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Association between Cognitive Reserve Indicator and Chronic Disease-Free Survival: A Large Community-Based Longitudinal Study 认知储备指标与无慢性病生存率之间的关系:一项大型社区纵向研究
IF 6.4 Q2 BUSINESS Pub Date : 2024-09-18 DOI: 10.14283/jpad.2024.160
P. Li, W. Yang, J. Wang, Hong Zhu, A. Dove, Weili Xu

Background

Cognitive reserve (CR) has been linked to dementia and might be a predictor of aged-related outcomes. However, the association between CR and risk of other chronic diseases and mortality remains unclear.

Objectives

We aimed to investigate the association of CR with survival free from major chronic diseases.

Design, Setting and Participants

This community-based longitudinal study used data from the UK Biobank. A total of 412,509 participants (mean age 55.71±8.10) free of major chronic disease (including dementia, diabetes, cardiovascular diseases, chronic obstructive pulmonary disease, and cancer) completed the baseline examination between 2006 to 2010 and were followed for changes in health status.

Measurements

Latent class analysis was used to generate an indicator of CR (categorized as low, moderate, or high) based on education, occupation, television viewing time, confiding, social connection, and leisure activities. Major chronic diseases and survival status were ascertained through self-reported history and/or linkages to medical and death records. Chronic disease-free survival was defined as survival without any of the aforementioned chronic diseases. Effect modifications and interactions between the CR indicator and sex, age, and lifestyle factors (including smoking status, alcohol consumption, physical activity, and body mass index) were explored.

Results

Over a median follow-up of 12.49 (interquartile range 11.42–13.41, range 0.01–15.87) years, 112,190 (27.2%) participants died or developed at least one chronic disease. High CR indicator was associated with lower risk of chronic disease/death (hazard ratio 0.82, 95% confidence interval: 0.80–0.83) compared to low CR indicator. Chronic disease-free survival was prolonged by 1.33 (1.21–1.44) years among participants with high CR compared to low CR indicator. Furthermore, the association between the CR indicator and chronic disease-free survival was strengthened among individuals aged <60 years and current smokers.

Conclusion

High CR indicator is associated with a lower risk of chronic disease/death and may prolong chronic disease-free survival. Our findings underscore the importance of CR-enhancing lifestyle and experiences in health longevity, especially for younger individuals and current smokers.

