摘要
轻度认知功能障碍(MCI)的概念首次被引入用于识别个人介于没有认知障碍和阿尔茨海默氏病(AD)之间的中间状态。最近, 随着其他疾病如脑血管疾病和帕金森病等被明确也会引起轻度认知障碍,MCI的异质性已经引起关注,并重新定义了MCI。神经病理学检测证实了MCI的异质性。大多数MCI患者不仅有淀粉样蛋白斑和神经元纤维tau蛋白缠结,而且存在大脑血管病理改变,如动脉硬化和脑淀粉样血管病(CAA)。进一步认知功能障碍促使CAA诱发脑梗塞或不同大小和类型的出血。人们认为β淀粉样蛋白消除障碍导致散发的AD和CAA,这主要由血管周的排水系统的干扰所致。因为严重的CAA是痴呆症的一个独立危险因素,人们建议促进β淀粉样蛋白被清除可作为对AD和MCI的潜在治疗方法。许多流行病学研究表明血管危险因素增加了MCI的发病率及其发展为AD的可能性。因此,控制这些因素被证实能降低转化为AD的风险并改善AD患者的认知障碍。因此,在预防神经学时代,神经血管途径治疗法可能会给治愈痴呆症带来希望。
关键词: 阿尔茨海默氏病,脑淀粉样血管病,脑血管病,西洛他唑,诊断,微小梗塞,轻度认知功能障碍,神经认知失调
Current Alzheimer Research
Title:Mild Cognitive Impairment: At the Crossroad of Neurodegeneration and Vascular Dysfunction
Volume: 12 Issue: 6
Author(s): Satoshi Saito, Yumi Yamamoto and Masafumi Ihara
Affiliation:
关键词: 阿尔茨海默氏病,脑淀粉样血管病,脑血管病,西洛他唑,诊断,微小梗塞,轻度认知功能障碍,神经认知失调
摘要: The concept of mild cognitive impairment (MCI) was first introduced for the purpose of identifying individuals in an intermediate state between no cognitive impairment and Alzheimer’s disease (AD). Recently, the heterogeneity of MCI has attracted attention as it has become clear that other diseases, such as cerebrovascular disease and Parkinson disease can also cause mild cognitive deficits, prompting a redefinition of MCI. Heterogeneity of MCI has been confirmed by neuropathological examinations. Most MCI patients not only possess amyloid plaques and neurofibrillary tau tangles, but also cerebral vascular pathology such as arteriosclerosis and cerebral amyloid angiopathy (CAA). CAA induces cerebral infarcts or hemorrhage of varying size and type, attributing to further cognitive impairment. Sporadic AD and CAA has been suggested to be the consequence of Aβ elimination failure, mainly caused by disturbance of the perivascular drainage system. Since severe CAA is an independent risk factor for dementia, facilitation of Aβ clearance has been suggested as a potential treatment of AD and MCI. Many epidemiological studies have shown that vascular risk factors increase incidence of MCI and its progression to AD. Accordingly, control of such factors has been shown to reduce risk of conversion to AD and ameliorate cognitive impairment in AD patients. Neurovascular approaches may therefore hold promise for the treatment of dementia in an era of preventive neurology.
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Satoshi Saito, Yumi Yamamoto and Masafumi Ihara , Mild Cognitive Impairment: At the Crossroad of Neurodegeneration and Vascular Dysfunction, Current Alzheimer Research 2015; 12 (6) . https://dx.doi.org/10.2174/1567205012666150530202508
DOI https://dx.doi.org/10.2174/1567205012666150530202508 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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