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Biomarkers and Alzheimer's disease: a bibliometric analysis. 生物标志物与阿尔茨海默病:文献计量分析。
IF 4.1 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-30 eCollection Date: 2024-01-01 DOI: 10.3389/fnagi.2024.1456824
Linyi Yang, Jingyan Zeng, Linlin Li, Yunwei Zhang

Objective: The diagnosis and treatment of biomarkers in Alzheimer's disease has emerged as a prominent topic within Alzheimer's disease research. In this paper, we conducted a bibliometric analysis of data from a wide range of literature in this field to enhance the in-depth understanding of this area.

Method: The core collection of the Science Citation Index database (web of science) was used to search for relevant literature in the above fields from 1 January 2006 to 14 November 2022 and Citespace software was used to visualize and analyze the literature data.

Results: A total of 1,138 papers were included, of which the United States ranked first with 607 papers and China ranked 6th in the world with 84 papers. The value of mediational centrality is 0.49 in the United States and 0.05 in China. In terms of the number of articles published by the research authors, the Swedish scholar Blennow Kaj ranks first with 82 articles published, and the scholars who rank second and third are Zetterberg Henrik (78 articles) and Morris John C (64 articles), respectively; in terms of the mediational centrality, the American scholar Trojanowski John Q ranked first in the world with 0.1, and the second and third ranked scholars were Blennow Kaj (0.09) and Zetterberg Henrik (0.06) respectively. Scholar JACK CR ranked first with 377 citation frequency. The journal NEUROLOGY is ranked first with 943 citations.

Conclusion: In recent years, global research in the field of biomarkers related to Alzheimer's disease has shown signs of softening, and the momentum of research has slightly diminished. However, this trend does not imply a decline in the quality of research. It is essential to enhance collaboration among countries, major research institutions, and scholars, with a particular emphasis on fostering international partnerships in the future.

目的:阿尔茨海默病生物标志物的诊断和治疗已成为阿尔茨海默病研究中的一个突出话题。本文对该领域的大量文献数据进行了文献计量学分析,以加深对该领域的深入了解:方法:利用《科学引文索引》数据库(web of science)的核心库检索2006年1月1日至2022年11月14日期间上述领域的相关文献,并使用Citespace软件对文献数据进行可视化分析:共收录了 1 138 篇论文,其中美国以 607 篇论文位居世界第一,中国以 84 篇论文位居世界第六。美国的中介中心度值为 0.49,中国为 0.05。从研究者发表文章的数量来看,瑞典学者Blennow Kaj以发表82篇文章排名第一,排名第二和第三的学者分别是Zetterberg Henrik(78篇)和Morris John C(64篇);从中介中心度来看,美国学者Trojanowski John Q以0.1排名世界第一,排名第二和第三的学者分别是Blennow Kaj(0.09)和Zetterberg Henrik(0.06)。学者 JACK CR 以 377 的引用频次排名第一。神经学》杂志以 943 次引用排名第一:近年来,全球在阿尔茨海默病相关生物标志物领域的研究出现了疲软迹象,研究势头略有减弱。然而,这一趋势并不意味着研究质量的下降。加强各国、主要研究机构和学者之间的合作至关重要,未来应特别强调促进国际合作伙伴关系。
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引用次数: 0
Elevated circulating levels of GFAP associated with reduced volumes in hippocampal subregions linked to mild cognitive impairment among community-dwelling elderly individuals. 循环中 GFAP 水平升高与海马亚区体积缩小有关,而海马亚区体积缩小与社区老年人的轻度认知障碍有关。
IF 4.1 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-29 eCollection Date: 2024-01-01 DOI: 10.3389/fnagi.2024.1461556
Ying Zhang, Jun Wang, Haibo Zhang, Zhenkun Tan, Yingyan Zheng, Junjiao Ping, Jie Zhang, Jiali Luo, Linsen Li, Liming Lu, Xinxia Liu

Objective: Cerebrospinal fluid biomarkers are challenging to use for diagnosing mild cognitive impairment (MCI) in large populations, and there is an urgent need for new blood biomarkers. The aim of this study is to investigate whether astrocyte activation is correlated with hippocampal atrophy, and to assess the potential of glial fibrillary acidic protein (GFAP) as a biomarker for diagnosing MCI among community-dwelling older individuals.

Methods: This cross-sectional study included 107 older adults. The levels of GFAP in serum were measured, and the volumetric assessment of gray matter within hippocampal subregions was conducted using Voxel-Based Morphometry (VBM). The relationship between hippocampal subregion volume and blood biomarkers were analyzed using partial correlation. The effectiveness of blood biomarkers in differentiating MCI was assessed using a receiver operating characteristic (ROC) curve.

Results: We found that serum GFAP levels were significantly elevated in the MCI group compared to the cognitively normal (CN) group. Additionally, individuals with MCI exhibited a reduction gray matter volume in specific hippocampal subregions. Notably, the right dentate gyrus (DG) and right cornu ammonis (CA) subregions were found to be effective for distinguishing MCI patients from CN individuals. Serum levels of GFAP demonstrate a sensitivity of 65.9% and a specificity of 75.6% in differentiating patients with MCI from CN individuals.

