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Morphometric Analysis of Corpus Callosum in Individuals with Alzheimer's Disease: Magnetic Resonance Imaging (MRI) Study. 阿尔茨海默氏症患者胼胝体的形态计量分析:磁共振成像(MRI)研究。
Pub Date : 2024-01-01 DOI: 10.2174/0115672050335744240820065952
Musa Acar, Sultan Uğur

Introduction: The Corpus Callosum (CC) is the largest commissural tract in the nervous system. Few studies have examined the extent of CC in Alzheimer's disease (AD) patients, and these studies have reported conflicting findings.

Materials and methods: The study was performed using 176 brain MRI images of 88 Alzheimer's patients (55 women-32 men) and 88 healthy individuals (44 women-44 men).

Results: In our study, 7 different parameters of the CC were measured, and their average values were determined. We measured each parameter separately in AD patients and healthy individuals and compared them with each other.

Conclusion: CC has an important place not only in Patients with AD but also in other neurodegenerative diseases. We consider that our study will be useful in the evaluation of Patients with AD.

简介胼胝体(CC)是神经系统中最大的神经束。很少有研究对阿尔茨海默病(AD)患者的胼胝体范围进行检查,而且这些研究报告的结果相互矛盾:研究使用了 88 名阿尔茨海默病患者(55 名女性-32 名男性)和 88 名健康人(44 名女性-44 名男性)的 176 张脑核磁共振图像:在我们的研究中,对 CC 的 7 个不同参数进行了测量,并确定了它们的平均值。我们分别测量了注意力缺失症患者和健康人的每个参数,并对它们进行了比较:结论:CC不仅在AD患者中具有重要地位,在其他神经退行性疾病中也同样重要。我们认为,我们的研究将有助于评估 AD 患者。
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引用次数: 0
Drive My CAR-AD Research here, there and Everywhere. Drive My CAR-AD Research here, there and Everywhere.
Pub Date : 2024-01-01 DOI: 10.2174/156720502101240524145811
Juan Manuel Górriz Sáez
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引用次数: 0
The Importance of Long-term Partner Observation in Cognitive Evaluation: A Very Early Creutzfeldt-Jakob Disease in a Patient with Mild Cognitive Impairment. 认知评估中长期伴侣观察的重要性:一名轻度认知障碍患者的早期克雅氏病》(Very Early Creutzfeldt-Jakob Disease in a Patient with Mild Cognic Impairment.
Pub Date : 2024-01-01 DOI: 10.2174/0115672050309694240708052535
Hatice Yuksel, Elif Bademci Eren, Baris Maldar, Ayse Pinar Titiz

Background: Creutzfeldt-Jakob disease (CJD) is a fatal degenerative brain disease characterized by rapidly progressive dementia. Sporadic CJD (sCJD) is the best-known and most common subtype. Because the disease is uncommon and has highly diverse presenting symptoms, early diagnosis is challenging. We herein report a case of probable sCJD diagnosed at a very early stage.

Case presentation: A 61-year-old female patient had mild attention and memory problems for a few months that were noticed by her husband but did not bother her and did not affect her daily life activities. The first brain magnetic resonance imaging (MRI) at another hospital was normal, lacking diffusion-weighted imaging (DWI). Although the newly taken brain MRI without DWI was normal, the patient's husband brought his patient to our outpatient clinic because he continued to think that there was a difference in his wife's attention and memory. A neurological examination of the patient revealed almost normal findings. The neuropsychiatric evaluation of the patient was consistent with mild cognitive impairment. The patient's electroencephalography taken upon admission had no characteristic findings for CJD but showed generalized epileptiform activity. Therefore, the patient was hospitalized, and a second brain MRI, including DWI sequences, was performed. DWI displayed bilateral asymmetrical typical patterns of restricted diffusion. Cerebrospinal fluid 14-3-3 was positive, and total-tau was highly elevated. She had a diagnosis of probable sCJD at an early stage. Later, the patient developed progressive dementia, ataxia, seizures, and extrapyramidal symptoms, followed by mutism, and died.

