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White Matter Hyperintensities Are Associated with Slower Gait Speed in Older Adults without Dementia. 白质过度密集与无痴呆症的老年人步速较慢有关。
IF 2.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-01-01 Epub Date: 2024-07-18 DOI: 10.1159/000538944
Juan P Vazquez, Joe Verghese, Nir Barzilai, Sofiya Milman, Helena M Blumen
<p><strong>Introduction: </strong>Slow gait speed is associated with poor health outcomes in aging, but the relationship between cerebral small vessel disease (CSVD) pathologies and gait speed in aging is not well understood. We investigated the relationships between CSVD imaging markers and gait speed during simple (normal pace walking [NPW]) and complex (walking while talking [WWT]) as both measures are associated with shared health outcomes such as falls, frailty, disability, mortality, and dementia.</p><p><strong>Methods: </strong>A total of 113 Ashkenazi Jewish adults over 65 (M age = 78.6 ± 6.3 years, 45.8% women) and without dementia were examined. Established rating systems were used to quantify white matter hyperintensities (WMHs) and lacunes of presumed vascular origin from fluid-attenuated inversion recovery (FLAIR) images. Linear regression models adjusted for age, sex, global health, and total intracranial volume were used to examine associations between CSVD markers and gait speed during NPW and WWT. Student t tests were used to contrast gait speed in those with "confluent-diffuse" WMH and those with "mild or no" WMH.</p><p><strong>Results: </strong>The number of WMH in the basal ganglia (β = -3.274 cm/s p = 0.047) and temporal lobes (β = -3.113 cm/s p = 0.048) were associated with slower NPW speed in adjusted models. Participants with higher CSVD burden (confluent-diffuse pattern) in the frontal lobe (94.65 cm/s vs. 105.21 cm/s, p = 0.018) and globally (98.98 cm/s vs. 107.24 cm/s, p = 0.028) also had lower NPW speed. WMHs were not associated with WWT speeds. Lacunes were not associated with NPW or WWT speed.</p><p><strong>Conclusion: </strong>Adjusted models found higher CSVD burden as measured by the presence of WMH in the basal ganglia and temporal lobes were associated with slower normal pace gait speed in older adults, but not with complex walking speeds. Participants with confluent-diffuse WMHs in the frontal lobes were found to have slower average normal gait speed. Further studies are needed to establish the temporality of WMH and gait speed decline as well as mechanistic links between the two.</p><p><strong>Introduction: </strong>Slow gait speed is associated with poor health outcomes in aging, but the relationship between cerebral small vessel disease (CSVD) pathologies and gait speed in aging is not well understood. We investigated the relationships between CSVD imaging markers and gait speed during simple (normal pace walking [NPW]) and complex (walking while talking [WWT]) as both measures are associated with shared health outcomes such as falls, frailty, disability, mortality, and dementia.</p><p><strong>Methods: </strong>A total of 113 Ashkenazi Jewish adults over 65 (M age = 78.6 ± 6.3 years, 45.8% women) and without dementia were examined. Established rating systems were used to quantify white matter hyperintensities (WMHs) and lacunes of presumed vascular origin from fluid-attenuated inversion recovery (FLAIR) imag
背景:步速缓慢与老年期健康状况不良有关,但人们对老年期脑小血管疾病(CSVD)病变与步速之间的关系还不甚了解。我们研究了脑小血管疾病(CSVD)成像标志物与简单步速(正常步伐行走(NPW))和复杂步速(边走边说(WWT))之间的关系,因为这两种测量方法都与跌倒、虚弱、残疾、死亡率和痴呆等共同的健康后果有关:共调查了 113 名 65 岁以上的阿什肯纳兹犹太裔成年人(男,年龄为 78.6±6.3 岁,45.8% 为女性),他们均未患有痴呆症。使用既定的评级系统对流体衰减反转恢复(FLAIR)图像中的白质高密度(WMH)和推测为血管性的裂隙进行量化。线性回归模型对年龄、性别、总体健康状况和颅内总容积进行了调整,以检验 CSVD 标记与 NPW 和 WWT 期间步速之间的关联。学生 t 检验用于对比 "融合-弥漫 "WMH 和 "轻度或无 "WMH 患者的步速:结果:在调整模型中,基底节(β=-3.274 cm/s p=0.047)和颞叶(β=-3.113 cm/s p=0.048)的 WMH 数量与较慢的 NPW 速度相关。额叶(94.65 cm/s vs. 105.21 cm/s,p=.018)和全局(98.98 cm/s vs. 107.24 cm/s,p=.028)CSVD负担(汇合-弥漫模式)较高的参与者的NPW速度也较低。WMH与WWT速度无关。结论:调整后的模型发现,CSVD的发病率更高:调整后的模型发现,根据基底节和颞叶是否存在WMH衡量的较高CSVD负担与老年人较慢的正常步伐步速有关,但与复杂步行速度无关。研究发现,额叶中存在汇合弥散性 WMH 的参与者平均正常步速较慢。要确定 WMH 和步速下降的时间性以及两者之间的机理联系,还需要进一步的研究。.
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引用次数: 0
Potential Correlation between Tea Intake and the Risk of Amyotrophic Lateral Sclerosis: A Mendelian Randomization Study. 茶叶摄入量与肌萎缩侧索硬化症风险之间的潜在相关性:孟德尔随机研究
IF 2.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-01-01 Epub Date: 2024-06-03 DOI: 10.1159/000539590
Jinyue Li, Songyu Li, Guoqiang Fei

