PDF(Pubmed)
Abstract：
BACKGROUND: The relationship between cerebrospinal fluid pressure (CSFP) and cognition has received little research attention. The purpose of this study was to explore the relationship between CSFP and cognition in patients with Alzheimer\'s disease (AD) and patients with Lewy body dementia (LBD).
METHODS: We included 178 participants, including 137 patients with AD and 41 patients with LBD (including dementia with Lewy bodies (DLBs) and Parkinson\'s disease dementia (PDD)). CSFP was measured by lumbar puncture, and a patient-reported history and laboratory test data were collected. Logistic and linear regression analyses were used to evaluate the associations between CSFP and cognition, the cerebrospinal fluid (CSF) / serum albumin ratio (Qalb), and CSF biomarkers of AD.
RESULTS: The mean age of the included patients was 63.58 ± 8.77 years old, and the mean CSFP was 121 ± 33.72 mmH2O. A total of 76.9% of the patients had a CSFP distribution of [90-170) mmH2O, 46 patients (25.8%) had severe dementia, 83 patients (46.6%) had moderate dementia, 28 patients (15.7%) had mild dementia, and 21 patients (11.8%) had mild cognitive impairment (MCI) (including 16 patients with MCI due to AD and 5 patients with MCI due to LBD). In all patients (p value < 0.001) and in patients with AD (p value = 0.01), the mean cerebrospinal fluid pressure (CSFP) was higher in patients with MCI than in patients with dementia. In multivariate analysis, in all patients (OR: 6.37, 95% confidential interval (CI): 1.76-23.04, p = 0.005) and patients with AD (odds ratio (OR): 5.43, 95% CI: 1.41-20.87, p = 0.005), a CSFP in the lowest quartile ([50-90) mmH2O) was associated with a higher level of severe dementia than a CSFP in the highest quartile ([170-210) mmH2O). In addition, there was a significant linear correlation between CSFP and the Mini-Mental State Examination (MMSE) score in all patients with dementia (r = 0.43, p = 0.04, Durbin-Watson test (D-W test) = 0.75).
CONCLUSIONS: In patients with AD, the mean cerebrospinal fluid pressure was higher in patients with MCI than in patients with dementia, and the decrease in CSFP was related to a more serious dementia level. However, no such relationship was found in patients with LBD.
METHODS: We included 178 participants, including 137 patients with AD and 41 patients with LBD (including dementia with Lewy bodies (DLBs) and Parkinson\'s disease dementia (PDD)). CSFP was measured by lumbar puncture, and a patient-reported history and laboratory test data were collected. Logistic and linear regression analyses were used to evaluate the associations between CSFP and cognition, the cerebrospinal fluid (CSF) / serum albumin ratio (Qalb), and CSF biomarkers of AD.
RESULTS: The mean age of the included patients was 63.58 ± 8.77 years old, and the mean CSFP was 121 ± 33.72 mmH2O. A total of 76.9% of the patients had a CSFP distribution of [90-170) mmH2O, 46 patients (25.8%) had severe dementia, 83 patients (46.6%) had moderate dementia, 28 patients (15.7%) had mild dementia, and 21 patients (11.8%) had mild cognitive impairment (MCI) (including 16 patients with MCI due to AD and 5 patients with MCI due to LBD). In all patients (p value < 0.001) and in patients with AD (p value = 0.01), the mean cerebrospinal fluid pressure (CSFP) was higher in patients with MCI than in patients with dementia. In multivariate analysis, in all patients (OR: 6.37, 95% confidential interval (CI): 1.76-23.04, p = 0.005) and patients with AD (odds ratio (OR): 5.43, 95% CI: 1.41-20.87, p = 0.005), a CSFP in the lowest quartile ([50-90) mmH2O) was associated with a higher level of severe dementia than a CSFP in the highest quartile ([170-210) mmH2O). In addition, there was a significant linear correlation between CSFP and the Mini-Mental State Examination (MMSE) score in all patients with dementia (r = 0.43, p = 0.04, Durbin-Watson test (D-W test) = 0.75).
