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Cerebral perfusion in post-stroke aphasia and its relationship to residual language abilities 脑灌注治疗脑卒中后失语症及其与残语能力的关系
Pub Date : 2023-10-05 DOI: 10.1093/braincomms/fcad252
Maria V Ivanova, Ioannis Pappas, Ben Inglis, Alexis Pracar, Timothy J Herron, Juliana V Baldo, Andrew S Kayser, Mark D’Esposito, Nina F Dronkers
Abstract Stroke alters blood flow to the brain resulting in damaged tissue and cell death. Moreover, the disruption of cerebral blood flow (perfusion) can be observed in areas surrounding and distal to the lesion. These structurally preserved but sub-optimally perfused regions may also affect recovery. Thus, to better understand aphasia recovery the relationship between cerebral perfusion and language needs to be systematically examined. In the current study, we aimed to evaluate 1) how stroke affects perfusion outside of lesioned areas in chronic aphasia, and 2) how perfusion in specific cortical areas and perilesional tissue relates to language outcomes in aphasia. We analyzed perfusion data from a large sample of participants with chronic aphasia due to left hemisphere stroke (n = 43) and age-matched healthy controls (n = 25). We used anatomically-defined regions of interest that covered the frontal, parietal, and temporal areas of the perisylvian cortex in both hemispheres, areas typically known to support language, along with several control regions not implicated in language processing. For the aphasia group we also looked at three regions of interest in the perilesional tissue. We compared perfusion levels between the two groups and investigated the relationship between perfusion levels and language subtest scores while controlling for demographic and lesion variables. First, we observed that perfusion levels outside the lesioned areas were significantly reduced in frontal and parietal regions in the left hemisphere in people with aphasia compared to the control group, while no differences were observed for the right hemisphere regions. Second, we found that perfusion in the left temporal lobe (and most strongly in the posterior part of both superior and middle temporal gyri) and inferior parietal areas (supramarginal gyrus) was significantly related to residual expressive and receptive language abilities. In contrast, perfusion in the frontal regions did not show such a relationship; no relationship with language was also observed for perfusion levels in control areas and all right hemisphere regions. Third, perilesional perfusion was only marginally related to language production abilities. Cumulatively, the current findings demonstrate that blood flow is reduced beyond the lesion site in chronic aphasia and that hypoperfused neural tissue in critical temporoparietal language areas has a negative impact on behavioral outcomes. These results, using perfusion imaging, underscore the critical and general role that left hemisphere posterior temporal regions play in various expressive and receptive language abilities. Overall, the study highlights the importance of exploring perfusion measures in stroke.
中风会改变流向大脑的血液,导致组织受损和细胞死亡。此外,在病变周围和远端可以观察到脑血流(灌注)的中断。这些结构上保存完好但未达到最佳灌注状态的区域也可能影响恢复。因此,为了更好地了解失语恢复,需要系统地研究脑灌注与语言之间的关系。在本研究中,我们旨在评估1)中风如何影响慢性失语症损伤区域外的灌注,以及2)特定皮质区域和病灶周围组织的灌注如何与失语症的语言结局相关。我们分析了大量左半球中风引起的慢性失语症患者(n = 43)和年龄匹配的健康对照(n = 25)的灌注数据。我们使用了解剖学定义的兴趣区域,覆盖了两个半球的外围皮层的额叶、顶叶和颞叶区域,这些区域通常被认为是支持语言的区域,以及几个与语言处理无关的控制区域。对于失语症组我们也观察了病灶周围组织的三个区域。我们比较了两组之间的灌注水平,并在控制人口统计学和病变变量的情况下,研究了灌注水平与语言亚测试分数之间的关系。首先,我们观察到,与对照组相比,失语症患者左半球额叶和顶叶受损区域外的灌注水平显著降低,而右半球区域没有观察到差异。其次,我们发现左颞叶(上颞回和中颞回后部最强烈)和下顶叶(边缘上回)的灌注与剩余的表达和接受语言能力显著相关。相比之下,额叶区的灌注没有表现出这种关系;对照区和所有右半球区域的灌注水平也与语言没有关系。第三,病灶周围灌注与语言产生能力只有微弱的相关性。总的来说,目前的研究结果表明,慢性失语症的血流量在病变部位以外减少,关键颞顶叶语言区神经组织灌注不足对行为结果有负面影响。这些结果,通过灌注成像,强调了左半球后颞区在各种表达和接受语言能力中发挥的关键和普遍作用。总之,该研究强调了探索脑卒中灌注措施的重要性。
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引用次数: 0
Optical coherence tomography with voxel-based morphometry: a new tool to unveil focal retinal neurodegeneration in multiple sclerosis 基于体素形态学的光学相干断层扫描:揭示多发性硬化症局灶性视网膜神经变性的新工具
Pub Date : 2023-09-28 DOI: 10.1093/braincomms/fcad249