Conclusion: Although there is no cure for CJD today, early diagnosis is essential, mainly because of its potential infectivity and for future planning. Diagnosing sCJD in its early stages is difficult. However, taking into account the observations of not only the patient's history but also their longterm partners in cognitive evaluations will be helpful in making an early and accurate diagnosis.

背景:克雅氏病(CJD)是一种致命的脑部变性疾病,其特征是快速进展性痴呆。散发性克雅氏病(sCJD)是最著名和最常见的亚型。由于该病并不常见,且表现症状多种多样,因此早期诊断极具挑战性。我们在此报告一例早期诊断出的疑似 sCJD 病例:病例介绍:一名 61 岁的女性患者在几个月前出现轻微的注意力和记忆力问题,她的丈夫也注意到了这一问题,但并没有打扰她,也没有影响她的日常生活活动。在另一家医院进行的首次脑磁共振成像(MRI)检查结果正常,但缺乏弥散加权成像(DWI)。虽然新做的脑部核磁共振成像(无弥散加权成像)正常,但患者的丈夫还是带患者来我院门诊就诊,因为他始终认为妻子的注意力和记忆力有异。对患者进行的神经系统检查显示结果基本正常。对患者进行的神经精神评估符合轻度认知障碍。入院时进行的脑电图检查没有发现脊髓灰质炎的特征性结果,但显示有全身癫痫样活动。因此,患者被安排住院,并进行了第二次脑部核磁共振成像,包括 DWI 序列。DWI 显示双侧不对称的典型弥散受限模式。脑脊液 14-3-3 呈阳性,总 tau 高度升高。她在早期被诊断为可能的 sCJD。后来,患者出现进行性痴呆、共济失调、癫痫发作和锥体外系症状,继而出现缄默症,最终死亡:尽管目前还无法治愈 CJD,但早期诊断是至关重要的,这主要是因为它具有潜在的传染性,同时也是为了未来的规划。早期诊断 sCJD 十分困难。然而,在认知评估中不仅要考虑患者的病史,还要考虑其长期伴侣的观察结果,这将有助于做出早期准确诊断。
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引用次数: 0
Therapeutic Effects of Arctiin on Alzheimer's Disease-like Model in Rats by Reducing Oxidative Stress, Inflammasomes and Fibrosis. 通过降低氧化应激、炎症体和纤维化,八角苷对阿尔茨海默病样模型大鼠的治疗作用
Pub Date : 2024-01-01 DOI: 10.2174/0115672050333388240801043509
Mohamed T Almeaqli, Yazeed Alaidaa, Faisal M Alnajjar, Abdullah S Al Shararh, Danah S Alharbi, Yazeed I Almslmani, Yousef A Alotibi, Hani S Alrashidi, Wael A Alshehri, Hanan M Hassan, Mohammed M H Al-Gayyar

Background: Alzheimer's disease (AD) affects approximately 50 million people globally and is expected to triple by 2050. Arctiin is a lignan found in the Arctium lappa L. plant. Arctiin possesses anti-proliferative, antioxidative and anti-adipogenic.

Objectives: We aimed to explore the potential therapeutic effects of Arctiin on rats with AD by evaluating the expression of TLR4, NLRP3, STAT3, TGF-β, cyclin D1, and CDK2.

Methods: AD was induced in rats by administering 70 mg/kg of aluminum chloride through intraperitoneal injection daily for six weeks. After inducing AD, some rats were treated with 25 mg/kg of Arctiin daily for three weeks through oral gavage. Furthermore, to examine the brain tissue structure, hippocampal sections were stained with hematoxylin/eosin and anti-TLR4 antibodies. The collected samples were analyzed for gene expression and protein levels of TLR4, NLRP3, STAT3, TGF-β, cyclin D1, and CDK2.

Results: In behavioral tests, rats showed a significant improvement in their behavior when treated with Arctiin. Microimages stained with hematoxylin/eosin showed that Arctiin helped to improve the structure and cohesion of the hippocampus, which was previously impaired by AD. Furthermore, Arctiin reduced the expression of TLR4, NLRP3, STAT3, TGF-β, cyclin D1, and CDK2.

