Recent evidence suggests that the presence of α-synuclein Lewy bodies (LBs) correlates with accelerated disease progression in patients with Alzheimer disease (AD) but it is unclear whether this effect is also exerted in the mild cognitive impairment (MCI) phase of AD. We sought to determine whether incidental LB pathology in patients with MCI due to AD is associated with a faster rate of cognitive decline compared to MCI controls without LB pathology. We identified patients within the National Alzheimer’s Coordinating Center (NACC) database with MCI due to AD and stratified the cohort by the presence or absence of synucleinopathy. We utilized a repeated measures longitudinal analysis of Mini-Mental State Examination (MMSE) scores to determine whether the decline in performance occurred at a greater rate in the synucleinopathy patients. A total of 206 participants were studied; 80 had coincident synucleinopathy. The rate of decline in MMSE scores between the groups did not differ. This may suggest that a synergistic effect of LB and AD neuropathology is only appreciable in the later stages of disease progression. Further investigation into the effect of mixed LB and AD pathology in the early stages of cognitive impairment is warranted to highlight opportunities for targeted early intervention in patients.

中文翻译：

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偶发性突触核蛋白病对阿尔茨海默病引起的轻度认知障碍的影响

最近的证据表明，α-突触核蛋白路易体 (LB) 的存在与阿尔茨海默病 (AD) 患者的疾病进展加速相关，但尚不清楚这种效应是否也在 AD 的轻度认知障碍 (MCI) 阶段发挥作用。我们试图确定与没有 LB 病理的 MCI 对照相比，AD 所致 MCI 患者的偶然 LB 病理是否与更快的认知能力下降有关。我们在国家阿尔茨海默病协调中心 (NACC) 数据库中确定了因 AD 导致 MCI 的患者，并根据是否存在突触核蛋白病对队列进行了分层。我们利用简易精神状态检查（MMSE）评分的重复测量纵向分析来确定突触核蛋白病患者的表现下降是否以更高的速度发生。总共对 206 名参与者进行了研究； 80 人同时患有突触核蛋白病。各组之间 MMSE 分数的下降率没有差异。这可能表明 LB 和 AD 神经病理学的协同效应仅在疾病进展的后期阶段才明显。有必要进一步研究 LB 和 AD 混合病理学在认知障碍早期阶段的影响，以强调对患者进行有针对性的早期干预的机会。