Conclusion: Specific atrophy within hippocampal subregions has been observed in the brains of community-dwelling elderly individuals. Elevated levels of circulating GFAP may serve as a sensitive peripheral biomarker indicative of hippocampal-specific cognitive alterations in patients with MCI.

目的:使用脑脊液生物标志物诊断大量人群的轻度认知障碍(MCI)具有挑战性,因此迫切需要新的血液生物标志物。本研究旨在调查星形胶质细胞活化是否与海马体萎缩相关,并评估胶质纤维酸性蛋白(GFAP)作为诊断社区老年人 MCI 的生物标志物的潜力:这项横断面研究包括 107 名老年人。测量了血清中 GFAP 的水平,并使用体素形态测量法(VBM)对海马亚区灰质的体积进行了评估。利用偏相关分析了海马亚区体积与血液生物标志物之间的关系。利用接收器操作特征曲线(ROC)评估了血液生物标志物在区分 MCI 方面的有效性:结果:我们发现,与认知正常(CN)组相比,MCI 组的血清 GFAP 水平明显升高。此外,MCI 患者特定海马亚区的灰质体积减少。值得注意的是,右侧齿状回(DG)和右侧胼胝体(CA)亚区可有效区分 MCI 患者和 CN 患者。在区分 MCI 患者和 CN 患者方面,血清 GFAP 水平的敏感性为 65.9%,特异性为 75.6%:结论:在社区居住的老年人大脑中观察到海马亚区的特异性萎缩。循环GFAP水平的升高可作为一种敏感的外周生物标志物,指示MCI患者海马特异性认知改变。
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引用次数: 0
Mechanisms of ozone-induced neurotoxicity in the development and progression of dementia: a brief review. 臭氧诱导的神经毒性在痴呆症发生和发展过程中的作用机制:简要回顾。
IF 4.1 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-28 eCollection Date: 2024-01-01 DOI: 10.3389/fnagi.2024.1494356
Luis A Marin-Castañeda, Guillermo Gonzalez-Garibay, Isabella Garcia-Quintana, Gerónimo Pacheco-Aispuro, Carmen Rubio

Dementia encompasses a spectrum of neurodegenerative disorders significantly impacting global health, with environmental factors increasingly recognized as crucial in their etiology. Among these, ozone, has been identified as a potential exacerbator of neurodegenerative processes, particularly in Alzheimer's disease (AD). Ozone exposure induces the production of reactive oxygen species (ROS), which penetrate the BBB, leading to oxidative damage in neuronal cells. This oxidative stress is closely linked with mitochondrial dysfunction and lipid peroxidation, processes that are foundational to the pathology observed in dementia, such as neuronal death and protein aggregation. Furthermore, ozone triggers chronic neuroinflammation, exacerbating these neurodegenerative processes and perpetuating a cycle of CNS damage. Recent studies highlight the role of peripheral biomarkers like High Mobility Group Box 1 (HMGB1) and Triggering Receptor Expressed on Myeloid cells 2 (TREM2) in mediating ozone's effects. Disruption of these and other identified proteins by ozone exposure impairs microglial function and response to amyloid plaques, suggesting a novel pathway through which ozone may influence AD pathology via immune dysregulation. This review discusses the concept of a bidirectional lung-brain axis, illustrating that systemic responses to air pollutants like ozone may reflect and contribute to neurodegenerative processes in the CNS. By delineating these mechanisms, we emphasize the critical need for integrating environmental health management into strategies for the prevention and treatment of dementia.

痴呆症包括一系列严重影响全球健康的神经退行性疾病,环境因素日益被认为是这些疾病的关键病因。其中,臭氧已被确认为神经退行性病变过程的潜在加剧因素,尤其是在阿尔茨海默病(AD)中。暴露于臭氧会诱发活性氧(ROS)的产生,ROS 会穿透 BBB,导致神经细胞氧化损伤。这种氧化应激与线粒体功能障碍和脂质过氧化密切相关,而线粒体功能障碍和脂质过氧化是痴呆症的病理基础,如神经元死亡和蛋白质聚集。此外,臭氧还会引发慢性神经炎症,加剧这些神经退行性病变过程,并使中枢神经系统损伤循环往复。最近的研究强调了外周生物标志物的作用,如高迁移率组框 1(HMGB1)和髓样细胞上表达的触发受体 2(TREM2)在臭氧效应中的介导作用。臭氧暴露会破坏这些蛋白质和其他已确定的蛋白质,从而损害小胶质细胞的功能和对淀粉样蛋白斑块的反应,这表明臭氧可能通过免疫调节失调影响艾滋病病理学的新途径。本综述讨论了肺-脑双向轴的概念,说明对臭氧等空气污染物的全身反应可能反映并促进中枢神经系统的神经退行性过程。通过阐述这些机制,我们强调了将环境健康管理纳入痴呆症预防和治疗策略的迫切需要。
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引用次数: 0
Abnormal outer and inner retina in a mouse model of Huntington's disease with age. 亨廷顿氏病小鼠模型的视网膜外层和内层随着年龄的增长而出现异常。
IF 4.1 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-28 eCollection Date: 2024-01-01 DOI: 10.3389/fnagi.2024.1434551
Dashuang Yang, Chunhui Huang, Xuemeng Guo, Yintian Li, Jiaxi Wu, Zaijun Zhang, Sen Yan, Ying Xu