Conclusion: Arctiin can enhance rats' behavior and structure of the hippocampus in AD rats. This is achieved through its ability to reduce the expression of both TLR4 and NLRP3, hence inhibiting the inflammasome pathway. Furthermore, Arctiin can improve tissue fibrosis by regulating STAT3 and TGF-β. Lastly, it can block the cell cycle proteins cyclin D1 and CDK2.

背景:阿尔茨海默病(AD)影响着全球约 5000 万人,预计到 2050 年将增加两倍。Arctiin 是一种木质素,存在于牛蒡(Arctium lappa L.)植物中。辛夷苷具有抗增殖、抗氧化和抗脂肪生成的作用:我们旨在通过评估 TLR4、NLRP3、STAT3、TGF-β、细胞周期蛋白 D1 和 CDK2 的表达,探讨牛蒡苷对 AD 大鼠的潜在治疗效果:每天腹腔注射 70 毫克/千克氯化铝诱导大鼠 AD,连续注射六周。诱导 AD 后,部分大鼠通过口服每天 25 毫克/千克的 Arctiin,持续三周。此外,为了检查脑组织结构,海马切片用苏木精/伊红和抗TLR4抗体染色。对采集的样本进行基因表达分析,并检测 TLR4、NLRP3、STAT3、TGF-β、细胞周期蛋白 D1 和 CDK2 的蛋白水平:在行为测试中,接受 Arctiin 治疗的大鼠行为明显改善。用苏木精/伊红染色的显微图像显示,Arctiin 有助于改善海马体的结构和凝聚力。此外,阿胶还能减少TLR4、NLRP3、STAT3、TGF-β、细胞周期蛋白D1和CDK2的表达:结论:牛蒡子素能改善AD大鼠的行为和海马结构,这是通过降低TLR4、NLRP3、STAT3、TGF-β、cyclin D1和CDK2的表达来实现的。结论:苦杏仁苷能改善 AD 大鼠的行为和海马结构,这是因为它能减少 TLR4 和 NLRP3 的表达,从而抑制炎性体通路。此外,阿克替因还能通过调节 STAT3 和 TGF-β 改善组织纤维化。最后,它还能阻断细胞周期蛋白 cyclin D1 和 CDK2。
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引用次数: 0
Plasma Biomarkers in Neurodegenerative Dementias: Unrevealing the Potential of Serum Oxytocin, BDNF, NPTX1, TREM2, TNF-alpha, IL-1 and Prolactin. 神经退行性痴呆症的血浆生物标志物:揭示血清催产素、BDNF、NPTX1、TREM2、TNF-α、IL-1 和催乳素的潜力。
Pub Date : 2024-01-01 DOI: 10.2174/0115672050313419240520051751
Yeşim Olğun, Cana Aksoy Poyraz, Melda Bozluolçay, Dildar Konukoğlu, Burç Çağrı Poyraz

Background: Dementia encompasses a range of neurodegenerative disorders characterized by cognitive decline and functional impairment. The identification of reliable biomarkers is essential for accurate diagnosis and gaining insights into the mechanisms underlying diseases.

Objective: This study aimed to investigate the plasma biomarker profiles associated with Brain- Derived Neurotrophic Factor (BDNF), Oxytocin, Neuronal Pentraxin-1 (NPTX1), Triggering Receptor Expressed on Myeloid Cells 2 (TREM2), Tumor Necrosis Factor-alpha (TNF-alpha), Interleukin- 1 (IL-1) and Prolactin in Alzheimer's disease (AD), dementia with Lewy bodies (DLB), frontotemporal dementias (FTD) and healthy controls.

Methods: Serum levels of the aforementioned biomarkers were analyzed in 23 AD, 28 DLB, 15 FTD patients recruited from outpatient units and 22 healthy controls. Diagnostic evaluations followed established criteria and standardized clinical tests were conducted. Blood samples were collected and analyzed using ELISA and electrochemiluminescence immunoassay methods.