Introduction: There were limited observation studies on the association between tea intake and amyotrophic lateral sclerosis (ALS) with inconsistent results. This study aimed to determine the potential relationship between tea intake and ALS by a two-sample Mendelian randomization (MR) analysis.

Methods: We identified 41 independent SNPs strongly associated with tea intake from 448,060 participants of European ancestry in the UK Biobank. Summary statistics associated with ALS were also obtained from the UK Biobank including 20,806 cases and 59,804 controls. The study used MR analysis to assess the potential effect of tea consumption on ALS, and several methods such as sensitivity analyses and MR-pleiotropy residual sum and outlier method were performed to further test the robustness of our findings.

Results: The F statistic was more than 10 in each SNP, which meets the first assumption for the MR study. Using the inverse variance weighted MR analysis as the primary method, we found that a one standard deviation increase in tea consumption was associated with a 14% lower risk of ALS (OR = 0.86, 95% CI = 0.74-0.99, p < 0.05). Sensitivity analyses detected no potential pleiotropy and directional heterogeneity.

Conclusion: Our MR study supported the potential relationship between tea intake and ALS risk, suggesting the potential advantages of tea intake for preventing ALS. Future clinical trials and research are needed to further validate the results and elucidate possible mechanisms.

导言:关于茶叶摄入量与肌萎缩性脊髓侧索硬化症(ALS)之间关系的观察研究有限,且结果不一致。本研究旨在通过双样本孟德尔随机分析(MR)确定茶摄入量与ALS之间的潜在关系:我们从英国生物库中 448,060 名欧洲血统的参与者中发现了 41 个与茶摄入量密切相关的独立 SNPs。我们还从英国生物库中获得了与 ALS 相关的汇总统计数据,其中包括 20806 例病例和 59804 例对照。研究采用MR分析评估饮茶对ALS的潜在影响,并采用了多种方法,如敏感性分析和MR-pleiotropy残差和离群值(MR-PRESSO)法,以进一步检验我们研究结果的稳健性:每个 SNP 的 F 统计量都大于 10,符合 MR 研究的第一个假设。以反向方差加权(IVW)MR分析为主要方法,我们发现茶叶消费量每增加一个标准差,ALS的发病风险就会降低14%(OR=0.86,95%CI=0.74-0.99,P<0.05)。敏感性分析未发现潜在的多效应和方向异质性:我们的磁共振研究证实了茶叶摄入量与 ALS 风险之间的潜在关系,表明摄入茶叶对预防 ALS 有潜在的好处。未来的临床试验和研究需要进一步验证结果并阐明可能的机制。
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引用次数: 0
Differential Effects of Disease Duration and Dopaminergic Replacement Therapy on Vocal Emotion Recognition in Asymmetric Parkinson's Disease. 疾病持续时间和多巴胺能替代治疗对非对称帕金森病声音情绪识别的差异影响。
IF 2.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-01-01 Epub Date: 2024-12-16 DOI: 10.1159/000542337
Philippe Voruz, Didier Grandjean, Sophie Drapier, Dominique Drapier, Marc Vérin, Julie Anne Péron

Introduction: Recently, studies have suggested a role of motor symptom asymmetry on impaired emotional recognition abilities in Parkinson's disease with a greater vulnerability in patients with a predominance of left-sided symptoms. However, none of them explored the interaction between motor symptom asymmetry and dopamine replacement therapy in different stages of the disease.