Huntington's disease (HD) is a progressive neurodegenerative disorder characterized by motor dysfunction and cognitive decline. While retinal abnormalities have been documented in some HD patients and animal models, the nature of these abnormalities-specifically whether they originate in the inner or outer retina-remains unclear, particularly regarding their progression with age. This study investigates the retinal structure and function in HD transgenic mice (R6/1) compared to C57BL/6 J control mice at 2, 4, and 6 months of age, encompassing both pre-symptomatic and symptomatic stages of HD. Pathological assessments of the striatum and evaluations of motor function confirmed significant HD-related alterations in R6/1 mice at 6 months. Visual function was subsequently analyzed, accompanied by immunofluorescent staining of retinal and optic nerve tissues over time. Our findings revealed that R6/1 mice exhibited pronounced HD symptoms at 6 months, characterized by neuronal loss in the striatum and impaired locomotor abilities. Functionally, visual acuity declined at 6 months, while retinal light responses began to deteriorate by 4 months. Structurally, R6/1 mice demonstrated a global reduction in cone opsin expression as early as 2 months, with a decrease in rhodopsin levels at 4 months, alongside a thinner retinal structure compared to controls. Notably, rod bipolar cell populations were decreased at 6 months, exhibiting shorter dendritic branches and reduced synaptic connections with photoreceptors in the outer retina. Additionally, ganglion cell numbers in the inner retina decreased at 6 months, accompanied by aberrant neural fibers in the optic nerve. Microglial activation was evident at 4 months, while astrocytic activation was observed at 6 months. Aggregates of mutant huntingtin (mHTT) were first detected in the ganglion cell layer and optic nerve at 2 months, subsequently disseminating throughout all retinal layers with advancing age. These results indicate that retinal pathology in R6/1 mice manifests earlier in the outer retina than in the inner retina, which does not align with the progression of mHTT aggregation. Consequently, the R6/1 mouse retina may serve as a more effective model for elucidating the mechanisms underlying HD and evaluating potential therapeutic strategies, rather than functioning as an early diagnostic tool for the disease.

亨廷顿氏病(Huntington's disease,HD)是一种以运动功能障碍和认知能力下降为特征的进行性神经退行性疾病。虽然在一些 HD 患者和动物模型中发现了视网膜异常,但这些异常的性质--特别是它们是源于视网膜内层还是外层--仍不清楚,尤其是它们随着年龄的增长而发展。本研究调查了 HD 转基因小鼠(R6/1)与 C57BL/6 J 对照组小鼠在 2、4 和 6 个月大时的视网膜结构和功能,包括 HD 的症状前期和症状期。纹状体病理学评估和运动功能评估证实,R6/1小鼠在6个月大时出现了与HD相关的显著变化。随后对视力功能进行了分析,并随时间推移对视网膜和视神经组织进行了免疫荧光染色。我们的研究结果表明,R6/1小鼠在6个月时表现出明显的HD症状,其特征是纹状体神经元缺失和运动能力受损。在功能上,视敏度在6个月时下降,而视网膜光反应在4个月时开始恶化。从结构上看,与对照组相比,R6/1小鼠的视锥视蛋白表达早在2个月时就全面减少,4个月时视网膜上的视紫红质水平下降,视网膜结构变薄。值得注意的是,视杆双极细胞群在 6 个月时减少,表现出树突分支变短,与外视网膜感光细胞的突触连接减少。此外,6 个月时视网膜内侧的神经节细胞数量减少,同时视神经中的神经纤维也出现异常。小胶质细胞在4个月时明显活化,而在6个月时则观察到星形胶质细胞活化。突变型亨廷汀(mHTT)的聚集体在2个月时首先在神经节细胞层和视神经中检测到,随后随着年龄的增长扩散到视网膜各层。这些结果表明,R6/1 小鼠视网膜病变在外视网膜上的表现早于在内视网膜上的表现,这与 mHTT 聚集的进展不一致。因此,R6/1小鼠视网膜可作为更有效的模型,用于阐明HD的发病机制和评估潜在的治疗策略,而不是作为疾病的早期诊断工具。
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引用次数: 0
A bibliometric analysis of the relationship between traumatic brain injury and Alzheimer's disease (1993-2023). 脑外伤与阿尔茨海默病之间关系的文献计量分析(1993-2023 年)。
IF 4.1 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-23 eCollection Date: 2024-01-01 DOI: 10.3389/fnagi.2024.1462132
Ji-Hua Hu, Xin Zhang, Hong-Mei Yang, Ya-Ling Xu, Ming Zhang, Xuan Niu

Background: Traumatic brain injury (TBI) increases the risk of developing Alzheimer's disease (AD), and a growing number of studies support a potential link between the two disorders. Therefore, the objective of this study is to systematically map the knowledge structure surrounding this topic over the past and to summarize the current state of research and hot frontiers in the field.

Methods: Data were retrieved from the Web of Science Core Collection (WOSCC) starting from the beginning until December 31, 2023, focusing on articles and reviews in English. Bibliometric tools including Bibliometrix R, VOSviewer, and Microsoft Excel were utilized for data analysis. The analysis included citations, authors, institutions, countries, journals, author keywords, and references.