Results: Serum BDNF and oxytocin levels did not significantly differ across groups. NPTX1, TREM2, TNF-alpha and IL-1 levels also did not show significant differences among dementia groups. However, prolactin levels exhibited distinct patterns, with lower levels in male DLB patients and higher levels in female AD patients compared to controls.

Conclusion: The study findings suggest potential shared mechanisms in dementia pathophysiology and highlight the importance of exploring neuroendocrine responses, particularly in AD and DLB. However, further research is warranted to elucidate the role of these biomarkers in dementia diagnosis and disease progression.

背景:痴呆症包括一系列以认知能力下降和功能障碍为特征的神经退行性疾病。鉴定可靠的生物标志物对于准确诊断和深入了解疾病的内在机制至关重要:本研究旨在调查与脑源性神经营养因子(BDNF)、催产素、神经元五肽-1(NPTX1)、髓样细胞上表达的触发受体 2(TREM2)相关的血浆生物标志物谱、肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)和催乳素在阿尔茨海默病(AD)、路易体痴呆(DLB)、额颞叶痴呆(FTD)和健康对照组中的作用。研究方法对从门诊部招募的 23 名 AD、28 名 DLB、15 名 FTD 患者和 22 名健康对照者的血清中上述生物标志物水平进行分析。诊断评估遵循既定标准,并进行了标准化临床测试。采集血样并采用 ELISA 和电化学发光免疫分析方法进行分析:结果:血清 BDNF 和催产素水平在各组间无明显差异。NPTX1、TREM2、TNF-α和IL-1水平在各痴呆组之间也无明显差异。然而,与对照组相比,催乳素水平表现出不同的模式,男性DLB患者的催乳素水平较低,而女性AD患者的催乳素水平较高:研究结果表明了痴呆症病理生理学的潜在共同机制,并强调了探索神经内分泌反应的重要性,尤其是在AD和DLB中。然而,要阐明这些生物标志物在痴呆症诊断和疾病进展中的作用,还需要进一步的研究。
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引用次数: 0
Effects of Cycloastragenol on Alzheimer's Disease in Rats by Reducing Oxidative Stress, Inflammation, and Apoptosis. 环黄芪醇通过减少氧化应激、炎症和细胞凋亡对大鼠阿尔茨海默病的影响
Pub Date : 2024-01-01 DOI: 10.2174/0115672050315334240508162754
Kadi M Alharbi, Shahad A Alshehri, Wasayf A Almarwani, Khulud K Aljohani, Ajwan Z Albalawi, Areej S Alatawi, Shekha M Al-Atwi, Lama S Alhwyty, Hanan M Hassan, Mohammed M H Al-Gayyar

Background: As individuals age, they may develop Alzheimer's disease (AD), which is characterized by difficulties in speech, memory loss, and other issues related to neural function. Cycloastragenol is an active ingredient of Astragalus trojanus and has been used to treat inflammation, aging, heart disease, and cancer.

Objectives: This study aimed to explore the potential therapeutic benefits of cycloastragenol in rats with experimentally induced AD. Moreover, the underlying molecular mechanisms were also evaluated by measuring Nrf2 and HO-1, which are involved in oxidative stress, NFκB and TNF-α, which are involved in inflammation, and BCL2, BAX, and caspase-3, which are involved in apoptosis.

Methods: Sprague-Dawley rats were given 70 mg/kg of aluminum chloride intraperitoneally daily for six weeks to induce AD. Following AD induction, the rats were given 25 mg/kg of cycloastragenol daily by oral gavage for three weeks. Hippocampal sections were stained with hematoxylin/ eosin and with anti-caspase-3 antibodies. The Nrf2, HO-1, NFκB, TNF-α, BCL2, BAX, and caspase-3 gene expressions and protein levels in the samples were analyzed.

Results: Cycloastragenol significantly improved rats' behavioral test performance. It also strengthened the organization of the hippocampus. Cycloastragenol significantly improved behavioral performance and improved hippocampal structure in rats. It caused a marked decrease in the expression of NFκB, TNF-α, BAX, and caspase-3, which was associated with an increase in the expression of BCL2, Nrf2, and HO-1.

