控制发作与痴呆症神经病理学的关联
Ifrah Zawar1, Aleksander Luniewski2, Rithvik Gundlapalli3
1Comprehensive Epilepsy Program, Department of Neurology, University of Virginia, Charlottesville, Virginia 22908, USA.
Brain : a journal of neurology
|January 16, 2025
概括
痴呆症患者 (PWD) 的活跃与早期死亡和更严重的阿尔茨海默氏病 (AD) 病理学有关. 对正在进行的发作保持警对于PWD预后至关重要.
科学领域:
- 神经学 神经学
- 病理学 病理学 病理学
- 老年学是一门学科.
背景情况:
- 痴呆症 (PWD) 患者的发作与加速的认知衰退和较差的结果有关.
- 在PWD中持续的活动和死后神经病理发现之间的联系以前没有被调查过.
研究的目的:
- 为了比较PWD的死后神经病理发现与活跃发作,远程发作和没有发作.
- 研究活跃活动与阿尔茨海默病 (AD) 和其他神经退行性病理的严重程度之间的关联.
主要方法:
- 一项多中心研究分析了来自39个阿尔茨海默病中心 (2005-2021) 的死后数据.
- PWD被分为活跃 (过去一年的发作),远程 (之前的发作,过去一年没有) 和没有发作的组.
- 人口统计,认知,死亡率和神经病理发现 (AD,FTD,勒维体,血管病理) 的比较使用统计测试进行.
主要成果:
- 与远程 (35%,77.9岁) 和没有发作 (34%,80.8岁) 组相比,活跃发作的参与者死亡率更高 (56%),死亡年龄更小 (75.8岁).
- 活跃发作与更严重的AD病理有关,包括更高的Braak阶段和CERAD得分,以及增加的神经退行 (大脑/海马缩).
- 在非AD痴呆症中,活跃发作显示AD共同病理 (较高的布拉克阶段) 更糟糕,但神经退行和其他病理,如FTD,勒维体和血管等病理的比较率相似.
结论:
- 在PWD中,活跃性发作与增加的死亡率,较年轻的死亡年龄以及更严重的神经病理性AD和ATN (粉样蛋白,,神经退行) 病理有关.
- 活跃性发作表明预后较差,并且与阿尔茨海默病的晚期阿尔茨海默病理学和非阿尔茨海默病的阿尔茨海默病理学相关.
- 临床医生应保持对PWD持续发作的高度怀疑指数,因为它们与不良结果有关.
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