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A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
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Manifestaciones Clínicas

Yi Jin Leow1, Justin Jit Hong Ong2, Nagaendran Kandiah2

  • 1nil, nil, nil, Nicaragua.

Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 26, 2025
PubMed
Resumen
Este resumen es generado por máquina.

Los pacientes con Deterioro Cognitivo Subjetivo (DCS) que presentan problemas amiloides y vasculares muestran el peor deterioro cognitivo. La positividad amiloide por sí sola puede causar cambios emocionales tempranos, destacando el DCS como una etapa preclínica crítica para la intervención.

Palabras clave:
Deterioro Cognitivo SubjetivoPatología AmiloidePatología VascularIntervención TempranaBiomarcadoresNeuroimagenFunción CognitivaEnfermedad de Alzheimer PreclínicaCambios EmocionalesApatía

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Área de la Ciencia:

  • Neurología
  • Neurociencia
  • Gerontología

Sus antecedentes:

  • El Deterioro Cognitivo Subjetivo (DCS) es una fase temprana clave de la enfermedad de Alzheimer (EA).
  • Comprender los mecanismos del DCS es vital para la intervención temprana en el Alzheimer.
  • Este estudio examina la patología amiloide, la carga cerebrovascular y los fenotipos cognitivo-conductuales en el DCS.

Objetivo del estudio:

  • Investigar el impacto combinado de la patología amiloide y vascular en los resultados cognitivos y conductuales en el DCS.
  • Delinear las trayectorias de la enfermedad de Alzheimer preclínica utilizando biomarcadores fluidos, neuroimagen y pruebas neuropsicológicas.
  • Identificar patrones distintos asociados con diferentes combinaciones de carga amiloide y vascular.

Principales métodos:

  • Se estratificaron 270 individuos cognitivamente normales con DCS en cuatro grupos basados en la carga de amiloide-beta (Aβ42/40) y vascular (puntuación de Fazekas).
  • Se utilizaron pruebas ANOVA y chi-cuadrado para analizar las diferencias grupales.
  • Se evaluó la función cognitiva (MoCA, ROCF, TMT-B), biomarcadores (GFAP, p-tau181/Aβ42), neuroimagen (Fazekas, lacunas, atrofia) y aspectos conductuales (DASS, MBI-C).

Principales resultados:

  • El grupo amiloide-positivo/vascular-positivo (A+V+) era el mayor y mostró los déficits cognitivos más severos (globales, visoespaciales, función ejecutiva).
  • Los grupos vascular-positivos tuvieron una mayor prevalencia de factores de riesgo cardiovascular y marcadores de neuroimagen de enfermedad cerebrovascular.
  • La positividad amiloide sola (A+V-) se asoció con niveles elevados de estrés y apatía, y niveles más altos de GFAP.

Conclusiones:

  • La patología amiloide y vascular coexistente en el DCS empeora sinérgicamente la función cognitiva.
  • La positividad amiloide sola puede contribuir a cambios emocionales y conductuales tempranos en el DCS.
  • La integración de evaluaciones cognitivas, de biomarcadores y conductuales en el DCS es crucial para identificar individuos de alto riesgo y guiar las intervenciones.