Conclusion: Cycloastragenol improved the structure of the hippocampus in rats with AD. It enhanced the outcomes of behavioral tests, decreased the concentration of AChE in the brain, and exerted antioxidant and anti-inflammatory effects. Antiapoptotic effects were also noted, leading to significant improvements in cognitive function, memory, and behavior in treated rats.

背景:随着年龄的增长,人们可能会患上阿尔茨海默病(AD),其特征是语言障碍、记忆力减退以及其他与神经功能有关的问题。环黄芪醇是黄芪的一种活性成分,已被用于治疗炎症、衰老、心脏病和癌症:本研究旨在探讨环黄芪醇对实验诱导的注意力缺失症大鼠的潜在治疗作用。此外,还通过测定参与氧化应激的Nrf2和HO-1、参与炎症的NFκB和TNF-α以及参与细胞凋亡的BCL2、BAX和caspase-3,对其潜在的分子机制进行了评估:连续六周每天腹腔注射 70 毫克/千克氯化铝诱导 Sprague-Dawley 大鼠产生 AD。诱导AD后,每天给大鼠灌胃25毫克/千克环黄芪醇,连续三周。海马切片用苏木精/伊红和抗天冬酶-3抗体染色。对样本中的Nrf2、HO-1、NFκB、TNF-α、BCL2、BAX和caspase-3基因表达和蛋白水平进行了分析:结果:环黄芪醇能明显改善大鼠的行为测试表现。结果:环黄芪醇能明显改善大鼠的行为测试表现,还能增强海马的组织结构。环黄芪醇能明显改善大鼠的行为表现并改善海马结构。环黄芪醇能显著降低NFκB、TNF-α、BAX和caspase-3的表达,同时增加BCL2、Nrf2和HO-1的表达:结论:环黄芪醇能改善AD大鼠的海马结构。结论:环黄芪醇能改善 AD 大鼠海马的结构,提高行为测试的结果,降低大脑中 AChE 的浓度,并发挥抗氧化和抗炎作用。它还具有抗细胞凋亡的作用,从而显著改善了治疗大鼠的认知功能、记忆力和行为。
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引用次数: 0
Handwriting Markers for the Onset of Alzheimer's Disease. 老年痴呆症发病的手写标记。
Pub Date : 2024-01-01 DOI: 10.2174/0115672050299338240222051023
Yury Chernov

Introduction: Alzheimer's disease has an impact on handwriting (AD). Numerous researchers reported that fact. Therefore, examining handwriting characteristics could be a useful way to screen for AD. The aim of the article is to present the reliability and effectiveness of the AD-HS tool.

Methods: Most of the existing studies examine either linguistic manifestations of writing or certain motor functions. However, handwriting is a complex of cognitive and motor activities. Since the influence of AD on handwriting is individual, it is important to analyze the complete set of handwriting features. The AD-HS instrument is based on this principle. Validation of the AD-HS instrument for revealing cognitive impairment in AD-diagnosed persons in comparison to the control group. The study is based on the evaluation of free handwritten texts. AD-HS includes 40 handwriting and 2 linguistic features of handwritten texts. It is based on the standard protocol for handwriting analysis. The cumulative evaluation of all features builds a quantitative AD-Indicator (ADI) as a marker of possible AD conditions. The analyzed experiment includes 53 AD-diagnosed persons and a control group of 192 handwriting specimens from the existing database.

Results: AD-HS shows a distinct difference in evaluated ADI for the participants (the mean value equals 0.49) and the control group (the mean value equals 0.28).

Conclusion: The handwriting marker of AD could be an effective supplement instrument for earlier screening. It is also useful when traditional biomarkers and neurological tests could not be applied. AD-HS can accompany therapy as an indication of its effect on a person.

