文摘
摘要目的:探索clinically-accessible treatment-responsiveness协会,我们评估了prospectively-measured临床和paraclinical特性之间的关系和结果脑淀粉样血管病患者与相关炎症(CAA-ri)用大剂量甲基强的松龙治疗。
背景:CAA-ri是一种罕见的与年龄有关的疾病,其特征是炎症反应在脑淀粉样血管。CAA-ri通常与糖皮质激素治疗,但对治疗的反应是可变的。
设计/方法:纵向临床过程,从血清和CSF测试和结果,综述了脑电图和神经影像从11 prospectively-accrued CAA-ri患者诊断、治疗和随后在三级保健中心(华盛顿大学医学院;圣路易斯,密苏里州)。MRI改变量化使用评分系统验证的情况下成像异常相关的淀粉样蛋白(ARIA-E)。临床结果评估改良Rankin规模变化(ΔmRS)从基线到最终评估(中位数从大剂量甲基强的松龙治疗175天;范围,31 - 513)。
结果:糟糕的结果后,甲基强的松龙治疗重症监护室入学要求(平均ΔmRS 5和1.5;p = 0.048), CSF脑脊液细胞增多(中位数ΔmRS 4.5和1;CSF Aβp = 0.04)或低40在演示(ρ=−0.83;p = 0.02)和扩散限制(中位数ΔmRS 4和1.5;p = 0.03)或更高的晚ARIA-E分数(ρ= 0.70;p = 0.02),神经影像,但不是先前存在的认知能力下降(中位数ΔmRS 2和2;p = 0.66)。
结论:与结果相关的临床和paraclinical措施可能通知CAA-ri患者临床咨询和治疗决策。基线认知状态与治疗无关响应表明先前存在的痴呆患者CAA-ri仍可能从治疗中获益。
披露:Plotzker博士没有披露。雷切尔·亨森没有披露。安妮·费根已经收到个人薪酬在500 - 4999美元的范围为大冢制药公司担任顾问。安妮·费根已经收到个人薪酬在5000 - 9999美元的范围为在科学咨询服务或数据安全监测委员会罗氏诊断。莫里斯博士已经收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会CBR国际顾问委员会。莫里斯博士已经收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会治愈老年痴呆症基金。莫里斯博士已经收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会指导委员会。莫里斯博士已经收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会阿尔茨海默病中心。莫里斯博士已经收到了研究机构国家卫生研究院的基金的支持。莫里斯博士收到发现或技术知识产权利益有关卫生保健。 Dr. Morris has received intellectual property interests from a discovery or technology relating to health care. Dr. Day has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Parabon Nanolabs. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for DynaMed (EBSCO Health). Dr. Day has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Barrow Law. The institution of Dr. Day has received research support from National Institutes of Health. The institution of Dr. Day has received research support from Chan Zuckerberg Initiative. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Presenter at regional meeting (CME) with Texas Neurological Society. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Grant Review (honorarium) with Pennsylvania Department of Health . Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Presenter at Annual Meeting (CME) with American Academy of Neurology. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Authorship with Continuum. Dr. Day has a non-compensated relationship as a Clinical Director with AntiNMDA Receptor Encephalitis Foundation that is relevant to AAN interests or activities.
