对ATNPD框架和生物流体标记物的评估,以预测早期帕金森病的认知衰退
Katheryn A Q Cousins1, David J Irwin1, Thomas F Tropea1
1From the Department of Neurology (K.A.Q.C., D.J.I., T.F.T., E.R., J.P., A.S.C.-P., D.W.), University of Pennsylvania, Philadelphia; Department of Biostatistics (M.C.B., C.S.C.), College of Public Health, University of Iowa, Iowa City; Department of Pharmacology and Clinical Pharmacology (J.H.K.), Inha University, Incheon, South Korea; Feinberg School of Medicine (T.S.), Northwestern University, Chicago, IL; Department of Medical and Molecular Genetics (T.M.F.), Indiana University, Indianapolis; Laboratory of Neuro Imaging (A.W.T.), University of Southern California, Los Angeles; Department of Neurology (C.M.T.), Weill Institute for Neurosciences, University of California San Francisco; Department of Neurology (K.D.K.), University of Rochester Medical Center, NY; Department of Neurology (B.M.), University Medical Center, Göttingen, Paracelsus-Elena-Klinik, Germany; Department of Neurology (D.G.), University of California San Diego; The Michael J. Fox Foundation (S.H.), New York, NY; Department of Psychiatry (D.W.), School of Medicine at the University of Pennsylvania; Michael J. Crescenz VA Medical Center (D.W.), Parkinson's Disease Research, Education, and Clinical Center; Department of Neurology (A.D.S.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Department of Neurology (K.L.P.), Stanford University, Palo Alto, CA; and Department of Pathology and Laboratory Medicine (L.M.S.), University of Pennsylvania, Philadelphia.
在帕金森病 (PD) 中,阿尔茨海默病 (AD) 生物标志物,如脑脊液 (CSF) 酸化tau 181 (p-tau181) 较低,并且不会随着时间的推移而增加. 一个修改的AD/tau/神经退行 (ATN) 框架 (ATNPD) 预测了早期PD的认知衰退.
科学领域:
- 神经科学是一个神经科学.
- 生物标志物研究 生物标志物研究
- 神经退行性疾病 神经退行性疾病
背景情况:
- 阿尔茨海默病 (AD) 副病理在帕金森病 (PD) 中很常见.
- 在PD中,AD脑脊液 (CSF) 生物标志物 (Aβ42,p-tau181,t-tau) 的纵向变化是不太了解的.
- 在PD中,CSF p-tau181和血清神经丝光 (NfL) 的预后效用需要进一步调查.
研究的目的:
- 描述PD中生物流体标记物的纵向轨迹.
- 修改ADβ-粉样/tau/神经退行 (ATN) 框架用于PD (ATNPD) 使用CSFAβ42,CSFp-tau181和血清NfL.
- 测试ATNPD能够预测早期PD的认知衰退的能力.
主要方法:
- 利用了来自帕金森病进展标记计划 (PPMI) 队列的数据.
- 采用线性混合效应模型 (LMEM) 来分析纵向生物标志物轨迹并预测认知结果.
- 将PD参与者分类为使用修改的ATNPD框架和认知衰退的评估预测 (MoCA分数).
主要成果:
- 患有PD的患者与对照人群相比,在基线时的CSF p-tau181和t-tau较低,在5年内没有显著变化.
- 与对照组相比,PD患者随着时间的推移表现出血清NfL增加.
- 与其他子组相比,ATNPD分类确定了一个子组 (A+T+N±) 的认知衰退 (MoCA) 明显更差.
结论:
- 在早期的PD中,CSF的p-tau181和t-tau较低,并没有纵向增加.
- 修改后的ATNPD框架有效地识别了PD子组.
- ATNPD分类改善了早期PD认知衰退的预测.
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