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Rethinking the detection and diagnosis of Alzheimer’s disease: Outcomes of a European Brain Council project 重新思考阿尔茨海默病的检测和诊断:欧洲大脑理事会项目的结果
Pub Date : 2023-01-01 DOI: 10.1016/j.nbas.2023.100093
Annette Dumas, Frédéric Destrebecq, Giovanni Esposito, Dominika Suchonova, Kristian Steen Frederiksen

Alzheimer’s disease (AD), the most common form of dementia, is a progressive and debilitating neurodegenerative condition which robs people of their memory, their independence, their relationships and, ultimately, their lives. It affects close to 7 million people in the European Union (EU) alone.

The detection and diagnosis of AD relies on a system that remains focused on the late stage of the disease, despite a better understanding of the disease progression. Clinical practice and healthcare systems’ readiness to detect, diagnose and treat the disease effectively are still lagging. The use of biomarkers (cerebrospinal fluid tests (CSF) and positron emission tomography scans (PET)), which are central to a diagnostic assessment for people with AD symptoms, as well as relevant diagnostic facilities are under-utilised. PET imaging is expensive and of limited availability, and CSF sampling may be considered invasive.

The European Brain Council’s ‘Rethinking Alzheimer’s disease: Detection and diagnosis’ White Paper has looked at the barriers to early diagnosis and how the healthcare systems infrastructure for detection and diagnosis of AD need to be transformed in order for people with AD to benefit from innovative solutions once they become approved for use.

阿尔茨海默病(AD)是最常见的痴呆症形式,是一种进行性和使人衰弱的神经退行性疾病,它剥夺了人们的记忆、独立性、人际关系,并最终剥夺了他们的生命。仅在欧盟,它就影响了近700万人。尽管对疾病进展有了更好的了解,但阿尔茨海默病的检测和诊断仍然依赖于一个专注于疾病晚期的系统。临床实践和卫生保健系统在有效检测、诊断和治疗该疾病方面的准备仍然滞后。生物标志物(脑脊液试验(CSF)和正电子发射断层扫描(PET))的使用,以及相关诊断设施的利用不足,这是对AD症状患者进行诊断评估的核心。PET成像昂贵且可用性有限,脑脊液取样可能被认为是侵入性的。欧洲大脑理事会的“重新思考阿尔茨海默病:检测和诊断”白皮书研究了早期诊断的障碍,以及如何改造用于阿尔茨海默病检测和诊断的医疗保健系统基础设施,以便阿尔茨海默病患者在获得批准使用后从创新解决方案中受益。
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引用次数: 0
Urine-derived cells from the aged donor for the 2D/3D modeling of neural cells via iPSCs 老年供者尿液来源的细胞通过iPSCs进行神经细胞的2D/3D建模
Pub Date : 2023-01-01 DOI: 10.1016/j.nbas.2023.100101
Sopak Supakul , Yuki Hatakeyama , Nicolas Leventoux , Maika Itsuno , Naoko Numata , Hayato Hiramine , Satoru Morimoto , Atsushi Iwata , Sumihiro Maeda , Hideyuki Okano

Human neural cell models derived from induced pluripotent stem cells (iPSCs) have been widely accepted to model various neurodegenerative diseases such as Alzheimer’s disease (AD) in vitro. Although the most common sources of iPSCs are fibroblasts and peripheral blood mononuclear cells, the collection of these cells is invasive. To reduce the donor’s burden, we propose the use of urine-derived cells (UDCs), which can be obtained non-invasively from a urine sample. However, the collection of UDCs from elderly donors suffering from age-related diseases such as AD has not been reported, and it is unknown whether these UDCs from the donor aged over 80 years old can be converted into iPSCs and differentiated into neural cells. In this study, we reported a case of using the UDCs from the urine sample of an 89-year-old AD patient, and the UDCs were successfully reprogrammed into iPSCs and differentiated into neural cells in four different ways: (i) the dual SMAD inhibition with small-molecules via the neural progenitor precursor stage, (ii) the rapid induction method using transient expression of Ngn2 and microRNAs without going through the neural progenitor stage, (iii) the cortical brain organoids for 3D culture, and (iv) the human astrocytes. The accumulation of phosphorylated Tau proteins, which is a pathological hallmark of AD, was examined in the neuronal models generated from the UDCs of the aged donor. The application of this cell source will broaden the target population for disease modeling using iPS technology.

