在临床前阿尔茨海默氏症疾病的意识轨迹的临床和病理进展
medRxiv : the preprint server for health sciences
|February 27, 2026
概括
在临床前阿尔茨海默氏症 (AD) 中,无意识 (意识下降) 表示更高的风险和更快的衰退,而高意识 (提高意识) 可能反映正常的衰老或早期AD过程.
科学领域:
- 神经科学是一个神经科学.
- 老年学是指老年学的学科.
- 生物标志物研究 生物标志物研究
背景情况:
- 在临床前阿尔茨海默氏症 (AD) 中,可以发生微妙的意识变化,但其临床意义尚不清楚.
- 了解意识轨迹对于早期检测和干预对于患AD风险的认知不受损的个体至关重要.
研究的目的:
- 研究不同意识轨迹 (稳定,增强,降低) 与认知不受损的老年人中的临床/生物标志物概况之间的关联.
- 探索意识变化与阿尔茨海默病病理学之间的关系,包括粉样蛋白和蛋白生物标志物,认知衰退和神经退行.
主要方法:
- 对A4和LEARN群体进行前性分析,随访时间为4.5年.
- 认知功能指数 (参与者与研究伙伴差异) 的混合效应建模定义的意识轨迹.
- 结果包括认知综合评分 (PACC),功能评估 (ADL-PI),临床评分 (CDR),血p-tau217,粉胺-PET,tau-PET和灰质体积 (GMv).
主要成果:
- 无意识症 (n=161,~10%) 与显著更高的粉样蛋白阳性 (~89%),更的认知/功能衰退,增加的血p-tau217,新皮层tau-PET和广泛的神经退行有关.
- 与稳定的意识 (n=1,325,~80%) 相比,超视觉 (n=157,~10%) 显示出适度的临床影响和有限的生物标志物关联.
- 通过GMv损失调解的区域性tau-PET积累被观察到,具有超视视觉 (早期布拉克阶段) 和无视视觉 (通用传播) 的独特模式.
结论:
- 临床前阿尔茨海默病的独特意识轨迹反映了特定阶段的病理过程和下游神经退行,具有不同的临床后果.
- 无意识症在早期的AD连续性中代表了显著的高风险轨迹.
- 超鼻可能表明与年龄相关的变化和早期AD相关的过程的结合.
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