CONCLUSIONS: In patients with AD, the mean cerebrospinal fluid pressure was higher in patients with MCI than in patients with dementia, and the decrease in CSFP was related to a more serious dementia level. However, no such relationship was found in patients with LBD.
摘要：
背景：脑脊液压力（CSFP）与认知之间的关系很少受到研究关注。目的探讨阿尔茨海默病(AD)和路易体痴呆(LBD)患者认知功能与CSFP的关系。
方法：我们包括178名参与者，包括137例AD患者和41例LBD患者（包括路易体痴呆（DLB）和帕金森病痴呆（PDD））。CSFP是通过腰椎穿刺测量的，收集患者报告的病史和实验室检测数据.Logistic和线性回归分析用于评估CSFP与认知之间的关联。脑脊液（CSF）/血清白蛋白比（Qalb），和AD的CSF生物标志物。
结果：纳入患者的平均年龄为63.58±8.77岁，平均CSFP为121±33.72mmH2O。共有76.9%的患者的CSFP分布为[90-170)mmH2O,46例（25.8%）患有严重痴呆，83例（46.6%）患有中度痴呆，28例患者（15.7%）有轻度痴呆，21例患者（11.8%）有轻度认知障碍（MCI）（包括16例由于AD引起的MCI患者和5例由于LBD引起的MCI患者）。在所有患者（p值<0.001）和AD患者（p值=0.01）中，MCI患者的平均脑脊液压(CSFP)高于痴呆患者.在多变量分析中，在所有患者中（OR：6.37，95％机密间隔（CI）：1.76-23.04，p=0.005）和AD患者（比值比（OR）：5.43，95％CI：1.41-20.87，p=0.005），与最高四分位数([170-210)mmH2O)的CSFP相比,最低四分位数([50-90)mmH2O)的CSFP与更高水平的严重痴呆相关.此外,在所有痴呆患者中,CSFP与简易精神状态检查(MMSE)评分之间存在显著的线性相关性(r=0.43,p=0.04,Durbin-Watson检验(D-W检验)=0.75).
结论：在AD患者中，MCI患者的平均脑脊液压高于痴呆患者,CSFP的下降与更严重的痴呆水平有关。然而,在LBD患者中未发现这种关系.
方法：我们包括178名参与者，包括137例AD患者和41例LBD患者（包括路易体痴呆（DLB）和帕金森病痴呆（PDD））。CSFP是通过腰椎穿刺测量的，收集患者报告的病史和实验室检测数据.Logistic和线性回归分析用于评估CSFP与认知之间的关联。脑脊液（CSF）/血清白蛋白比（Qalb），和AD的CSF生物标志物。
结果：纳入患者的平均年龄为63.58±8.77岁，平均CSFP为121±33.72mmH2O。共有76.9%的患者的CSFP分布为[90-170)mmH2O,46例（25.8%）患有严重痴呆，83例（46.6%）患有中度痴呆，28例患者（15.7%）有轻度痴呆，21例患者（11.8%）有轻度认知障碍（MCI）（包括16例由于AD引起的MCI患者和5例由于LBD引起的MCI患者）。在所有患者（p值<0.001）和AD患者（p值=0.01）中，MCI患者的平均脑脊液压(CSFP)高于痴呆患者.在多变量分析中，在所有患者中（OR：6.37，95％机密间隔（CI）：1.76-23.04，p=0.005）和AD患者（比值比（OR）：5.43，95％CI：1.41-20.87，p=0.005），与最高四分位数([170-210)mmH2O)的CSFP相比,最低四分位数([50-90)mmH2O)的CSFP与更高水平的严重痴呆相关.此外,在所有痴呆患者中,CSFP与简易精神状态检查(MMSE)评分之间存在显著的线性相关性(r=0.43,p=0.04,Durbin-Watson检验(D-W检验)=0.75).
结论：在AD患者中，MCI患者的平均脑脊液压高于痴呆患者,CSFP的下降与更严重的痴呆水平有关。然而,在LBD患者中未发现这种关系.