背景认知储备(CR)与痴呆症有关,可能是预测老年相关结果的一个指标。我们旨在研究认知储备与无主要慢性疾病生存率之间的关系。这项基于社区的纵向研究使用了英国生物库的数据。共有 412,509 名参与者(平均年龄为 55.71±8.10 岁)在 2006 年至 2010 年期间完成了基线检查,并对其健康状况的变化进行了跟踪调查,这些参与者均无主要慢性疾病(包括痴呆、糖尿病、心血管疾病、慢性阻塞性肺病和癌症)。主要慢性病和生存状况通过自我报告的病史和/或与医疗和死亡记录的联系来确定。无慢性病存活被定义为无任何上述慢性病的存活。研究还探讨了CR指标与性别、年龄和生活方式因素(包括吸烟状况、饮酒量、体力活动和体重指数)之间的效应修正和交互作用。结果在中位随访12.49年(四分位距为11.42-13.41,范围为0.01-15.87)期间,有112190人(27.2%)死亡或至少罹患一种慢性疾病。与低 CR 指标相比,高 CR 指标与较低的慢性病/死亡风险相关(危险比为 0.82,95% 置信区间为 0.80-0.83)。与低CR指标相比,高CR指标参与者的无慢性病生存期延长了1.33(1.21-1.44)年。结论高 CR 指标与较低的慢性病/死亡风险相关,并可延长无慢性病生存期。我们的研究结果强调了增强 CR 的生活方式和经验对健康长寿的重要性,尤其是对年轻人和当前吸烟者而言。
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引用次数: 0
Phase 1 Studies of the Anti-Tau Monoclonal Antibody JNJ-63733657 in Healthy Participants and Participants with Alzheimer’s Disease 抗 Tau 单克隆抗体 JNJ-63733657 在健康参与者和阿尔茨海默病参与者中的 1 期研究
IF 6.4 Q2 BUSINESS Pub Date : 2024-09-10 DOI: 10.14283/jpad.2024.163
Wendy R. Galpern, G. Triana-Baltzer, L. Li, K. Van Kolen, M. Timmers, K. Haeverans, L. Janssens, H. Kolb, P. Nandy, K. Aida, H. Shimizu, M. Mercken, H. Sun
<h3 data-test="abstract-sub-heading">Background</h3><p>JNJ-63733657 (posdinemab) is a humanized IgG1/kappa monoclonal anti-phospho tau antibody that binds with high affinity to phosphorylated amino acid 217 (pT217) in the proline-rich domain. The parent molecule, PT3, was raised against Alzheimer’s disease brain purified paired helical filament, and preclinical studies with the humanized version, JNJ-63733657, have demonstrated reductions in tau seeding. The results of the first-in-human clinical trial of JNJ-63733657 and a separate single ascending dose study in Japanese participants are presented.</p><h3 data-test="abstract-sub-heading">Objectives</h3><p>To evaluate the safety and tolerability, pharmacokinetics, immunogenicity, and pharmacodynamics of JNJ-63733657 after single and multiple intravenous dose administrations in healthy participants and participants with prodromal or mild Alzheimer’s disease.</p><h3 data-test="abstract-sub-heading">Design</h3><p>A two part first-in-human, phase 1, randomized, double-blind, placebo-controlled trial: Single ascending dose (Part 1) and multiple ascending dose (Part 2). And a phase 1, randomized, double-blind, placebo-controlled single ascending dose trial in healthy Japanese participants.</p><h3 data-test="abstract-sub-heading">Setting</h3><p>7 sites in Belgium, Netherlands, Spain, and Germany; 1 site in Japan.</p><h3 data-test="abstract-sub-heading">Participants</h3><p>A total of 40 healthy participants aged 55–75 were enrolled in Part 1 of the first-in-human study; a total of 16 healthy participants and 13 participants with prodromal or mild AD aged 55–80 years were enrolled in Part 2. In the Japanese trial, a total of 24 participants aged 55–75 were enrolled.</p><h3 data-test="abstract-sub-heading">Intervention</h3><p>In Part 1, single doses of 1, 3, 10, 30, or 60 mg/kg of JNJ-63733657 or placebo were administered to healthy participants. In Part 2, two dose levels of JNJ-63733657 (5 mg/kg or 50 mg/kg) or placebo were evaluated in healthy participants, and 2 dose levels (15 mg/kg or 30 mg/kg) or placebo were evaluated in participants with Alzheimer’s disease; doses were administered on Days 1, 29, and 57. In the Japanese trial, single doses of 3, 15, or 60 mg/kg of JNJ-63733675 or placebo were administered. All doses were administered intravenously.</p><h3 data-test="abstract-sub-heading">Measurements</h3><p>Safety assessments, serum and cerebrospinal fluid pharmacokinetic parameters, immunogenicity, and cerebrospinal fluid pharmacodynamic changes in free and total p217+tau, total tau, and p181tau were evaluated.</p><h3 data-test="abstract-sub-heading">Results</h3><p>JNJ-63733657 was generally safe and well-tolerated in healthy participants and participants with Alzheimer’s disease. In healthy participants and participants with Alzheimer’s disease, JNJ-63733657 demonstrated linear PK, and serum C<sub>max</sub> and AUC were approximately dose proportional following single and multiple doses. Dose-de
背景JNJ-63733657(posdinemab)是一种人源化IgG1/kappa单克隆抗磷酸化tau抗体,能与富脯氨酸结构域中的磷酸化氨基酸217(pT217)高亲和力结合。母体分子 PT3 是针对阿尔茨海默氏症脑纯化的成对螺旋丝提出的,人源化版本 JNJ-63733657 的临床前研究已证明可减少 tau 的播散。本文介绍了 JNJ-63733657 首次人体临床试验的结果,以及在日本参与者中进行的单独单次上升剂量研究的结果。目标评估健康参与者和阿尔茨海默病前驱期或轻度患者单次和多次静脉注射 JNJ-63733657 后的安全性和耐受性、药代动力学、免疫原性和药效学:单次递增剂量(第 1 部分)和多次递增剂量(第 2 部分)。在比利时、荷兰、西班牙和德国的 7 个研究机构;日本的 1 个研究机构。参加者首次人体试验的第一部分共招募了 40 名 55-75 岁的健康参加者;第二部分共招募了 16 名健康参加者和 13 名 55-80 岁的前驱或轻度 AD 患者。在日本的试验中,共有 24 名年龄在 55-75 岁之间的参与者参加。干预在第 1 部分中,健康参与者服用单剂量 1、3、10、30 或 60 mg/kg 的 JNJ-63733657 或安慰剂。在第二部分中,健康参与者接受了两个剂量水平(5 毫克/千克或 50 毫克/千克)的 JNJ-63733657 或安慰剂的评估,阿尔茨海默氏症患者接受了两个剂量水平(15 毫克/千克或 30 毫克/千克)的 JNJ-63733657 或安慰剂的评估;剂量分别在第 1、29 和 57 天给药。在日本的试验中,JNJ-63733675 或安慰剂的单剂量分别为 3、15 或 60 毫克/千克。结果JNJ-63733657在健康参与者和阿尔茨海默病患者中总体安全且耐受性良好。在健康人和阿尔茨海默病患者体内,JNJ-63733657 表现出线性 PK,单次和多次给药后血清 Cmax 和 AUC 大致与剂量成正比。观察到脑脊液中游离和总 p217+tau 呈剂量依赖性降低。结论在这些 1 期试验中,没有发现安全性或耐受性方面的问题,而且在服用 JNJ-63733657 后,脑脊液中 p217+tau 的减少呈剂量依赖性。安全性和生物标志物特征支持继续研究这种化合物,以减缓阿尔茨海默病的病情发展。
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引用次数: 0
Roles of TREM2 in the Pathological Mechanism and the Therapeutic Strategies of Alzheimer’s Disease TREM2 在阿尔茨海默病的病理机制和治疗策略中的作用
IF 6.4 Q2 BUSINESS Pub Date : 2024-09-10 DOI: 10.14283/jpad.2024.164
M. Lin, J.-X. Yu, W.-X. Zhang, F.-X. Lao, Han-Chang Huang

Alzheimer’s disease (AD) is an age-related degenerative disease, which is characteristic by the deposition of senile plaques (SP) outside the cells, the neurofibrillary tangles (NFTs) inside the neurons, and the loss of synapse and neurons. Neuroinflammation may play an important role in the pathogenesis of AD. Microglia are the immune cells in the central nervous system. However, microglia might become disease-related microglia (DAMs) when stimulated by the external environment. DAMs have been shown to be involved in a series of events of AD development including Aβ accumulation and tau phosphorylation. The triggering receptor expressed on myeloid cells 2 (TREM2) is a transmembrane receptor that is mainly expressed by microglia in the central nervous system (CNS). TREM2 plays an important role in the physiological function of microglia, and the dyshomeostasis of TREM2 is related to the development of late-onset AD. This article summarized the latest advances in TREM2 biology and its impact on the roles of microglia in AD development, with a particular emphasis on the structure, ligands, signal transduction, and the agonistic antibodies of TREM2 for AD treatment. We further discussed the survival, migration, phagocytosis, inflammation, and cellular metabolism of microglia, as well as the role of sTREM2 in neuroprotection and as a biomarker for AD. It provides a reference for further research on the molecular mechanism of microglial TREM2 in the occurrence and development of AD and on the therapeutic strategies targeted on the microglial TREM2.

