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目的: 对伴有认知意识受损的遗忘型轻度认知功能障碍（amnestic mild cognitive impairment, aMCI）患者的自我参照网络（self-referential network, SRN）和脑脊液病理标志物β淀粉样蛋白（amyloid βprotein，Aβ），总Tau蛋白（total Tau，t-Tau）和磷酸化Tau蛋白（phosphorylated Tau，p-Tau）改变特征进行研究。方法: 共纳入51例aMCI患者，根据认知意识指数将其分为认知意识受损aMCI组（n=20）与认知意识保留aMCI 组（n=31）。两组患者均行静息态功能磁共振、腰椎穿刺、认知评估检查，采用独立成分分析方法提取SRN；用双样本t检验比较两组间SRN功能连接和脑脊液（Aβ，t-tau和p-tau）改变；用Pearson相关分析探讨认知意识指数与功能连接改变和脑脊液Aβ，t-tau和p-tau水平的关系。结果：认知意识受损aMCI组较认知意识保留aMCI组在双侧内侧眶额叶皮层、左侧前扣带回和右侧直回显示出功能连接增强（AlphaSim 校正，P＜0.001，体素数＞17），两组间脑功能连接差异脑区信号值与认知意识指数呈负相关（r=-0.457，P＜0.001）。认知意识受损aMCI组较认知意识保留aMCI组脑脊液Aβ水平明显降低（P＜0.01），脑脊液ttau水平（P＜0.001）和 ptau水平（P＜0.001）显著升高，Aβ水平与认知意识指数呈正相关（r=0.331，P =0.025），t-tau、p-tau水平与认知意识指数呈负相关（r=-0.534，-0.508，P均＜0.001）。结论： SRN是认知意识的神经影像基础；伴有认知意识受损的aMCI患者存在SRN的功能连接受损和更严重的阿尔茨海默病病理标志物的沉积。

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	陈姗姗1
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	林兴建1

关键词 ：自我参照网络, 轻度认知功能障碍, 认知意识受损, 阿尔茨海默病, 脑脊液

Abstract：Objective: To analyse the changes of selfreferential network （SRN）and cerebrospinal fluid pathological markers amyloid βprotein （Aβ）, total tau （ttau） and phosphorylated tau （p-tau） for patients with amnestic mild cognitive impairment（aMCI）. Methods: A total of 51 aMCI patients were enrolled in the study. According to the cognitive awareness index, they were divided into the aMCI group with impaired cognitive awareness（n=20）and the aMCI group（n=31）with cognitive awareness preserved. All patients underwent resting functional magnetic resonance （rsfMRI）, lumbar puncture, and cognitive assessment. Independent component analysis was used to extract SRN; two-sample t test was used to explore the functional connectivity of SRN and cerebrospinal fluid （Aβ, ttau and ptau）changes; Pearson correlation analysis was used to explore the relationship between cognitive awareness index and functional connectivity changes and the levels of cerebrospinal fluid Aβ, t-tau and p-tau. Results: The aMCI group with impaired cognitive awareness showed hyperconnectivity in the bilateral medial orbitofrontal cortex, left anterior cingulate gyrus and right rectus gyrus （AlphaSim correction, P<0.001, voxel number>17）. The difference in brain function connectivity between the two groups was negatively correlated with the cognitive awareness index（r=-0.457, P<0.000）. The level of Aβ in cerebrospinal fluid in the aMCI group with impaired cognitive awareness was significantly lower than that of the aMCI group with cognitive awareness preserved（P<0.01）, ptau and ttau in cerebrospinal fluid were significantly increased than those of the aMCI group with cognitive awareness preserved（P<0.001）. The cerebrospinal fluid Aβ level was positively correlated with cognitive awareness index（r=0.331, P=0.025）, and cerebrospinal fluid t-tau and p-tau levels were negatively correlated with cognitive consciousness index （r=-0.534,-0.508, both P<0.001）. Conclusion: SRN is the neuroimaging basis of cognitive awareness; aMCI patients with impaired cognitive awareness have impaired functional connectivity of SRN and more severe deposition of Alzheimer′s disease pathological markers.

收稿日期: 2021-01-05

基金资助:国家自然科学青年基金资助项目（81701675）；南京市医学科技发展项目—杰出青年基金资助项目（JQX18005）

通讯作者: 林兴建（通讯作者），主任医师，副教授，硕士生导师，E-mail：linxingjian@njmu.edu.cn

作者简介: 陈姗姗（1996—），女，硕士研究生

引用本文:

陈姗姗1，陈玖2，许雯雯1，宋钰1，林兴建1.

认知意识受损对遗忘型轻度认知功能障碍患者的自我参照网络及病理标志物的影响

[J]. 江苏大学学报:医学版, 2021, 31(02): 108-113. CHEN Shanshan1, CHEN Jiu2, XU Wenwen1, SONG Yu1, LIN Xingjian1. Effect of impaired cognitive awareness on the characteristics of self-referential network and pathological markers in amnestic mild cognitive impairment patients. Journal of Jiangsu University(Medicine Edition), 2021, 31(02): 108-113.

