Background:Mild cognitive impairment (MCI) is considered by some to be a prodromal phase of a progressive disease (i.e., neurodegeneration) resulting in dementia; however, a substantial portion of individuals (ranging from 5–30%) remain cognitively stable over the long term (sMCI). The etiology ofsMCI is unclear but may be linked to cerebrovascular disease (CVD), as evidence from longitudinal studies suggest a significant proportion of individuals with vasculopathy remain stable over time. Objective:To quantify the presence of neurodegenerative and vascular pathologies in individuals with long-term (>5-year) sMCI, in a preliminary test of the hypothesis that CVD may be a contributor to non-degenerative cognitive impairment. We expect frequent vasculopathy at autopsy in sMCI relative to neurodegenerative disease, and relative to individuals who convert to dementia. Methods:In this retrospective study, using data from the National Alzheimer’s Coordinating Center, individuals with sMCI (n = 28) were compared to those with MCI who declined over a 5 to 9-year period (dMCI; n = 139) on measures of neurodegenerative pathology (i.e., Aβ plaques, neurofibrillary tangles, TDP-43, and cerebral amyloid angiopathy) and CVD (infarcts, lacunes, microinfarcts, hemorrhages, and microbleeds). Results:Alzheimer’s disease pathology (Aβ plaques, neurofibrillary tangles, and cerebral amyloid angiopathy) was significantly higher in the dMCI group than the sMCI group. Microinfarcts were the only vasculopathy associated with group membership; these were more frequent in sMCI. Conclusion:The most frequent neuropathology in this sample of long-term sMCI was microinfarcts, tentatively suggesting that silent small vessel disease may characterize non-worsening cognitive impairment.

中文翻译：

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长期稳定的轻度认知障碍中的脑血管和神经退行性疾病

背景：轻度认知障碍 (MCI) 被一些人认为是导致痴呆的进行性疾病（即神经变性）的前驱阶段；然而，相当一部分人（从 5% 到 30%）在长期内保持认知稳定（sMCI）。sMCI 的病因尚不清楚，但可能与脑血管疾病 (CVD) 相关，因为纵向研究的证据表明，很大一部分患有血管病变的个体随着时间的推移保持稳定。目的：量化长期（> 5 年）sMCI 个体中神经退行性和血管病变的存在，初步检验 CVD 可能是非退行性认知障碍的贡献者的假设。我们预计与神经退行性疾病相关的 sMCI 在尸检时会出现频繁的血管病变，并且相对于转变为痴呆症的个体。方法：在这项回顾性研究中，使用来自国家阿尔茨海默病协调中心的数据，将患有 sMCI 的个体（n = 28）与那些在 5 至 9 年期间下降的 MCI 个体（dMCI；n = 139）进行比较。神经退行性疾病（即 Aβ 斑块、神经原纤维缠结、TDP-43 和脑淀粉样血管病）和 CVD（梗塞、腔隙、微梗塞、出血和微出血）。结果：dMCI 组的阿尔茨海默病病理（Aβ 斑块、神经原纤维缠结和脑淀粉样血管病）显着高于 sMCI 组。微梗死是唯一与组成员相关的血管病变；这些在 sMCI 中更为常见。结论：该长期 sMCI 样本中最常见的神经病理学是微梗死，