Su-Chun Huang, Marco Pisa, Simone Guerrieri, Gloria Dalla Costa, Giancarlo Comi, Letizia Leocani
Abstract Neurodegeneration is the main contributor to disability accumulation in multiple sclerosis. Previous studies in neuro-ophthalmology have revealed that neurodegeneration in multiple sclerosis also affects the neuro-retina. Optical coherence tomography (OCT) has been used to measure thinning of retinal layers, which correlates with several other markers for axonal/neuronal loss in multiple sclerosis. However, the existing analytical tools have limitations in terms of sensitivity and do not provide topographical information. In this study, we aim to evaluate whether voxel-based morphometry (VBM) can increase sensitivity in detecting neuroaxonal degeneration in the retina and offer topographical information. A total of 131 people with multiple sclerosis (41 clinically isolated syndrome, 53 relapsing-remitting, and 37 progressive multiple sclerosis) and 50 healthy subjects were included. Only eyes with normal global peripapillary retinal nerve fiber layer thickness (RNFL) and no history of optic neuritis were considered. VBM and voxel-wise statistical comparisons were performed on: 1) patients at different disease stages. 2) patients experienced the first demyelination attack without subclinical optic neuritis, assessed by visual evoked potentials. Standard parameters failed to discern any differences; however, VBM-OCT successfully detected focal macular atrophy of RNFL and ganglion cell/inner plexiform layer, along with thickening of inner nuclear layer in patients who experienced the first demyelination attack (disease duration = 4.2 months). Notably, the atrophy pattern of the ganglion cell/inner plexiform layer was comparable across disease phenotypes. In contrast, the RNFL atrophy spread from the optic nerve head to the fovea as the disease evolved toward the progressive phase. Furthermore, for patients who experienced the first neurological episode, the severity of RNFL atrophy at entry could predict a second attack. Our results demonstrate that VBM-OCT exhibits greater sensitivity than standard parameters in detecting focal retinal atrophy, even at clinical presentation, in eyes with no history of optic neuritis and with normal latency of visual evoked potentials. Thinning of ganglion cell/inner plexiform layer primarily concentrated in nasal perifovea in all disease phenotypes, indicating selective vulnerability of retinal ganglion cells and their perifoveal axons. Conversely, the degree of RNFL thinning seems to be related to the clinical course of multiple sclerosis. The findings suggest bidirectional neurodegeneration in the visual pathway. VBM-OCT shows potential as a valuable tool for monitoring neurodegeneration on a patient level and evaluating the efficacy of novel neuroprotective treatments.
神经退行性变是多发性硬化症致残的主要原因。神经眼科学先前的研究表明,多发性硬化症的神经变性也影响神经视网膜。光学相干断层扫描(OCT)已被用于测量视网膜层变薄,这与多发性硬化症中轴突/神经元损失的其他几个标志物相关。然而,现有的分析工具在灵敏度方面存在局限性,并且不能提供地形信息。在这项研究中,我们旨在评估基于体素的形态测量(VBM)是否可以提高检测视网膜神经轴突变性的灵敏度并提供地形信息。共纳入131名多发性硬化症患者(41名临床孤立综合征,53名复发缓解型,37名进行性多发性硬化症)和50名健康受试者。仅考虑乳头周围视网膜神经纤维层厚度(RNFL)正常且无视神经炎史的眼睛。VBM和体素统计比较:1)不同疾病分期的患者。2)首次脱髓鞘发作,无亚临床视神经炎,视诱发电位评估。标准参数未发现任何差异;然而,在首次脱髓鞘发作(病程4.2个月)的患者中,VBM-OCT成功检测到RNFL和神经节细胞/内丛状层局灶性黄斑萎缩,并伴有内核层增厚。值得注意的是,神经节细胞/内丛状层的萎缩模式在各种疾病表型中具有可比性。相反,随着疾病进展,RNFL萎缩从视神经头向中央窝扩散。此外,对于经历过第一次神经系统发作的患者,入院时RNFL萎缩的严重程度可以预测第二次发作。我们的研究结果表明,即使在没有视神经炎病史和视觉诱发电位潜伏期正常的眼睛中,vvm - oct在检测局灶性视网膜萎缩方面也比标准参数具有更高的灵敏度。在所有疾病表型中,神经节细胞/内丛状层变薄主要集中在鼻窝周,表明视网膜神经节细胞及其窝周轴突的选择性易感性。相反,RNFL变薄的程度似乎与多发性硬化症的临床病程有关。研究结果表明视觉通路存在双向神经变性。VBM-OCT显示了作为一种有价值的工具在患者水平上监测神经变性和评估新的神经保护治疗的疗效的潜力。
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引用次数: 0
Spinocerebellar ataxia 27B: episodic symptoms and acetazolamide response in 34 patients. 脊髓小脑共济失调 27B:34 名患者的发作性症状和乙酰唑胺反应。
Pub Date : 2023-09-10 eCollection Date: 2023-01-01 DOI: 10.1093/braincomms/fcad239
Catherine Ashton, Elisabetta Indelicato, David Pellerin, Guillemette Clément, Matt C Danzi, Marie-Josée Dicaire, Céline Bonnet, Henry Houlden, Stephan Züchner, Matthis Synofzik, Phillipa J Lamont, Mathilde Renaud, Sylvia Boesch, Bernard Brais