Methodology: We explored the recognition of vocal emotion (i.e., emotional prosody) in 15 newly diagnosed Parkinson's disease patients in the early stages of the disease, 15 patients in the advanced stages of the disease and 15 healthy controls. The early patients were studied in two conditions: ON and OFF dopaminergic replacement therapy and both Parkinson's disease groups (early and advanced) were divided into two subgroups according to the asymmetry of motor symptoms.

Results: The analyses revealed two patterns of results. First, as predicted, we observed a reduction in performance for the recognition of vocal emotions in patients with a predominance of left-sided symptoms as compared to both healthy controls and predominantly right-sided symptom patients. Second, in the early stages of the disease, we observed a deleterious effect of dopatherapy on the recognition of vocal emotions for the patients with left-predominant symptoms, and the inverse pattern (i.e., a positive effect of dopatherapy) for the patients with right-predominant symptoms.

Conclusions: Our results bring to knowledge the differential effects of disease duration, dopaminergic replacement therapy and motor symptom asymmetry on vocal emotion recognition in Parkinson's disease.

最近的研究表明,运动症状不对称在帕金森病患者情绪识别能力受损中的作用,在以左侧症状为主的患者中更容易受到影响。然而,没有一项研究探讨运动症状不对称与多巴胺替代治疗在疾病不同阶段的相互作用。方法:研究15例新诊断的帕金森病早期患者、15例疾病晚期患者和15例健康对照者对声音情绪(即情绪韵律)的识别。将早期患者分为两种情况进行研究:开和关多巴胺能替代治疗,并根据运动症状的不对称性将两个帕金森病组(早期和晚期)分为两个亚组。结果:分析揭示了两种结果模式。首先,正如预测的那样,我们观察到,与健康对照组和以右侧症状为主的患者相比,左侧症状为主的患者在识别声音情绪方面的表现有所下降。其次,在疾病的早期阶段,我们观察到多巴胺疗法对左显性症状患者的声音情绪识别的有害影响,而对右显性症状患者的逆转模式。结论:我们的研究结果揭示了病程、多巴胺能替代疗法和运动症状不对称对帕金森病声音情绪识别的不同影响。
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引用次数: 0
Contents Vol. 22, 2022 目录22, 2022
IF 3 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-10-01 DOI: 10.1159/000534159
Gilles Allali, Roger M. Nitsch, Wenzhen Duan, S. T. DeKosky
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引用次数: 0
Lithium: An Old Drug for New Therapeutic Strategy for Alzheimer's Disease and Related Dementia. 锂:阿尔茨海默病及相关痴呆的新治疗策略的老药。
IF 2.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 Epub Date: 2023-09-04 DOI: 10.1159/000533797
Seong Sool Shim, Ken Berglund, Shan Ping Yu

Background: Although Alzheimer's disease (AD) is the most common form of dementia, the effective treatment of AD is not available currently. Multiple trials of drugs, which were developed based on the amyloid hypothesis of AD, have not been highly successful to improve cognitive and other symptoms in AD patients, suggesting that it is necessary to explore additional and alternative approaches for the disease-modifying treatment of AD. The diverse lines of evidence have revealed that lithium reduces amyloid and tau pathology, attenuates neuronal loss, enhances synaptic plasticity, and improves cognitive function. Clinical studies have shown that lithium reduces the risk of AD and deters the progress of mild cognitive impairment and early AD.

Summary: Our recent study has revealed that lithium stabilizes disruptive calcium homeostasis, and subsequently, attenuates the downstream neuropathogenic processes of AD. Through these therapeutic actions, lithium produces therapeutic effects on AD with potential to modify the disease process. This review critically analyzed the preclinical and clinical studies for the therapeutic effects of lithium on AD. We suggest that disruptive calcium homeostasis is likely to be the early neuropathological mechanism of AD, and the stabilization of disruptive calcium homeostasis by lithium would be associated with its therapeutic effects on neuropathology and cognitive deficits in AD.

Key messages: Lithium is likely to be efficacious for AD as a disease-modifying drug by acting on multiple neuropathological targets including disruptive calcium homeostasis.