简介阿尔茨海默病会影响书写(AD)。许多研究人员都报告了这一事实。因此,检查笔迹特征可能是筛查阿兹海默症的有效方法。本文旨在介绍 AD-HS 工具的可靠性和有效性:现有的大多数研究要么检查书写的语言表现,要么检查某些运动功能。然而,手写是认知和运动活动的综合体。由于注意力缺失症对笔迹的影响是个体性的,因此分析一整套笔迹特征非常重要。AD-HS 仪器就是基于这一原则设计的。与对照组相比,AD-HS 仪器在揭示注意力缺失症诊断者的认知障碍方面进行了验证。该研究基于对自由手写文本的评估。AD-HS 包括手写文本的 40 个笔迹特征和 2 个语言特点。它基于手写分析的标准协议。通过对所有特征的累积评估,可以建立一个定量的注意力缺失指标(ADI),作为可能的注意力缺失状况的标记。分析实验包括 53 名被诊断为注意力缺失症的人和来自现有数据库的 192 份手写样本组成的对照组:结果:AD-HS 对参与者(平均值为 0.49)和对照组(平均值为 0.28)的 ADI 评估结果显示出明显差异:结论:注意力缺失症手写标记可作为早期筛查的有效补充工具。结论:AD 手写标记可作为早期筛查的有效补充工具,在无法使用传统生物标志物和神经测试时也很有用。AD-HS 可以作为治疗的辅助手段,显示治疗对患者的效果。
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引用次数: 0
Disruptions of Gut Microbiota are Associated with Cognitive Deficit of Preclinical Alzheimer's Disease: A Cross-Sectional Study. 肠道微生物群紊乱与临床前阿尔茨海默病的认知缺陷有关:一项横断面研究
Pub Date : 2024-01-01 DOI: 10.2174/0115672050303878240319054149
Binbin Yu, Guomeng Wan, Shupeng Cheng, Pengcheng Wen, Xi Yang, Jiahuan Li, Huifang Tian, Yaxin Gao, Qian Zhong, Jin Liu, Jianan Li, Yi Zhu

Background: Alzheimer's Disease (AD) is the most prevalent type of dementia. The early change of gut microbiota is a potential biomarker for preclinical AD patients.

Objective: The study aimed to explore changes in gut microbiota characteristics in preclinical AD patients, including those with Subjective Cognitive Decline (SCD) and Mild Cognitive Impairment (MCI), and detect the correlation between gut microbiota characteristics and cognitive performances.

Methods: This study included 117 participants [33 MCI, 54 SCD, and 30 Healthy Controls (HC)]. We collected fresh fecal samples and blood samples from all participants and evaluated their cognitive performance. We analyzed the diversity and structure of gut microbiota in all participants through qPCR, screened characteristic microbial species through machine learning models, and explored the correlations between these species and cognitive performances and serum indicators.

Results: Compared to the healthy controls, the structure of gut microbiota in MCI and SCD patients was significantly different. The three characteristic microorganisms, including Bacteroides ovatus, Bifidobacterium adolescentis, and Roseburia inulinivorans, were screened based on the best classification model (HC and MCI) having intergroup differences. Bifidobacterium adolescentis is associated with better performance in multiple cognitive scores and several serum indicators. Roseburia inulinivorans showed negative correlations with the scores of the Functional Activities Questionnaire (FAQ).

Conclusion: The gut microbiota in patients with preclinical AD has significantly changed in terms of composition and richness. Correlations have been discovered between changes in characteristic species and cognitive performances. Gut microbiota alterations have shown promise in affecting AD pathology and cognitive deficit.

