The Interaction Between Vascular Risk Factors, Cerebral Small Vessel Disease, and Amyloid Burden in Older Adults.

IF 3.4 3区 医学 Q2 NEUROSCIENCES
Rebecca Koncz, Wei Wen, Steve R Makkar, Ben C P Lam, John D Crawford, Christopher C Rowe, Perminder Sachdev
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引用次数: 6

Abstract

Background: Cerebral small vessel disease (SVD) and Alzheimer's disease pathology, namely amyloid-β (Aβ) deposition, commonly co-occur. Exactly how they interact remains uncertain.

Objective: Using participants from the Alzheimer's Disease Neuroimaging Initiative (n = 216; mean age 73.29±7.08 years, 91 (42.1%) females), we examined whether the presence of vascular risk factors and/or baseline cerebral SVD was related to a greater burden of Aβ cross-sectionally, and at 24 months follow-up.

Method: Amyloid burden, assessed using 18F-florbetapir PET, was quantified as the global standardized uptake value ratio (SUVR). Multimodal imaging was used to strengthen the quantification of baseline SVD as a composite variable, which included white matter hyperintensity volume using MRI, and peak width of skeletonized mean diffusivity using diffusion tensor imaging. Structural equation modeling was used to analyze the associations between demographic factors, Apolipoprotein E ɛ4 carrier status, vascular risk factors, SVD burden and cerebral amyloid.

Results: SVD burden had a direct association with Aβ burden cross-sectionally (coeff. = 0.229, p = 0.004), and an indirect effect over time (indirect coeff. = 0.235, p = 0.004). Of the vascular risk factors, a history of hypertension (coeff. = 0.094, p = 0.032) and a lower fasting glucose at baseline (coeff. = -0.027, p = 0.014) had a direct effect on Aβ burden at 24 months, but only the direct effect of glucose persisted after regularization.

Conclusion: While Aβ and SVD burden have an association cross-sectionally, SVD does not appear to directly influence the accumulation of Aβ longitudinally. Glucose regulation may be an important modifiable risk factor for Aβ accrual over time.

老年人血管危险因素、脑血管疾病和淀粉样蛋白负担之间的相互作用
背景:脑血管病(SVD)和阿尔茨海默病的病理,即淀粉样蛋白-β (Aβ)沉积,通常同时发生。它们究竟如何相互作用仍不确定。目的:使用来自阿尔茨海默病神经影像学倡议的参与者(n = 216;平均年龄73.29±7.08岁,91例(42.1%)女性),我们在24个月的随访中横断面检查了血管危险因素和/或基线脑SVD的存在是否与a β负担增加有关。方法:使用18F-florbetapir PET评估淀粉样蛋白负荷,并将其量化为全球标准化摄取值比(SUVR)。采用多模态成像加强基线SVD作为复合变量的量化,其中包括MRI的白质高强度体积和弥散张量成像的骨架化平均扩散率峰宽。采用结构方程模型分析人口统计学因素、载脂蛋白E / 4携带者状况、血管危险因素、SVD负担与脑淀粉样蛋白的关系。结果:SVD负荷与a β负荷在横切面上有直接关系(coeff = 0.229, p = 0.004),在时间上有间接关系(间接coeff = 0.235, p = 0.004)。在血管危险因素中,高血压史(coeff = 0.094, p = 0.032)和基线时较低的空腹血糖(coeff = -0.027, p = 0.014)对24个月时的a β负荷有直接影响,但在正常化后只有血糖的直接影响持续存在。结论:虽然Aβ与SVD负荷在横断面上存在关联,但SVD在纵向上似乎不直接影响Aβ的积累。随着时间的推移,葡萄糖调节可能是一个重要的可改变的风险因素。
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来源期刊
Journal of Alzheimer's Disease
Journal of Alzheimer's Disease 医学-神经科学
CiteScore
6.40
自引率
7.50%
发文量
1327
审稿时长
2 months
期刊介绍: The Journal of Alzheimer''s Disease (JAD) is an international multidisciplinary journal to facilitate progress in understanding the etiology, pathogenesis, epidemiology, genetics, behavior, treatment and psychology of Alzheimer''s disease. The journal publishes research reports, reviews, short communications, hypotheses, ethics reviews, book reviews, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research that will expedite our fundamental understanding of Alzheimer''s disease.
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