阿尔茨海默病(AD)是一种与年龄有关的退行性疾病,其特征是细胞外沉积老年斑(SP)、神经元内沉积神经纤维缠结(NFT)以及突触和神经元的丧失。神经炎症可能在老年痴呆症的发病机制中扮演重要角色。小胶质细胞是中枢神经系统中的免疫细胞。然而,当受到外部环境刺激时,小胶质细胞可能会变成与疾病相关的小胶质细胞(DAMs)。已有研究表明,小胶质细胞参与了AD发展过程中的一系列事件,包括Aβ积累和tau磷酸化。髓系细胞上表达的触发受体 2(TREM2)是一种跨膜受体,主要由中枢神经系统(CNS)中的小胶质细胞表达。TREM2在小胶质细胞的生理功能中发挥着重要作用,而TREM2的失衡与晚发性AD的发病有关。本文总结了TREM2生物学的最新进展及其对小胶质细胞在AD发展中的作用的影响,特别强调了TREM2的结构、配体、信号转导和用于AD治疗的激动抗体。我们进一步讨论了小胶质细胞的存活、迁移、吞噬、炎症和细胞代谢,以及 sTREM2 在神经保护和作为 AD 生物标志物中的作用。它为进一步研究小胶质细胞TREM2在AD发生和发展中的分子机制以及针对小胶质细胞TREM2的治疗策略提供了参考。
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引用次数: 0
Development and Validation the Mobile Toolbox (MTB) Spelling Test 移动工具箱(MTB)拼写测试的开发与验证
IF 6.4 Q2 BUSINESS Pub Date : 2024-09-04 DOI: 10.14283/jpad.2024.158
E. LaForte, Stephanie Ruth Young, E. M. Dworak, M. A. Novack, A. J. Kaat, H. Adam, C. J. Nowinski, Z. Hosseinian, J. Slotkin, S. Amagai, M. V. Diaz, A. A. Correa, K. Alperin, M. Camacho, B. Landavazo, R. Nosheny, M. W. Weiner, R. M. Gershon

Background

Spelling assessments can provide a valuable marker of cognitive change in Alzheimer’s disease and related dementias (ADRD) and play an important role in ADRD research. However, most commercial assessments are not well-suited to the needs of researchers or participants; they are expensive and often require face-to-face administration by a trained examiner. To help overcome these barriers and foster progress in ADRD research, the National Institute on Aging (NIA)-funded Mobile Toolbox (MTB) offers a library of cognitive measures that can be self-administered remotely on a participant’s own smartphone, including a brand-new Spelling test.

Objective

The goal of this paper is to describe the design, piloting, calibration, and validation of the MTB Spelling test.

Design

We describe a pilot study, calibration study, and three validation studies, all of which use a cross-sectional design.

Setting

The pilot study, calibration study, and validation studies 2 and 3 were conducted remotely, while validation study 1 was conducted in the lab.

Participants

Participants for all of the studies were recruited from the general population by a thirdparty market research firm and the samples were stratified by age, gender, race, ethnicity, and education to represent the U.S. population. The pilot sample included 1,950 participants and the calibration study included 1335 participants over the age of 8. Validation study 1 included 92 participants ages 20 to 84, validation study 2 included 1021 participants ages 18 to 90, and validation study 3 included 168 participants ages 28 to 87.

Measurements

Participants in each of the studies completed the MTB Spelling test. Participants in validation studies 1 and 2 completed measures from the NIH Toolbox including Oral Reading Recognition as a measure of convergent validity, and Visual Reasoning and the Rey Auditory Verbal Learning as measures of divergent validity. As an additional measure of convergent validity, participants in study 1 also completed the Spelling subtest from the Wechsler Individual Achievement Test, 4th Edition.

Results

The MTB Spelling test demonstrated evidence of internal consistency (r=.79 to.83) convergent validity (r=.56 to.81, p<.01), discriminant validity (r =.23 to.36, p <.01), test-retest reliability (ICC=.63), and correlations with normal cognitive aging (r = −.06 to −.04, p >.01).

Conclusion

Findings suggest the MTB Spelling test is a reliable and valid measure of English spelling abilities in general population samples, and has potential in ADRD research.

