PDF(Pubmed)
Abstract：
OBJECTIVE: Although sarcopenia is common in patients with Alzheimer\'s disease (AD), the neural substrates involved remain unclear. We investigated the relationship between sarcopenia, as well as its definition components, and regional cerebral blood flow (rCBF) in older adults with progression of normal cognition to AD.
METHODS: 99m Tc-ethyl-cysteinate-dimer single-photon emission computed tomography was carried out in 95 older adults with progression of normal cognition to AD (40 men and 55 women, mean ± SD age 80.9 ± 6.8 years). The associations of rCBF determined by 3-D stereotactic region of interest template software, with sarcopenia and its definition components, slower gait speed, weaker grip strength, and decline in appendicular skeletal muscle mass index (ASMI) were analyzed.
RESULTS: Logistic regression analysis adjusted by age, sex, mini-mental state examination score and education showed that sarcopenia as well as ASMI less than the cut-off (men 7.0 kg/m2 , women 5.7 kg/m2 ) were associated with significantly reduced rCBF in the key hub of the central autonomic network, including the insula, anterior cingulate cortex, subcallosal area, rectal gyrus, hypothalamus, amygdala and caudate head. Sarcopenia and ASMI decline were associated with hypoperfusion in the aforementioned cortical hubs of the central autonomic network in men, but with hypoperfusion of the hypothalamus in women. Linear regression analysis showed significant correlations of ASMI/cut-off with rCBF in the bilateral medial frontal cortex, as well as rCBF in the aforementioned key hubs.
CONCLUSIONS: Hypoperfusion in key hubs of central autonomic network is implicated in the emergence of sarcopenia, probably through ASMI decline in vulnerable older adults. Geriatr Gerontol Int 2023; 23: 16-24.
METHODS: 99m Tc-ethyl-cysteinate-dimer single-photon emission computed tomography was carried out in 95 older adults with progression of normal cognition to AD (40 men and 55 women, mean ± SD age 80.9 ± 6.8 years). The associations of rCBF determined by 3-D stereotactic region of interest template software, with sarcopenia and its definition components, slower gait speed, weaker grip strength, and decline in appendicular skeletal muscle mass index (ASMI) were analyzed.
RESULTS: Logistic regression analysis adjusted by age, sex, mini-mental state examination score and education showed that sarcopenia as well as ASMI less than the cut-off (men 7.0 kg/m2 , women 5.7 kg/m2 ) were associated with significantly reduced rCBF in the key hub of the central autonomic network, including the insula, anterior cingulate cortex, subcallosal area, rectal gyrus, hypothalamus, amygdala and caudate head. Sarcopenia and ASMI decline were associated with hypoperfusion in the aforementioned cortical hubs of the central autonomic network in men, but with hypoperfusion of the hypothalamus in women. Linear regression analysis showed significant correlations of ASMI/cut-off with rCBF in the bilateral medial frontal cortex, as well as rCBF in the aforementioned key hubs.
CONCLUSIONS: Hypoperfusion in key hubs of central autonomic network is implicated in the emergence of sarcopenia, probably through ASMI decline in vulnerable older adults. Geriatr Gerontol Int 2023; 23: 16-24.
摘要：
目的：尽管肌肉减少症在阿尔茨海默病（AD）患者中很常见，涉及的神经底物尚不清楚。我们调查了肌少症，以及它的定义组件，和局部脑血流量（rCBF）在老年人的正常认知进展为AD。
方法：99mTc-乙基-半胱氨酸-二聚体单光子发射计算机断层扫描在95名认知正常进展为AD的老年人中进行（40名男性和55名女性，平均±SD年龄80.9±6.8岁）。通过3-D立体定向感兴趣区域模板软件确定的rCBF的关联，肌少症及其定义成分，较慢的步态速度，握力较弱,并分析了阑尾骨骼肌质量指数（ASMI）的下降。
结果：按年龄调整的Logistic回归分析，性别,小型精神状态考试成绩和教育表明，肌少症和ASMI低于临界值(男性7.0kg/m2，女性5.7kg/m2）与中央自主网络关键枢纽的rCBF显着降低有关，包括脑岛，前扣带皮质,call下区域，直肠回,下丘脑,杏仁核和尾状头。肌肉减少症和ASMI下降与男性中央自主神经网络的上述皮质中心的灌注不足有关，但是女性下丘脑灌注不足。线性回归分析显示，双侧内侧额叶皮质ASMI/cut-off与rCBF显著相关，以及上述关键枢纽的rCBF。
结论：中枢自主神经网络关键枢纽的低灌注与肌少症的出现有关，可能是由于脆弱的老年人ASMI下降。GeriatrGerontolInt2022；••：••-•。
方法：99mTc-乙基-半胱氨酸-二聚体单光子发射计算机断层扫描在95名认知正常进展为AD的老年人中进行（40名男性和55名女性，平均±SD年龄80.9±6.8岁）。通过3-D立体定向感兴趣区域模板软件确定的rCBF的关联，肌少症及其定义成分，较慢的步态速度，握力较弱,并分析了阑尾骨骼肌质量指数（ASMI）的下降。
结果：按年龄调整的Logistic回归分析，性别,小型精神状态考试成绩和教育表明，肌少症和ASMI低于临界值(男性7.0kg/m2，女性5.7kg/m2）与中央自主网络关键枢纽的rCBF显着降低有关，包括脑岛，前扣带皮质,call下区域，直肠回,下丘脑,杏仁核和尾状头。肌肉减少症和ASMI下降与男性中央自主神经网络的上述皮质中心的灌注不足有关，但是女性下丘脑灌注不足。线性回归分析显示，双侧内侧额叶皮质ASMI/cut-off与rCBF显著相关，以及上述关键枢纽的rCBF。
结论：中枢自主神经网络关键枢纽的低灌注与肌少症的出现有关，可能是由于脆弱的老年人ASMI下降。GeriatrGerontolInt2022；••：••-•。
