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Manifestaciones Clínicas

Jennifer R Gatchel1,2,3, Kexin Yu4, Phebe Palmer5,6

  • 1Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 25, 2025
PubMed
Resumen
Este resumen es generado por máquina.

Los biomarcadores plasmáticos como p-tau217, NfL y GFAP muestran asociaciones distintas con los síntomas neuropsiquiátricos (SNP) en la enfermedad de Alzheimer y demencias relacionadas (EADR) temprana. El fosfo-tau217 juega un papel clave en las etapas de deterioro cognitivo leve (DCL).

Palabras clave:
biomarcadores plasmáticossíntomas neuropsiquiátricosenfermedad de Alzheimerdeterioro cognitivo levetaupatíasneurofilamentosproteína ácida fibrilar glial

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Área de la Ciencia:

  • Neurociencia
  • Investigación de Biomarcadores
  • Gerontología

Sus antecedentes:

  • Los síntomas neuropsiquiátricos (SNP) son prevalentes en la enfermedad de Alzheimer y demencias relacionadas (EADR) temprana, impactando el declive cognitivo y funcional.
  • La neurobiología subyacente y los marcadores pronósticos para los SNP en las EADR siguen siendo poco comprendidos.
  • Este estudio investiga la relación entre los biomarcadores plasmáticos basales y la progresión longitudinal de los SNP en adultos mayores.

Objetivo del estudio:

  • Examinar las asociaciones entre biomarcadores plasmáticos (p-tau217, NfL, GFAP) y trayectorias longitudinales de SNP.
  • Diferenciar las firmas de biomarcadores para SNP afectivos versus generales.
  • Comprender el valor pronóstico de los biomarcadores plasmáticos en la predicción de SNP a lo largo del curso de las EADR.

Principales métodos:

  • Análisis de muestras de plasma de participantes cognitivamente normales (CN) y con deterioro cognitivo leve (DCL).
  • Ensayo de biomarcadores plasmáticos basales: fosfo-tau217 (p-tau217), neurofilamento ligero (NfL) y proteína ácida fibrilar glial (GFAP).
  • Evaluación longitudinal de SNP utilizando la Escala de Depresión Geriátrica (GDS-15) y el Cuestionario de Inventario Neuropsiquiátrico (NPI-Q) durante 7-8 años.
  • Modelos lineales mixtos para analizar las asociaciones de biomarcadores con los cambios en los SNP a lo largo del tiempo, controlando la edad y el sexo.

Principales resultados:

  • En individuos cognitivamente normales, NfL y GFAP predijeron cambios en los síntomas depresivos (GDS-15).
  • En el deterioro cognitivo leve, p-tau217 y NfL se asociaron con síntomas depresivos, mientras que los tres biomarcadores (p-tau217, NfL, GFAP) predijeron un aumento general de los SNP (NPI-Q).
  • El fosfo-tau217 surgió como el predictor más significativo de SNP generales en el grupo de DCL.

Conclusiones:

  • Las asociaciones de biomarcadores plasmáticos con los SNP difieren en el espectro temprano de las EADR.
  • El fosfo-tau217 juega un papel central en la predicción de SNP en la etapa de deterioro cognitivo leve.
  • Las firmas de biomarcadores pueden diferenciar los síntomas neuropsiquiátricos afectivos versus más amplios, ofreciendo información pronóstica.