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Risk of Dementia in Posttraumatic Stress Disorder.
Journal of Geriatric Psychiatry and Neurology ( IF 2.6 ) Pub Date : 2020-09-10 , DOI: 10.1177/0891988720957088
Alby Elias 1, 2 , Christopher Rowe 1 , Malcolm Hopwood 2
Affiliation  

Several studies have investigated the risk of dementia in posttraumatic stress disorder (PTSD) using a varying methodology. Epidemiological studies have found an increased risk of dementia with PTSD in Vietnam veterans as well as the general population. Laboratory studies reported the accelerated formation of β-amyloid and tau, which represent the primary pathology of Alzheimer’s dementia in animal models of PTSD. These investigations were conducted against a background of cognitive impairment and atrophy of the hippocampus and certain cortical areas in patients with PTSD. Very few studies have investigated the pathological basis in humans for the reported association of PTSD with dementia. This important gap in the literature has recently been partly addressed by very few studies that estimated the burden of β-amyloid and tau. The PET studies did not show an association between PTSD and the specific pathology of Alzheimer’s disease or signs of neurodegenerative diseases underlying other dementia syndromes. Another study demonstrated decreased plasma β-amyloid load and increased plasma β-amyloid 42/40 ratio in PTSD without PET evaluation. While PTSD is associated with an increased risk of dementia syndrome in general, there is no convincing evidence that it causes or accelerates the pathology of Alzheimer’s disease, which causes the most common type of dementia. Factors that may account for the association between PTSD and a clinical diagnosis of dementia are discussed in this review.



中文翻译:

创伤后应激障碍的痴呆风险。

几项研究使用不同的方法调查了创伤后应激障碍 (PTSD) 患痴呆症的风险。流行病学研究发现,越南退伍军人和普通人群患 PTSD 痴呆症的风险增加。实验室研究报告了 β-淀粉样蛋白和 tau 的加速形成,它们代表了 PTSD 动物模型中阿尔茨海默病痴呆的主要病理。这些调查是在 PTSD 患者的认知障碍和海马体和某些皮质区域萎缩的背景下进行的。很少有研究调查了人类所报告的 PTSD 与痴呆症关联的病理基础。最近,很少有研究估计 β-淀粉样蛋白和 tau 的负担,从而部分解决了文献中的这一重要空白。PET 研究未显示 PTSD 与阿尔茨海默病的特定病理或其他痴呆综合征潜在的神经退行性疾病迹象之间存在关联。另一项研究表明,在未进行 PET 评估的 PTSD 中,血浆 β-淀粉样蛋白负荷减少,血浆 β-淀粉样蛋白 42/40 比率增加。虽然 PTSD 总体上与痴呆综合征风险增加有关,但没有令人信服的证据表明它会导致或加速阿尔茨海默病的病理,阿尔茨海默病是最常见的痴呆类型。本综述讨论了可能解释 PTSD 与痴呆临床诊断之间关联的因素。另一项研究表明,在未进行 PET 评估的 PTSD 中,血浆 β-淀粉样蛋白负荷减少,血浆 β-淀粉样蛋白 42/40 比率增加。虽然 PTSD 总体上与痴呆综合征风险增加有关,但没有令人信服的证据表明它会导致或加速阿尔茨海默病的病理,阿尔茨海默病是最常见的痴呆类型。本综述讨论了可能解释 PTSD 与痴呆临床诊断之间关联的因素。另一项研究表明,在未进行 PET 评估的 PTSD 中,血浆 β-淀粉样蛋白负荷减少,血浆 β-淀粉样蛋白 42/40 比率增加。虽然 PTSD 总体上与痴呆综合征风险增加有关,但没有令人信服的证据表明它会导致或加速阿尔茨海默病的病理,阿尔茨海默病是最常见的痴呆类型。本综述讨论了可能解释 PTSD 与痴呆临床诊断之间关联的因素。

更新日期:2020-09-11
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