Abstract
This study investigated the relationships among plasma biomarkers, regional brain atrophy, and clinical symptoms in patients with Alzheimer’s disease (AD; n = 177), mild cognitive impairment (MCI; N = 60) and controls (n = 108). The Mini-Mental Status Examination (MMSE), Clinical Dementia Rating (CDR), and Neuropsychiatric Inventory (NPI) subscales were administered to subjects. Magnetic resonance imaging was performed and medial temporal atrophy (MTA) and posterior atrophy (PA) were assessed visually. We examined associations among cognition, NPI score, plasma β-amyloid (Aβ) and clusterin levels, and regional brain atrophy in patients with AD by regression analysis. The mean MTA score was associated with the plasma Aβ1-42/Aβ1-40 ratio (r = 0.38, p = 0.01) and with MMSE scores (r = 0.43, p < 0.01). The plasma clusterin level was correlated with CDR sum of box and right-side PA scores (r = 0.28, p = 0.01 and r = 0.30, p = 0.03, respectively). Right-side PA scores were correlated significantly with NPI agitation/aggression (r = 0.30, p = 0.03) subscale scores. In conclusion, the plasma ratio of Aβ1-42/Aβ1-40 and clusterin level may be associated with different patterns of regional brain atrophy, which in turn may account for the clinical symptoms in patients with AD.
Highlights
Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by progressive cognitive dysfunction, behavioral changes, and loss of functional ability
In a regression analysis adjusted for age, sex, and ApoE4 carrier status, the significant higher level of in plasma amyloid ß peptide 1–40 (Aß1-40) and clusterin levels were found in patients with AD and mild cognitive impairment (MCI) than controls
The plasma amyloid ß peptide 1–42 (Aß1-42)/Aß1-40 ratio was correlated with the mean medial temporal atrophy (MTA) score, and the clusterin level was correlated with the right-side posterior atrophy (PA) score, in patients with AD
Summary
Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by progressive cognitive dysfunction, behavioral changes, and loss of functional ability. Several cognitive screening tests, including the Mini-Mental State Examination (MMSE) and the DemTect[1, 2], have been developed to measure the cognitive deficits in AD These deficits are correlated with structural changes in the brain[3, 4]. Various brain regions are associated with agitation and aggression symptoms, their relationships to regional brain changes and plasma biomarkers remain unknown. Right-side posterior atrophy (PA) and medial temporal atrophy (MTA), measured by MRI, were associated with the NPI agitation/aggression subscale score and cognitive impairment in patients with AD11. The current study was conducted to further investigate the relationships among plasma Aß and clusterin levels, atrophy ratings determined by MRI assessment, and clinical symptoms in patients with AD and those with mild cognitive impairment (MCI)
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