背景拼写评估可以作为阿尔茨海默病和相关痴呆症(ADRD)认知变化的重要标志,在 ADRD 研究中发挥着重要作用。然而,大多数商业评估并不能很好地满足研究人员或参与者的需求;它们价格昂贵,而且通常需要训练有素的考官进行面对面的管理。为了帮助克服这些障碍并促进 ADRD 研究的进展,由美国国家老龄化研究所(NIA)资助的移动工具箱(MTB)提供了一个认知测量库,可以在参与者自己的智能手机上进行远程自我管理,其中包括一个全新的拼写测试。设计我们介绍了一项试点研究、校准研究和三项验证研究,所有研究均采用横断面设计。环境试点研究、校准研究、验证研究 2 和 3 是远程进行的,而验证研究 1 是在实验室进行的。参与者所有研究的参与者都是由第三方市场调研公司从普通人群中招募的,样本按年龄、性别、种族、民族和教育程度进行了分层,以代表美国人口。试验样本包括 1,950 名参与者,校准研究包括 1335 名 8 岁以上的参与者。 验证研究 1 包括 92 名 20 至 84 岁的参与者,验证研究 2 包括 1021 名 18 至 90 岁的参与者,验证研究 3 包括 168 名 28 至 87 岁的参与者。验证研究 1 和 2 的参与者都完成了 NIH 工具箱中的测量项目,其中包括作为聚合效度测量项目的口语阅读识别,以及作为发散效度测量项目的视觉推理和雷伊听觉言语学习。作为收敛效度的额外测量,研究 1 的参与者还完成了韦氏个人成就测验第四版中的拼写分测验。结果MTB 拼写测验显示了内部一致性(r=.79 至.83)、收敛效度(r=.56 至.81,p<.01)、区分效度(r=.23 至.36、结论研究结果表明,在普通人群样本中,MTB 拼写测试是一种可靠、有效的英语拼写能力测量方法,在 ADRD 研究中具有潜力。
{"title":"Development and Validation the Mobile Toolbox (MTB) Spelling Test","authors":"E. LaForte, Stephanie Ruth Young, E. M. Dworak, M. A. Novack, A. J. Kaat, H. Adam, C. J. Nowinski, Z. Hosseinian, J. Slotkin, S. Amagai, M. V. Diaz, A. A. Correa, K. Alperin, M. Camacho, B. Landavazo, R. Nosheny, M. W. Weiner, R. M. Gershon","doi":"10.14283/jpad.2024.158","DOIUrl":"https://doi.org/10.14283/jpad.2024.158","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Spelling assessments can provide a valuable marker of cognitive change in Alzheimer’s disease and related dementias (ADRD) and play an important role in ADRD research. However, most commercial assessments are not well-suited to the needs of researchers or participants; they are expensive and often require face-to-face administration by a trained examiner. To help overcome these barriers and foster progress in ADRD research, the National Institute on Aging (NIA)-funded Mobile Toolbox (MTB) offers a library of cognitive measures that can be self-administered remotely on a participant’s own smartphone, including a brand-new Spelling test.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>The goal of this paper is to describe the design, piloting, calibration, and validation of the MTB Spelling test.</p><h3 data-test=\"abstract-sub-heading\">Design</h3><p>We describe a pilot study, calibration study, and three validation studies, all of which use a cross-sectional design.</p><h3 data-test=\"abstract-sub-heading\">Setting</h3><p>The pilot study, calibration study, and validation studies 2 and 3 were conducted remotely, while validation study 1 was conducted in the lab.</p><h3 data-test=\"abstract-sub-heading\">Participants</h3><p>Participants for all of the studies were recruited from the general population by a thirdparty market research firm and the samples were stratified by age, gender, race, ethnicity, and education to represent the U.S. population. The pilot sample included 1,950 participants and the calibration study included 1335 participants over the age of 8. Validation study 1 included 92 participants ages 20 to 84, validation study 2 included 1021 participants ages 18 to 90, and validation study 3 included 168 participants ages 28 to 87.</p><h3 data-test=\"abstract-sub-heading\">Measurements</h3><p>Participants in each of the studies completed the MTB Spelling test. Participants in validation studies 1 and 2 completed measures from the NIH Toolbox including Oral Reading Recognition as a measure of convergent validity, and Visual Reasoning and the Rey Auditory Verbal Learning as measures of divergent validity. As an additional measure of convergent validity, participants in study 1 also completed the Spelling subtest from the Wechsler Individual Achievement Test, 4th Edition.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The MTB Spelling test demonstrated evidence of internal consistency (r=.79 to.83) convergent validity (r=.56 to.81, p&lt;.01), discriminant validity (r =.23 to.36, p &lt;.01), test-retest reliability (ICC=.63), and correlations with normal cognitive aging (r = −.06 to −.04, p &gt;.01).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Findings suggest the MTB Spelling test is a reliable and valid measure of English spelling abilities in general population samples, and has potential in ADRD research.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"69 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correlates of Subjective Cognitive Decline in Black American Men 美国黑人男性主观认知能力下降的相关因素
IF 6.4 Q2 BUSINESS Pub Date : 2024-09-04 DOI: 10.14283/jpad.2024.162
Darlingtina K. Esiaka, C. Nwakasi, A. Q. Briggs, D. F. Conserve, R. J. Thorpe

Background

Past research suggests that subjective cognitive decline serves as an early and potentially important indicator that individuals may be at risk for future cognitive decline or neurodegenerative conditions. However, there is a dearth of studies on factors influencing the experience of subjective cognitive decline in Black Americans, especially in Black American men.

Objective

The current study explored correlates of subjective cognitive decline in Black American men.

Participants

A total of 117 Black American men, with a mean age of 38.5 (SD = 7.14) years, participated in the study.

Measurement

Participants completed a survey that assessed their demographic characteristics, self-rated health, neighborhood problems, length of residency in neighborhood, bodily symptoms, sleep comorbidities, sleep difficulties, and subjective cognitive decline. Linear regression analyses was performed and standardized beta coefficients were reported to describe the estimated independent effect of the predictor variables.

Results

We found that socioecomic status (β = −.222, p=.003), bodily symptoms (β =.246, p=.005), length of residency in neighborhood (β =.157, p=.029), and sleep difficulties (β =.305, p<.001) were significant correlates of subjective cognitive decline among Black American men.

Conclusion

These findings underscore the intricate roles of socioeconomic status, bodily symptoms, neighborhood factors, and sleep health in shaping subjective cognitive experiences in this population. Research on subjective cognitive decline can contribute to the early identification of individuals at risk for cognitive decline, allowing for timely interventions, lifestyle modifications, and potential preventive measures.

背景过去的研究表明,主观认知能力下降是个人可能面临未来认知能力下降或神经退行性疾病风险的一个早期且潜在的重要指标。然而,有关影响美国黑人,尤其是美国黑人男性主观认知能力下降的因素的研究却非常缺乏。测量参与者完成了一项调查,该调查评估了他们的人口统计学特征、自评健康状况、邻里问题、邻里居住时间、身体症状、睡眠合并症、睡眠困难和主观认知能力下降。结果我们发现,社会经济状况(β = -.222,p=.003)、身体症状(β =.246,p=.005)、邻里居住时间(β =.157,p=.结论这些发现强调了社会经济地位、身体症状、邻里因素和睡眠健康在影响该人群主观认知体验方面的复杂作用。对主观认知能力下降的研究有助于及早发现有认知能力下降风险的人群,以便及时采取干预措施、生活方式调整和潜在的预防措施。
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引用次数: 0
Initial Experience with Lecanemab and Lessons Learned in 71 Patients in a Regional Medical Center 一家地区医疗中心 71 名患者使用来卡尼单抗的初步经验和汲取的教训
IF 6.4 Q2 BUSINESS Pub Date : 2024-09-03 DOI: 10.14283/jpad.2024.159
L. B. E. Shields, H. Hust, S. D. Cooley, G. E. Cooper, R. N. Hart, B. C. Dennis, S. W. Freeman, J. F. Cain, W. Y. Shang, K. M. Wasz, A. T. Orr, C. B. Shields, S. S. Barve, Kenneth G. Pugh

Background and Objectives

On July 6, 2023 the U.S. Food and Drug Administration approved the anti-amyloid monoclonal antibody lecanemab (Leqembi®) for treatment of patients with mild cognitive impairment or mild dementia due to Alzheimer’s disease (AD). Our early experience and lessons learned with lecanemab in a regional community medical center are described.

Design, Setting, and Participants

This retrospective observational study highlights the first 71 patients treated with lecanemab at our multidisciplinary Norton Neuroscience Institute Memory Center. All patients had positive cerebrospinal fluid biomarkers for AD and underwent at least 1 lecanemab infusion. Two patients had additional amyloid PET scans which were positive.

