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Title: [Changes in Plasma Amyloid-β Level and Their Relationship With White Matter Microstructure in Patients With Mild Cognitive Impairment].
Author: Li CC, Zhou X, Zhu WH, Wan K, Yin WW, Tang YT, Li MX, Zhu XQ, Sun ZW.
Journal: Zhongguo Yi Xue Ke Xue Yuan Xue Bao; 2023 Aug; 45(4):571-580. PubMed ID: 37654137.
Abstract:
Objective To investigate the changes in plasma amyloid-β (Aβ) level and their relationship with white matter microstructure in the patients with amnesic mild cognitive impairment(aMCI) and vascular mild cognitive impairment (vMCI).Methods A total of 36 aMCI patients,20 vMCI patients,and 34 sex and age matched healthy controls (HC) in the outpatient and inpatient departments of the First Affiliated Hospital of Anhui Medical University were enrolled in this study.Neuropsychological scales,including the Mini-Mental State Examination,the Montreal Cognitive Assessment,and the Activity of Daily Living Scale,were employed to assess the participants.Plasma samples of all the participants were collected for the measurement of Aβ42 and Aβ40 levels.All the participants underwent magnetic resonance scanning to obtain diffusion tensor imaging (DTI) data.The DTI indexes of 48 white matter regions of each individual were measured (based on the ICBM-DTI-81 white-matter labels atlas developed by Johns Hopkins University),including fractional anisotropy (FA) and mean diffusivity (MD).The cognitive function,plasma Aβ42,Aβ40,and Aβ42/40 levels,and DTI index were compared among the three groups.The correlations between the plasma Aβ42/40 levels and DTI index of aMCI and vMCI patients were analyzed.Results The Mini-Mental State Examination and the Montreal Cognitive Assessment scores of aMCI and vMCI groups were lower than those of the HC group (all P<0.001).There was no significant difference in the Activity of Daily Living Scale score among the three groups (P=0.654).The plasma Aβ42 level showed no significant difference among the three groups (P=0.227).The plasma Aβ40 level in the vMCI group was higher than that in the HC group (P=0.014),while it showed no significant difference between aMCI and HC groups (P=1.000).The plasma Aβ42/40 levels in aMCI and vMCI groups showed no significant differences from that in the HC group (P=1.000,P=0.105),while the plasma Aβ42/40 level was lower in the vMCI group than in the aMCI group (P=0.016).The FA value of the left anterior limb of internal capsule in the vMCI group was lower than those in HC and aMCI groups (all P=0.001).The MD values of the left superior corona radiata,left external capsule,left cingulum (cingulate gyrus),and left superior fronto-occipital fasciculus in the vMCI group were higher than those in HC (P=0.024,P=0.001,P=0.003,P<0.001) and aMCI (P=0.015,P=0.004,P=0.019,P=0.001) groups,while the MD values of the right posterior limb of internal capsule (P=0.005,P=0.001) and left cingulum (hippocampus) (P=0.017,P=0.031) in the aMCI and vMCI groups were higher than those in the HC group.In the aMCI group,plasma Aβ42/40 level was positively correlated with FA of left posterior limb of internal capsule (r=0.403,P=0.015) and negatively correlated with MD of the right fonix (r=-0.395,P=0.017).In the vMCI group,plasma Aβ42/40 level was positively correlated with FA of the right superior cerebellar peduncle and the right anterior limb of internal capsule (r=0.575,P=0.008;r=0.639,P=0.002),while it was negatively correlated with MD of the right superior cerebellar peduncle and the right anterior limb of internal capsule (r=-0.558,P=0.011;r=-0.626,P=0.003).Conclusions Plasma Aβ levels vary differently in the patients with aMCI and vMCI.The white matter regions of impaired microstructural integrity differ in the patients with different dementia types in the early stage.The plasma Aβ levels in the patients with aMCI and vMCI are associated with the structural integrity of white matter,and there is regional specificity between them. 目的探讨遗忘型轻度认知障碍(aMCI)与血管性轻度认知障碍(vMCI)患者血浆β淀粉样蛋白(Aβ)水平变化及其与脑白质微观结构的关系。方法纳入安徽医科大学第一附属医院门诊及住院收治的aMCI患者36例,vMCI患者20例及性别、年龄匹配的健康对照(HC)34例。对所有研究对象进行神经心理学量表评估,包括简易精神智力状态检查量表、蒙特利尔认知评估量表和日常生活能力量表;采集所有研究对象的血液标本并检测血浆Aβ42、Aβ40;所有研究对象均进行磁共振扫描以获取弥散张量成像(DTI)数据;采用基于感兴趣区的DTI分析方法获取个体48个白质区域的DTI参数(基于约翰霍普金斯大学制订的ICBM-DTI-81脑白质图谱),包括分数各向异性(FA)和平均扩散系数(MD)。比较3组的认知功能,血浆Aβ42、Aβ40、Aβ42/40水平和DTI参数,并对aMCI和vMCI的血浆Aβ42/40水平和DTI参数进行相关分析。结果 aMCI和vMCI组的简易精神智力状态检查量表、蒙特利尔认知评估量表评分均显著低于HC组(P均<0.001);日常生活能力量表评分3组差异无统计学意义(P=0.654)。3组血浆Aβ42水平差异无统计学意义(P=0.227);vMCI组血浆Aβ40水平较HC组显著升高(P=0.014),aMCI与HC组比较差异无统计学意义(P=1.000);aMCI和vMCI组血浆Aβ42/40水平与HC组比较差异均无统计学意义(P=1.000,P=0.105),而vMCI组血浆Aβ42/40水平较aMCI组显著下降(P=0.016)。vMCI组左侧内囊前肢的FA较HC及aMCI组显著降低(P均=0.001);vMCI组左侧上放射冠、左侧外囊、左侧扣带束扣带回部、左侧上额枕束的MD较HC组(P=0.024,P=0.001,P=0.003,P<0.001)及aMCI组(P=0.015,P=0.004,P=0.019,P=0.001)显著升高;aMCI、vMCI组右侧内囊后肢(P=0.005,P=0.001)、左侧扣带束海马部(P=0.017,P=0.031)的MD较HC组显著升高。aMCI组血浆Aβ42/40水平与左侧内囊后肢FA呈正相关(r=0.403,P=0.015),与右侧穹隆的MD呈负相关(r=-0.395,P=0.017);vMCI组血浆Aβ42/40水平与右侧小脑上脚、右侧内囊前肢的FA呈正相关(r=0.575,P=0.008;r=0.639,P=0.002);与右侧小脑上脚、右侧内囊前肢的MD呈负相关(r=-0.558,P=0.011;r=-0.626,P=0.003)。结论 aMCI和vMCI患者血浆Aβ水平变化不同,不同痴呆类型早期白质微观结构完整性损害的区域存在差异,aMCI和vMCI患者血浆Aβ水平均与脑白质结构完整性有关,且二者存在区域特异性。.

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