Results: A total of 1,515 publications were identified, comprising 872 articles (57.56%) and 643 reviews (42.44%). The annual number of publications increased steadily, especially after 2013, with an R2 value of 0.978 indicating a strong upward trend. The USA was the leading country in terms of publications (734 articles), followed by China (162 articles) and the United Kingdom (77 articles). Meanwhile Boston University was the most productive institution. Collaborative networks show strong collaborative author links between the USA and the United Kingdom, as well as China. The analysis also showed that the Journal of Alzheimer's Disease was the most productive journal, while the article authored by McKee achieved the highest local citations value. The top three author keywords, in terms of occurrences, were "Alzheimer's disease," "traumatic brain injury," and "neurodegeneration." Thematic mapping showed a consolidation of research themes over time, decreasing from 11 main themes to 8. Emerging themes such as "obesity" and "diffusion tensor imaging" indicate new directions in the field.

Conclusion: The research on AD after TBI has attracted a great deal of interest from scientists. Notably, the USA is at the forefront of research in this field. There is a need for further collaborative research between countries. Overall, this study provides a comprehensive overview of developments in TBI and AD research, highlighting key contributors, emerging topics, and potential areas for future investigation.

背景:创伤性脑损伤(TBI)会增加罹患阿尔茨海默病(AD)的风险,越来越多的研究支持这两种疾病之间存在潜在联系。因此,本研究的目的是系统地梳理过去围绕这一主题的知识结构,并总结该领域的研究现状和热点前沿:方法:从 Web of Science Core Collection (WOSCC)(科学网核心数据库)中检索数据,检索时间从开始到 2023 年 12 月 31 日,重点是英文文章和评论。数据分析使用的文献计量工具包括 Bibliometrix R、VOSviewer 和 Microsoft Excel。分析内容包括引文、作者、机构、国家、期刊、作者关键词和参考文献:共发现 1,515 篇出版物,包括 872 篇文章(57.56%)和 643 篇综述(42.44%)。每年发表的论文数量稳步增长,尤其是在 2013 年之后,R2 值为 0.978,显示出强劲的上升趋势。美国的论文数量居首位(734 篇),其次是中国(162 篇)和英国(77 篇)。同时,波士顿大学是发表论文最多的机构。合作网络显示,美国、英国和中国之间的合作作者联系紧密。分析还显示,《阿尔茨海默病杂志》是最富有成效的杂志,而麦基撰写的文章则获得了最高的本地引用值。作者关键词出现次数排名前三位的是 "阿尔茨海默病"、"创伤性脑损伤 "和 "神经变性"。主题图显示,随着时间的推移,研究主题有所整合,从 11 个主要主题减少到 8 个。肥胖症 "和 "弥散张量成像 "等新兴主题指明了该领域的新方向:结论:有关创伤性脑损伤后注意力缺失症的研究引起了科学家们的极大兴趣。值得注意的是,美国在这一领域的研究处于领先地位。各国之间需要进一步开展合作研究。总之,本研究全面概述了创伤性脑损伤和注意力缺失症的研究进展,突出强调了主要贡献者、新出现的课题以及未来可能的研究领域。
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引用次数: 0
Immediate modulatory effects of transcutaneous vagus nerve stimulation on patients with Parkinson's disease: a crossover self-controlled fMRI study. 经皮迷走神经刺激对帕金森病患者的即时调节作用:一项交叉自控 fMRI 研究。
IF 4.1 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-23 eCollection Date: 2024-01-01 DOI: 10.3389/fnagi.2024.1444703
Chengwei Fu, Xiaoyan Hou, Chunye Zheng, Yue Zhang, Zhijie Gao, Zhaoxian Yan, Yongsong Ye, Bo Liu

Background: Previous studies have evaluated the safety and efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) for the treatment of Parkinson's disease (PD). However, the mechanism underlying the effect of taVNS on PD remains to be elucidated. This study aimed to investigate the immediate effects of taVNS in PD patients.

Methods: This crossover self-controlled study included 50 PD patients. Each patient underwent three sessions of resting-state functional magnetic resonance imaging (rs-fMRI) under three conditions: real taVNS, sham taVNS, and no taVNS intervention. We analyzed whole-brain amplitude of low-frequency fluctuations (ALFF) from preprocessed fMRI data across different intervention conditions. ALFF values in altered brain regions were correlated with clinical symptoms in PD patients.

Results: Forty-seven participants completed the study and were included in the final analysis. Real taVNS was associated with a widespread decrease in ALFF in the right hemisphere, including the superior parietal lobule, precentral gyrus, postcentral gyrus, middle occipital gyrus, and cuneus (voxel p < 0.001, GRF corrected). The ALFF value in the right superior parietal lobule during real taVNS was negatively correlated with the Unified Parkinson's Disease Rating Scale Part III (r = -0.417, p = 0.004, Bonferroni corrected).

Conclusion: TaVNS could immediately modulate the functional activity of brain regions involved in superior parietal lobule, precentral gyrus, postcentral gyrus, middle occipital gyrus, and cuneus. These findings offer preliminary insights into the mechanism of taVNS in treating PD and bolster confidence in its long-term therapeutic potential. TaVNS appears to reduce ALFF values in specific brain regions, suggesting a potential modulation mechanism for treating PD.