Results

The mean age was 72 years (49–90 years), and 44 (62%) patients were female. Most were Caucasian (68 [96%]), and 54 [76%] were referred to our Memory Center by their primary care provider. Comorbidities were common, including hypertension (34 [48%]), hypercholesterolemia (51 [72%]), diabetes mellitus (17 [24%]), and cardiovascular disease excluding hypertension (22 [31%]). The mean body mass index was 27.0 (range: 17.8–45.0). A total of 36 (51%) patients were heterozygous for the ApoE4 genotype, and 9 (13%) were homozygous. A total of 61 [86%] patients had been treated with donepezil; 40 (56%) patients had received memantine. Of the 50 patients who completed 1 or more safety monitoring brain MRIs following infusion, 12 (24%) had amyloid-related imaging abnormalities (ARIA) detected: solitary ARIA-H (hemorrhage) in 5, solitary ARIA-E (edema) in 3, and both ARIA-H and ARIA-E in 4. Of the 12 patients with ARIA, 9 were asymptomatic, 4 were homozygous for the ApoE4 genotype, and 6 were heterozygous for the ApoE4 genotype. Of the 9 who were homozygous for the ApoE4 genotype in this study, 4 (44%) had evidence of ARIA. Of the 36 who were heterozygous for the ApoE4 genotype, 6 (17%) were diagnosed with ARIA. Twenty-six (37%) patients experienced infusion reactions after their first lecanemab infusion: headaches (12 patients) and shaking/chills/rigors (11 patients) were most common. Twenty-three (88%) of these 26 patients reported the side effects either at the infusion center or within the first 24 hours post-infusion. One patient died shortly after the first lecanemab infusion of a myocardial infarction. It is uncertain whether or not this death was related to lecanemab treatment.

Conclusion

Through our early experience with lecanemab, we have recognized several areas of improvement which have clarified and enhanced the lecanemab infusion experience.

背景和目的2023年7月6日,美国食品和药物管理局批准了抗淀粉样蛋白单克隆抗体来卡尼单抗(Leqembi®),用于治疗阿尔茨海默病(AD)引起的轻度认知障碍或轻度痴呆患者。本回顾性观察研究重点介绍了诺顿神经科学研究所记忆中心多学科联合治疗的首批 71 例莱卡尼单抗患者。所有患者的 AD 脑脊液生物标志物均呈阳性,并接受了至少一次左卡尼单抗输注。结果平均年龄为 72 岁(49-90 岁),44 名(62%)患者为女性。大多数患者为白种人(68[96%]),54[76%]名患者由主治医生转介到我们的记忆中心。合并症很常见,包括高血压(34 [48%])、高胆固醇血症(51 [72%])、糖尿病(17 [24%])和心血管疾病(不包括高血压)(22 [31%])。平均体重指数为 27.0(范围:17.8-45.0)。共有 36 名患者(51%)为载脂蛋白 E4 基因型杂合子,9 名患者(13%)为同型杂合子。共有 61 名(86%)患者接受过多奈哌齐治疗;40 名(56%)患者接受过美金刚治疗。在输液后完成一次或多次安全性监测脑磁共振成像的 50 名患者中,有 12 人(24%)检测到淀粉样蛋白相关成像异常 (ARIA):5 人出现单发 ARIA-H(出血),3 人出现单发 ARIA-E(水肿),4 人同时出现 ARIA-H 和 ARIA-E。在 12 名 ARIA 患者中,9 人无症状,4 人是 ApoE4 基因型的同卵双生者,6 人是 ApoE4 基因型的异卵双生者。在本研究中,9 名 ApoE4 基因型的同卵双生者中,有 4 人(44%)有 ARIA 的证据。在 36 名 ApoE4 基因型杂合子患者中,有 6 人(17%)被诊断为 ARIA。26名患者(37%)在首次输注来卡尼单抗后出现了输注反应:最常见的反应是头痛(12名)和发抖/发冷/恶心(11名)。这 26 名患者中有 23 人(88%)在输液中心或输液后 24 小时内报告了副作用。一名患者在首次输注莱卡奈单抗后不久死于心肌梗死。结论通过使用利卡尼单抗的早期经验,我们认识到了几个需要改进的方面,这些改进澄清并改善了利卡尼单抗的输注体验。
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引用次数: 0
Views and Perceptions of Amyloid Imaging in a Preclinical Alzheimer’s Disease Trial 临床前阿尔茨海默病试验中对淀粉样蛋白成像的看法和认知
IF 6.4 Q2 BUSINESS Pub Date : 2024-09-03 DOI: 10.14283/jpad.2024.157
Marina Ritchie, R. Raman, K. Ernstrom, S. Wang, M. C. Donohue, P. Aisen, D. Henley, G. Romano, G. P. Novak, H. R. Brashear, R. A. Sperling, J. D. Grill

Background

Many cognitively unimpaired older adults are interested in learning their Alzheimer’s disease (AD) biomarker status, but little is known about motivations to undergo biomarker testing and result disclosure in the setting of preclinical AD trials.

Objectives

Examine whether motivations to undergo AD biomarker testing and disclosure differ for individuals who have elevated amyloid compared to those with not elevated amyloid, and whether disclosure of amyloid results impacts participants’ motivations.

Design, Setting, Participants

We conducted post-hoc analyses using data from the EARLY study, a preclinical AD trial of the beta-secretase inhibitor atabecestat. As part of the screening process of the trial, participants underwent biomarker testing and disclosure. We analyzed data from n=2241 participants.

Measurements

We analyzed data from the Views and Perceptions of Amyloid Imaging (VPAI), a 9-item questionnaire assessing how strongly participants agreed with motivating factors for undergoing amyloid testing. The VPAI was administered at the first screening visit and again after amyloid disclosure.

