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Taghdiri F, Multani N, Tarazi A, Naeimi SA, Khodadadi M, Esopenko C, Green R, Colella B, Wennberg R, Mikulis D, Davis KD, Goswami R, Tator C, Levine B, Tartaglia MC. Elevated cerebrospinal fluid total tau in former professional athletes with multiple concussions. Neurology 2019; 92:e2717-e2726. [PMID: 31068482 DOI: 10.1212/wnl.0000000000007608] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 02/01/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To identify CSF biomarkers that are related to decreased white matter (WM) integrity and poor cognitive performance in former professional athletes with a history of multiple concussions. METHODS Concentrations of phosphorylated tau181, total tau (t-tau), and β-amyloid in the CSF were measured in 3 groups: 22 former professional athletes with multiple concussions (mean ± SD age 55.9 ± 12.2 years), 5 healthy controls (age 57.4 ± 5.2 years), and 12 participants (age 60.0 ± 6.6 years) diagnosed with Alzheimer disease (AD). All participants in the former athletes group underwent diffusion tensor imaging to determine WM tract integrity and completed neuropsychological testing. We divided the former athletes group into those with normal (<300 pg/mL) and high (>300 pg/mL) CSF t-tau. RESULTS CSF t-tau in the former athletes group was significantly higher than in the healthy control group (349.3 ± 182.6 vs 188.8 ± 39.9 pg/mL, p = 0.003) and significantly lower than in the patients with AD (349.3 ± 182.6 vs 857.0 ± 449.3 pg/mL, p = 0.007). Fractional anisotropy values across all the tracts were significantly lower in the high CSF t-tau group compared to the normal CSF t-tau group (p = 0.036). Participants in the high CSF t-tau group scored significantly lower on the Trail Making Test (TMT) Part B compared to the normal CSF t-tau group (t scores 45.6 ± 18.8 vs 62.3 ± 10.1, p = 0.017). CONCLUSION Our findings indicate that former athletes with multiple concussions are at increased risk of elevated levels of CSF t-tau and that high CSF t-tau is associated with reduced WM integrity and worse scores on the TMT Part B.
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Affiliation(s)
- Foad Taghdiri
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - Namita Multani
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - Apameh Tarazi
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - Seyed Ali Naeimi
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - Mozghan Khodadadi
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - Carrie Esopenko
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - Robin Green
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - Brenda Colella
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - Richard Wennberg
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - David Mikulis
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - Karen Deborah Davis
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - Ruma Goswami
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - Charles Tator
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - Brian Levine
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada
| | - Maria Carmela Tartaglia
- From the Tanz Centre for Research in Neurodegenerative Diseases (F.T., N.M., M.C.T.), Department of Rehabilitation Sciences (R. Green, B.C.), Institute of Medical Science (R. Green, R.W., D.M., K.D.D., C.T., B.L., M.C.T.), Department of Surgery (K.D.D.), and Department of Psychology and Neurology (B.L.), University of Toronto; Canadian Concussion Center (F.T., A.T., S.A.N., M.K., R. Green, B.C., R.W., D.M., K.D.D., R. Goswami, C.T., M.C.T.) and Division of Neurosurgery (C.T.), Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network; Division of Neurology (A.T., S.A.N., R.W., M.C.T.) and Division of Neuroradiology (D.M.), Joint Department of Medical Imaging, University Health Network; and Rotman Research Institute at Baycrest (C.E.), Toronto, Ontario, Canada.
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Jiang L, Dong H, Cao H, Ji X, Luan S, Liu J. Exosomes in Pathogenesis, Diagnosis, and Treatment of Alzheimer's Disease. Med Sci Monit 2019; 25:3329-3335. [PMID: 31056537 PMCID: PMC6515980 DOI: 10.12659/msm.914027] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by the accumulation of β-amyloid peptide 1-42 and phosphorylation of tau protein in the brain. Thus far, the transfer mechanism of these cytotoxic proteins between nerve cells remains unclear. Recent studies have shown that nanoscale extracellular vesicles (exosomes) originating from cells may play important roles in this transfer process. In addition, several genetic materials and proteins are also involved in intercellular communication by the secretion of the exosomes. That proposes novel avenues for early diagnosis and biological treatment in AD, based on exosome detection and intervention. In this review, exosome-related pathways of cytotoxic protein intercellular transfer in AD, and the effect of membrane proteins on exosomes targeting cells are first introduced. The advances in exosome-related biomarker detection in AD are summarized. Finally, the advantages and challenges of reducing cytotoxic protein accumulation via exosomal intervention for AD treatment are discussed. It is envisaged that future research in exosomes may well provide new insights into the pathogenesis, diagnosis, and treatment of AD.