Ashton C et al report a retrospective multi-centre cohort of 34 patients from Canada, France, Austria and Australia with spinocerebellar ataxia 27B, describing the common feature of episodic ataxia and other episodic features, as well as the inefficacy of acetazolamide in these patients.

Ashton C 等人报告了一项多中心回顾性队列研究,研究对象是来自加拿大、法国、奥地利和澳大利亚的 34 名脊髓小脑共济失调 27B 患者,描述了发作性共济失调和其他发作性特征的共同特点,以及乙酰唑胺对这些患者的无效性。
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引用次数: 0
Genetic risks of Alzheimer's by APOE and MAPT on cortical morphology in young healthy adults. 年轻健康成年人皮层形态APOE和MAPT对阿尔茨海默病的遗传风险。
Pub Date : 2023-09-08 eCollection Date: 2023-01-01 DOI: 10.1093/braincomms/fcad234
Weijie Huang, Jianmin Zeng, Lina Jia, Dajiang Zhu, John O'Brien, Craig Ritchie, Ni Shu, Li Su

Genetic risk factors such as APOE ε4 and MAPT (rs242557) A allele are associated with amyloid and tau pathways and grey matter changes at both early and established stages of Alzheimer's disease, but their effects on cortical morphology in young healthy adults remain unclear. A total of 144 participants aged from 18 to 24 underwent 3T MRI and genotyping for APOE and MAPT to investigate unique impacts of these genetic risk factors in a cohort without significant comorbid conditions such as metabolic and cardiovascular diseases. We segmented the cerebral cortex into 68 regions and calculated the cortical area, thickness, curvature and folding index for each region. Then, we trained machine learning models to classify APOE and MAPT genotypes using these morphological features. In addition, we applied a growing hierarchical self-organizing maps algorithm, which clustered the 68 regions into 4 subgroups representing different morphological patterns. Then, we performed general linear model analyses to estimate the interaction between APOE and MAPT on cortical patterns. We found that the classifiers using all cortical features could accurately classify individuals carrying genetic risks of dementia outperforming each individual feature alone. APOE ε4 carriers had a more convoluted and thinner cortex across the cerebral cortex. A similar pattern was found in MAPT A allele carriers only in the regions that are vulnerable for early tau pathology. With the clustering analysis, we found a synergetic effect between APOE ε4 and MAPT A allele, i.e. carriers of both risk factors showed the most deviation of cortical pattern from the typical pattern of that cluster. Genetic risk factors of dementia by APOE ε4 and MAPT (rs242557) A allele were associated with variations of cortical morphology, which can be observed in young healthy adults more than 30 years before Alzheimer's pathology is likely to occur and 50 years before dementia symptoms may begin.

