血浆β-淀粉样蛋白42、β-淀粉样蛋白40、α-突触核蛋白及p-tau181蛋白水平对初诊帕金森病患者轻度认知功能障碍的诊断价值

Diagnostic value of plasma level ofβ-amyloid 42,β-amyloid 40,α-synuclein and p-tau181 on early diagnosed Parkinson’s disease with mild cognitive impairment

目的评估β-淀粉样蛋白(Aβ)42、Aβ40、α-突触核蛋白(α-syn)及p-tau181蛋白对早期初诊帕金森病轻度认知功能障碍(PD-MCI)的诊断价值。方法利用超灵敏单分子阵列技术方法(SiMoA)检测2018年7月至2021年5月至南京脑科医院门诊就诊的23例早期初诊PD认知功能正常患者(PD-NC组)、32例早期初诊PD-MCI患者(PD-MCI组)及21名健康对照者(NC组)血浆中的Aβ42、Aβ40、α-syn及p-tau181蛋白浓度并计算Aβ42/Aβ40、Aβ42/α-syn及Aβ40/α-syn比值,分析上述指标在各组间的差异、与各认知域的相关性及对诊断PD-MCI的敏感性和特异性。结果PD-NC组、PD-MCI组及NC组间血浆Aβ42、Aβ40、α-syn、p-tau181蛋白浓度及Aβ42/α-syn、Aβ40/α-syn比值的差异无统计学意义。但PD-MCI相较于PD-NC组Aβ42/Aβ40比值明显下降(0.069±0.012 vs.0.079±0.001,P<0.05)。Aβ42/Aβ40比值诊断PD-MCI的敏感性为82.6%,特异性为62.5%。Aβ42/Aβ40比值与PD认知功能损害的特定认知领域如视空间与执行功能(r=0.274,P=0.043)及语言认知领域(r=0.322,P=0.016)存在显著相关性。结论Aβ42/Aβ40比值可用来诊断早期PD-MCI患者,且与特定认知域损害有关,具有一定的临床辅助诊断价值。

Objective To observe the diagnostic value ofβ-amyloid(Aβ)42,Aβ40,α-synuclein(α-syn)and p-tau181 in patients with early diagnosed Parkinson’s disease(PD)with mild cognitive impairment(MCI).Methods Twenty-three early diagnosed PD patients with normal cognition(PD-NC group),32 early diagnosed PD-MCI patients(PD-MCI group),and 21 normal controls(NC group)in Nanjing Brain Hospital from July 2018 to May 2021 were tested by super sensitive single molecule array technique(SiMoA).The levels of Aβ42,Aβ40,α-syn,and p-tau181 were meatured,and the Aβ42/Aβ40,Aβ42/α-syn,Aβ40/α-syn ratios were calculated in all participants.The differences in plasma levels of the biomarkers and the correlation with the cognitive area and the sensitivity to diagnosis PD-MCI were analyzed.Results The plasma levels of Aβ42,Aβ40,α-syn,and p-tau181 and the ratios of Aβ42/α-syn and Aβ40/α-syn were found no difference among PD-NC group,PD-MCI group and NC group.The ratio of Aβ42/Aβ40 was significantly lower(0.069±0.012 vs.0.079±0.001,P<0.05)in PD-MCI group compared to PD-NC group.The diagnostic value of Aβ42/Aβ40 ratio on PD-MCI with the sensitivity was 82.6%and the specificity was 62.5%.Aβ42/Aβ40 ratio was associated with PD-MCI in specific cognitive areas,such as visuospatial/executive(r=0.274,P=0.043)and language(r=0.322,P=0.016).Conclusions Aβ42/Aβ40 ratio can be used to diagnose early patients with PD-MCI and is related to the impairment of specific cognitive domains.It has a certain clinical auxiliary diagnostic value.