由诱导多能干细胞(iPSCs)衍生的人类神经细胞模型已被广泛接受用于体外模拟各种神经退行性疾病,如阿尔茨海默病(AD)。虽然iPSCs最常见的来源是成纤维细胞和外周血单个核细胞,但这些细胞的收集是侵入性的。为了减轻供者的负担,我们建议使用尿源性细胞(UDCs),这种细胞可以从尿液样本中非侵入性地获得。然而,从患有年龄相关疾病(如AD)的老年供体收集UDCs尚未有报道,并且尚不清楚这些来自80岁以上供体的UDCs是否可以转化为iPSCs并分化为神经细胞。在本研究中,我们报道了一例使用来自89岁AD患者尿液样本的UDCs的病例,UDCs成功重编程为iPSCs,并以四种不同的方式分化为神经细胞:(i)通过神经祖细胞前体阶段用小分子双重抑制SMAD, (ii)不经过神经祖细胞阶段使用瞬时表达Ngn2和microrna的快速诱导方法,(iii)用于3D培养的皮质脑类器官,以及(iv)人类星形胶质细胞。磷酸化Tau蛋白的积累是阿尔茨海默病的病理标志,在老年供体UDCs产生的神经元模型中进行了检查。这种细胞源的应用将扩大利用iPS技术进行疾病建模的目标人群。
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引用次数: 0
Brain apolipoprotein E levels in mice challenged by a Western diet increase in an allele-dependent manner 西方饮食刺激小鼠脑载脂蛋白E水平以等位基因依赖的方式增加
Pub Date : 2023-01-01 DOI: 10.1016/j.nbas.2023.100102
Braison Liemisa , Samantha F. Newbury , Mariah J. Novy , Jonathan A. Pasato , Jose Morales-Corraliza , Katherine Y. Peng , Paul M. Mathews

Human apolipoprotein E (APOE) is the greatest determinant of genetic risk for memory deficits and Alzheimer’s disease (AD). While APOE4 drives memory loss and high AD risk, APOE2 leads to healthy brain aging and reduced AD risk compared to the common APOE3 variant. We examined brain APOE protein levels in humanized mice homozygous for these alleles and found baseline levels to be age- and isoform-dependent: APOE2 levels were greater than APOE3, which were greater than APOE4. Despite the understanding that APOE lipoparticles do not traverse the blood–brain barrier, we show that brain APOE levels are responsive to dietary fat intake. Challenging mice for 6 months on a Western diet high in fat and cholesterol increased APOE protein levels in an allele-dependent fashion with a much greater increase within blood plasma than within the brain. In the brain, APOE2 levels responded most to the Western diet challenge, increasing by 20 % to 30 %. While increased lipoparticles are generally deleterious in the periphery, we propose that higher brain APOE2 levels may represent a readily available pool of beneficial lipid particles for neurons.

人类载脂蛋白E (APOE)是记忆缺陷和阿尔茨海默病(AD)遗传风险的最大决定因素。与常见的APOE3变体相比,APOE4导致记忆丧失和高AD风险,而APOE2导致健康的大脑衰老和降低AD风险。我们检测了这些等位基因纯合的人源化小鼠的脑APOE蛋白水平,发现基线水平与年龄和同型异构体相关:APOE2水平高于APOE3, APOE3高于APOE4。尽管我们知道APOE脂质颗粒不会穿过血脑屏障,但我们发现大脑APOE水平对饮食脂肪摄入量有反应。用高脂肪和高胆固醇的西方饮食挑战小鼠6个月,APOE蛋白水平以等位基因依赖的方式增加,血浆中的APOE蛋白水平比大脑中的增加要大得多。在大脑中,APOE2水平对西方饮食的挑战反应最大,增加了20%到30%。虽然增加的脂质颗粒在外周通常是有害的,但我们认为较高的脑APOE2水平可能代表了一个容易获得的有益于神经元的脂质颗粒池。
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引用次数: 0
Monitoring clusterin and fibrillar structures in aging and dementia 监测衰老和痴呆中的聚集蛋白和纤维结构
Pub Date : 2023-01-01 DOI: 10.1016/j.nbas.2023.100080
Dário Trindade, Maria Cachide, Tânia Soares Martins, Sandra Guedes, Ilka M. Rosa, Odete A.B. da Cruz e Silva, Ana Gabriela Henriques

