西班牙裔和非西班牙裔白人阿尔茨海默氏症患者队列中的小血管疾病和路易病理的神经病理学特征。

IF 6.2 2区 医学 Q1 NEUROSCIENCES
Hsin-Pei Wang, Rebeca Scalco, Naomi Saito, Laurel Beckett, My-Le Nguyen, Emily Z Huie, Lawrence S Honig, Charles DeCarli, Robert A Rissman, Andrew F Teich, Dan M Mungas, Lee-Way Jin, Brittany N Dugger
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引用次数: 0

摘要

脑血管和α-突触核蛋白病变经常与阿尔茨海默病(AD)同时出现。由于阿尔茨海默病的异质性,有必要采用综合方法进行尸检研究,包括对历史上代表性不足的种族群体进行研究。在这项队列研究中,我们评估了三个阿尔茨海默病研究中心的西班牙裔死者(HD,n = 92)和非西班牙裔白人死者(NHWD,n = 184)的小血管疾病病理和α-突触核蛋白沉积:哥伦比亚大学、加州大学圣地亚哥分校和加州大学戴维斯分校。研究包括根据美国国家老龄化研究所-阿尔茨海默病协会(NIA-AA)和/或 NIA-Reagan 标准进行病理诊断的中度/高度 AD 病例。一个 2:1 的非老年痴呆症患者随机对比样本按年龄和性别与老年痴呆症患者进行了频率平衡和配对。一位对人口统计学和中心起源保密的专家采用既定标准,以半定量方法评估了动脉硬化、脑淀粉样血管病(CAA)和路易体/路易神经元(LBs/LNs)。各组之间存在许多相似之处和一些差异。经 Wilcoxon 检验,HD 患者小脑的 Vonsattel CAA 分级更严重(P = 0.04),后部海马和小脑的 CAA 密度更高(PS = 0.01),额叶(P = 0.01)和颞叶皮质的路易体/路易神经元密度更高(P = 0.03)。除颞叶皮层的 LBs/LNs 外,调整年龄、性别和中心的顺序逻辑回归证实了这些发现。结果表明,与年龄和性别匹配的NHWD患者相比,患有AD的HD患者在某些神经解剖区域表现出更大的CAA和α-突触核蛋白负担。这些发现有助于在病理确诊的AD患者中推广并发动脉硬化、CAA和LBs/LNs的地形和严重程度,特别是在西班牙裔患者中,显示出与NHW后裔的许多相似之处和一些不同之处,并为精准医疗方法提供了启示。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The neuropathological landscape of small vessel disease and Lewy pathology in a cohort of Hispanic and non-Hispanic White decedents with Alzheimer disease.

Cerebrovascular and α-synuclein pathologies are frequently observed alongside Alzheimer disease (AD). The heterogeneity of AD necessitates comprehensive approaches to postmortem studies, including the representation of historically underrepresented ethnic groups. In this cohort study, we evaluated small vessel disease pathologies and α-synuclein deposits among Hispanic decedents (HD, n = 92) and non-Hispanic White decedents (NHWD, n = 184) from three Alzheimer's Disease Research Centers: Columbia University, University of California San Diego, and University of California Davis. The study included cases with a pathological diagnosis of Intermediate/High AD based on the National Institute on Aging- Alzheimer's Association (NIA-AA) and/or NIA-Reagan criteria. A 2:1 random comparison sample of NHWD was frequency-balanced and matched with HD by age and sex. An expert blinded to demographics and center origin evaluated arteriolosclerosis, cerebral amyloid angiopathy (CAA), and Lewy bodies/Lewy neurites (LBs/LNs) with a semi-quantitative approach using established criteria. There were many similarities and a few differences among groups. HD showed more severe Vonsattel grading of CAA in the cerebellum (p = 0.04), higher CAA density in the posterior hippocampus and cerebellum (ps = 0.01), and increased LBs/LNs density in the frontal (p = 0.01) and temporal cortices (p = 0.03), as determined by Wilcoxon's test. Ordinal logistic regression adjusting for age, sex, and center confirmed these findings except for LBs/LNs in the temporal cortex. Results indicate HD with AD exhibit greater CAA and α-synuclein burdens in select neuroanatomic regions when compared to age- and sex-matched NHWD with AD. These findings aid in the generalizability of concurrent arteriolosclerosis, CAA, and LBs/LNs topography and severity within the setting of pathologically confirmed AD, particularly in persons of Hispanic descent, showing many similarities and a few differences to those of NHW descent and providing insights into precision medicine approaches.

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来源期刊
Acta Neuropathologica Communications
Acta Neuropathologica Communications Medicine-Pathology and Forensic Medicine
CiteScore
11.20
自引率
2.80%
发文量
162
审稿时长
8 weeks
期刊介绍: "Acta Neuropathologica Communications (ANC)" is a peer-reviewed journal that specializes in the rapid publication of research articles focused on the mechanisms underlying neurological diseases. The journal emphasizes the use of molecular, cellular, and morphological techniques applied to experimental or human tissues to investigate the pathogenesis of neurological disorders. ANC is committed to a fast-track publication process, aiming to publish accepted manuscripts within two months of submission. This expedited timeline is designed to ensure that the latest findings in neuroscience and pathology are disseminated quickly to the scientific community, fostering rapid advancements in the field of neurology and neuroscience. The journal's focus on cutting-edge research and its swift publication schedule make it a valuable resource for researchers, clinicians, and other professionals interested in the study and treatment of neurological conditions.
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