- 學位論文
健康年輕成年人之載脂蛋白基因型與認知功能研究
The Apolipoprotein E (ApoE) genotype and cognitive function in healthy young adults
摘要
背景：過去研究發現載脂蛋白（Apolipoprotein E, ApoE）基因與阿茲海默氏症有所相關，其中ε4對偶基因會增加罹患晚發型阿茲海默氏症的風險。為探求其作用機制，過去許多研究關注於ApoE與阿茲海默氏症患者以及認知功能無明顯缺損之健康老年與中年人的腦部變化與認知功能改變的關聯性，並發現ApoE ε4基因型與負向的腦部變化及認知功能改變有關。過去研究亦發現在健康年輕人中，ApoE ε4基因型與負向的腦部變化有關，然而研究資料相對較少，且行為研究的結果並不一致。目的：本研究欲透過探索台灣之健康年輕成年人的認知功能與ApoE基因型的關係，來增進ApoE基因對於台灣此年齡群產生之影響效應的了解，以釐清ApoE基因對於認知功能的影響是僅存於老化的過程中，還是在發展過程中即有所表現，以期對ApoE ε4基因型提高阿茲海默氏症風險的機制有更多的了解。方法：本研究募集162 位健康年輕成年人並對其進行ApoE基因型檢測，之後從中挑選出35位健康年輕成年人 (ε4 16位; 非ε4 19位)並對其進行神經心理功能的評估，受試者年齡範圍為20至29歲，。神經心理測驗涵蓋智力、語言、視覺空間建構、學習與記憶功能、執行功能、工作記憶、注意力與處理速度。結果：相較於非ε4基因型的年輕人，ε4基因型的年輕人在執行功能有關之Delis-Kaplan執行功能系統色彩文字干擾測驗（抑制/轉換情況）以及類別語意流暢度測驗上表現較差，顯示ε4基因型的年輕人執行功能相對較差。結論：本研究顯示在台灣的年輕族群中，ApoE ε4對偶基因對於執行功能有負面的效應，進一步指涉ApoE ε4對偶基因在發展過程中即對認知功能產生影響，背後可能隱含其在發展過程中對於腦部功能的負面影響，進而增加腦部對於後續不良因子或老化歷程的脆弱性。
並列摘要
Background: The Apolipoprotein E (ApoE) ε4 genotype has been associated with increased risk of developing Alzheimer’s disease (AD). The majority of the research has focused on the change of cognitive functioning and brain in association with the ApoE genotype in patients with AD, non-demented elderly and middle-aged adults, and evidence has shown that the ApoE ε4 genotype was associated with negative changes of cognitive functioning and brain. Previous studies have also found negative brain changes associated with the ApoE ε4 genotype in young adults; however, the related studies were relatively scarce, and the behavioral findings were inconsistent. Objective: The study aimed to investigate the neuropsychological function in association with the ApoE genotype in a sample of Taiwanese young adults in order to increase the understanding of the effect of ApoE on cognition in the youth cohort. The findings would advance our understanding on the role of ApoE in relation to the development of AD and help clarify whether the effect of ApoE on cognition could be observed in early developing process or only in aging process. Methods: The study recruited 162 healthy young adults and analyzed their ApoE genotype. Among them, 35 healthy young adults aged from 20 to 29 were selected (16 ε4 carriers and 19 non-ε4 carriers) and underwent a comprehensive assessment of neuropsychological function. The neuropsychological assessment included general intelligence, language, visuospatial construction, learning and memory, executive function, working memory, attention, and processing speed. Results: Compared to ApoE non- ε4 group, the ε4 group performed more poorly on the Color-Word Inference Test (the Inhibition/Switching condition) from The Delis-Kaplan Executive Function System and the Semantic Associated Verbal Fluency test, indicating a poorer executive function in Taiwanese young ApoE ε4 carriers. Conclusion: The present study showed a negative effect of ApoE ε4 genotype on executive function in Taiwanese young adults, indicating an early effect of ApoE on cognition during the developing process. The result may imply a negative effect of ApoE ε4 on brain functioning in development, which makes the brain more vulnerable to later normal and/or pathological aging process.
參考文獻
延伸閱讀
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