Brain Atrophy Subtypes and the ATN Classification Scheme in Alzheimer's Disease.

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Neurodegenerative Diseases Pub Date : 2020-01-01 Epub Date: 2021-03-31 DOI:10.1159/000515322

Nira Cedres, Urban Ekman, Konstantinos Poulakis, Sara Shams, Lena Cavallin, Sebastian Muehlboeck, Tobias Granberg, Lars-Olof Wahlund, Daniel Ferreira, Eric Westman

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引用次数: 4

Abstract

Introduction: We investigated the association between atrophy subtypes of Alzheimer's disease (AD), the ATN classification scheme, and key demographic and clinical factors in 2 cohorts with different source characteristics (a highly selective research-oriented cohort, the Alzheimer's Disease Neuroimaging Initiative [ADNI]; and a naturalistic heterogeneous clinically oriented cohort, Karolinska Imaging Dementia Study [KIDS]).

Methods: A total of 382 AD patients were included. Factorial analysis of mixed data was used to investigate associations between AD subtypes based on brain atrophy patterns, ATN profiles based on cerebrospinal fluid biomarkers, and age, sex, Mini Mental State Examination (MMSE), cerebrovascular disease (burden of white matter signal abnormalities, WMSAs), and APOE genotype.

Results: Older patients with high WMSA burden, belonging to the typical AD subtype and showing A+T+N+ or A+T+N- profiles clustered together and were mainly from ADNI. Younger patients with low WMSA burden, limbic-predominant or minimal atrophy AD subtypes, and A+T-N- or A+T-N+ profiles clustered together and were mainly from KIDS. APOE ε4 carriers more frequently showed the A+T-N- and A+T+N- profiles.

Conclusions: Our findings align with the recent framework for biological subtypes of AD: the combination of risk factors, protective factors, and brain pathologies determines belonging of AD patients to distinct subtypes.

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阿尔茨海默病的脑萎缩亚型和ATN分类方案。

我们在两个具有不同来源特征的队列中研究了阿尔茨海默病(AD)萎缩亚型、ATN分类方案以及关键人口统计学和临床因素之间的关系(一个高度选择性的研究型队列，阿尔茨海默病神经影像学倡议[ADNI];和一个自然的异质临床定向队列，卡罗林斯卡成像痴呆研究[KIDS])。方法:共纳入382例AD患者。使用混合数据的析因分析来研究基于脑萎缩模式的AD亚型、基于脑脊液生物标志物的ATN谱、年龄、性别、迷你精神状态检查(MMSE)、脑血管疾病(白质信号异常负担，WMSAs)和APOE基因型之间的相关性。结果:老年患者WMSA负担高，属于典型的AD亚型，表现为A+T+N+或A+T+N-聚集型，主要来自ADNI。低WMSA负荷、边缘显性或最小萎缩AD亚型、A+T-N-或A+T-N+谱的年轻患者聚集在一起，主要来自儿童。APOE ε4载体多表现为A+T-N-和A+T+N-。结论:我们的研究结果与阿尔茨海默病生物学亚型的最新框架一致:危险因素、保护因素和脑部病理的结合决定了阿尔茨海默病患者属于不同的亚型。

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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来源期刊

Neurodegenerative Diseases 医学-临床神经学

CiteScore

5.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Neurodegenerative Diseases'' is a bimonthly, multidisciplinary journal for the publication of advances in the understanding of neurodegenerative diseases, including Alzheimer''s disease, Parkinson''s disease, amyotrophic lateral sclerosis, Huntington''s disease and related neurological and psychiatric disorders.