背景:虽然阿尔茨海默病(AD)是最常见的痴呆形式,但目前还没有有效的治疗方法。基于AD的淀粉样蛋白假说开发的多项药物试验在改善AD患者的认知和其他症状方面并没有非常成功,这表明有必要探索其他和替代的方法来改善AD的疾病治疗。各种各样的证据表明,锂可以减少淀粉样蛋白和tau蛋白病理,减轻神经元损失,增强突触可塑性,改善认知功能。临床研究表明,锂可以降低阿尔茨海默病的风险,并阻止轻度认知障碍和早期阿尔茨海默病的进展。摘要:我们最近的研究表明,锂可以稳定破坏性钙稳态,并随后减弱阿尔茨海默病的下游神经致病过程。通过这些治疗作用,锂对阿尔茨海默病产生治疗作用,并有可能改变疾病进程。这篇综述批判性地分析了锂治疗阿尔茨海默病的临床前和临床研究。我们认为,破坏钙稳态可能是阿尔茨海默病的早期神经病理机制,锂离子对破坏钙稳态的稳定可能与其对阿尔茨海默病神经病理和认知缺陷的治疗作用有关。关键信息:锂作为一种疾病修饰药物,通过作用于多种神经病理靶点,包括破坏钙稳态,可能对阿尔茨海默病有效。
{"title":"Lithium: An Old Drug for New Therapeutic Strategy for Alzheimer's Disease and Related Dementia.","authors":"Seong Sool Shim, Ken Berglund, Shan Ping Yu","doi":"10.1159/000533797","DOIUrl":"10.1159/000533797","url":null,"abstract":"<p><strong>Background: </strong>Although Alzheimer's disease (AD) is the most common form of dementia, the effective treatment of AD is not available currently. Multiple trials of drugs, which were developed based on the amyloid hypothesis of AD, have not been highly successful to improve cognitive and other symptoms in AD patients, suggesting that it is necessary to explore additional and alternative approaches for the disease-modifying treatment of AD. The diverse lines of evidence have revealed that lithium reduces amyloid and tau pathology, attenuates neuronal loss, enhances synaptic plasticity, and improves cognitive function. Clinical studies have shown that lithium reduces the risk of AD and deters the progress of mild cognitive impairment and early AD.</p><p><strong>Summary: </strong>Our recent study has revealed that lithium stabilizes disruptive calcium homeostasis, and subsequently, attenuates the downstream neuropathogenic processes of AD. Through these therapeutic actions, lithium produces therapeutic effects on AD with potential to modify the disease process. This review critically analyzed the preclinical and clinical studies for the therapeutic effects of lithium on AD. We suggest that disruptive calcium homeostasis is likely to be the early neuropathological mechanism of AD, and the stabilization of disruptive calcium homeostasis by lithium would be associated with its therapeutic effects on neuropathology and cognitive deficits in AD.</p><p><strong>Key messages: </strong>Lithium is likely to be efficacious for AD as a disease-modifying drug by acting on multiple neuropathological targets including disruptive calcium homeostasis.</p>","PeriodicalId":19115,"journal":{"name":"Neurodegenerative Diseases","volume":" ","pages":"1-12"},"PeriodicalIF":2.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10154771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting the Rapid Progression of Mild Cognitive Impairment by Intestinal Flora and Blood Indicators through Machine Learning Method. 通过机器学习方法,利用肠道菌群和血液指标预测轻度认知障碍的快速进展。
IF 2.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 Epub Date: 2024-02-28 DOI: 10.1159/000538023
Lingling Wang, Jing Yan, Huiqin Liu, Xiaohui Zhao, Haihan Song, Juan Yang

Introduction: The aim of the work was to establish a prediction model of mild cognitive impairment (MCI) progression based on intestinal flora by machine learning method.

Method: A total of 1,013 patients were recruited, in which 87 patients with MCI finished a two-year follow-up. To establish a prediction model, 61 patients were randomly divided into a training set and 26 patients were divided into a testing set. A total of 121 features including demographic characteristics, hematological indicators, and intestinal flora abundance were analyzed.

