认知弹性对阿尔茨海默病病理的神经影像学预测。

IF 8.1 1区 医学 Q1 CLINICAL NEUROLOGY
McKenna E. Williams MS, Christine Fennema-Notestine PhD, Tyler R. Bell PhD, Shu-Ju Lin PhD, Stephen J. Glatt PhD, William S. Kremen PhD, Jeremy A. Elman PhD, for the Alzheimer's Disease Neuroimaging Initiative
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引用次数: 0

摘要

目的:一些个体表现出更强的认知弹性,即在不利的大脑相关变化下保持认知表现的能力,其机制尚不清楚。我们通过调节阿尔茨海默病(AD)相关脑区皮层较薄和tau蛋白水平较高的影响,研究了几个脑区皮层厚度是否赋予淀粉样蛋白阳性成人抗认知能力下降的弹性。方法:纳入来自阿尔茨海默病神经影像学倡议并具有相关影像学资料的淀粉样蛋白阳性参与者(n = 160,观察值= 473)。危险因素包括AD脑特征和脑脊液磷酸化tau。认知测试是情景记忆和执行功能的组合。混合效应模型测试了特定区域的皮质厚度是否调节了AD风险标记物与记忆或执行功能之间的关系。结果:在横截面上,8个区域较厚的皮质使较薄的皮质/较小的AD特征区域对执行功能的负面影响最小化。纵向上,这8个区域复合的基线厚度越高,预测记忆衰退越少(p = 0.007),磷酸化tau对记忆衰退的负面影响减弱(p = 0.014),独立于基线认知和风险标记。解释:面对已确定的阿尔茨海默病病理指标,我们确定了8个皮层区域在横切面和纵向上似乎赋予认知弹性。促进执行功能的大脑区域可能会补偿后来的记忆表现,并赋予认知弹性,以对抗磷酸化tau和ad相关的皮层变化的影响。这些“弹性”区域表明关注大脑区域的价值,而不仅仅是那些被确定与ad相关的区域,并可能部分解释ad相关认知轨迹的变异性。Ann neurol 2025。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neuroimaging Predictors of Cognitive Resilience against Alzheimer's Disease Pathology

Objective

Some individuals demonstrate greater cognitive resilience—the ability to maintain cognitive performance despite adverse brain-related changes—through as yet unknown mechanisms. We examined whether cortical thickness in several brain regions confers resilience against cognitive decline in amyloid-positive adults by moderating the effects of thinner cortex in Alzheimer's disease (AD)-related brain regions and of higher levels of tau.

Methods

Amyloid-positive participants from the Alzheimer's Disease Neuroimaging Initiative with relevant imaging data were included (n = 160, observations = 473). Risk factors included an AD brain signature and cerebrospinal fluid phosphorylated tau. Cognitive measures were episodic memory and executive function composites. Mixed effects models tested whether region-specific cortical thickness moderated relationships between markers of AD risk and memory or executive function.

Results

Cross-sectionally, thicker cortex in 8 regions minimized the negative impact of thinner cortex/smaller volume in AD signature regions on executive function. Longitudinally, higher baseline thickness in a composite of these 8 regions predicted less memory decline (p = 0.007) and weakened negative effects of phosphorylated tau on memory decline (p = 0.014), independent of baseline cognition and risk markers.

Interpretation

We identified 8 cortical regions that appear to confer cognitive resilience cross-sectionally and longitudinally in the face of established indicators of AD pathology. Brain regions fostering executive function may enable compensation in later memory performance and confer cognitive resilience against effects of phosphorylated tau and AD-related cortical changes. These “resilience” regions suggest the value of focusing on brain regions beyond only those determined to be AD-related and may partially explain variability in AD-related cognitive trajectories. ANN NEUROL 2025;97:1038–1050

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来源期刊
Annals of Neurology
Annals of Neurology 医学-临床神经学
CiteScore
18.00
自引率
1.80%
发文量
270
审稿时长
3-8 weeks
期刊介绍: Annals of Neurology publishes original articles with potential for high impact in understanding the pathogenesis, clinical and laboratory features, diagnosis, treatment, outcomes and science underlying diseases of the human nervous system. Articles should ideally be of broad interest to the academic neurological community rather than solely to subspecialists in a particular field. Studies involving experimental model system, including those in cell and organ cultures and animals, of direct translational relevance to the understanding of neurological disease are also encouraged.
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