Objective

Clusterin is involved in a variety of physiological processes, including proteostasis. Several clusterin polymorphisms were associated with an increased risk of developing Alzheimer’s disease, the world-leading cause of dementia. Herein, the effect of a clusterin polymorphism, aging and dementia in the levels of clusterin in human plasma were analysed in a primary care-based cohort, and the association of this chaperone with fibrillar structures discussed.

Methods

64 individuals with dementia (CDR≥1) and 64 age- and sex-matched Controls from a Portuguese cohort were genotyped for CLU rs1136000 polymorphism, and the plasma levels of clusterin and fibrils were assessed.

Results

An increased prevalence of the CC genotype was observed for the dementia group, although no significant robustness was achieved. CLU rs11136000 SNP did not significantly change plasma clusterin levels in demented individuals. Instead, clusterin levels decreased with aging and even more in individuals with dementia. Importantly, plasma clusterin levels correlated with the presence of fibrillar structures in Control individuals, but not in those with dementia.

Conclusion

This study reveals a significant decrease in plasma clusterin in demented individuals with aging, which related to altered clusterin-fibrils dynamics. Potentially, plasma clusterin and its association with fibrillar structures can be used to monitor dementia progression along aging.

目的Clusterin参与多种生理过程,包括蛋白稳定。几个聚类蛋白多态性与阿尔茨海默病的风险增加有关,阿尔茨海默病是世界上痴呆症的主要病因。在此,在一个基于初级保健的队列中分析了聚类素多态性、衰老和痴呆对人类血浆中聚类素水平的影响,并讨论了这种伴侣与原纤维结构的关系。方法对来自葡萄牙队列的64名痴呆(CDR≥1)患者和64名年龄和性别匹配的对照进行CLU rs1136000多态性的基因分型,并评估血浆簇蛋白和原纤维水平。结果痴呆组CC基因型的患病率增加,尽管没有达到显著的稳健性。CLU rs11136000 SNP没有显著改变痴呆个体的血浆聚集蛋白水平。相反,clusterin水平随着年龄的增长而下降,痴呆患者的clusterin水平甚至更高。重要的是,对照组的血浆聚集蛋白水平与原纤维结构的存在相关,而痴呆组则不然。结论本研究显示,随着年龄的增长,痴呆患者的血浆聚集蛋白显著降低,这与聚集蛋白原纤维动力学的改变有关。血浆团簇蛋白及其与原纤维结构的相关性可用于监测痴呆症随年龄的进展。
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引用次数: 0
To sleep or not to sleep – Effects on memory in normal aging and disease 睡觉还是不睡觉——正常衰老和疾病对记忆的影响
Pub Date : 2023-01-01 DOI: 10.1016/j.nbas.2023.100068
Daniel Kroeger , Ramalingam Vetrivelan

Sleep behavior undergoes significant changes across the lifespan, and aging is associated with marked alterations in sleep amounts and quality. The primary sleep changes in healthy older adults include a shift in sleep timing, reduced slow-wave sleep, and impaired sleep maintenance. However, neurodegenerative and psychiatric disorders are more common among the elderly, which further worsen their sleep health. Irrespective of the cause, insufficient sleep adversely affects various bodily functions including energy metabolism, mood, and cognition. In this review, we will focus on the cognitive changes associated with inadequate sleep during normal aging and the underlying neural mechanisms.

