与情绪和精神病障碍相比,在行为变异前性痴呆症中的血神经丝光
Dhamidhu Eratne1,2, Matthew Kang1,2, Charles Malpas3,4
1Neuropsychiatry, The Royal Melbourne Hospital, Melbourne, VIC, Australia.
The Australian and New Zealand journal of psychiatry
|July 21, 2023
概括
血神经纤维光 (NfL) 有效地区分了行为变异前性痴呆症 (bvFTD) 和初级精神疾病 (PPD). 这种血液生物标志物具有很高的准确性,有助于神经退行性疾病的差异诊断.
科学领域:
- 神经科学是一个神经科学.
- 生物标志物发现发现
- 精神病学是一个精神病学.
背景情况:
- 神经纤维光 (NfL) 是神经退行性疾病的有前途的血液生物标志物.
- 从临床上讲,将神经退行性疾病与初级精神疾病 (PPD) 区分开来是一项挑战.
- 行为变异前性痴呆症 (bvFTD) 经常被误诊为PPD.
研究的目的:
- 调查血NfL在区分bvFTD和PPD中的诊断效用.
- 评估NfL解释的大型规范数据集和统计模型的性能.
- 评估主要抑郁症 (MDD),双相情感障碍 (BPAD) 和耐治疗精神分裂症 (TRS) 的血NfL水平.
主要方法:
- 在患有MDD,BPAD,TRS和bvFTD的患者中测量了血NfL水平.
- 一个大型参考队列 (对照组2,n=1926) 用于位置,尺度和形状 (GAMLSS) 建模的通用添加模型进行建模.
- 使用一般线性模型分析了年龄匹配的对照组 (对照组1,n=96).
主要成果:
- 与所有PPD和对照组 (<11 pg/mL) 相比,bvFTD (34.9 pg/mL) 的血NfL水平显著更高.
- 在区分bvFTD与PPD方面,NfL表现出高准确度 (88%的特异性,86%的灵敏度).
- 使用大型参考队列的GAMLSS模型提供了对个别NfL水平的精确解释,优于使用本地控制的模型. 与对照和TRS相比,在BPAD中观察到略高的NfL.
结论:
- 血NfL是区分bvFTD和PPD的宝贵生物标志物,对于差异诊断至关重要.
- 这项研究呈现了迄今为止针对NfL分析的最大的BPAD患者队列.
- 使用大型参考队列和先进建模 (GAMLSS) 对临床转化和神经退行和精神疾病的未来研究有重大影响.
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