Cognitive and cerebral phenotypes of neurocognitive disorders due to alcohol or Alzheimer's disease.

IF 4.5 Q1 CLINICAL NEUROLOGY
Brain communications Pub Date : 2025-08-20 eCollection Date: 2025-01-01 DOI:10.1093/braincomms/fcaf289
Célia Soussi, Shailendra Segobin, Nicolas Cabé, Alice Laniepce, Laurent Coulbault, Céline Boudehent, Vincent de la Sayette, Gaël Chételat, Anne-Lise Pitel
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Abstract

Distinguishing aetiologies of neurocognitive disorder (NCD) between alcohol-induced pathologies (OH) and Alzheimer's disease poses a major clinical challenge while dual diagnosis may be common. We aimed to define commonalities and specificities of neurocognitive alterations in OH or Alzheimer's Disease, considering the NCD severity (mild/major). In this retrospective cross-sectional study, we included 203 participants: 50 Mild-NCD-OH patients, 18 Major-NCD-OH patients, 30 Mild-NCD-AD patients, 24 Major-NCD-AD patients, as well as 81 healthy controls. Patients were compared on a neuropsychological and multimodal neuroimaging assessment (grey/white matter density and glucose metabolism). Analyses explored commonalities and specificities of each patient group within each NCD severity. All patient groups had episodic memory impairments, medial temporal lobe damage and hypometabolism in thalami and posteromedial cortex. NCD-AD patients had more severe cognitive deficits than NCD-OH patients, and the reverse pattern was observed for brain damage. NCD-OH patients notably showed more severe thalamic and cingulate alterations. NCD-OH patients also presented cerebellar damage not observed in NCD-AD. Volume deficits in the medial temporal lobe and memory deficits were more severe in Mild-NCD-AD than Mild-NCD-OH, but similar in Major-NCD-AD and Major-NCD-OH. Common alterations are observed in NCD-OH and NCD-AD, mainly within the memory circuit. Only cerebellar damage appears to be specific to NCD-OH. The specificity of NCD-AD deficits relies on their severity since they are also present to a lesser extent in NCD-OH, reinforcing how the neurocognitive phenotypes overlap. These results reaffirm the importance of questioning alcohol consumption in NCD-AD patients and considering an Alzheimer's Disease diagnosis in NCD-OH patients.

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酒精或阿尔茨海默病引起的神经认知障碍的认知和大脑表型
在酒精引起的病理(OH)和阿尔茨海默病之间区分神经认知障碍(NCD)的病因是一个重大的临床挑战,而双重诊断可能是常见的。考虑到非传染性疾病的严重程度(轻度/重度),我们旨在确定OH或阿尔茨海默病中神经认知改变的共性和特异性。在这项回顾性横断面研究中,我们纳入了203名参与者:50名轻度ncd - oh患者,18名重度ncd - oh患者,30名轻度ncd - ad患者,24名重度ncd - ad患者,以及81名健康对照。比较患者的神经心理学和多模态神经影像学评估(灰质/白质密度和葡萄糖代谢)。分析探讨了每个非传染性疾病严重程度中每个患者组的共性和特异性。所有患者组均有情景记忆障碍、内侧颞叶损伤和丘脑和后内侧皮层代谢低下。NCD-AD患者比NCD-OH患者有更严重的认知缺陷,在脑损伤方面观察到相反的模式。NCD-OH患者明显表现出更严重的丘脑和扣带改变。NCD-OH患者也出现了在NCD-AD中未观察到的小脑损伤。轻度ncd - ad患者内侧颞叶容量缺损和记忆缺损比轻度ncd - oh患者更为严重,但重度ncd - ad和重度ncd - oh患者相似。在NCD-OH和NCD-AD中观察到常见的改变,主要是在存储电路中。只有小脑损伤似乎是NCD-OH特有的。NCD-AD缺陷的特异性取决于它们的严重程度,因为它们在NCD-OH中也以较小的程度存在,从而加强了神经认知表型重叠的方式。这些结果重申了质疑非传染性疾病- ad患者饮酒和考虑非传染性疾病- oh患者阿尔茨海默病诊断的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
7.00
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