美国退伍军人与 62 岁以上阿尔茨海默氏症患者大脑中 Aβ 分布的差异。

Stanislav Kolpakov, Arseniy Yashkin, Igor Akushevich
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引用次数: 0

摘要

背景:大脑中淀粉样蛋白浓度升高会导致脑出血和早期抑郁症/痴呆症发病后早期老年痴呆症发病风险升高。在这项研究中,我们比较了美国退伍军人和 62 岁以上非退伍军人成年人大脑 8 个相关区域的淀粉样蛋白沉积模式:数据:数据来自 ADNI 和 DoD-ADNI 研究。为了实现可比性,减少年龄不匹配造成的偏差,并考虑从国防部-ADNI和ADNI数据库中提取的子样本之间与治疗无关的差异,采用了伪随机化算法。参与者库包括年龄、种族、载脂蛋白ε4等位基因(APOE)状态、改良哈钦斯基缺血评分、教育水平和老年抑郁评分等数据,这些数据用于建立倾向评分:预测因素和结果:PET 图像分析得出的关键脑区的 Aβ 浓度以及描述 0.79 和 1.11 临界值的两个分类变量被用作结果,而退伍军人和注意力缺失状态被用作预测因素:为了平衡子样本,我们采用了伪随机化算法,消除了观察到的异质性来源。连续变量采用广义线性模型,二元变量采用逻辑回归模型:研究结果:退伍军人大脑中 Aβ 的分布模式与典型的 AD 模式不同。退伍军人的淀粉样蛋白沉积主要集中在小脑灰质和小脑。与此相反,AD模式显示更多的Aβ沉积在额叶、扣带回皮层、顶叶和颞叶,同时全脑淀粉样蛋白浓度较高。由于Florbetapir PET无法区分老年斑和血管中的沉积物,退伍军人小脑中淀粉样蛋白浓度升高可能意味着脑出血和早期抑郁/痴呆发病后早期AD发病的风险升高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Differences in the Distribution of Aβ in the Brain between U.S. Veterans and Adults aged 62+ and suffering from Alzheimer's Disease.

Background: Elevated concentration of amyloids in the cerebrum results in elevated risks for cerebral hemorrhage and early AD onset following early depression/dementia onset. In this study, we compare patterns of amyloid depositions across eight regions of interest of the human brain between U.S. Veterans and non-Veterans adults aged 62+.

Data: Data were taken from the ADNI and DoD-ADNI studies. A pseudo-randomization algorithm was applied to achieve comparability, reduce bias due to age mismatching, and account for non-treatment-related differences between subsamples extracted from DoD-ADNI and ADNI databases. The pool of participants included data about age, race, apolipoprotein ε4 allele (APOE) status, modified Hachinski Ischemic Score, education level, and geriatric depression score, which were used to build a propensity score.

Predictors and outcomes: Aβ concentration, resulting from the PET image analysis, in key brain regions of interest, and two categorical variables describing the 0.79 and 1.11 cutoffs were used as outcomes, while the Veteran and AD status were used as predictors.

Methods: To balance subsamples, we applied a pseudo-randomization algorithm, eliminating the observed sources of heterogeneity. We used a generalized linear model for continuous variables and the logistic regression model for binary variables.

Findings: The pattern of the Aβ distribution in Veteran's brains was found to be different from the classic AD pattern. The amyloid depositions following Veteran status were concentrated in cerebellar gray matter and the cerebellum in general. In contrast, the AD pattern shows more Aβ depositions in the frontal lobe, cingulate cortex, parietal, and temporal lobes, along with higher whole-cerebrum concentration of amyloids. Since Florbetapir PET cannot distinguish between senile plaques and depositions in blood vessels, the elevated concentration of amyloids in a cerebellum for participants with the Veteran status may suppose elevated risks for cerebral hemorrhage and early AD onset following early depression/dementia onset.

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