遗传风险因素,如APOEε4和MAPT(rs242557)A等位基因与阿尔茨海默病早期和晚期的淀粉样蛋白和tau通路以及灰质变化有关,但它们对年轻健康成年人皮层形态的影响尚不清楚。共有144名年龄在18岁至24岁之间的参与者接受了3T MRI和APOE和MAPT基因分型,以研究这些遗传风险因素在没有代谢和心血管疾病等重大合并症的队列中的独特影响。我们将大脑皮层划分为68个区域,并计算每个区域的皮层面积、厚度、曲率和折叠指数。然后,我们训练机器学习模型,利用这些形态学特征对APOE和MAPT基因型进行分类。此外,我们应用了一种增长的分层自组织映射算法,将68个区域聚类为4个子组,代表不同的形态模式。然后,我们进行了一般的线性模型分析,以估计APOE和MAPT在皮层模式上的相互作用。我们发现,使用所有皮层特征的分类器可以准确地对具有痴呆遗传风险的个体进行分类,优于单独的每个特征。APOEε4携带者在整个大脑皮层中有一个更复杂、更薄的皮层。仅在易受早期tau病理影响的区域,在MAPT A等位基因携带者中发现了类似的模式。通过聚类分析,我们发现APOEε4和MAPT a等位基因之间存在协同效应,即两种危险因素的携带者表现出与该聚类的典型模式最大的皮层模式偏差。APOEε4和MAPT(rs242557)A等位基因导致痴呆的遗传风险因素与皮层形态变化有关,在阿尔茨海默病可能发生前30多年和痴呆症状可能开始前50年,可以在年轻健康成年人中观察到皮层形态变化。
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引用次数: 1
Put your publication money where your mouth is. 把你的出版费放在嘴边。
Pub Date : 2023-08-31 eCollection Date: 2023-01-01 DOI: 10.1093/braincomms/fcad220
Tara L Spires-Jones, David Belin

Two members of our Editorial Board discuss how the proceeds from article processing charges from Brain Communications and our sister journal Brain are put back into the translational neuroscience community.

我们编委会的两名成员讨论了《大脑通讯》和我们的姊妹期刊《大脑》的文章处理费用如何重新投入转化神经科学界。
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引用次数: 0
Altered neural oscillations underlying visuospatial processing in cerebral visual impairment. 大脑视觉障碍中视觉空间处理的基础神经振荡发生了改变。
Pub Date : 2023-08-28 eCollection Date: 2023-01-01 DOI: 10.1093/braincomms/fcad232
Alessandra Federici, Christopher R Bennett, Corinna M Bauer, Claire E Manley, Emiliano Ricciardi, Davide Bottari, Lotfi B Merabet

Visuospatial processing deficits are commonly observed in individuals with cerebral visual impairment, even in cases where visual acuity and visual field functions are intact. Cerebral visual impairment is a brain-based visual disorder associated with the maldevelopment of central visual pathways and structures. However, the neurophysiological basis underlying higher-order perceptual impairments in this condition has not been clearly identified, which in turn poses limits on developing rehabilitative interventions. Using combined eye tracking and EEG recordings, we assessed the profile and performance of visual search on a naturalistic virtual reality-based task. Participants with cerebral visual impairment and controls with neurotypical development were instructed to search, locate and fixate on a specific target placed among surrounding distractors at two levels of task difficulty. We analysed evoked (phase-locked) and induced (non-phase-locked) components of broadband (4-55 Hz) neural oscillations to uncover the neurophysiological basis of visuospatial processing. We found that visual search performance in cerebral visual impairment was impaired compared to controls (as indexed by outcomes of success rate, reaction time and gaze error). Analysis of neural oscillations revealed markedly reduced early-onset evoked theta [4-6 Hz] activity (within 0.5 s) regardless of task difficulty. Moreover, while induced alpha activity increased with task difficulty in controls, this modulation was absent in the cerebral visual impairment group identifying a potential neural correlate related to deficits with visual search and distractor suppression. Finally, cerebral visual impairment participants also showed a sustained induced gamma response [30-45 Hz]. We conclude that impaired visual search performance in cerebral visual impairment is associated with substantial alterations across a wide range of neural oscillation frequencies. This includes both evoked and induced components suggesting the involvement of feedforward and feedback processing as well as local and distributed levels of neural processing.

