β-淀粉样蛋白鉴别轻度认知障碍患者和正常人认知的改变

Distinguish mild cognitive impairment and normal cognitive change byβ-amyloid PET imaging

目的探究轻度认知障碍(MCI)患者和认知正常(NC)者脑内β-淀粉样蛋白(Aβ)沉积与认知域受损的关系。方法回顾性分析2018年12月至2021年1月间在上海交通大学附属第六人民医院完成神经心理学量表测试和MRI检查,并在复旦大学附属华山医院完成^(18)F-florbetapir(AV45)PET检查的受试者305名[男113名、女192名,年龄(64.0±7.7)岁],依据神经心理学量表评分诊断为MCI组和NC组,再进一步根据PET显像结果分为Aβ阳性组和阴性组。采用两独立样本t检验、Mann-Whitney U检验和χ^(2)检验分析数据。结果MCI组118例,NC组187名;MCI组Aβ阳性率(37.3%,44/118)高于NC组(26.2%,49/187;χ^(2)=4.19,P=0.041)。MCI组在一般总体认知功能、记忆功能、语言功能和执行功能的评估表现均劣于NC组(t值:-10.63~-6.31,z值:-11.01~-6.03,均P<0.001);MCI组Aβ阳性者的听觉词语学习测验-延迟回忆(AVLT-LDR)评分低于Aβ阴性者[1.00(0.00,3.00)和3.00(1.00,4.00)分;z=-2.49,P=0.013];NC组Aβ阳性者的蒙特利尔认知测评基础量表(MoCA-B)评分低于Aβ阴性者[(25.29±2.67)和(26.36±2.42)分;t=-2.61,P=0.010]。结论在MCI患者中,Aβ阳性者的记忆认知域受损较Aβ阴性者明显;在NC者中,Aβ阳性者一般总体认知功能受损较Aβ阴性者明显。

Objective To explore the association of the impaired cognition and the deposition ofβ-amyloid(Aβ)in normal cognitive(NC)and mild cognitive impairment(MCI).Methods From December 2018 to January 2021,305 subjects(113 males,192 females;age(64.0±7.7)years)who completed neuropsychological tests and MRI in Shanghai Sixth People′s Hospital,Shanghai Jiao Tong University and ^(18)F-florbetapir(AV45)PET imaging in Huashan Hospital,Fudan University were retrospectively analyzed.The subjects were divided into MCI group and NC group based on neuropsychological tests,and each group was further divided into Aβ-positive and Aβ-negative based on PET imaging results.Independent-sample t test,Mann-Whitney U test andχ^(2) test were used to analyze the data.Results There were 118 subjects in MCI group and 187 subjects in NC group.The Aβ-positive rate in MCI group(37.3%,44/118)was higher than that in NC group(26.2%,49/187;χ^(2)=4.19,P=0.041).The assessment performances of MCI group in general cognitive function,memory function,language function and executive function were inferior to those of NC group(t values:from-10.63 to-6.31,z values:from-11.01 to-6.03,all P<0.001).The Auditory Verbal Learning Test-Long Delay Recall(AVLT-LDR)score of Aβ-positive subjects was lower than that of Aβ-negative subjects in MCI group(1.00(0.00,3.00)and 3.00(1.00,4.00);z=-2.49,P=0.013).The Montreal Cognitive Assessment Basic(MoCA-B)score of Aβ-positive subjects was lower than that of Aβ-negative subjects in NC group(25.29±2.67 and 26.36±2.42;t=-2.61,P=0.010).Conclusion Compared to Aβ-negative subjects,MCI patients with Aβ-positive perform worse on memory tests,and NC subjects with Aβ-positive perform worse on general cognitive function.