@article {Mohantye323作者= {Rosaleena莫汉蒂和丹尼尔·费雷拉和西蒙Frerich J-Sebastian Muehlboeck米歇尔·j·Grothe和埃里克·韦斯特曼代表{\ textquoteright}年代老年痴呆症神经影像倡议},title = {Neuropathologic临死前的特征Atrophy-Based亚型的阿尔茨海默病},体积={99}={4},页面= {e323——e333} = {2022}, doi = {10.1212 / WNL。出版商0000000000200573}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景和目标调查是否临死前的mri萎缩的阿尔茨海默病(AD)不同亚型neurop首页athologic特性和共病non-AD病理尸检。方法从{\ textquoteright}年代老年痴呆症神经影像倡议中,我们包含了临死前的MRI评估脑萎缩患者2年内死亡之前,临死前的诊断AD痴呆/轻度认知障碍和postmortem-confirmed广告neuropathologic变化。临死前的萎缩亚型被建模为连续现象基于最近的一个概念性的框架:典型性(跨越limbic-predominant广告hippocampal-sparing广告)和严重性(生成典型的广告最小萎缩广告)。后期neuropathologic评价包括广告标志、β-amyloid和τnon-AD病态,α-突触核蛋白和焦油dna结合蛋白43 (TDP-43)。我们也调查了这些病态的总体相伴。部分相关性评估临死前的萎缩亚型之间的关联和后期neuropathologic结果。导致31人(AD痴呆26日/ 5轻度认知障碍,平均年龄= 80年,26 \ %的女性),临死前的典型性与neuropathologic显著负相关特征,包括β-amyloid整体(ρ= -0.39),τ(ρ= -0.38区域),α-突触核蛋白(ρ= -0.39区域),TDP-43整体(ρ= -0.49),和伴随疾病(ρ= -0.59区域)。Limbic-predominant广告需要较高的阶段,有关神经炎的斑块密度、和TDP-43而hippocampal-sparing广告的存在。地区,limbic-predominant广告显示更高的τ和α-突触核蛋白存在病态在内侧颞结构,更高的TDP-43存在,相伴病态皮质与皮质下/ hippocampal-sparing广告。临死前的严重程度显著负相关相伴的病态(ρ= -0.43区域),这样典型的广告显示的病态相伴高于最小萎缩广告。讨论,我们提供了一个直接antemortem-to-postmortem验证,强调理解atrophy-based异质性的重要性在广告相对于广告和non-AD病态。我们建议(1)典型性和严重性大脑萎缩反映易感性的微分方面的广告和non-AD病态; and (2) limbic-predominant AD and typical AD subtypes share similar biological pathways, making them more vulnerable to AD and non-AD pathologies compared with hippocampal-sparing AD, which may follow a different biological pathway. Our findings provide a deeper understanding of associations of atrophy subtypes in AD with different pathologies, enhancing the prevailing knowledge of biological heterogeneity in AD and could contribute toward tracking disease progression and designing clinical trials in the future.AD=Alzheimer disease; ADNC=AD neuropathologic change; ADNI=Alzheimer{\textquoteright}s Disease Neuroimaging Initiative; ADNI-EF=composite cognitive score for executive function; ADNI-MEM=composite scores for memory; aMCI=amnestic mild cognitive impairment; Aβ=β-amyloid; CDR=Clinical Dementia Rating; MMSC=Mini-Mental State Examination; NCI=neuronal cytoplasmic inclusion; NFT=neurofibrillary tangle; TDP-43=TAR DNA-binding protein 43; α-syn=α-synuclein}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/99/4/e323}, eprint = {//www.ez-admanager.com/content/99/4/e323.full.pdf}, journal = {Neurology} }