即使在视敏度和视野功能完好的情况下,脑性视力障碍患者也常出现视觉空间处理障碍。脑性视力障碍是一种基于大脑的视觉障碍,与中枢视觉通路和结构发育不良有关。然而,这种情况下的高阶知觉障碍的神经生理学基础尚未明确确定,这反过来又限制了康复干预措施的开发。利用眼动跟踪和脑电图记录,我们评估了视觉搜索在自然虚拟现实任务中的概况和表现。脑性视力障碍参与者和神经发育正常的对照组被要求在两个难度级别的任务中搜索、定位和固定在周围干扰物中的特定目标上。我们分析了宽带(4-55 Hz)神经振荡的诱发(锁相)和诱导(非锁相)成分,以揭示视觉空间处理的神经生理学基础。我们发现,与对照组相比,脑性视力障碍患者的视觉搜索能力受损(以成功率、反应时间和注视误差等结果为指标)。神经振荡分析显示,无论任务难度如何,早期诱发的θ[4-6赫兹]活动(0.5秒内)都明显减少。此外,在对照组中,诱发的阿尔法活动会随着任务难度的增加而增加,而在脑性视力障碍组中却没有这种调节作用。最后,脑性视力障碍参与者还表现出持续的诱导伽马反应[30-45 Hz]。我们的结论是,脑性视力障碍患者的视觉搜索能力受损与广泛的神经振荡频率的实质性改变有关。这包括诱发和诱导成分,表明前馈和反馈处理以及局部和分布式神经处理水平的参与。
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引用次数: 0
Depression and HIV: a scoping review in search of neuroimmune biomarkers. 抑郁症与艾滋病:寻找神经免疫生物标志物的范围综述。
Pub Date : 2023-08-25 eCollection Date: 2023-01-01 DOI: 10.1093/braincomms/fcad231
Arish Mudra Rakshasa-Loots

People with HIV are at increased risk for depression, though the neurobiological mechanisms underlying this are unclear. In the last decade, there has been a substantial rise in interest in the contribution of (neuro)inflammation to depression, coupled with rapid advancements in the resolution and sensitivity of biomarker assays such as Luminex, single molecular array and newly developed positron emission tomography radioligands. Numerous pre-clinical and clinical studies have recently leveraged these next-generation immunoassays to identify biomarkers that may be associated with HIV and depression (separately), though few studies have explored these biomarkers in co-occurring HIV and depression. Using a systematic search, we detected 33 publications involving a cumulative N = 10 590 participants which tested for associations between depressive symptoms and 55 biomarkers of inflammation and related processes in participants living with HIV. Formal meta-analyses were not possible as statistical reporting in the field was highly variable; future studies must fully report test statistics and effect size estimates. The majority of included studies were carried out in the United States, with samples that were primarily older and primarily men. Substantial further work is necessary to diversify the geographical, age, and sex distribution of samples in the field. This review finds that alterations in concentrations of certain biomarkers of neuroinflammation (interleukin-6, tumour necrosis factor-α, neopterin) may influence the association between HIV and depression. Equally, the chemokines monocyte chemoattractant protein-1 (MCP-1) and interleukin-8 (IL-8) or the metabolic index kynurenine:tryptophan (Kyn:Trp), which have been the focus of several studies, do not appear to be associated with depressive symptoms amongst people living with HIV, as all (MCP-1) or most (IL-8 and Kyn:Trp) available studies of these biomarkers reported non-significant associations. We propose a biomarker-driven hypothesis of the neuroimmunometabolic mechanisms that may precipitate the increased risk of depression among people with HIV. Chronically activated microglia, which trigger key neuroinflammatory cascades shown to be upregulated in people with HIV, may be the central link connecting HIV infection in the central nervous system with depressive symptoms. Findings from this review may inform research design in future studies of HIV-associated depression and enable concerted efforts towards biomarker discovery.

