알츠하이머병 치매에서 대뇌 아밀로이드 축적 여부에 따른 임상적 특성의 차이

• 영문명: Distinct Clinical Characteristics Depending on Cerebral Amyloid Positivity in Patients with Alzheimer Disease Dementia
• 발행기관: 대한노인정신의학회
• 저자명: 전소연(So Yeon Jeon) 변민수(Min Soo Byun,) 이다현(Dahyun Yi) 이준호(Jun Ho Lee) 최영민(Young Min Choe) 김현정(Hyun Jung Kim) 백혜원(Hyewon Baek) 이준영(Jun Young Lee) 이동우(Dong Woo Lee) 한나영(Na Young Han) 이승훈(Seung Hoon Lee) 고 강(Kang Ko) 김유경(Yu Kyeong Kim) 이윤상(Yun-Sang Lee) 이영화(Younghwa Lee) 고현웅(Hyunwoong Ko) 추경진(Kyoungjin Chu)이동영(Dong Young Lee)
• 간행물 정보: 『노인정신의학』노인정신의학 제20권 제2호, 68~74쪽, 전체 7쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2016.10.30

영문 초록

Objective：The present study investigated the clinical characteristics of Alzheimer’s disease (AD) dementia with low brain amyloid-beta (Aβ-AD) burden comparing with AD dementia with high amyloid-beta burden (Aβ+AD). We also developed a prediction model for the amyloid positivity on 11 C-labelled Pittsburgh Compound B (PiB) positron emission tomography (PET) with distinct clinical variables in AD dementia patients. Methods：Fifty-nine clinically defined AD dementia individuals, who participated in the Korean Brain Aging Study for Early diagnosis and prediction of AD (KBASE) study, were included. All the subjects received comprehensive clinical evaluations and PiB-PET. Based on cerebral PiB retention, all subjects were divided into Aβ+AD (n=47) and Aβ-AD (n=12) subgroups. To develop a prediction model for amyloid positivity, stepwise multiple logistic regression analysis was conducted. Results：When compared to Aβ+AD, Aβ-AD showed older age, later age-at-onset, and lower education. In regard of risk factors for dementia, Aβ-AD had higher frequency of hypertension and diabetes mellitus as well as lower frequency of apolipoprotein E (APOE) ε4 allele. Although there was no between group difference in Clinical Dementia Rating (CDR) or CDR sumof-boxes scores, mini-mental state examination and constructional recall scores were higher for Aβ-AD than Aβ+AD. The final amyloid positivity prediction model included APOE4 genotype, hypertension, and diabetes mellitus. Conclusion：The findings from this study indicated that clinically diagnosed AD dementia may have high possibility of not being pathological AD if they have older age and higher vascular risks, and did not have APOE4 genotype.

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키워드

Alzheimer dementia Beta amyloid Apolipoprotein E Hypertension Diabetes mellitus