Results: Of the 87 patients who finished a two-year follow-up, 44 presented rapid progression. Model 1 was established based on 121 features with the accuracy 85%, sensitivity 85%, and specificity 83%. Model 2 was based on the first fifteen features of model 1 (triglyceride, uric acid, alanine transaminase, F-Clostridiaceae, G-Megamonas, S-Megamonas, G-Shigella, G-Shigella, S-Shigella, average hemoglobin concentration, G-Alistipes, S-Collinsella, median cell count, average hemoglobin volume, low-density lipoprotein), with the accuracy 97%, sensitivity 92%, and specificity 100%. Model 3 was based on the first ten features of model 1, with the accuracy 97%, sensitivity 86%, and specificity 100%. Other models based on the demographic characteristics, hematological indicators, or intestinal flora abundance features presented lower sensitivity and specificity.

Conclusion: The 15 features (including intestinal flora abundance) could establish an effective model for predicting rapid MCI progression.

引言这项研究的目的是通过机器学习方法建立一个基于肠道菌群的轻度认知障碍(MCI)进展预测模型:方法:共招募了 1013 名患者,其中 87 名 MCI 患者完成了为期两年的随访。为了建立预测模型,61 名患者被随机分为训练集,26 名患者被分为测试集。结果:结果:在完成两年随访的 87 名患者中,44 人的病情发展迅速。模型 1 基于 121 个特征建立,准确率为 85%,灵敏度为 85%,特异性为 83%。模型 2 基于模型 1 的前 15 个特征(甘油三酯、尿酸、丙氨酸转氨酶、F-梭状芽孢杆菌、G-麦加莫纳菌、S-麦加莫纳菌、G-志贺菌、G-志贺菌、S-志贺菌、平均血红蛋白浓度、G-Alistipes、S-Collinsella、中位细胞计数、平均血红蛋白体积、低密度脂蛋白),准确率为 97%,灵敏度为 92%,特异性为 100%。模型 3 基于模型 1 的前十个特征,准确率为 97%,灵敏度为 86%,特异性为 100%。其他基于人口统计学特征、血液学指标或肠道菌群丰富度特征的模型的灵敏度和特异性较低: 结论:15 个特征(包括肠道菌群丰富度)可以建立一个预测 MCI 快速进展的有效模型。
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引用次数: 0
A Paradigm Shift in the Management of Patients with Parkinson's Disease. 帕金森病患者管理模式的转变。
IF 2.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 Epub Date: 2023-11-01 DOI: 10.1159/000533798
Konstantinos I Tsamis, Per Odin, Angelo Antonini, Heinz Reichmann, Spyridon Konitsiotis

Background: Technological evolution leads to the constant enhancement of monitoring systems and recording symptoms of diverse disorders.

Summary: For Parkinson's disease, wearable devices empowered with machine learning analysis are the main modules for objective measurements. Software and hardware improvements have led to the development of reliable systems that can detect symptoms accurately and be implicated in the follow-up and treatment decisions.

Key messages: Among many different devices developed so far, the most promising ones are those that can record symptoms from all extremities and the trunk, in the home environment during the activities of daily living, assess gait impairment accurately, and be suitable for a long-term follow-up of the patients. Such wearable systems pave the way for a paradigm shift in the management of patients with Parkinson's disease.

背景:技术的发展导致监测系统的不断增强,记录各种疾病的症状。摘要:对于帕金森氏症,具有机器学习分析功能的可穿戴设备是进行客观测量的主要模块。软件和硬件的改进导致了可靠系统的发展,这些系统可以准确地检测症状,并参与后续和治疗决策。关键信息:在迄今为止开发的许多不同设备中,最有前途的是那些可以在日常生活活动中在家庭环境中记录四肢和躯干的症状,准确评估步态障碍,并适合患者的长期随访的设备。这种可穿戴系统为帕金森病患者管理模式的转变铺平了道路。
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引用次数: 0
Cerebral Tau Deposition in Comorbid Progressive Supranuclear Palsy and Amyotrophic Lateral Sclerosis: An [18F]-Flortaucipir and 7T MRI Study. 共病进行性核上性麻痹和肌萎缩侧索硬化症的脑tau沉积:[18F]-flortaucipir和7T磁共振成像研究。
IF 2.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 Epub Date: 2024-03-25 DOI: 10.1159/000536614
Ian Cheong, Yong Du, Gwenn Smith, Jun Hua, Xu Li, Alexander Pantelyat

Introduction: Progressive supranuclear palsy (PSP) is a four-repeat tauopathy characterized by multiple clinicopathologic subtypes. Advanced neuroimaging techniques have shown an early ability to distinguish PSP subtypes noninvasively for improved diagnosis. This study utilized tau PET imaging and MRI techniques at 7T to determine the neuroimaging profile of a participant with comorbid PSP and amyotrophic lateral sclerosis (ALS).

