基于神经影像技术的认知下降预测及其在AD临床前期诊疗中的应用

Alzheimer’s disease (AD) is the most common cause of dementia, which severely injures multiple domains of cognitive functions in the aging people, bringing heavy burden to the society and families. Studying the cognitive brain damage mechanism of subjective cognitive decline (SCD), the preclinical stage of AD, would provide great opportunities for understanding the pathogenesis of AD and clinical value for early diagnosis and intervention in AD. The project intends to utilize amyloid-PET for screening and then employ the comprehensive neuropsychological examination combined with multi-modal neuroimaging techniques to study the brain functions and structures of the normal aging and SCD. The imaging data would be analyzed from several levels, including the cognitive dimensions, brain activation patterns, and especially functional and structural networks to establish the models of normal and pathological cognitive aging, which mainly be modulated by frontal-parietal control system. We aim to establish models of normal and pathological cognitive aging. Furthermore, the longitudinal data of SCD population would be collected to study the dynamic changes of brain networks so as to explore the progressive mechanisms of AD on brain networks and to construct a high-precision multi-modal model for early diagnosis.

阿尔茨海默病（Alzheimer’s disease, AD）是最常见的痴呆病因，严重损害老年人的认知功能，给社会和家庭带来沉重的负担。研究AD临床前期主观认知下降（subjective cognitive decline, SCD）的脑机制，对理解AD的发病机制进而开发早期诊断与干预新方法具有重要的科学意义和临床价值。申请人在前期研究的基础上，拟利用淀粉样蛋白PET筛选AD临床前期患者，综合运用神经心理检查和以磁共振为主的多模态神经成像技术，结合主观的认知评估和客观的神经环路结构、功能评价指标，系统研究以额顶控制系统为主要调控机制的正常认知老化和病理认知老化机制，建立可区分正常老化和病理老化的数学模型。进一步通过随访数据研究SCD人群的脑网络的动态变化规律，明确SCD向AD转化的神经机制。基于上述研究结果，建立SCD的多维度客观预测和诊断的神经成像多模数据模型，以期用于AD超早期诊断。

随着阿尔茨海默病(Alzheimer’s disease, AD)发病率的逐年升高，已给全球造成巨大的经济社会负担。AD临床前期早期诊断对于降低发病率延缓疾病发展至关重要。主观认知下降（subjective cognitive decline, SCD）被认为是AD临床前期最重要的临床表现。磁共振检查目前已被广泛应用于AD痴呆、轻度认知障碍以及临床前期SCD阶段的相关研究。但目前仍缺乏标准化的诊断规范和稳定可重复的影像诊断指标。本课题采用多模态磁共振成像技术，包括结构磁共振、弥散张量成像和静息态功能磁共振，旨在于探索SCD人群的大脑的特征性改变，提取AD临床前期诊断影像标记物，明确认知加工的脑网络机制，为AD临床前期SCD超早期诊断与干预寻找客观依据。