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Apolipoprotein E-dependent load of white matter hyperintensities in Alzheimer’s disease: a voxel-based lesion mapping study

机译:载脂蛋白E依赖的白质高信号负荷在阿尔茨海默氏病中的作用:基于体素的病灶定位研究

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摘要

Introduction: White matter (WM) magnetic resonance imaging (MRI) hyperintensities are common in Alzheimer’s disease (AD), but their pathophysiological relevance and relationship to genetic factors are unclear. In the present study, we investigated potential apolipoprotein E (APOE)-dependent effects on the extent and cognitive impact of WM hyperintensities in patients with AD. Methods: WM hyperintensity volume on fluid-attenuated inversion recovery images of 201 patients with AD (128 carriers and 73 non-carriers of the APOE ε4 risk allele) was determined globally as well as regionally with voxel-based lesion mapping. Clinical, neuropsychological and MRI data were collected from prospective multicenter trials conducted by the German Dementia Competence Network. Results: WM hyperintensity volume was significantly greater in non-carriers of the APOE ε4 allele. Lesion distribution was similar among ε4 carriers and non-carriers. Only ε4 non-carriers showed a correlation between lesion volume and cognitive performance. Conclusion: The current findings indicate an increased prevalence of WM hyperintensities in non-carriers compared with carriers of the APOE ε4 allele among patients with AD. This is consistent with a possibly more pronounced contribution of heterogeneous vascular risk factors to WM damage and cognitive impairment in patients with AD without APOE ε4-mediated risk.
机译:简介:白质(WM)磁共振成像(MRI)高强度在阿尔茨海默氏病(AD)中很常见,但尚不清楚它们的病理生理学意义和与遗传因素的关系。在本研究中,我们调查了潜在的载脂蛋白E(APOE)依赖效应对AD患者WM高强度的程度和认知影响。方法:通过基于体素的病灶定位,在全球范围内以及区域范围内确定201例AD患者(128例携带者和73例非携带者的APOEε4风险等位基因)的体液衰减反转恢复图像上的WM高强度。临床,神经心理学和MRI数据来自德国痴呆症能力网络进行的前瞻性多中心试验。结果:在APOEε4等位基因的非携带者中,WM高信号量明显更大。病变分布在ε4携带者和非携带者之间相似。仅ε4非携带者显示病变体积与认知能力之间的相关性。结论:目前的发现表明,与APOEε4等位基因携带者相比,AD携带者中非携带者的WM高强度患病率增加。这与在没有APOEε4介导的风险的AD患者中,异质血管危险因素可能对WM损伤和认知功能障碍的贡献更为显着。

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