Method: [18F]-flortaucipir PET imaging was performed on one participant with PSP-ALS, one participant with typical PSP (Richardson's syndrome; PSP-RS), and 15 healthy control volunteers. Standardized uptake value ratio (SUVR) in each brain region was compared between PSP participants and controls. Quantitative susceptibility mapping (QSM) and inflow-based vascular-space occupancy MRI at 7T were performed on the two PSP participants and on two age-matched healthy controls to evaluate for differences in regional brain iron content and arteriolar cerebral blood volume (CBVa), respectively.

Results: In the participant with PSP-ALS, the precentral gyrus demonstrated the highest [18F]-flortaucipir uptake of all brain regions relative to controls (z-score 1.94). In the participant with PSP-RS, [18F]-flortaucipir uptake relative to controls was highest in subcortical regions, including the pallidum, thalamus, hippocampus, and brainstem (z-scores 1.08, 1.41, 1.49, 1.32, respectively). Susceptibility values as a measure of brain iron content were higher in the globus pallidus and substantia nigra than in the midbrain and pons in each participant, regardless of group. CBVa values tended to be higher in the subcortical gray matter in PSP participants than in controls, although large measurement variability was noted in controls across multiple regions.

Conclusion: In vivo tau PET imaging of an individual with PSP-ALS overlap demonstrated increased tau burden in the motor cortex that was not observed in PSP-RS or control participants. Consistent with prior PET studies, tau burden in PSP-RS was mainly observed in subcortical regions, including the brainstem and basal ganglia. QSM data suggest that off-target binding to iron may account for some but not all of the increased [18F]-flortaucipir uptake in the basal ganglia in PSP-RS. These findings support existing evidence that tau PET imaging can distinguish among PSP subtypes by detecting distinct regional patterns of tau deposition in the brain. Larger studies are needed to determine whether CBVa is sensitive to changes in brain microvasculature in PSP.

导言:进行性核上性麻痹(PSP)是一种四重复tauopathy,具有多种临床病理亚型。先进的神经影像学技术已显示出早期无创区分 PSP 亚型以改善诊断的能力。本研究利用 tau-PET 成像和 7 特斯拉(7T)核磁共振成像技术确定了一名合并 PSP 和肌萎缩侧索硬化症(ALS)患者的神经影像学特征。该方法对一名 PSP-ALS 患者、一名典型 PSP(理查森综合征;PSP-RS)患者和 15 名健康对照志愿者进行了[18F]-flortaucipir PET 成像检查。比较了 PSP 患者和对照组每个脑区的标准化摄取值比(SUVR)。在 7T 下对两名 PSP 患者和两名年龄匹配的健康对照者进行了定量易感性映射(QSM)和基于流入的血管空间占位(iVASO)磁共振成像,以分别评估区域脑铁含量和动脉脑血容量(CBVa)的差异。结果 在 PSP-ALS 患者中,相对于对照组,前中央回的[18F]-flortaucipir 摄取量在所有脑区中最高(z-score 1.94)。在 PSP-RS 患者中,皮层下区域(包括苍白球、丘脑、海马和脑干)的[18F]-flortaucipir 摄取量相对于对照组最高(z 值分别为 1.08、1.41、1.49 和 1.32)。作为脑铁含量的测量指标,每位受试者的球状苍白球和黑质的易感性值均高于中脑和脑桥,与组别无关。与对照组相比,PSP 参与者皮层下灰质中的 CBVa 值往往更高,但对照组在多个区域的测量结果差异较大。结论 对一名PSP-ALS重叠患者进行的体内tau PET成像显示,运动皮层中的tau负荷增加,而在PSP-RS或对照组患者中未观察到这一现象。与之前的 PET 研究一致,PSP-RS 患者的 tau 负荷主要出现在皮层下区域,包括脑干和基底节。QSM数据表明,与铁的脱靶结合可能是PSP-RS基底节中[18F]-flortaucipir摄取增加的部分原因,但不是全部原因。这些发现支持现有的证据,即 tau PET 成像可以通过检测大脑中不同区域的 tau 沉积模式来区分 PSP 亚型。还需要进行更大规模的研究,以确定CBVa对PSP患者脑微血管的变化是否敏感。
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引用次数: 0
Epidemiological Impact of Neurodegenerative Diseases in the Rural Spanish-Portuguese Cross-Border Region. 神经退行性疾病对西班牙-葡萄牙跨境农村地区的流行病学影响。
IF 2.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 Epub Date: 2023-12-21 DOI: 10.1159/000535683
Montserrat Alonso-Sardón, Manuel Paulino, Adília Fernandes, María Antonia Martín-Delgado, Raixa Noemí Pérez-Martín, Carlos Pires Magalhães, Helena Pimentel, Augusta Mata, Justina Silvano, Agostinha Corte, Teresa Paiva, Ermelinda Marques

