目的分析老年期痴呆的行为精神症状(behavioral and psychological symptom of dementia,BPSD)的非药物治疗效果及其与载脂蛋白E(apolipoprotein E,ApoE)基因多态性的关系。方法选取2016年1月至2022年12月江西省人民医院收治的90例老年...目的分析老年期痴呆的行为精神症状(behavioral and psychological symptom of dementia,BPSD)的非药物治疗效果及其与载脂蛋白E(apolipoprotein E,ApoE)基因多态性的关系。方法选取2016年1月至2022年12月江西省人民医院收治的90例老年期痴呆患者为研究对象,根据随机数字表法将其分为常规组、对照组和观察组,每组各30例。常规组患者给予盐酸美金刚片治疗,对照组患者在常规组基础上加以音乐疗法,观察组患者在常规组基础上加以重复经颅磁刺激治疗,三组均连续治疗12周。比较三组患者的BPSD严重程度、痴呆严重程度、认知功能、日常生活能力、ApoE基因多态性。结果治疗前,三组患者的神经精神问卷(neuropsychiatric inventory,NPI)、临床痴呆评定量表(clinical dementia rating,CDR)、简明精神状态检查量表(mini-mental state examination,MMSE)、日常生活能力评定量表(activity of daily living scale,ADL)评分比较差异均无统计学意义(P>0.05);治疗后,三组患者的NPI、CDR评分均显著低于本组治疗前,MMSE、ADL评分均显著高于本组治疗前(P<0.05);观察组和对照组患者的NPI、CDR评分均显著低于常规组,MMSE、ADL评分均显著高于常规组(P<0.05)。ApoE共有ε2、ε3、ε4三种等位基因,其中ε3表达频率最高,共55例,其次为ε4和ε2;三组患者的ApoE不同基因检出率比较差异无统计学意义(P>0.05)。ApoEε4型患者的NPI评分显著高于ApoEε3型与ApoEε2型(P<0.05)。结论非药物治疗老年期痴呆患者效果显著,可减轻BPSD和痴呆表现,提高患者的认知功能和日常生活能力,ApoEε4型基因与老年期痴呆患者的BPSD存在紧密联系。展开更多
Apolipoprotein E receptor 2(ApoER2)is a receptor for the protein ApoE,the most common genetic risk factor for late-onset Alzheimer's disease(AD).It is also a key modulator of syna ptic homeostasis,in part through ...Apolipoprotein E receptor 2(ApoER2)is a receptor for the protein ApoE,the most common genetic risk factor for late-onset Alzheimer's disease(AD).It is also a key modulator of syna ptic homeostasis,in part through its effect on the expression of neuronal genes including those implicated in AD and other neuropsychiatric disorders.In this perspective,we highlight several genes affected by ApoER2 and its alternatively spliced forms and how aberrant expression can be rescued by the reintroduction of the ApoER2 intracellular domain in the mouse hippocampus.展开更多
目的:探讨不同β淀粉样蛋白(β-amyloid, Aβ)状态调控ApoE ɛ4对轻度认知功能障碍(Mild Cognitive Impairment, MCI)患者的认知功能(cognitive function)的影响。材料与方法:选取阿尔茨海默病神经影像学计划(Alzheimer’s Disease Neuro...目的:探讨不同β淀粉样蛋白(β-amyloid, Aβ)状态调控ApoE ɛ4对轻度认知功能障碍(Mild Cognitive Impairment, MCI)患者的认知功能(cognitive function)的影响。材料与方法:选取阿尔茨海默病神经影像学计划(Alzheimer’s Disease Neuroimaging Initiative, ADNI)数据库中名421名MCI。收集他们的信息如性别、年龄、受教育年限、婚姻状况、18F-florbetapir-PET (用于检测脑内Aβ沉积的放射性检查)、脑脊液(cerebral spinal fluid, CSF) Aβ、CSF tau蛋白、CSF p-tau蛋白、神经心理学量表等。根据载脂蛋白E (Apolipoprotein E, ApoE)基因型将MCI患者分为ApoE ɛ4(+)组(n=202)和ApoE ɛ4(−)组(n = 219),进一步根据Aβ状态分为Aβ(+)亚组和Aβ(−)亚组。通过统计学方法比较对应分组之间的差异,并分析引起差异的原因。结果:在MCI患者的ApoE ɛ4(+)和ApoE ɛ4(−)分组中,Aβ(+)亚组的年龄均显著大于Aβ(−)亚组,差异具有统计学意义(P β(+)亚组的CSF Aβ比Aβ(−)亚组低,CSF tau、p-tau比Aβ(−)亚组高,差异均具有统计学意义(P ɛ4(+)组Aβ(+)亚组的多项神经心理学量表测评差于Aβ(−)亚组,尤其是在反映记忆功能量表方面,差异具有统计学意义(P β与ApoE ɛ4的相互作用引起了MCI患者的认知功能下降,其中记忆功能的下降更为明显。