睡眠行为在一生中都会发生重大变化,而衰老与睡眠量和质量的显著变化有关。健康老年人的主要睡眠变化包括睡眠时间的改变、慢波睡眠减少和睡眠维持受损。然而,神经退行性疾病和精神疾病在老年人中更为常见,这会进一步恶化他们的睡眠健康。不管是什么原因,睡眠不足都会对各种身体功能产生不利影响,包括能量代谢、情绪和认知。在这篇综述中,我们将重点关注正常衰老过程中与睡眠不足相关的认知变化以及潜在的神经机制。
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引用次数: 3
Neural distinctiveness and discriminability underlying unitization and associative memory in aging 衰老过程中统一记忆和联想记忆的神经独特性和可辨别性
Pub Date : 2023-01-01 DOI: 10.1016/j.nbas.2023.100097
A.C. Steinkrauss , C.M. Carpenter , M.K. Tarkenton , A.A. Overman , N.A. Dennis

Previous work has suggested unitized pairs behave as a single unit and more critically, are processed neurally different than those of associative memories. The current works examines the neural differences between unitization and non-unitized memory using fMRI and multivoxel analyses. Specifically, we examined the differences across face-occupation pairings as a function of whether the pairing was viewed as a person performing the given job (unitized binding) or a person saying they knew someone who had a particular job (non-unitized binding). The results show that at encoding and retrieval, the angular gyrus can discriminate between unitized and non-unitized target trials. Additionally, during encoding, the medial temporal lobe (hippocampus and perirhinal cortex), frontal parietal regions (angular gyrus and medial frontal gyrus) and visual regions (middle occipital cortex) exhibit distinct neural patterns to recollected unitized and non-unitized targets. Furthermore, the perirhinal cortex and medial frontal gyrus show greater neural similarity within subsequently recollected unitized trials compared to non-unitized trials. We conclude that an encoding based strategy to elicit unitization can produce greater associative memory compared to non-unitized trials in older adults. Additionally, when unitized trials are subsequently recollected in the perirhinal cortex older adults show greater neural similarity within unitized trials compared to non-unitized trials.

先前的研究表明,组合成对的行为是一个单一的单元,更重要的是,它们在神经上的处理与联想记忆不同。目前的工作使用功能磁共振成像和多体素分析来检查统一记忆和非统一记忆之间的神经差异。具体来说,我们研究了面部-职业配对之间的差异,作为配对是被视为执行给定工作的人(统一绑定)还是被视为认识某个从事特定工作的人的人(非统一绑定)的函数。结果表明,在编码和检索时,角回可以区分统一和非统一目标试验。此外,在编码过程中,内侧颞叶(海马体和嗅缘皮层)、额顶叶区域(角回和额内侧回)和视觉区域(枕中皮层)对回忆的统一和非统一目标表现出不同的神经模式。此外,与非联合试验相比,在随后回忆的联合试验中,嗅周皮质和额内侧回显示出更大的神经相似性。我们得出的结论是,与在老年人中进行的非单元化试验相比,基于编码的引发单元化的策略可以产生更大的联想记忆。此外,当随后在嗅周皮层中回忆起联合试验时,与非联合试验相比,老年人在联合试验中表现出更大的神经相似性。
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引用次数: 0
Memory, aging and the brain: Old findings and current issues 记忆、衰老和大脑:旧的发现和当前的问题
Pub Date : 2023-01-01 DOI: 10.1016/j.nbas.2023.100096
Fergus I.M. Craik

In this article I reprise some selected findings and issues from my previous behavioural work on age-related differences in memory, and relate them to current work on the neural correlates of encoding, retrieval and representation. In particular, I describe the case study of a woman who had persistent experiences of erroneous recollection. I also describe the results of a study showing a double dissociation of implicit and explicit memory in younger and older adults. Finally, I assess recent work on loss of specificity in older adults’ encoding and retrieval processes of episodic events. In all cases I attempt to relate these older findings to current ideas and empirical results in the area of memory, aging, and the brain.

在这篇文章中,我重述了我之前关于年龄相关的记忆差异的行为研究中的一些发现和问题,并将它们与当前关于编码、检索和表征的神经相关研究联系起来。特别是,我描述了一个案例研究,一个女人有持续的错误回忆的经历。我还描述了一项研究的结果,显示了年轻人和老年人内隐记忆和外显记忆的双重分离。最后,我评估了最近在老年人的编码和情景事件检索过程特异性丧失的工作。在所有情况下,我都试图将这些旧的发现与记忆、衰老和大脑领域的当前观点和经验结果联系起来。
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引用次数: 0
No moderating influence of education on the association between changes in hippocampus volume and memory performance in aging 教育对老年海马体积变化与记忆表现的关系无调节作用
Pub Date : 2023-01-01 DOI: 10.1016/j.nbas.2023.100082
Martin Lövdén , Amos Pagin , David Bartrés-Faz , Carl-Johan Boraxbekk , Andreas M. Brandmaier , Naiara Demnitz , Christian A. Drevon , Klaus P. Ebmeier , Anders M. Fjell , Paolo Ghisletta , Tetiana Gorbach , Ulman Lindenberger , Anna Plachti , Kristine B. Walhovd , Lars Nyberg