Results

Prior to amyloid disclosure, a greater proportion of participants in the elevated amyloid group responded at the two highest levels of endorsement for the items, “to confirm the feeling that I might already be developing symptoms of AD dementia” (p<0.001) and “to prepare my family for my possible illness in the future” (p=0.008), compared to participants in the not elevated amyloid group. Following disclosure, the not elevated amyloid group had higher odds of positive change in categorical VPAI item level scores for the items “to put mind at ease” (OR: 0.54; p<0.001), “to confirm the feeling that I might already be developing symptoms of AD dementia” (OR: 0.79; p=0.049), and “to prepare my family for my possible illness in the future” (OR: 0.67; p=<0.001), while the elevated amyloid group had higher odds of positive change for the item “curiosity” (OR:1.32; p=0.014).

Conclusions

Investigators might consider adjusting recruitment strategies for future trials to align with the motivations to undergo biomarker testing and disclosure most strongly endorsed by participants with elevated amyloid.

背景许多认知功能未受损的老年人对了解自己的阿尔茨海默病(AD)生物标志物状态很感兴趣,但在临床前AD试验中,人们对接受生物标志物检测和结果披露的动机知之甚少。目的探讨与淀粉样蛋白未升高者相比,淀粉样蛋白升高者接受AD生物标志物检测和结果披露的动机是否不同,以及淀粉样蛋白结果披露是否会影响参与者的动机。作为试验筛选过程的一部分,参与者接受了生物标志物检测并进行了信息披露。我们分析了2241名参与者的数据。我们分析了淀粉样蛋白成像的观点和看法(VPAI)的数据,这是一份由9个项目组成的问卷,评估参与者对接受淀粉样蛋白检测的动机因素的认同程度。结果与淀粉样蛋白未升高组的参与者相比,淀粉样蛋白升高组的参与者在 "确认我可能已经出现了AD痴呆症的症状"(p<0.001)和 "让我的家人为我将来可能患病做好准备"(p=0.008)这两个最高认可度的项目上,在淀粉样蛋白升高组的参与者中所占的比例更大。披露后,未升高淀粉样蛋白组在 "让我安心"(OR:0.54;p<0.001)、"确认我可能已经出现 AD 痴呆症状"(OR:0.79;p=0.049)和 "让我的家人为我将来可能患病做好准备"(OR:0.结论研究者可以考虑调整未来试验的招募策略,以符合淀粉样蛋白升高参与者最强烈认可的生物标记物检测和信息披露动机。
{"title":"Views and Perceptions of Amyloid Imaging in a Preclinical Alzheimer’s Disease Trial","authors":"Marina Ritchie, R. Raman, K. Ernstrom, S. Wang, M. C. Donohue, P. Aisen, D. Henley, G. Romano, G. P. Novak, H. R. Brashear, R. A. Sperling, J. D. Grill","doi":"10.14283/jpad.2024.157","DOIUrl":"https://doi.org/10.14283/jpad.2024.157","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Many cognitively unimpaired older adults are interested in learning their Alzheimer’s disease (AD) biomarker status, but little is known about motivations to undergo biomarker testing and result disclosure in the setting of preclinical AD trials.</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>Examine whether motivations to undergo AD biomarker testing and disclosure differ for individuals who have elevated amyloid compared to those with not elevated amyloid, and whether disclosure of amyloid results impacts participants’ motivations.</p><h3 data-test=\"abstract-sub-heading\">Design, Setting, Participants</h3><p>We conducted post-hoc analyses using data from the EARLY study, a preclinical AD trial of the beta-secretase inhibitor atabecestat. As part of the screening process of the trial, participants underwent biomarker testing and disclosure. We analyzed data from n=2241 participants.</p><h3 data-test=\"abstract-sub-heading\">Measurements</h3><p>We analyzed data from the Views and Perceptions of Amyloid Imaging (VPAI), a 9-item questionnaire assessing how strongly participants agreed with motivating factors for undergoing amyloid testing. The VPAI was administered at the first screening visit and again after amyloid disclosure.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Prior to amyloid disclosure, a greater proportion of participants in the elevated amyloid group responded at the two highest levels of endorsement for the items, “to confirm the feeling that I might already be developing symptoms of AD dementia” (p&lt;0.001) and “to prepare my family for my possible illness in the future” (p=0.008), compared to participants in the not elevated amyloid group. Following disclosure, the not elevated amyloid group had higher odds of positive change in categorical VPAI item level scores for the items “to put mind at ease” (OR: 0.54; p&lt;0.001), “to confirm the feeling that I might already be developing symptoms of AD dementia” (OR: 0.79; p=0.049), and “to prepare my family for my possible illness in the future” (OR: 0.67; p=&lt;0.001), while the elevated amyloid group had higher odds of positive change for the item “curiosity” (OR:1.32; p=0.014).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Investigators might consider adjusting recruitment strategies for future trials to align with the motivations to undergo biomarker testing and disclosure most strongly endorsed by participants with elevated amyloid.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"7 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142197469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quantifying Personalized Shift-Work Molecular Portraits Underlying Alzheimer’s Disease through Computational Biology 通过计算生物学量化阿尔茨海默病的个性化转变工作分子特征
IF 6.4 Q2 BUSINESS Pub Date : 2024-09-03 DOI: 10.14283/jpad.2024.161
Y. Xu, G. Zhang, L. Yang, H. Qin, Z. Zhou, Q. Li, H. Liu, R. Wang, Z. Cai, L. Jing, Y. Li, Y. Yao, Z. Gong, P. Yuan, T. Fu, X. Zhao, Tao Peng, Yanjie Jia

Background

Shift work, the proven circadian rhythm-disrupting behavior, has been linked to the increased risk of Alzheimer’s disease (AD). However, the putative causal effect and potential mechanisms of shift work for AD were still unclear.

Methods

Mendelian randomization (MR) analysis was performed to discover the putative causal effect of shift work for AD. Expression quantitative trait loci (eQTLs) and transcriptome data were integrated to identify genes causally associated with AD from circadian-related genes. An in vitro experiment was also conducted to validate the expression of target genes. Based on the identified genes, a novel integrative program and 4,077 samples from 16 microarray datasets were leveraged to assess the extent of circadian rhythm disruption (CRD), defined as the clock deviation level (CDL).

