BACKGROUND There is growing interest in the comorbidity of vascular and neurodegenerative pathologies in patients with cerebrovascular disease (CVD) beyond cerebral amyloid angiopathy (CAA). However, the relationship between amyloid-β and vascular cognitive impairment (VCI) remains debated. OBJECTIVE To investigate the association between VCI and amyloid-β deposition in non-CAA CVD patients. METHODS PubMed, Embase, Web of Science, PsycINFO and CENTRAL databases were systematically searched. Observational studies, including case-control and cohort studies, associating cognitive scores with amyloid load measured by positron emission tomography were selected. Meta-analyses were performed to assess the strength of amyloid-cognition associations across CVD subtypes and cognitive domains. A random-effects model using the inverse variance method was used, with heterogeneity evaluated by Q-statistics and I2 statistics. Meta-regression analyses were conducted to examine the influence of moderators, and publication bias was assessed using funnel plots and Egger's test. All statistical analyses were performed using StataMP 18. RESULTS Twenty-seven eligible studies encompassing 2894 participants were included. Among non-CAA CVD patients, global cognitive performance was significantly lower in those with higher amyloid-β deposition (standardized mean difference = -0.43, P < 0.001). The correlation strength varied across cognitive domains (executive function: r = -0.41; language: r = -0.36; memory: r = -0.29; all P < 0.001). The correlation was significant in patients with subcortical vascular disease (r = -0.43, P < 0.001) but not post-stroke patients (r = -0.19, P > 0.05). CONCLUSIONS Amyloid-β load is associated with cognitive decline in non-CAA CVD patients. This is more pronounced in patients with subcortical vascular disease than in post-stroke patients. Executive function is the most susceptible domain in VCI when the level of amyloid-β increases.

中文翻译：

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脑淀粉样血管病以外的脑血管疾病中淀粉样蛋白β负荷与认知之间的关联：正电子发射断层扫描研究的系统评价和荟萃分析。


背景 人们对脑淀粉样血管病 （CAA） 以外的脑血管疾病 （CVD） 患者血管和神经退行性疾病的共病越来越感兴趣。然而，淀粉样蛋白β与血管性认知障碍 （VCI） 之间的关系仍存在争议。目的 探讨非 CAA CVD 患者 VCI 与 β 淀粉样蛋白沉积之间的相关性。方法 系统检索 PubMed、Embase、Web of Science、PsycINFO 和 CENTRAL 数据库。选择了观察性研究，包括病例对照和队列研究，将认知评分与正电子发射断层扫描测量的淀粉样蛋白负荷相关联。进行荟萃分析以评估 CVD 亚型和认知领域之间淀粉样蛋白-认知关联的强度。使用使用逆方差法的随机效应模型，通过 Q 统计和 I2 统计评估异质性。进行 Meta 回归分析以检查调节因素的影响，并使用漏斗图和 Egger 检验评估发表偏倚。所有统计分析均使用 StataMP 18 进行。结果 共纳入 27 项符合条件的研究，涉及 2894 名参与者。在非 CAA CVD 患者中，淀粉样蛋白β沉积较高的患者的整体认知能力显著降低 （标准化平均差 = -0.43，P < 0.001）。相关强度因认知领域而异 （执行功能： r = -0.41;语言： r = -0.36;记忆： r = -0.29;均 P < 0.001）。皮质下血管疾病患者 （r = -0.43，P < 0.001） 相关，但中风后患者 （r = -0.19，P > 0.05） 不显著。结论 淀粉样蛋白β载量与非 CAA CVD 患者的认知能力下降相关。 这在皮质下血管疾病患者中比在中风后患者中更明显。当淀粉样蛋白 β 水平升高时，执行功能是 VCI 中最易感的结构域。