Contemporary accounts of factors that may modify the risk for age-related neurocognitive disorders highlight education and its contribution to a cognitive reserve. By this view, individuals with higher educational attainment should show weaker associations between changes in brain and cognition than individuals with lower educational attainment. We tested this prediction in longitudinal data on hippocampus volume and episodic memory from 708 middle-aged and older individuals using local structural equation modeling. This technique does not require categorization of years of education and does not constrain the shape of relationships, thereby maximizing the chances of revealing an effect of education on the hippocampus-memory association. The results showed that the data were plausible under the assumption that there was no influence of education on the association between change in episodic memory and change in hippocampus volume. Restricting the sample to individuals with elevated genetic risk for dementia (APOE ε4 carriers) did not change these results. We conclude that the influence of education on changes in episodic memory and hippocampus volume is inconsistent with predictions by the cognitive reserve theory.

当代对可能改变年龄相关神经认知障碍风险的因素的描述强调了教育及其对认知储备的贡献。根据这种观点,受教育程度较高的人应该比受教育程度较低的人表现出大脑变化和认知之间较弱的关联。我们使用局部结构方程模型,在708名中老年人的海马体积和情景记忆纵向数据中测试了这一预测。这项技术不需要对受教育年限进行分类,也不限制关系的形状,从而最大限度地提高揭示教育对海马体记忆关联影响的机会。结果表明,在假设教育对情景记忆变化和海马体积变化之间的关联没有影响的情况下,这些数据是可信的。将样本限制在痴呆遗传风险较高的个体(APOEε4携带者)并没有改变这些结果。我们得出的结论是,教育对情景记忆和海马体积变化的影响与认知储备理论的预测不一致。
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引用次数: 0
Reduction of brain stem pathology and transient amelioration of early cognitive symptoms in transgenic mice treated with a monoclonal antibody against α-synuclein oligomers/protofibrils 抗α-突触核蛋白寡聚物/原原纤维单克隆抗体治疗转基因小鼠脑干病理减少和早期认知症状的短暂改善
Pub Date : 2023-01-01 DOI: 10.1016/j.nbas.2023.100086
S. Ekmark-Lewén , A. Aniszewska , A. Molisak , A. Gumucio , V. Lindström , P.J. Kahle , E. Nordström , C. Möller , J. Fälting , L. Lannfelt , J. Bergström , M. Ingelsson

Immunotherapy against alpha-synuclein (α-syn) is a promising novel treatment strategy for Parkinson's disease (PD) and related α-synucleinopathies. We have previously shown that systemic treatment with the monoclonal oligomer/protofibril-selective antibody mAb47 targeting cytotoxic α-syn leads to reduced central nervous system levels of such species as well as an indication of reduced late-stage symptoms in aged (Thy-1)-h[A30P] α-syn transgenic mice.

Here, we performed an early-onset long-term treatment study with this antibody to evaluate effects on brain pathology and behavioral outcomes in the same mouse model. Compared to the placebo group, the treatment strongly reduced phosphorylated α-syn (pS129 α-syn) pathology in the upper brain stem. Moreover, a preserved recognition memory and risk assessment behavior could be seen in antibody-treated mice at six months of age, even although these effects were no longer significant at eleven months of age. Importantly, no evidence of inflammatory responses or other potential toxic effects was seen with the treatment. Taken together, this study supports the strategy to target α-syn oligomers/protofibrils with monoclonal antibodies to counteract early symptoms and slow down the progression of PD and other α-synucleinopathies.