Introduction: Epidemiological data indicate that neurodegenerative diseases show a high prevalence with a progressive increasing trend, especially in aging populations, as is the case in rural areas. The objective of this study was to assess the quantitative impact of neurodegenerative diseases in rural areas of the Spanish-Portuguese border region and to describe the epidemiological profile of the most prevalent disorders in one of the most depopulated and aged regions of Europe.

Methods: A cross-sectional descriptive study was designed to estimate the prevalence of subjects diagnosed with the most common neurodegenerative disorders: dementia (Alzheimer's disease and other dementias), Parkinson's disease and Parkinsonism, and multiple sclerosis in the Spanish-Portuguese cross-border border region in 2020. It includes Bragança and Guarda Districts (Portugal) and Salamanca (Castilla y León, Spain).

Results: Neurodegenerative diseases accounted for 1.85% in the Spanish-Portuguese cross-border region in 2020; a total of 5,819 records were reported: 987 (prevalence, 2.51%) in Salamanca (Spain); 2,332 (prevalence, 1.87%) in Bragança; and 2,500 (prevalence, 1.66%) in Guarda. Female population suffered from them in higher proportion (2.35 vs. 1.32%). Dementia represented 1.19% (3,744), Parkinson's disease and Parkinsonism 0.58% (1,823), and multiple sclerosis 0.08% (252). These disorders impacted older age groups. In the rural border region of Spain, 1 out of 4 cases were institutionalized.

Conclusion: The findings reveal the health impact of neurodegenerative diseases in the Spanish-Portuguese cross-border region. The epidemiological data emphasize the region's circumstances and highlight research priorities. Intervention strategies must be implemented in the region to ensure quality healthcare in rural areas.

导言:流行病学数据表明,神经退行性疾病的发病率很高,且呈逐渐上升趋势,尤其是在农村地区的老龄人口中。本研究的目的是评估神经退行性疾病对西班牙-葡萄牙边境地区农村地区的定量影响,并描述欧洲人口最稀少、老龄化最严重地区之一的最流行疾病的流行病学概况:这项横断面描述性研究旨在估算 2020 年西班牙-葡萄牙边境地区最常见的神经退行性疾病:痴呆症(阿尔茨海默病和其他痴呆症)、帕金森病和帕金森综合症以及多发性硬化症的患病率。该地区包括布拉干萨区和瓜尔达区(葡萄牙)以及萨拉曼卡(西班牙卡斯蒂利亚-莱昂):结果:2020 年,神经退行性疾病在西班牙-葡萄牙跨境地区占 1.85%,共有 5819 条记录:萨拉曼卡(西班牙)报告了987例(发病率,2.51%);布拉干萨报告了2332例(发病率,1.87%);瓜尔达报告了2500例(发病率,1.66%)。女性患者的比例更高(2.35% 对 1.32%)。痴呆症占 1.19%(3,744 人),帕金森病和帕金森综合症占 0.58%(1,823 人),多发性硬化症占 0.08%(252 人)。这些疾病对老年群体的影响较大。在西班牙的农村边境地区,每 4 个病例中就有 1 个住进了养老院:调查结果揭示了神经退行性疾病对西班牙-葡萄牙跨境地区健康的影响。流行病学数据强调了该地区的情况,并突出了研究重点。必须在该地区实施干预战略,以确保农村地区的医疗质量。
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引用次数: 0
Neuroimaging and Neurodegeneration. 神经成像与神经退行性变。
IF 2.6 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 Epub Date: 2024-01-31 DOI: 10.1159/000536438
Daniele Botta, Karl-Olof Lövblad
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引用次数: 0
期刊
Neurodegenerative Diseases
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