艾滋病毒感染者患抑郁症的风险增加,尽管其神经生物学机制尚不清楚。在过去的十年里,人们对(神经)炎症对抑郁症的影响的兴趣大幅上升,同时生物标志物测定的分辨率和灵敏度也迅速提高,如Luminex、单分子阵列和新开发的正电子发射断层扫描放射性配体。最近,许多临床前和临床研究利用这些下一代免疫测定法来识别可能与HIV和抑郁症相关的生物标志物(分别),尽管很少有研究在HIV和抑郁症并存的情况下探索这些生物标志物。通过系统搜索,我们检测到33篇涉及累计N=10590名参与者的出版物,这些出版物测试了艾滋病毒感染者的抑郁症状与55种炎症和相关过程的生物标志物之间的关联。正式的荟萃分析是不可能的,因为该领域的统计报告变化很大;未来的研究必须全面报告测试统计数据和效应大小估计。大多数纳入的研究是在美国进行的,样本主要是老年人,主要是男性。为了使实地样本的地理、年龄和性别分布多样化,还需要开展大量的进一步工作。这篇综述发现,某些神经炎症生物标志物(白细胞介素-6、肿瘤坏死因子-α、新蝶呤)的浓度变化可能影响HIV与抑郁症之间的关系。同样,趋化因子单核细胞趋化蛋白-1(MCP-1)和白细胞介素-8(IL-8)或代谢指数犬尿氨酸:色氨酸(Kyn:Trp)是几项研究的焦点,它们似乎与HIV感染者的抑郁症状无关,因为这些生物标志物的所有(MCP-1)或大多数(IL-8和Kyn:Trp)可用研究报告了非显著关联。我们提出了一个由生物标志物驱动的神经免疫代谢机制假说,该假说可能会增加艾滋病毒感染者患抑郁症的风险。慢性激活的小胶质细胞触发关键的神经炎症级联反应,在HIV感染者中被证明是上调的,可能是连接中枢神经系统HIV感染与抑郁症状的中心环节。这篇综述的发现可能为未来HIV相关抑郁症研究的研究设计提供信息,并使人们能够共同努力发现生物标志物。
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引用次数: 0
Focal seizures unfold variably over time. 局灶性癫痫发作随时间变化。
Pub Date : 2023-08-25 eCollection Date: 2023-01-01 DOI: 10.1093/braincomms/fcad230
Maxime O Baud, Vikram R Rao

This scientific commentary refers to 'Chronic intracranial EEG recordings and interictal spike rate reveal multiscale temporal modulations in seizure states' by Schroeder et al. (https://doi.org/10.1093/braincomms/fcad205).

这篇科学评论引用了Schroeder等人的“慢性颅内脑电图记录和发作间期棘波率揭示了癫痫发作状态的多尺度时间调节”(https://doi.org/10.1093/braincomms/fcad205)。
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引用次数: 0
Alzheimer's disease biomarker profiling in a memory clinic cohort without common comorbidities. 无常见合并症的记忆临床队列中阿尔茨海默病生物标志物分析。
Pub Date : 2023-08-25 eCollection Date: 2023-01-01 DOI: 10.1093/braincomms/fcad228
Makrina Daniilidou, Francesca Eroli, Vilma Alanko, Julen Goikolea, Maria Latorre-Leal, Patricia Rodriguez-Rodriguez, William J Griffiths, Yuqin Wang, Manuela Pacciarini, Ann Brinkmalm, Henrik Zetterberg, Kaj Blennow, Anna Rosenberg, Nenad Bogdanovic, Bengt Winblad, Miia Kivipelto, Delphine Ibghi, Angel Cedazo-Minguez, Silvia Maioli, Anna Matton