针对α-突触核蛋白(α-syn)的免疫治疗是治疗帕金森病(PD)和相关α-突触蛋白疾病的一种很有前途的新策略。我们之前已经表明,用靶向细胞毒性α-syn的单克隆寡聚物/原纤维选择性抗体mAb47进行全身治疗会导致这些物种的中枢神经系统水平降低,并表明衰老(Thy-1)-h[A30P]α-syn转基因小鼠的晚期症状降低。在这里,我们用这种抗体进行了一项早发性长期治疗研究,以评估在同一小鼠模型中对大脑病理和行为结果的影响。与安慰剂组相比,该治疗显著降低了上脑干的磷酸化α-syn(pS129α-syn)病理。此外,在6个月大的抗体治疗小鼠中可以看到保留的识别记忆和风险评估行为,尽管这些影响在11个月大时不再显著。重要的是,该治疗没有发现炎症反应或其他潜在毒性作用的证据。总之,这项研究支持用单克隆抗体靶向α-突触低聚物/原纤维的策略,以对抗早期症状并减缓PD和其他α-突触核蛋白疾病的进展。
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引用次数: 0
Brain-predicted age difference mediates the association between PROMIS sleep impairment, and self-reported pain measure in persons with knee pain 脑预测的年龄差异介导了PROMIS睡眠障碍和膝关节疼痛患者自我报告疼痛测量之间的关联
Pub Date : 2023-01-01 DOI: 10.1016/j.nbas.2023.100088
Soamy Montesino-Goicolea , Pedro Valdes-Hernandez , Chavier Laffitte Nodarse , Alisa J. Johnson , James H. Cole , Lisa H. Antoine , Burel R. Goodin , Roger B. Fillingim , Yenisel Cruz-Almeida

Knee pain, the most common cause of musculoskeletal pain (MSK), constitutes a severe public health burden. Its neurobiological causes, however, remain poorly understood. Among many possible causes, it has been proposed that sleep problems could lead to an increase in chronic pain symptomatology, which may be driven by central nervous system changes. In fact, we previously found that brain cortical thickness mediated the relationship between sleep qualities and pain severity in older adults with MSK. We also demonstrated a significant difference in a machine-learning-derived brain-aging biomarker between participants with low-and high-impact knee pain. Considering this, we examined whether brain aging was associated with self-reported sleep and pain measures, and whether brain aging mediated the relationship between sleep problems and knee pain. Exploratory Spearman and Pearson partial correlations, controlling for age, sex, race and study site, showed a significant association of brain aging with sleep related impairment and self-reported pain measures. Moreover, mediation analysis showed that brain aging significantly mediated the effect of sleep related impairment on clinical pain and physical symptoms. Our findings extend our prior work demonstrating advanced brain aging among individuals with chronic pain and the mediating role of brain-aging on the association between sleep and pain severity. Future longitudinal studies are needed to further understand whether the brain can be a therapeutic target to reverse the possible effect of sleep problems on chronic pain.

膝关节疼痛是肌肉骨骼疼痛(MSK)的最常见原因,构成了严重的公共卫生负担。然而,其神经生物学原因仍然知之甚少。在许多可能的原因中,有人提出睡眠问题可能导致慢性疼痛症状的增加,这可能是由中枢神经系统的变化驱动的。事实上,我们之前发现大脑皮质厚度介导了老年MSK患者睡眠质量和疼痛严重程度之间的关系。我们还证明了机器学习衍生的脑老化生物标志物在低冲击和高冲击膝关节疼痛的参与者之间存在显著差异。考虑到这一点,我们研究了大脑衰老是否与自我报告的睡眠和疼痛测量有关,以及大脑衰老是否介导了睡眠问题和膝盖疼痛之间的关系。探索性的斯皮尔曼和皮尔逊部分相关性,控制了年龄、性别、种族和研究地点,显示出大脑衰老与睡眠相关损伤和自我报告的疼痛测量有显著关联。此外,中介分析显示,脑老化显著介导睡眠相关损害对临床疼痛和身体症状的影响。我们的研究结果扩展了我们之前的工作,证明慢性疼痛患者的大脑衰老程度较高,大脑衰老在睡眠和疼痛严重程度之间的关联中起着中介作用。未来的纵向研究需要进一步了解大脑是否可以成为一个治疗目标,以扭转睡眠问题对慢性疼痛的可能影响。
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引用次数: 0
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Aging brain
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