Miguel Quintas-Neves, Francisco C Almeida, Kathryn Gauthreaux, Merilee A Teylan, Charles N Mock, Walter A Kukull, John F Crary, Tiago Gil Oliveira
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引用次数: 0
Abstract
Background: Brain vascular pathology is an important comorbidity in Alzheimer's disease (AD), with white matter damage independently predicting cognitive impairment. However, it is still unknown how vascular pathology differentially impacts primary age-related tauopathy (PART) compared to AD. Therefore, our objectives were to compare the brain microangiopathic burden in patients with PART and AD, evaluated by MRI, while assessing its relation with neuropathological findings, patterns of brain atrophy and degree of clinical impairment.
Methods: Clinical information, brain MRI (T1 and T2-FLAIR) and neuropathological data were obtained from the National Alzheimer's Coordinating Centre ongoing study, with a total sample of 167 patients identified, that were divided according to the presence of neuritic plaques in Consortium to Establish a Registry for Alzheimer's disease (CERAD) 0 to 3. Microangiopathic burden and brain atrophy were evaluated by two certified neuroradiologists, using, respectively, the Fazekas score and previously validated visual rating scales to assess brain regional atrophy.
Results: Significant correlations were found between the Fazekas score and atrophy in the fronto-insular and medial temporal regions on both groups, with PART showing overall stronger positive correlations than in AD, especially in the fronto-insular region. For this specific cohort, no significant correlations were found between the Fazekas score and the degree of clinical impairment.
Conclusion: Our results show that PART presents different pathological consequences at the brain microvascular level compared with AD and further supports PART as an independent pathological entity from AD.
背景：脑血管病变是阿尔茨海默病（AD）的一个重要合并症，白质损伤可独立预测认知障碍。然而，与阿尔茨海默病（AD）相比，血管病理如何对原发性年龄相关性牛磺酸脑病（PART）产生不同的影响仍是未知数。因此，我们的目的是通过核磁共振成像评估，比较原发性老年相关性牛磺酸脑病（PART）和原发性老年相关性牛磺酸脑病（AD）患者的脑部微血管病变负担，同时评估其与神经病理学发现、脑萎缩模式和临床损伤程度的关系：临床信息、脑磁共振成像（T1和T2-FLAIR）和神经病理学数据均来自国家阿尔茨海默氏症协调中心正在进行的研究，共确定了167名患者样本，并根据阿尔茨海默氏症登记联盟（CERAD）0至3级神经斑块的存在情况对其进行了划分。微血管病变负担和脑萎缩由两名认证神经放射学专家进行评估，分别使用法泽卡斯评分和先前验证的视觉评分量表来评估脑区域萎缩：结果：两组患者的法泽卡斯评分与前内侧区和颞内侧区的萎缩之间均存在显著相关性，PART患者的相关性总体强于AD患者，尤其是前内侧区。在这一特定人群中，Fazekas评分与临床损害程度之间没有发现明显的相关性：我们的研究结果表明，与 AD 相比，PART 在脑微血管水平上表现出不同的病理后果，并进一步证明 PART 是一种独立于 AD 的病理实体。
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