Findings/Results

Shift work causally increased the risk of AD [odds ratio (OR) = 2.49, 95% CI = 1.79 - 3.19, p = 0.01]. Seven circadian-related genes were causally associated with AD, including CCS, CDS2, MYRIP, NRP1, PLEKHA5, POLR1D, and PPP4C. These genes were significantly correlated with the circadian rhythm pathway. CDL was higher in CRD mice group, shift work group, sleep restriction group, and AD patients compared to control mice group (p = 0.043), non-shift group (p = 0.004), sleep extension group (p = 0.025), and health controls (multiple cohorts, p < 0.05). Additionally, CDL was also significantly correlated with AD’s clinical biomarkers.

Interpretations/Conclusion

By combining GWAS and transcriptome data, this study demonstrated the causal role of CRD behavior in AD, identified the potential target genes in shift work-induced AD, and generated CDL to characterize CRD status, which provided evidence and prospects for disease prevention and future therapeutic interventions.

背景轮班工作是已被证实会破坏昼夜节律的行为,它与阿尔茨海默病(AD)患病风险的增加有关。然而,轮班工作对阿尔茨海默病的假定因果效应和潜在机制仍不清楚。方法为了发现轮班工作对阿尔茨海默病的假定因果效应,研究人员进行了孟德尔随机化(MR)分析。通过整合表达定量性状位点(eQTLs)和转录组数据,从昼夜节律相关基因中找出与AD有因果关系的基因。同时还进行了体外实验来验证目标基因的表达。根据确定的基因,利用新的整合程序和来自 16 个微阵列数据集的 4,077 个样本来评估昼夜节律紊乱(CRD)的程度,即时钟偏差水平(CDL)。7个昼夜节律相关基因与AD存在因果关系,包括CCS、CDS2、MYRIP、NRP1、PLEKHA5、POLR1D和PPP4C。这些基因与昼夜节律途径明显相关。与对照小鼠组(p = 0.043)、非轮班组(p = 0.004)、睡眠延长组(p = 0.025)和健康对照组(多个队列,p <0.05)相比,CRD小鼠组、轮班工作组、睡眠限制组和AD患者的CDL更高。此外,CDL还与AD的临床生物标志物显著相关。解释/结论本研究通过结合GWAS和转录组数据,证明了CRD行为在AD中的因果作用,确定了轮班工作诱发AD的潜在靶基因,并生成了表征CRD状态的CDL,为疾病预防和未来的治疗干预提供了证据和前景。
{"title":"Quantifying Personalized Shift-Work Molecular Portraits Underlying Alzheimer’s Disease through Computational Biology","authors":"Y. Xu, G. Zhang, L. Yang, H. Qin, Z. Zhou, Q. Li, H. Liu, R. Wang, Z. Cai, L. Jing, Y. Li, Y. Yao, Z. Gong, P. Yuan, T. Fu, X. Zhao, Tao Peng, Yanjie Jia","doi":"10.14283/jpad.2024.161","DOIUrl":"https://doi.org/10.14283/jpad.2024.161","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Shift work, the proven circadian rhythm-disrupting behavior, has been linked to the increased risk of Alzheimer’s disease (AD). However, the putative causal effect and potential mechanisms of shift work for AD were still unclear.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Mendelian randomization (MR) analysis was performed to discover the putative causal effect of shift work for AD. Expression quantitative trait loci (eQTLs) and transcriptome data were integrated to identify genes causally associated with AD from circadian-related genes. An in vitro experiment was also conducted to validate the expression of target genes. Based on the identified genes, a novel integrative program and 4,077 samples from 16 microarray datasets were leveraged to assess the extent of circadian rhythm disruption (CRD), defined as the clock deviation level (CDL).</p><h3 data-test=\"abstract-sub-heading\">Findings/Results</h3><p>Shift work causally increased the risk of AD [odds ratio (OR) = 2.49, 95% CI = 1.79 - 3.19, p = 0.01]. Seven circadian-related genes were causally associated with AD, including CCS, CDS2, MYRIP, NRP1, PLEKHA5, POLR1D, and PPP4C. These genes were significantly correlated with the circadian rhythm pathway. CDL was higher in CRD mice group, shift work group, sleep restriction group, and AD patients compared to control mice group (p = 0.043), non-shift group (p = 0.004), sleep extension group (p = 0.025), and health controls (multiple cohorts, p &lt; 0.05). Additionally, CDL was also significantly correlated with AD’s clinical biomarkers.</p><h3 data-test=\"abstract-sub-heading\">Interpretations/Conclusion</h3><p>By combining GWAS and transcriptome data, this study demonstrated the causal role of CRD behavior in AD, identified the potential target genes in shift work-induced AD, and generated CDL to characterize CRD status, which provided evidence and prospects for disease prevention and future therapeutic interventions.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"9 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anti-Hypertensives Reduce the Rate of Alzheimer’s Disease Progression: A Cohort Study Linked with Genetic and Neuropathological Analyses 抗高血压药可降低阿尔茨海默病的进展速度:与遗传学和神经病理学分析相关的队列研究
IF 6.4 Q2 BUSINESS Pub Date : 2024-08-26 DOI: 10.14283/jpad.2024.156
Zohara Sternberg, R. Podolsky, J. Yu, S. Hua, S. Halvorsen, D. Hojnacki, B. J. Schaller

Background

Arterial hypertension contributes to both the development and progression of dementia due to both Alzheimer’s disease (A.D.) and vascular pathology. However, the effects of different classes of anti-hypertensives (A.H.T.s), on the rate of dementia progression and brain neuropathology are unknown.

Objective

To investigate the effect of each class of A.H.T., both as single and combined, on the rate of dementia progression. In addition, we analyzed the effect of A.H.T.s on brain neuropathology in AD participants, indicated by Braak staging, hippocampal atrophy, and baseline CSF levels of A-β42, total (T) tau, and P-181 tau.

Methods

We have used the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set (UDS).