Alzheimer's disease is a multifactorial disorder with large heterogeneity. Comorbidities such as hypertension, hypercholesterolaemia and diabetes are known contributors to disease progression. However, less is known about their mechanistic contribution to Alzheimer's pathology and neurodegeneration. The aim of this study was to investigate the relationship of several biomarkers related to risk mechanisms in Alzheimer's disease with the well-established Alzheimer's disease markers in a memory clinic population without common comorbidities. We investigated 13 molecular markers representing key mechanisms underlying Alzheimer's disease pathogenesis in CSF from memory clinic patients without diagnosed hypertension, hypercholesterolaemia or diabetes nor other neurodegenerative disorders. An analysis of covariance was used to compare biomarker levels between clinical groups. Associations were analysed by linear regression. Two-step cluster analysis was used to determine patient clusters. Two key markers were analysed by immunofluorescence staining in the hippocampus of non-demented control and Alzheimer's disease individuals. CSF samples from a total of 90 participants were included in this study: 30 from patients with subjective cognitive decline (age 62.4 ± 4.38, female 60%), 30 with mild cognitive impairment (age 65.6 ± 7.48, female 50%) and 30 with Alzheimer's disease (age 68.2 ± 7.86, female 50%). Angiotensinogen, thioredoxin-1 and interleukin-15 had the most prominent associations with Alzheimer's disease pathology, synaptic and axonal damage markers. Synaptosomal-associated protein 25 kDa and neurofilament light chain were increased in mild cognitive impairment and Alzheimer's disease patients. Grouping biomarkers by biological function showed that inflammatory and survival components were associated with Alzheimer's disease pathology, synaptic dysfunction and axonal damage. Moreover, a vascular/metabolic component was associated with synaptic dysfunction. In the data-driven analysis, two patient clusters were identified: Cluster 1 had increased CSF markers of oxidative stress, vascular pathology and neuroinflammation and was characterized by elevated synaptic and axonal damage, compared with Cluster 2. Clinical groups were evenly distributed between the clusters. An analysis of post-mortem hippocampal tissue showed that compared with non-demented controls, angiotensinogen staining was higher in Alzheimer's disease and co-localized with phosphorylated-tau. The identification of biomarker-driven endophenotypes in cognitive disorder patients further highlights the biological heterogeneity of Alzheimer's disease and the importance of tailored prevention and treatment strategies.

阿尔茨海默病是一种多因素疾病,具有很大的异质性。众所周知,高血压、高胆固醇血症和糖尿病等合并症是导致疾病进展的因素。然而,人们对它们对阿尔茨海默病和神经退行性变的机制贡献知之甚少。本研究的目的是在没有常见合并症的记忆临床人群中,研究与阿尔茨海默病风险机制相关的几种生物标志物与公认的阿尔茨海默病标志物的关系。我们研究了13种分子标记物,这些标记物代表了未被诊断为高血压、高胆固醇血症、糖尿病或其他神经退行性疾病的记忆临床患者CSF中阿尔茨海默病发病机制的关键机制。协方差分析用于比较临床组之间的生物标志物水平。通过线性回归分析相关性。使用两步聚类分析来确定患者聚类。通过免疫荧光染色分析了非痴呆对照组和阿尔茨海默病患者海马中的两个关键标志物。共有90名参与者的CSF样本被纳入本研究:30名主观认知能力下降患者(年龄62.4±4.38,女性60%),30名轻度认知障碍患者(年龄65.6±7.48,女性50%)和30名阿尔茨海默病患者(年龄68.2±7.86,女性50%)。血管紧张素原、硫氧还蛋白-1和白细胞介素-15与阿尔茨海默病病理、突触和轴突损伤标志物的相关性最为显著。突触体相关蛋白25 kDa和神经丝轻链在轻度认知障碍和阿尔茨海默病患者中增加。根据生物功能对生物标志物进行分组显示,炎症和存活成分与阿尔茨海默病病理、突触功能障碍和轴突损伤有关。此外,血管/代谢成分与突触功能障碍有关。在数据驱动的分析中,确定了两个患者集群:与集群2相比,集群1具有增加的氧化应激、血管病理和神经炎症的CSF标志物,并以突触和轴突损伤增加为特征。临床组平均分布在各组之间。对死后海马组织的分析表明,与非痴呆对照组相比,阿尔茨海默病患者的血管紧张素原染色更高,并且与磷酸化的tau共定位。认知障碍患者中生物标志物驱动的内表型的识别进一步突出了阿尔茨海默病的生物学异质性以及量身定制的预防和治疗策略的重要性。
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引用次数: 0
Clinical features and imaging characteristics in achiasmia. 痤疮的临床特征和影像学特征。
Pub Date : 2023-08-22 eCollection Date: 2023-01-01 DOI: 10.1093/braincomms/fcad219
Anastasia Pilat, Rebecca J McLean, Anna Vanina, Robert A Dineen, Irene Gottlob