背景:阿尔茨海默病(AD)是最常见的痴呆类型。肠道微生物群的早期变化是临床前阿兹海默症患者的潜在生物标志物:本研究旨在探讨临床前 AD 患者(包括主观认知功能减退(SCD)和轻度认知功能障碍(MCI)患者)肠道微生物群特征的变化,并检测肠道微生物群特征与认知表现之间的相关性:本研究包括 117 名参与者[33 名 MCI、54 名 SCD 和 30 名健康对照组 (HC)]。我们收集了所有参与者的新鲜粪便样本和血液样本,并评估了他们的认知能力。我们通过 qPCR 分析了所有参与者肠道微生物群的多样性和结构,通过机器学习模型筛选了特征微生物物种,并探讨了这些物种与认知能力和血清指标之间的相关性:与健康对照组相比,MCI 和 SCD 患者的肠道微生物群结构有显著差异。根据具有组间差异的最佳分类模型(HC 和 MCI)筛选出了三种特征微生物,包括卵形乳杆菌(Bacteroides ovatus)、青春期双歧杆菌(Bifidobacterium adolescentis)和菊苣菌(Roseburia inulinivorans)。青少年双歧杆菌在多项认知评分和几项血清指标方面表现更佳。罗氏菊苣菌与功能活动问卷(FAQ)的得分呈负相关:结论:临床前注意力缺失症患者的肠道微生物群在组成和丰富度方面发生了显著变化。结论:临床前注意力缺失症患者的肠道微生物群在组成和丰富度方面发生了显著变化,发现特征物种的变化与认知能力之间存在相关性。肠道微生物群的改变有望影响 AD 的病理和认知缺陷。
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引用次数: 0
Associations of Multimorbidity with Cerebrospinal Fluid Biomarkers for Neurodegenerative Disorders in Early Parkinson's Disease: A Crosssectional and Longitudinal Study. 早期帕金森病患者的多病症与脑脊液神经退行性疾病生物标志物的关系:一项横断面和纵向研究
Pub Date : 2024-01-01 DOI: 10.2174/0115672050314397240708060314
Ming-Zhan Zhang, Yan Sun, Yan-Ming Chen, Fan Guo, Pei-Yang Gao, Lan Tan, Meng-Shan Tan

Object: The study aims to determine whether multimorbidity status is associated with cerebrospinal fluid (CSF) biomarkers for neurodegenerative disorders.

Methods: A total of 827 patients were enrolled from the Parkinson's Progression Markers Initiative (PPMI) database, including 638 patients with early-stage Parkinson's disease (PD) and 189 healthy controls (HCs). Multimorbidity status was evaluated based on the count of long-term conditions (LTCs) and the multimorbidity pattern. Using linear regression models, cross-sectional and longitudinal analyses were conducted to assess the associations of multimorbidity status with CSF biomarkers for neurodegenerative disorders, including α-synuclein (αSyn), amyloid-β42 (Aβ42), total tau (t-tau), phosphorylated tau (p-tau), glial fibrillary acidic protein (GFAP), and neurofilament light chain protein (NfL).

Results: At baseline, the CSF t-tau (p = 0.010), p-tau (p = 0.034), and NfL (p = 0.049) levels showed significant differences across the three categories of LTC counts. In the longitudinal analysis, the presence of LTCs was associated with lower Aβ42 (β < -0.001, p = 0.020), and higher t-tau (β = 0.007, p = 0.026), GFAP (β = 0.013, p = 0.022) and NfL (β = 0.020, p = 0.012); Participants with tumor/musculoskeletal/mental disorders showed higher CSF levels of t-tau (β = 0.016, p = 0.011) and p-tau (β = 0.032, p = 0.044) than those without multimorbidity.

Conclusion: Multimorbidity, especially severe multimorbidity and the pattern of mental/musculoskeletal/ tumor disorders, was associated with CSF biomarkers for neurodegenerative disorders in early-stage PD patients, suggesting that multimorbidity might play a crucial role in aggravating neuronal damage in neurodegenerative diseases.