背景:以往的研究评估了经皮耳迷走神经刺激(taVNS)治疗帕金森病(PD)的安全性和有效性。然而,taVNS 对帕金森病的作用机制仍有待阐明。本研究旨在调查 taVNS 对帕金森病患者的直接影响:这项交叉自我对照研究包括 50 名帕金森病患者。每位患者在三种条件下接受了三次静息态功能磁共振成像(rs-fMRI)检查:真实taVNS、假taVNS和无taVNS干预。我们从预处理的 fMRI 数据中分析了不同干预条件下的全脑低频波动振幅(ALFF)。改变脑区的 ALFF 值与帕金森病患者的临床症状相关:47名参与者完成了研究并被纳入最终分析。真正的 taVNS 与右半球 ALFF 的广泛降低有关,包括顶叶上叶、中央前回、中央后回、枕叶中回和楔回(体素 p r = -0.417,p = 0.004,Bonferroni 校正):结论:TaVNS 可立即调节顶叶上部、中央前回、中央后回、枕中回和楔状回相关脑区的功能活动。这些发现初步揭示了 TaVNS 治疗帕金森病的机制,并增强了人们对其长期治疗潜力的信心。TaVNS 似乎能降低特定脑区的 ALFF 值,这表明它具有治疗帕金森病的潜在调节机制。
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引用次数: 0
Hyperthyroidism, hypothyroidism, thyroid stimulating hormone, and dementia risk: results from the NHANES 2011-2012 and Mendelian randomization analysis. 甲状腺功能亢进症、甲状腺功能减退症、促甲状腺激素与痴呆症风险:2011-2012 年国家健康调查(NHANES)和孟德尔随机分析的结果。
IF 4.1 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-23 eCollection Date: 2024-01-01 DOI: 10.3389/fnagi.2024.1456525
Xixi Sheng, Jixiang Gao, Kunfei Chen, Xuzhen Zhu, Yu Wang
<p><strong>Introduction: </strong>As the world ages, dementia places a heavy burden on society and the economy, but current methods of diagnosing dementia are still limited and there are no better therapies that target the causes of dementia. The purpose of this work is to explore the relationship between thyroid disease, thyroid stimulating hormone (TSH) concentrations, free tetraiodothyronine (FT4) concentrations and cognitive function.</p><p><strong>Methods: </strong>This study utilized cognitive function and thyroid data from the 2011-2012 National Health and Nutrition Examination Survey (NHANES) to assess the relationship between different groups of TSH and FT4 concentrations and cognitive function using weighted logistic regression and restricted cubic spline (RCS), and then used two-sample Mendelian Randomization (MR) to assess the causal relationship between hyperthyroidism, hypothyroidism, TSH and FT4 concentrations with dementia.</p><p><strong>Results: </strong>Our analysis of the 2011-2012 NHANES data showed that the individuals with low TSH concentrations had higher Alzheimer's Disease Word List Registry Consortium1 (CERAD1) and CERAD.delay.recall scores than individuals with high TSH concentrations, and individuals with low FT4 concentrations had higher CERAD3 and Animal Fluency Test scores than individuals with high FT4 concentrations. Our results also showed a non-linear relationship between serum TSH and FT4 concentrations and the Animal Fluency Test. The TSH concentrations within the range of 1.703 to 3.145 mIU/L exhibit a positive correlation with Animal Fluency Test, whereas concentrations outside this range are negatively correlated with Animal Fluency Test. The FT4 concentrations exhibited a positive correlation with Animal Fluency Test to the left of the FT4 concentrations inflection point (0.849 ng/L), whereas to the right of this inflection point, correlation was negative. MR analysis results further indicate that genetic predisposition to hyperthyroidism may be associated with a reduced risk of dementia and vascular dementia(VaD). Conversely, genetic predisposition to hypothyroidism appears to be linked with an increased risk of dementia and VaD. Additionally, genetic predisposition to elevated TSH concentrations may be correlated with a heightened risk of risk of Alzheimer's disease (AD).</p><p><strong>Conclusion: </strong>This study provides evidence of a nonlinear relationship between TSH and FT4 concentrations and cognitive function, with hyperthyroidism decreasing the risk of dementia and VaD, hypothyroidism increasing the risk of dementia and VaD, and elevated serum TSH concentrations increasing the risk of AD. Furthermore, prioritizing early detection, diagnosis, and treatment through the assessment of thyroid function in individuals at high risk for developing dementia is of paramount importance. This strategy has the potential to significantly contribute to the prevention and deceleration of dementia progression.
导言:随着全球老龄化的加剧,痴呆症给社会和经济带来了沉重的负担,但目前诊断痴呆症的方法仍然有限,而且还没有针对痴呆症病因的更好疗法。本研究旨在探讨甲状腺疾病、促甲状腺激素(TSH)浓度、游离四碘甲状腺原氨酸(FT4)浓度与认知功能之间的关系:本研究利用2011-2012年美国国家健康与营养调查(NHANES)中的认知功能和甲状腺数据,采用加权逻辑回归和受限立方样条法(RCS)评估了不同组别的促甲状腺激素(TSH)和游离四碘甲状腺原氨酸(FT4)浓度与认知功能之间的关系,然后采用双样本孟德尔随机法(MR)评估了甲状腺功能亢进、甲状腺功能减退、TSH和FT4浓度与痴呆之间的因果关系:我们对2011-2012年NHANES数据的分析表明,与TSH浓度高的人相比,TSH浓度低的人的阿尔茨海默病单词表注册联盟1(CERAD1)和CERAD.delay.recall得分更高;与FT4浓度高的人相比,FT4浓度低的人的CERAD3和动物流畅性测试得分更高。我们的研究结果还显示,血清促甲状腺激素和 FT4 浓度与动物流畅性测试之间存在非线性关系。TSH 浓度在 1.703 至 3.145 mIU/L 范围内与动物流畅度测试呈正相关,而超出此范围则与动物流畅度测试呈负相关。在 FT4 浓度拐点(0.849 纳克/升)左侧,FT4 浓度与动物流畅度测试呈正相关,而在拐点右侧则呈负相关。磁共振分析结果进一步表明,甲状腺功能亢进症的遗传易感性可能与痴呆症和血管性痴呆症(VaD)的风险降低有关。相反,甲状腺功能减退症的遗传易感性似乎与痴呆症和血管性痴呆症的风险增加有关。此外,TSH浓度升高的遗传易感性可能与阿尔茨海默病(AD)风险的增加有关:本研究提供的证据表明,TSH 和 FT4 浓度与认知功能之间存在非线性关系,甲状腺功能亢进会降低痴呆症和 VaD 的风险,甲状腺功能减退会增加痴呆症和 VaD 的风险,而血清 TSH 浓度升高会增加 AD 的风险。此外,通过评估痴呆症高危人群的甲状腺功能,优先考虑早期检测、诊断和治疗也是至关重要的。这一策略有可能大大有助于预防和减缓痴呆症的进展。
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引用次数: 0
Longitudinal accelerated brain age in mild cognitive impairment and Alzheimer's disease. 轻度认知障碍和阿尔茨海默病的纵向加速脑年龄。
IF 4.1 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-22 eCollection Date: 2024-01-01 DOI: 10.3389/fnagi.2024.1433426
Maria Ly, Gary Yu, Sang Joon Son, Tharick Pascoal, Helmet T Karim