链接本文:

http://zzs.ujs.edu.cn/xbyxb/CN/ 或 http://zzs.ujs.edu.cn/xbyxb/CN/Y2021/V31/I02/108

［1］Gauthier S, Reisberg B, Zaudig M, et al. Mild cognitive impairment\[J\]. Lancet, 2006, 367（9518）: 1262-1270.

［2］Starkstein SE, Jorge R, Mizrahi R,et al.A diagnostic formulation for anosognosia in Alzheimer′s disease\[J\]. J Neurol Neurosurg Psychiatry, 2006, 77（6）:719-725.

［3］Cacciamani F, Tandetnik C, Gagliardi G, et al. Low cognitive awareness, but not complaint, is a good marker of preclinical Alzheimer′s disease\[J\].J Alzheimers Dis, 2017, 59（2）: 753-762.

［4］Gerretsen P, Chung JK, Shah P, et al. Anosognosia is an independent predictor of conversion from mild cognitive impairment to Alzheimer′s disease and is associated with reduced brain metabolism\[J\]. J Clin Psychiatry, 2017, 78（9）:e1187-e1196.

［5］Gusnard DA, Akbudak E, Shulman GL, et al.Medial prefrontal cortex and selfreferential mental activity: relation to a default mode of brain function\[J\]. Proc Natl Acad Sci U S A, 2001, 98（7）: 4259-4264.

［6］Vannini P, Hanseeuw B, Munro CE， et al.Anosognosia for memory deficits in mild cognitive impairment: insight into the neural mechanism using functional and molecular imaging\[J\]. Neuroimage Clin, 2017, 15（4）:408-414.

［7］D′Argembeau A, Collette F, Van der Linden M, et al.Selfreferential reflective activity and its relationship with rest: a PET study\[J\]. Neuroimage,2005,25（2）:616-624.

［8］Mondragón JD, Maurits NM, De Deyn PP.Functional neural correlates of anosognosia in mild cognitive impairment and Alzheimer′s disease: a systematic review\[J\]. Neuropsychol Rev, 2019, 29（2）:139-165.

［9］Therriault J, Ng KP, Pascoal TA, et al.Anosognosia predicts default mode network hypometabolism and clinical progression to dementia\[J\]. Neurology,2018,90（11）:e932-e939.

［10］Bai F, Shi Y, Yuan Y, et al.Altered selfreferential network in restingstate amnestic type mild cognitive impairment\[J\]. Cortex, 2012, 48（5）:604-613.

［11］Liao W, Mantini D, Zhang Z, et al.Evaluating the effective connectivity of resting state networks using conditional granger causality\[J\]. Biol Cybern, 2010, 102（1）:57-69.

［12］Delli Pizzi S, Punzi M, Sensi SL, et al.Functional signature of conversion of patients with mild cognitive impairment\[J\]. Neurobiol Aging, 2019, 74（2）:21-37.

［13］Chao OY, de Souza Silva MA, Yang YM, et al.The medial prefrontal cortexhippocampus circuit that integrates information of object, place and time to construct episodic memory in rodents: behavioral, anatomical and neurochemical properties\[J\]. Neurosci Biobehav Rev, 2020, 113（3）:373-407.

［14］Perrotin A, Desgranges B, Landeau B, et al.Anosognosia in Alzheimer disease: Disconnection between memory and selfrelated brain networks\[J\]. Ann Neurol, 2015, 78（3）:477-486.

［15］Wallis JD. Orbitofrontal cortex and its contribution to decisionmaking\[J\]. Annu Rev Neurosci, 2007（30）:31-56.

［16］Ballmaier M, Toga AW, Blanton RE, et al. Anterior cingulate, gyrus rectus, and orbitofrontal abnormalities in elderly depressed patients: an MRIbased parcellation of the prefrontal cortex\[J\].Am J Psychiatry,2004,161（1）:99-108.

［17］Leng F, Edison P. Neuroinflammation and microglial activation in Alzheimer disease: where do we go from here?\[J\]. Nat Rev Neurol, 2020.Online ahead of print.

［18］Busche MA,Hyman BT.Synergy between amyloidβ and tau in Alzheimer′s disease\[J\].Nat Neurosci,2020,23（10）:1183-1193.

［19］d′Oleire Uquillas F, Jacobs HIL, Schultz AP, et al. Functional and pathological correlates of judgments of learning in cognitively unimpaired older adults\[J\].Cereb Cortex, 2020, 30（3）: 1974-1983.

［20］Hanseeuw BJ, Scott MR, Sikkes SAM, et al. Evolution of anosognosia in Alzheimer′s disease and its relationship to amyloid\[J\].Ann Neurol, 2020, 87（2）: 267-280.