Achiasmia is a rare visual pathway maldevelopment with reduced decussation of the axons in the optic chiasm. Our aim was to investigate clinical characteristics, macular, optic nerve and brain morphology in achiasmia. A prospective, cross-sectional, observational study of 12 participants with achiasmia [8 males and 4 females; 29.6 ± 18.4 years (mean ± standard deviation)] and 24 gender-, age-, ethnicity- and refraction-matched healthy controls was done. Full ophthalmology assessment, eye movement recording, a high-resolution spectral-domain optical coherence tomography of the macular and optic disc, five-channel visual-evoked responses, eye movement recordings and MRI scans of the brain and orbits were acquired. Achiasmia was confirmed in all 12 clinical participants by visual-evoked responses. Visual acuity in this group was 0.63 ± 0.19 and 0.53 ± 0.19 for the right and left eyes, respectively; most participants had mild refractive errors. All participants with achiasmia had see-saw nystagmus and no measurable stereo vision. Strabismus and abnormal head position were noted in 58% of participants. Optical coherence tomography showed optic nerve hypoplasia with associated foveal hypoplasia in four participants. In the remaining achiasmia participants, macular changes with significantly thinner paracentral inner segment (P = 0.002), wider pit (P = 0.04) and visual flattening of the ellipsoid line were found. MRI demonstrated chiasmatic aplasia in 3/12 (25%), chiasmatic hypoplasia in 7/12 (58%) and a subjectively normal chiasm in 2/12 (17%). Septo-optic dysplasia and severe bilateral optic nerve hypoplasia were found in three patients with chiasmic aplasia/hypoplasia on MRI. In this largest series of achiasmia patients to date, we found for the first time that neuronal abnormalities occur already at the retinal level. Foveal changes, optic nerve hypoplasia and the midline brain anomaly suggest that these abnormalities could be part of the same spectrum, with different manifestations of events during foetal development occurring with varying severity.

Achiasmia是一种罕见的视觉通路发育不良,视交叉轴突交叉减少。我们的目的是研究跟腱炎的临床特征、黄斑、视神经和大脑形态。一项前瞻性、横断面、观察性研究对12名无成就感参与者[8名男性和4名女性;29.6±18.4岁(平均值±标准差)]和24名性别、年龄、种族和屈光匹配的健康对照进行了研究。获得了完整的眼科评估、眼动记录、黄斑和视盘的高分辨率光谱域光学相干断层扫描、五通道视觉诱发反应、眼动记录以及大脑和眼眶的MRI扫描。所有12名临床参与者都通过视觉诱发反应确认了无意识血症。该组右眼和左眼的视力分别为0.63±0.19和0.53±0.19%;大多数参与者都有轻微的屈光不正。所有患有无成就感的参与者都有眼震,没有可测量的立体视觉。58%的参与者出现斜视和头部位置异常。光学相干断层扫描显示四名参与者的视神经发育不全并伴有中央凹发育不全。在其余的无成就感参与者中,发现黄斑病变,中央旁内段明显变薄(P=0.002),凹坑变宽(P=0.04),椭球线视觉变平。MRI显示3/12例(25%)交叉发育不全,7/12例(58%)交叉发育不良,2/12例(17%)主观正常交叉。3例交叉性视神经发育不全/发育不全患者在MRI上发现视间隔发育不良和双侧视神经严重发育不全。在这一迄今为止规模最大的一系列无关节炎患者中,我们首次发现神经元异常已经发生在视网膜水平。胎儿变化、视神经发育不全和大脑中线异常表明,这些异常可能是同一谱系的一部分,在胎儿发育过程中,不同表现的事件具有不同的严重程度。
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Brain Communications
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