Introduction: Brain age is a machine learning-derived estimate that captures lower brain volume. Previous studies have found that brain age is significantly higher in mild cognitive impairment and Alzheimer's disease (AD) compared to healthy controls. Few studies have investigated changes in brain age longitudinally in MCI and AD. We hypothesized that individuals with MCI and AD would show heightened brain age over time and across the lifespan. We also hypothesized that both MCI and AD would show faster rates of brain aging (higher slopes) over time compared to healthy controls.

Methods: We utilized data from an archival dataset, mainly Alzheimer's disease Neuroimaging Initiative (ADNI) 1 with 3Tesla (3 T) data which totaled 677 scans from 183 participants. This constitutes a secondary data analysis on existing data. We included control participants (healthy controls or HC), individuals with MCI, and individuals with AD. We predicted brain age using a pre-trained model and tested for accuracy. We investigated cross-sectional differences in brain age by group [healthy controls or HC, mild cognitive impairment (MCI), and AD]. We conducted longitudinal modeling of age and brain age by group using time from baseline in one model and chronological age in another model.

Results: We predicted brain age with a mean absolute error (MAE) < 5 years. Brain age was associated with age across the study and individuals with MCI and AD had greater brain age on average. We found that the MCI group had significantly higher rates of change in brain age over time compared to the HC group regardless of individual chronologic age, while the AD group did not differ in rate of brain age change.

Discussion: We replicated past studies that showed that MCI and AD had greater brain age than HC. We additionally found that this was true over time, both groups showed higher brain age longitudinally. Contrary to our hypothesis, we found that the MCI, but not the AD group, showed faster rates of brain aging. We essentially found that while the MCI group was actively experiencing faster rates of brain aging, the AD group may have already experienced this acceleration (as they show higher brain age). Individuals with MCI may experience higher rates of brain aging than AD and controls. AD may represent a homeostatic endpoint after significant neurodegeneration. Future work may focus on individuals with MCI as one potential therapeutic option is to alter rates of brain aging, which ultimately may slow cognitive decline in the long-term.

