Neurology:别忽视“自我感知”!这是早期发现阿尔茨海默症的重要指标

2020-07-21 “中国生物技术网”微信号 “中国生物技术网”微信号

“自我感知”是早期发现阿尔茨海默症的一个重要指标。

近日,发表在美国神经病学学会官方出版物《Neurology》上的一项研究中,由德国神经退行性疾病中心(DZNE)领导的一个研究团队表明,“自我感知”是早期发现阿尔茨海默症的一个重要指标。

在这项涉及449名老年人的新研究中,研究人员发现,主观上感觉出现记忆障碍的个体通常也会表现出与脊髓液异常相关的可检测认知缺陷。这些发现将有助于早期诊断和治疗阿尔茨海默症。

当一个人自我感觉到记忆退化,但根据客观标准衡量的智力水平仍然属于正常范围时,这种情况被称为“主观认知下降”(SCD)。

该研究通讯作者、DZNE研究团队负责人、波恩大学医院记忆门诊的高级心理学家Michael Wagner教授说:“从长期来看,SCD患者患痴呆症的风险增加。然而,关于主观记忆问题的潜在机制我们知之甚少。这种影响是复杂的,过去的研究只包括相对较小的人群,这使得很难进行统计上可靠的评估。据我们所知,我们的研究所包括的个体样本是最多的。”

一项全国性的研究

由DZNE协调的德国大学和大学医院组成的网络参与了这项研究。该研究共招募了449名参与者,平均年龄约为70岁。其中,有240人通过这些大学医院的记忆门诊被招募。这些人通常在转诊之后去咨询记忆门诊,从而对持续性主观认知障碍进行了明确诊断。然而,在常规的测试中,他们被评估为认知正常,因此被确诊为SCD。另外通过报纸广告报名参与研究的209名受试者根据访谈结果和相同的认知测验,被归类为认知健康。

该研究第一作者Steffen Wolfsgruber博士解释说:“我们能证明那些因SCD而求助于记忆门诊的人具有尽管很轻微但可检测的认知缺陷。调查结果基于广泛的测试、完善的数据分析以及相对大量的受检人员。这显着提高了测量灵敏度。因此,我们发现,被认为健康的受试者在智力方面的表现通常要好于SCD患者。这些差异很难通过标准的分析方法和少量人群样本发现。对单个个体的研究更难取得这种发现。无论如何,我们都需要一个大数据集。”

广泛测试

参加这项研究的男性和女性受试者都接受了各种心理能力测试。除了记忆表现外,重点还有专注力和各种情况下集中注意力的能力。他们还测试了语言技能以及正确识别和叫出物体名称的能力。

此外,研究人员还分析了180名受试者的脑脊液,其中104人患有SCD,并测量了淀粉样β肽和tau蛋白的水平。

Wolfsgruber说:“这些生物标志物数据为潜在的神经损伤和阿尔茨海默症相关的机制提供了结论。”

Wagner说:“在研究中我们发现,SCD患者通常具有轻度的认知缺陷,并且这些缺陷与预示早期阿尔茨海默症的蛋白质有关。因此,我们认为主观感受智力衰退和轻微认知缺陷均归因于阿尔茨海默症。这不是理所当然的事情,因为导致记忆问题的原因有很多。需要强调的是,这些人是因为自己感受到认知问题或被转诊才去的记忆门诊。因此,这些发现不能一概而论,因为许多出现暂时主观记忆障碍的老年人没有早期阿尔茨海默症。”

早期治疗

这项研究结果基于DZNE的DELCODE研究中的数据,该研究调查了阿尔茨海默症的早期阶段,即明显症状出现之前的阶段。在DELCODE的框架内,对大约1000名参与者的认知发展进行了数年的监测。

Wagner说:“然后,我们就可以清楚地确定谁真正患上了痴呆症,以及通过SCD提前评估痴呆症的风险程度。有关数据仍在收集和评估中。无论如何,我们目前的结果支持了SCD可以用于早期检测阿尔茨海默症指标的观点。但是,SCD只能作为诊断的一部分依据,我们还必须考虑生物标志物 ”。

Wagner补充说:“这项新发现也可能有助于开发新的疗法。目前针对阿尔茨海默症的治疗开始得太晚,那时大脑已经严重受损。更好地理解SCD可以为早期治疗奠定基础。为了测试能在阿尔茨海默症早期阶段起作用的疗法,有必要确定患病风险较高的人。为此,SCD可能是一个重要指标。”

原始出处:

Steffen Wolfsgruber, Luca Kleineidam, Jannis Guski, et al. Minor neuropsychological deficits in patients with subjective cognitive decline. Neurology, 2020. DOI: https://doi.org/10.1212/WNL.0000000000010142

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style='color:#2F92EE;'>#早期发现#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59355, encryptionId=35e7593559a, topicName=早期发现)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9cb02500048, createdName=ms6832696159214430, createdTime=Thu Jul 23 11:07:30 CST 2020, time=2020-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1470386, encodeId=e19a14e03862b, content=<a href='/topic/show?id=45a79e7788c' target=_blank style='color:#2F92EE;'>#阿尔茨海默#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97778, encryptionId=45a79e7788c, topicName=阿尔茨海默)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5917090900, createdName=yhj-time, createdTime=Thu Jul 23 11:07:30 CST 2020, time=2020-07-23, status=1, ipAttribution=), 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  4. 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  5. 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  6. 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createdBy=15f45402018, createdName=ms1000000554757526, createdTime=Tue Jul 21 22:42:29 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803730, encodeId=d5a1803e305e, content=<a href='/topic/show?id=2d0b9e786cd' target=_blank style='color:#2F92EE;'>#阿尔茨海默氏症#</a>患者的自我感知,其实是非常重要的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97786, encryptionId=2d0b9e786cd, topicName=阿尔茨海默氏症)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Tue Jul 21 20:30:09 CST 2020, time=2020-07-21, status=1, ipAttribution=)]
    2020-07-22 ms 内分泌科张

    0

  7. 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    2020-07-22 13b0e868m81暂无昵称

    对于这个课题,只期待治疗的出现了。

    0

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  9. 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    2020-07-21 ms1000000554757526

    👏

    0

  10. 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    2020-07-21 lovetcm

    #阿尔茨海默氏症#患者的自我感知,其实是非常重要的。

    0

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