阿尔茨海默氏症和行为变异性额颞叶痴呆症患者脑脊液生物标志物与灰质萎缩之间的相关性

Gaetano Scianatico, Valerio Manippa, Domenico Zacà, Jorge Jovicich, Benedetta Tafuri, Davide Rivolta, Giancarlo Logroscino
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引用次数: 0

摘要

导言:在早期阶段区分额颞叶痴呆(FTD)和阿尔茨海默病(AD)仍然是一项重大的临床挑战。脑脊液(CSF)生物标志物(总Tau、磷酸化Tau和β-淀粉样蛋白)是识别这两种疾病早期差异的有望候选指标:本研究调查了额颞叶痴呆行为变异型(bvFTD)和阿尔茨海默病(AD)的灰质密度与 CSF 标志物之间的关系。研究人员采集了14名bvFTD患者、15名AD患者和13名认知正常(CN)匹配受试者的脑脊液和三维T1加权磁共振(MR)图像。比较了三组患者的脑脊液标记物及其相对比率(总Tau/β-淀粉样蛋白、磷酸化Tau/β-淀粉样蛋白)。为了描述bvFTD和AD患者与CN受试者相比在解剖学上的变化,还进行了基于体素的形态测量(VBM)。通过自动分割 3.0 特斯拉三维 T1 加权磁共振图像获得灰质密度图,并研究其与 CSF 标记和相对比率的相关性。结果表明,与 CN 受试者相比,AD 患者的脑脊液总 Tau 水平较高,而β-淀粉样蛋白水平较低;但是,β-淀粉样蛋白和相对比率可将 AD 与 bvFTD 区分开来。此外,AD和bvFTD患者表现出不同的萎缩模式,AD表现出更多的中央(颞叶区域)萎缩,而bvFTD表现出更多的前部(额叶区域)萎缩:在AD组中,灰质密度图与脑脊液标记物浓度之间存在相关性,总Tau和磷酸化Tau水平与左侧颞上回的低灰质密度高度相关:该研究得出结论:虽然bvFTD缺乏CSF标志物图谱,但CSFβ-淀粉样蛋白水平有助于区分AD和bvFTD。此外,磁共振结构成像也有助于区分这两种病症。
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Correlations between Cerebrospinal Fluid Biomarkers and Gray Matter Atrophy in Alzheimer's and Behavioural Variant Frontotemporal Dementia.

Introduction: Distinguishing between frontotemporal dementia (FTD) and Alzheimer's disease (AD) in their early stages remains a significant clinical challenge. Cerebrospinal fluid (CSF) biomarkers (total Tau, phosphorylated Tau, and beta-amyloid) are promising candidates for identifying early differences between these conditions.

Method: This study investigates the relationship between grey matter density and CSF markers in the behavioural variant of frontotemporal dementia (bvFTD) and Alzheimer's disease (AD). CSF and 3D T1-weighted magnetic resonance (MR) images were acquired from 14 bvFTD patients, 15 AD patients, and 13 cognitively normal (CN) matched subjects. The CSF markers and their relative ratios (total Tau/beta-amyloid, phosphorylated Tau/beta-amyloid) were compared across the three groups. Voxel-based morphometry (VBM) was performed to characterize the anatomical changes in bvFTD and AD patients compared to CN subjects. Grey matter density maps were obtained by automatic segmentation of 3.0 Tesla 3D T1-Weighted MR Images, and their correlation with CSF markers and relative ratios was investigated. Results demonstrated that, as compared to CN subjects, AD patients are characterised by higher CSF total Tau levels and lower beta-amyloid levels; however, beta-amyloid and relative ratios discriminated AD from bvFTD. In addition, AD and bvFTD patients showed different patterns of atrophy, with AD exhibiting more central (temporal areas) and bvFTD more anterior (frontal areas) atrophy.

Results: A correlation was found between grey matter density maps and CSF marker concentrations in the AD group, with total Tau and phosphorylated Tau levels showing a high association with low grey matter density in the left superior temporal gyrus.

Conclusion: The study concludes that while bvFTD lacks a CSF marker profile, CSF beta-amyloid levels are useful for differentiating AD from bvFTD. Furthermore, MR structural imaging can contribute significantly to distinguishing between the two pathologies.

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