研究目的该研究旨在确定多病状态是否与神经退行性疾病的脑脊液(CSF)生物标志物有关:从帕金森病进展标志物倡议(PPMI)数据库中招募了827名患者,其中包括638名早期帕金森病(PD)患者和189名健康对照者(HCs)。多病状态根据长期病症(LTC)的数量和多病模式进行评估。利用线性回归模型进行了横向和纵向分析,以评估多病状态与脑脊液中神经退行性疾病生物标志物(包括α-突触核蛋白(αSyn)、淀粉样蛋白-β42(Aβ42)、总tau(t-tau)、磷酸化tau(p-tau)、胶质纤维酸性蛋白(GFAP)和神经丝轻链蛋白(NfL))之间的关系:基线时,三类 LTC 计数的 CSF t-tau(p = 0.010)、p-tau(p = 0.034)和 NfL(p = 0.049)水平存在显著差异。在纵向分析中,LTC 的存在与较低的 Aβ42 (β < -0.001,p = 0.020)、较高的 t-tau (β = 0.007,p = 0.026)、GFAP (β = 0.013,p = 0.022)和 NfL (β = 0.020,p = 0.012);患有肿瘤/肌肉骨骼/精神疾病的参与者的 CSF t-tau(β = 0.016,p = 0.011)和 p-tau(β = 0.032,p = 0.044)水平高于无多病症者:结论:多病,尤其是严重多病和精神/肌肉骨骼/肿瘤疾病模式,与早期帕金森病患者CSF神经退行性疾病生物标志物相关,表明多病可能在加重神经退行性疾病的神经元损伤中起关键作用。
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引用次数: 0
Estimating Dementia Onset: AT(N) Profiles and Predictive Modeling in Mild Cognitive Impairment Patients. 痴呆症发病的估计:轻度认知障碍患者的 AT(N) 图谱和预测模型
Pub Date : 2024-01-01 DOI: 10.2174/0115672050295317240223162312
Carlos Platero, Jussi Tohka, Bryan Strange

Background: Mild Cognitive Impairment (MCI) usually precedes the symptomatic phase of dementia and constitutes a window of opportunities for preventive therapies.

Objectives: The objective of this study was to predict the time an MCI patient has left to reach dementia and obtain the most likely natural history in the progression of MCI towards dementia.

Methods: This study was conducted on 633 MCI patients and 145 subjects with dementia through 4726 visits over 15 years from Alzheimer Disease Neuroimaging Initiative (ADNI) cohort. A combination of data from AT(N) profiles at baseline and longitudinal predictive modeling was applied. A data-driven approach was proposed for categorical diagnosis prediction and timeline estimation of cognitive decline progression, which combined supervised and unsupervised learning techniques.

Results: A reduced vector of only neuropsychological measures was selected for training the models. At baseline, this approach had high performance in detecting subjects at high risk of converting from MCI to dementia in the coming years. Furthermore, a Disease Progression Model (DPM) was built and also verified using three metrics. As a result of the DPM focused on the studied population, it was inferred that amyloid pathology (A+) appears about 7 years before dementia, and tau pathology (T+) and neurodegeneration (N+) occur almost simultaneously, between 3 and 4 years before dementia. In addition, MCI-A+ subjects were shown to progress more rapidly to dementia compared to MCI-A- subjects.

Conclusion: Based on proposed natural histories and cross-sectional and longitudinal analysis of AD markers, the results indicated that only a single cerebrospinal fluid sample is necessary during the prodromal phase of AD. Prediction from MCI into dementia and its timeline can be achieved exclusively through neuropsychological measures.

背景:轻度认知障碍(MCI)通常早于痴呆症的症状期,是预防性疗法的机会之窗:本研究的目的是预测 MCI 患者达到痴呆的剩余时间,并获得 MCI 向痴呆发展过程中最有可能出现的自然病史:这项研究的对象是阿尔茨海默病神经影像学倡议(ADNI)队列中的633名MCI患者和145名痴呆症患者,他们在15年间共就诊4726次。研究结合了基线AT(N)特征数据和纵向预测模型。结合监督和非监督学习技术,提出了一种数据驱动的方法,用于分类诊断预测和认知能力下降进程的时间轴估计:结果:在训练模型时,只选择了神经心理测量的缩减向量。在基线阶段,这种方法在检测未来几年从 MCI 转为痴呆症的高风险受试者方面表现出色。此外,还建立了疾病进展模型(DPM),并使用三个指标进行了验证。根据以研究人群为重点的 DPM,推断出淀粉样病变(A+)出现在痴呆症出现前 7 年左右,而 tau 病变(T+)和神经变性(N+)几乎同时出现,即在痴呆症出现前 3 到 4 年之间。此外,与MCI-A-受试者相比,MCI-A+受试者发展为痴呆症的速度更快:结论:根据所提出的自然病史以及对AD标记物的横断面和纵向分析,结果表明在AD的前驱阶段只需采集一份脑脊液样本。从 MCI 到痴呆的预测及其时间表完全可以通过神经心理测量来实现。
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Current Alzheimer research
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