Objective: Exploring the effect of different β-amyloid (Aβ) regulating ApoE ɛ4 on cognitive function in patients with Mild Cognitive Impairment (MCI). Methods: We selected 421 MCI patients from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). We collected their information, including gender, age, years of education, marital status, 18F-florbetapir-PET scan (a radiological test used to detect Aβ deposition in the brain), cerebrospinal fluid (CSF) Aβ, CSF tau protein, CSF p-tau protein, and neuropsychological test scores. Based on their Apolipoprotein E (ApoE) genotype, MCI patients were categorized into ApoE ε4(+) group (n = 202) and ApoE ε4(−) group (n = 219), further subdivided into Aβ(+) and Aβ(−) subgroups based on Aβ status. We compared the differences between corresponding groups using statistical methods and analyzed the factors contributing to these differences. Results: In the MCI patient groups with ApoE ε4(+) and ApoE ε4(−), the age of the Aβ(+) subgroup was significantly higher than that of the Aβ(−) subgroup, with the difference being statistically significant (P β in the Aβ(+) subgroup was lower than those in the Aβ(−) subgroup, while the CSF tau and p-tau were higher, with the differences being statistically significant (P ε4(+) group’s Aβ(+) subgroup performed worse on multiple neuropsychological scales compared to the Aβ(−) subgroup, particularly in memory function scales, with the difference being statistically significant (P β and ApoE ε4 leads to a decline in cognitive functions among MCI patients, with a particularly pronounced impairment in memory.展开更多
文摘目的分析老年期痴呆的行为精神症状(behavioral and psychological symptom of dementia,BPSD)的非药物治疗效果及其与载脂蛋白E(apolipoprotein E,ApoE)基因多态性的关系。方法选取2016年1月至2022年12月江西省人民医院收治的90例老年期痴呆患者为研究对象,根据随机数字表法将其分为常规组、对照组和观察组,每组各30例。常规组患者给予盐酸美金刚片治疗,对照组患者在常规组基础上加以音乐疗法,观察组患者在常规组基础上加以重复经颅磁刺激治疗,三组均连续治疗12周。比较三组患者的BPSD严重程度、痴呆严重程度、认知功能、日常生活能力、ApoE基因多态性。结果治疗前,三组患者的神经精神问卷(neuropsychiatric inventory,NPI)、临床痴呆评定量表(clinical dementia rating,CDR)、简明精神状态检查量表(mini-mental state examination,MMSE)、日常生活能力评定量表(activity of daily living scale,ADL)评分比较差异均无统计学意义(P>0.05);治疗后,三组患者的NPI、CDR评分均显著低于本组治疗前,MMSE、ADL评分均显著高于本组治疗前(P<0.05);观察组和对照组患者的NPI、CDR评分均显著低于常规组,MMSE、ADL评分均显著高于常规组(P<0.05)。ApoE共有ε2、ε3、ε4三种等位基因,其中ε3表达频率最高,共55例,其次为ε4和ε2;三组患者的ApoE不同基因检出率比较差异无统计学意义(P>0.05)。ApoEε4型患者的NPI评分显著高于ApoEε3型与ApoEε2型(P<0.05)。结论非药物治疗老年期痴呆患者效果显著,可减轻BPSD和痴呆表现,提高患者的认知功能和日常生活能力,ApoEε4型基因与老年期痴呆患者的BPSD存在紧密联系。
基金supported by NIH grants NS093382,NS108115,AG053391,HL063762 (to JH)supported by Blue Field Project to Cure FTD,BrightFocus Foundation (A20135245 and A2016396S)。
文摘Apolipoprotein E receptor 2(ApoER2)is a receptor for the protein ApoE,the most common genetic risk factor for late-onset Alzheimer's disease(AD).It is also a key modulator of syna ptic homeostasis,in part through its effect on the expression of neuronal genes including those implicated in AD and other neuropsychiatric disorders.In this perspective,we highlight several genes affected by ApoER2 and its alternatively spliced forms and how aberrant expression can be rescued by the reintroduction of the ApoER2 intracellular domain in the mouse hippocampus.
