患者组均存在情景记忆障碍、内侧颞叶损伤以及丘脑和后内侧皮质代谢减低。NCD-AD患者的认知缺陷比NCD-OH患者更严重，而脑损伤情况则相反。NCD-OH患者丘脑和扣带回改变尤为严重。NCD-OH患者还存在NCD-AD中未观察到的小脑损伤。内侧颞叶体积缩小和记忆缺陷在轻度NCD-AD中比轻度NCD-OH更严重，但在重度NCD-AD和重度NCD-OH中相似。NCD-OH和NCD-AD存在共同改变，主要在记忆回路内。只有小脑损伤似乎是NCD-OH特有的。NCD-AD缺陷的特异性在于其严重程度，因为在NCD-OH中也有较轻程度的存在，这进一步强调了神经认知表型的重叠。这些结果再次证实了询问NCD-AD患者饮酒情况以及考虑对NCD-OH患者进行阿尔茨海默病诊断的重要性。