Results

A.H.T.s were associated with reduced yearly increase in the CDR-SOB scores of 1.025 during a 10-year follow-up (P<0.001). The overall survival rate was higher in A.H.T. users than non-users [HR: 0.912: 0.860, 0.967) P=0.002]. These trends continued when stratifying participants by age, gender, and APOE4 allele. Participants who did not use A.H.T.s had a mean yearly increase of 1.71±1.7 in the CDR-SOB scores. This value was reduced to 1.48±1.6, P=0.006 and 1.45±1.6, P=0.024 for participants with documented use of βB and A.R.B.s, respectively. Combining diuretics with α1-AB or ACEI led to synergistic effects in reducing the rise in CDR-SOB scores. The proportion of participants who were diagnosed having AD postmortem with severe Braak staging was significantly lower in A.H.T.-users than non-users. The severity of Braak staging, and hippocampal atrophy differed in participants >70 vs. <70 years old, in both males and females. A significant relationship was observed between hippocampal atrophy and Braak staging; and between hippocampal atrophy and baseline CSF levels of P-181 tau.

Conclusion

Our results could have implications for halting the progression of dementia regardless of the etiology being related to AD or vascular pathology. The choice of combination of A.H.T. therapy should also consider the combination which would lead to an optimum benefit in slowing the progression of dementia. Additionally, our results underline a more complex A.D. disease model than previously thought, which opens new treatment options.

背景由于阿尔茨海默病(A.D.)和血管病变,动脉高血压会导致痴呆症的发生和发展。然而,不同类别的抗高血压药(A.H.T.s)对痴呆症进展速度和脑神经病理学的影响尚不清楚。目的 研究各类抗高血压药(包括单药和联合用药)对痴呆症进展速度的影响。此外,我们还分析了A.H.T.对AD患者脑神经病理学的影响,具体表现为布拉克分期、海马萎缩以及A-β42、总(T)tau和P-181 tau的基线CSF水平。方法我们使用了国家阿尔茨海默氏症协调中心(NACC)的统一数据集(UDS)。结果A.H.T.患者的CDR-SOB评分在10年随访期间每年增加1.025分(P<0.001),而A.H.T.患者的CDR-SOB评分每年增加1.025分(P<0.001)。A.H.T.使用者的总生存率高于非使用者[HR:0.912:0.860, 0.967) P=0.002]。按年龄、性别和 APOE4 等位基因对参与者进行分层后,这些趋势依然存在。未使用A.H.T.s的参与者的CDR-SOB评分平均每年增加1.71±1.7分。有记录显示使用βB和A.R.B.s的参与者的这一数值分别降至1.48±1.6(P=0.006)和1.45±1.6(P=0.024)。将利尿剂与α1-AB或ACEI结合使用可产生协同效应,降低CDR-SOB评分的上升。A.H.T.使用者在死后被诊断为AD并伴有严重Braak分期的比例明显低于非使用者。70岁与70岁的男女参与者的布拉克分期严重程度和海马萎缩程度不同。海马萎缩与布拉克分期之间、海马萎缩与P-181 tau的基线CSF水平之间存在明显关系。在选择A.H.T.疗法的组合时,还应考虑能在延缓痴呆症进展方面产生最佳疗效的组合。此外,我们的研究结果还强调了一种比以前认为的更为复杂的急性髓性白血病疾病模型,这为我们提供了新的治疗方案。
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引用次数: 0
Acoustic Speech Analysis in Alzheimer’s Disease: A Systematic Review and Meta-Analysis 阿尔茨海默病的语音声学分析:系统回顾与元分析
IF 6.4 Q2 BUSINESS Pub Date : 2024-08-13 DOI: 10.14283/jpad.2024.132
S. Saeedi, S. Hetjens, M. O. W. Grimm, Ben Barsties v. Latoszek

Background

The potential of biomarkers in the detection of Alzheimer’s disease (AD) is prominent. Acoustics may be useful in this context but the evaluation and weighting for specific acoustic parameters on continuous speech is missing. This meta-analysis aimed to explore the significance of acoustic parameters from acoustic speech analysis on continuous speech, as a diagnostic tool for clinical AD.

Methods

Applying PRISMA protocol, a comprehensive search was done in MEDLINE, Scopus, Web of Science, and CENTRAL, from 1960 to January 2024. Cross-sectional studies comparing the acoustic speech analysis between AD patients and healthy controls (HC), were taken into account. The bias risk of the included studies were examined via JBI checklist. Using Review Manager v.5.4.1, the mean differences of acoustic speech parameters among AD and HC were weighted, and the pooled analysis and the heterogeneity statistics were conducted.

Results

In total, 1112 records (without duplicates) were obtained, and 11 papers with 7 acoustic parameters were included for this study, and 8 from 11 studies were identified with a low level of bias. Five from 7 acoustic parameters revealed significant differences among the two groups (p-values ≤ 0.01), in which for all rate-related and interruption-related acoustic parameters were the most prominent and less in temporal-related acoustic parameters.

Conclusions

Although a small number of acoustic parameters on continuous speech could be evaluated in the detection of clinical AD, the greatest potential of acoustic biomarkers for AD appeared to exist in two of three categories. Further contributions of high-quality studies are needed to support evidence for acoustics as biomarkers for AD.

背景生物标志物在检测阿尔茨海默病(AD)方面的潜力十分突出。声学在这方面可能很有用,但对连续语音的特定声学参数的评估和权重却缺乏。本荟萃分析旨在探讨连续语音声学分析中的声学参数作为临床 AD 诊断工具的意义。方法采用 PRISMA 协议,在 1960 年至 2024 年 1 月期间的 MEDLINE、Scopus、Web of Science 和 CENTRAL 中进行了全面检索。纳入的研究均为横断面研究,比较了 AD 患者和健康对照组(HC)的语音声学分析。纳入研究的偏倚风险通过 JBI 核对表进行检查。使用 Review Manager v.5.4.1,对 AD 和 HC 之间的语音声学参数的平均差异进行加权处理,并进行汇总分析和异质性统计。7个声学参数中有5个在两组间存在显著差异(P值≤0.01),其中与语速相关的声学参数和与中断相关的声学参数最为突出,而与时间相关的声学参数则较少。结论虽然在检测临床AD时可以对连续语音的少量声学参数进行评估,但AD声学生物标志物的最大潜力似乎存在于三类中的两类。需要更多高质量的研究来支持声学作为AD生物标志物的证据。
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引用次数: 0
期刊
The Journal of Prevention of Alzheimer's Disease
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