文摘目的:探讨不同β淀粉样蛋白(β-amyloid, Aβ)状态调控ApoE ɛ4对轻度认知功能障碍(Mild Cognitive Impairment, MCI)患者的认知功能(cognitive function)的影响。材料与方法:选取阿尔茨海默病神经影像学计划(Alzheimer’s Disease Neuroimaging Initiative, ADNI)数据库中名421名MCI。收集他们的信息如性别、年龄、受教育年限、婚姻状况、18F-florbetapir-PET (用于检测脑内Aβ沉积的放射性检查)、脑脊液(cerebral spinal fluid, CSF) Aβ、CSF tau蛋白、CSF p-tau蛋白、神经心理学量表等。根据载脂蛋白E (Apolipoprotein E, ApoE)基因型将MCI患者分为ApoE ɛ4(+)组(n=202)和ApoE ɛ4(−)组(n = 219),进一步根据Aβ状态分为Aβ(+)亚组和Aβ(−)亚组。通过统计学方法比较对应分组之间的差异,并分析引起差异的原因。结果:在MCI患者的ApoE ɛ4(+)和ApoE ɛ4(−)分组中,Aβ(+)亚组的年龄均显著大于Aβ(−)亚组,差异具有统计学意义(P β(+)亚组的CSF Aβ比Aβ(−)亚组低,CSF tau、p-tau比Aβ(−)亚组高,差异均具有统计学意义(P ɛ4(+)组Aβ(+)亚组的多项神经心理学量表测评差于Aβ(−)亚组,尤其是在反映记忆功能量表方面,差异具有统计学意义(P β与ApoE ɛ4的相互作用引起了MCI患者的认知功能下降,其中记忆功能的下降更为明显。Objective: Exploring the effect of different β-amyloid (Aβ) regulating ApoE ɛ4 on cognitive function in patients with Mild Cognitive Impairment (MCI). Methods: We selected 421 MCI patients from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). We collected their information, including gender, age, years of education, marital status, 18F-florbetapir-PET scan (a radiological test used to detect Aβ deposition in the brain), cerebrospinal fluid (CSF) Aβ, CSF tau protein, CSF p-tau protein, and neuropsychological test scores. Based on their Apolipoprotein E (ApoE) genotype, MCI patients were categorized into ApoE ε4(+) group (n = 202) and ApoE ε4(−) group (n = 219), further subdivided into Aβ(+) and Aβ(−) subgroups based on Aβ status. We compared the differences between corresponding groups using statistical methods and analyzed the factors contributing to these differences. Results: In the MCI patient groups with ApoE ε4(+) and ApoE ε4(−), the age of the Aβ(+) subgroup was significantly higher than that of the Aβ(−) subgroup, with the difference being statistically significant (P β in the Aβ(+) subgroup was lower than those in the Aβ(−) subgroup, while the CSF tau and p-tau were higher, with the differences being statistically significant (P ε4(+) group’s Aβ(+) subgroup performed worse on multiple neuropsychological scales compared to the Aβ(−) subgroup, particularly in memory function scales, with the difference being statistically significant (P β and ApoE ε4 leads to a decline in cognitive functions among MCI patients, with a particularly pronounced impairment in memory.