简介脑年龄是一种通过机器学习得出的估计值,可捕捉较低的脑容量。以往的研究发现,与健康对照组相比,轻度认知障碍和阿尔茨海默病(AD)患者的脑年龄明显偏高。很少有研究对 MCI 和 AD 患者的脑年龄变化进行纵向调查。我们假设 MCI 和 AD 患者的脑年龄会随着时间的推移和寿命的延长而增加。我们还假设,与健康对照组相比,随着时间的推移,MCI 和 AD 患者的大脑老化速度更快(斜率更高):我们利用了一个档案数据集的数据,主要是阿尔茨海默病神经成像倡议(ADNI)1的3特斯拉(3 T)数据,该数据集共有183名参与者的677次扫描。这是对现有数据的二次数据分析。我们纳入了对照组参与者(健康对照组或 HC)、MCI 患者和 AD 患者。我们使用预先训练好的模型预测大脑年龄,并测试其准确性。我们调查了各组(健康对照组或 HC、轻度认知障碍(MCI)和注意力缺失症)脑年龄的横断面差异。我们在一个模型中使用从基线算起的时间,在另一个模型中使用年代年龄,按组别对年龄和脑年龄进行了纵向建模:结果:我们以平均绝对误差(MAE)预测了脑年龄:我们重复了过去的研究,这些研究表明 MCI 和 AD 的脑龄大于 HC。此外,我们还发现,随着时间的推移,这一点也是正确的,两组人的脑年龄纵向都较高。与我们的假设相反,我们发现 MCI 组的大脑老化速度更快,而 AD 组则不然。我们基本上发现,虽然 MCI 组正在积极经历更快的大脑衰老速度,但注意力缺失症组可能已经经历了这种加速(因为他们显示出更高的大脑年龄)。与注意力缺失症患者和对照组相比,MCI 患者的大脑衰老速度可能更快。注意力缺失症可能是神经退化显著后的一个平衡终点。未来的工作可能会侧重于 MCI 患者,因为一个潜在的治疗方案是改变大脑的衰老速度,这最终可能会减缓认知能力的长期衰退。
{"title":"Longitudinal accelerated brain age in mild cognitive impairment and Alzheimer's disease.","authors":"Maria Ly, Gary Yu, Sang Joon Son, Tharick Pascoal, Helmet T Karim","doi":"10.3389/fnagi.2024.1433426","DOIUrl":"10.3389/fnagi.2024.1433426","url":null,"abstract":"<p><strong>Introduction: </strong>Brain age is a machine learning-derived estimate that captures lower brain volume. Previous studies have found that brain age is significantly higher in mild cognitive impairment and Alzheimer's disease (AD) compared to healthy controls. Few studies have investigated changes in brain age longitudinally in MCI and AD. We hypothesized that individuals with MCI and AD would show heightened brain age over time and across the lifespan. We also hypothesized that both MCI and AD would show faster rates of brain aging (higher slopes) over time compared to healthy controls.</p><p><strong>Methods: </strong>We utilized data from an archival dataset, mainly Alzheimer's disease Neuroimaging Initiative (ADNI) 1 with 3Tesla (3 T) data which totaled 677 scans from 183 participants. This constitutes a secondary data analysis on existing data. We included control participants (healthy controls or HC), individuals with MCI, and individuals with AD. We predicted brain age using a pre-trained model and tested for accuracy. We investigated cross-sectional differences in brain age by group [healthy controls or HC, mild cognitive impairment (MCI), and AD]. We conducted longitudinal modeling of age and brain age by group using time from baseline in one model and chronological age in another model.</p><p><strong>Results: </strong>We predicted brain age with a mean absolute error (MAE) < 5 years. Brain age was associated with age across the study and individuals with MCI and AD had greater brain age on average. We found that the MCI group had significantly higher rates of change in brain age over time compared to the HC group regardless of individual chronologic age, while the AD group did not differ in rate of brain age change.</p><p><strong>Discussion: </strong>We replicated past studies that showed that MCI and AD had greater brain age than HC. We additionally found that this was true over time, both groups showed higher brain age longitudinally. Contrary to our hypothesis, we found that the MCI, but not the AD group, showed faster rates of brain aging. We essentially found that while the MCI group was actively experiencing faster rates of brain aging, the AD group may have already experienced this acceleration (as they show higher brain age). Individuals with MCI may experience higher rates of brain aging than AD and controls. AD may represent a homeostatic endpoint after significant neurodegeneration. Future work may focus on individuals with MCI as one potential therapeutic option is to alter rates of brain aging, which ultimately may slow cognitive decline in the long-term.</p>","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"16 ","pages":"1433426"},"PeriodicalIF":4.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Post-stroke fatigue and its correlation with family functioning in patients who have experienced a first episode of stroke. 首次中风患者的中风后疲劳及其与家庭功能的相关性。
IF 4.1 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-21 eCollection Date: 2024-01-01 DOI: 10.3389/fnagi.2024.1440163
Ruhuang Zhu, Haiping Huang, Yueting Yu, Shaorui Bao, Na Lin, Meichun Shu

Objective: This study aimed to analyse the relevant factors that may affect post-stroke fatigue (PSF) in patients with stroke and further explore the correlation between family functioning and PSF.

Methods: Patients who had experienced a first episode of stroke and were admitted to the Department of Neurology of the First Affiliated Hospital of Wenzhou Medical University were rigorously screened. The general data and family functioning of the patients on admission were collected, and their family adaptation, partnership, growth, affection and resolve scores and their PSF on the 5th day of admission were collected using the fatigue severity scale (FSS). Multiple linear regression analysis was then utilized to explore the factors affecting PSF in patients with stroke.

Results: A total of 220 questionnaires were distributed, and 220 were returned, with 212 valid questionnaires and a valid return rate of 96.4%. These 212 patients had a family functioning score of 6.58 ± 2.00 and an FSS score of 36.62 ± 10.96. Spearman's correlation analysis showed negative correlations between the FSS scores and the adaptation, partnership, growth, affection, resolve and family functioning scores (r = -0.380, -0.505, -0.470, -0.303, -0.281 and -0.712, respectively; p < 0.001). Furthermore, multiple linear regression analysis showed that family functioning (β' = -0.516), marital status (β' = -0.244), household income (β' = -0.185), literacy (β' = -0.181) and activities of daily living (β' = -0.084) were influential factors for PSF in patients with stroke (p < 0.05).

