Tau as a biomarker of cognitive impairment and neuropsychiatric symptom in Alzheimer's disease

作者：Mingxi Dang, Qian Chen, Xiaobin Zhao, Kewei Chen, Xin Li, Junying Zhang, Jie Lu, Lin Ai, Yaojing Chen, Zhanjun Zhang · 发表于：Human Brain Mapping · 年份：2022 · DOI：10.1002/hbm.26043 · 被引用次数：27 · 研究领域：Dementia and Cognitive Impairment Research、Alzheimer's disease research and treatments、Advanced Neuroimaging Techniques and Applications

The A/T/N research framework has been proposed for the diagnosis and prognosis of Alzheimer's disease (AD). However, the spatial distribution of ATN biomarkers and their relationship with cognitive impairment and neuropsychiatric symptoms (NPS) need further clarification in patients with AD. We scanned 83 AD patients and 38 cognitively normal controls who independently completed the mini-mental state examination and Neuropsychiatric Inventory scales. Tau, Aβ, and hypometabolism spatial patterns were characterized using Statistical Parametric Mapping together with [18F]flortaucipir, [18F]florbetapir, and [18F]FDG positron emission tomography. Piecewise linear regression, two-sample t-tests, and support vector machine algorithms were used to explore the relationship between tau, Aβ, and hypometabolism and cognition, NPS, and AD diagnosis. The results showed that regions with tau deposition are region-specific and mainly occurred in inferior temporal lobes in AD, which extensively overlaps with the hypometabolic regions. While the deposition regions of Aβ were unique and the regions affected by hypometabolism were widely distributed. Unlike Aβ, tau and hypometabolism build up monotonically with increasing cognitive impairment in the late stages of AD. In addition, NPS in AD were associated with tau deposition closely, followed by hypometabolism, but not with Aβ. Finally, hypometabolism and tau had higher accuracy in differentiating the AD patients from controls (accuracy = 0.88,...