Conclusion: There is a significant negative correlation between family functioning and PSF, suggesting that better family functioning may help mitigate the severity of post-stroke fatigue. Healthcare providers should identify interventions to help patients and families address fatigue, boost disease recovery, promote patients' physical and mental health and improve their quality of life.

研究目的本研究旨在分析可能影响脑卒中患者卒中后疲劳(PSF)的相关因素,并进一步探讨家庭功能与 PSF 的相关性:方法:对温州医科大学附属第一医院神经内科收治的首次脑卒中患者进行严格筛查。收集患者入院时的一般资料和家庭功能,使用疲劳严重程度量表(FSS)收集患者入院第 5 天的家庭适应、伙伴关系、成长、亲情和决心评分以及 PSF。然后利用多元线性回归分析探讨影响脑卒中患者 PSF 的因素:共发放问卷 220 份,回收 220 份,其中有效问卷 212 份,有效回收率为 96.4%。这 212 名患者的家庭功能评分为(6.58±2.00)分,FSS 评分为(36.62±10.96)分。斯皮尔曼相关分析显示,FSS 评分与适应、伙伴关系、成长、亲情、决心和家庭功能评分之间存在负相关(r = -0.380、-0.505、-0.470、-0.303、-0.281 和 -0.712,p < 0.001)。此外,多元线性回归分析显示,家庭功能(β' = -0.516)、婚姻状况(β' = -0.244)、家庭收入(β' = -0.185)、文化程度(β' = -0.181)和日常生活活动(β' = -0.084)是脑卒中患者 PSF 的影响因素(P < 0.05):结论:家庭功能与 PSF 之间存在明显的负相关,表明改善家庭功能有助于减轻卒中后疲劳的严重程度。医疗服务提供者应确定干预措施,帮助患者和家属解决疲劳问题,促进疾病康复,促进患者身心健康,提高生活质量。
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引用次数: 0
Nasal lymphatic obstruction of CSF drainage as a possible cause of Alzheimer's disease and dementia. 鼻腔淋巴阻塞脑脊液引流可能是阿尔茨海默病和痴呆症的病因。
IF 4.1 2区 医学 Q2 GERIATRICS & GERONTOLOGY Pub Date : 2024-10-21 eCollection Date: 2024-01-01 DOI: 10.3389/fnagi.2024.1482255
William Thomas Phillips, Joyce Gensberg Schwartz

Alzheimer's disease, the most common form of dementia among older adults, slowly destroys memory and thinking skills. In recent years, scientists have made tremendous progress in understanding Alzheimer's disease, still, they do not yet fully understand what causes the disease. This article proposes a novel etiology for Alzheimer's disease. Our hypothesis developed from a review of nuclear medicine scans, in which the authors observed a significant increase in nasal turbinate vasodilation and blood pooling in patients with hypertension, sleep apnea, diabetes and/or obesity, all risk factors for Alzheimer's disease. The authors propose that nasal turbinate vasodilation and resultant blood pooling lead to the obstruction of normal nasal lymphatic clearance of cerebrospinal fluid and its waste products from the brain. The nasal turbinate vasodilation, due to increased parasympathetic activity, occurs alongside the well-established increased sympathetic activity of the cardiovascular system as seen in patients with hypertension. The increased parasympathetic activity is likely due to an autonomic imbalance secondary to the increase in worldwide consumption of highly processed food associated with dysregulation of the glucose regulatory system. The authors' hypothesis offers a novel mechanism and a new paradigm for the etiology of Alzheimer's disease and helps explain the rapid worldwide rise in the disease and other dementias which are expected to double in the next 20 years. This new paradigm provides compelling evidence for the modulation of the parasympathetic nervous system as a novel treatment strategy for Alzheimer's disease and other degenerative brain diseases, specifically targeting nasal turbinate lymphatic flow.

阿尔茨海默病是老年人中最常见的一种痴呆症,它会慢慢摧毁人的记忆和思维能力。近年来,科学家们在了解阿尔茨海默病方面取得了巨大进步,但仍未完全弄清该病的病因。本文提出了阿尔茨海默病的新病因。我们的假设源于对核医学扫描的回顾,作者在扫描中观察到高血压、睡眠呼吸暂停、糖尿病和/或肥胖症患者的鼻甲血管扩张和血液淤积显著增加,而这些都是阿尔茨海默病的危险因素。作者认为,鼻甲血管扩张和由此导致的血液淤积会阻碍鼻腔淋巴对脑脊液及其废物的正常清除。副交感神经活动增加导致的鼻甲血管扩张与高血压患者心血管系统交感神经活动增加同时发生。副交感神经活动的增加很可能是由于世界范围内高度加工食品消费量的增加以及葡萄糖调节系统失调导致的自律神经失衡。作者的假设为阿尔茨海默氏症的病因学提供了一种新的机制和新的范式,并有助于解释该疾病和其他痴呆症在全球范围内的迅速增长,预计在未来 20 年内将翻一番。这一新范式提供了令人信服的证据,证明调节副交感神经系统是治疗阿尔茨海默病和其他退化性脑部疾病的新策略,特别是针对鼻甲淋巴流的治疗。
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引用次数: 0
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Frontiers in Aging Neuroscience
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