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Affiliation(s)
- Liqun Jiang
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland)
| | - Huijie Dong
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland)
| | - Hua Cao
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland)
| | - Xiaofei Ji
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland)
| | - Siyu Luan
- Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland)
| | - Jing Liu
- Stem Cell Clinical Research Center, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland)
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de Castro AA, Soares FV, Pereira AF, Polisel DA, Caetano MS, Leal DHS, da Cunha EFF, Nepovimova E, Kuca K, Ramalho TC. Non-conventional compounds with potential therapeutic effects against Alzheimer’s disease. Expert Rev Neurother 2019; 19:375-395. [DOI: 10.1080/14737175.2019.1608823] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Alexandre A. de Castro
- Laboratory of Molecular Modeling, Department of Chemistry, Federal University of Lavras, Lavras, Brazil
| | - Flávia V. Soares
- Laboratory of Molecular Modeling, Department of Chemistry, Federal University of Lavras, Lavras, Brazil
| | - Ander F. Pereira
- Laboratory of Molecular Modeling, Department of Chemistry, Federal University of Lavras, Lavras, Brazil
| | - Daniel A. Polisel
- Laboratory of Molecular Modeling, Department of Chemistry, Federal University of Lavras, Lavras, Brazil
| | - Melissa S. Caetano
- Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Daniel H. S. Leal
- Laboratory of Molecular Modeling, Department of Chemistry, Federal University of Lavras, Lavras, Brazil
- Department of Health Sciences, Federal University of Espírito Santo, São Mateus, Brazil
| | - Elaine F. F. da Cunha
- Laboratory of Molecular Modeling, Department of Chemistry, Federal University of Lavras, Lavras, Brazil
| | - Eugenie Nepovimova
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Kamil Kuca
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Teodorico C. Ramalho
- Laboratory of Molecular Modeling, Department of Chemistry, Federal University of Lavras, Lavras, Brazil
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, Czech Republic
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Sales TA, Prandi IG, Castro AAD, Leal DHS, Cunha EFFD, Kuca K, Ramalho TC. Recent Developments in Metal-Based Drugs and Chelating Agents for Neurodegenerative Diseases Treatments. Int J Mol Sci 2019; 20:E1829. [PMID: 31013856 PMCID: PMC6514778 DOI: 10.3390/ijms20081829] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/07/2019] [Accepted: 04/09/2019] [Indexed: 02/07/2023] Open
Abstract
The brain has a unique biological complexity and is responsible for important functions in the human body, such as the command of cognitive and motor functions. Disruptive disorders that affect this organ, e.g. neurodegenerative diseases (NDDs), can lead to permanent damage, impairing the patients' quality of life and even causing death. In spite of their clinical diversity, these NDDs share common characteristics, such as the accumulation of specific proteins in the cells, the compromise of the metal ion homeostasis in the brain, among others. Despite considerable advances in understanding the mechanisms of these diseases and advances in the development of treatments, these disorders remain uncured. Considering the diversity of mechanisms that act in NDDs, a wide range of compounds have been developed to act by different means. Thus, promising compounds with contrasting properties, such as chelating agents and metal-based drugs have been proposed to act on different molecular targets as well as to contribute to the same goal, which is the treatment of NDDs. This review seeks to discuss the different roles and recent developments of metal-based drugs, such as metal complexes and metal chelating agents as a proposal for the treatment of NDDs.
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Affiliation(s)
- Thais A Sales
- Laboratory of Molecular Modeling, Department of Chemistry, Federal University of Lavras, Lavras/MG, 37200-000, Brazil.
| | - Ingrid G Prandi
- Laboratory of Molecular Modeling, Department of Chemistry, Federal University of Lavras, Lavras/MG, 37200-000, Brazil.
| | - Alexandre A de Castro
- Laboratory of Molecular Modeling, Department of Chemistry, Federal University of Lavras, Lavras/MG, 37200-000, Brazil.
| | - Daniel H S Leal
- Department of Health Sciences, Federal University of Espírito Santo, São Mateus/ES, 29932-540, Brazil.
| | - Elaine F F da Cunha
- Laboratory of Molecular Modeling, Department of Chemistry, Federal University of Lavras, Lavras/MG, 37200-000, Brazil.
| | - Kamil Kuca
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, 500 03, Czech Republic..
- Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, 500 03 Czech Republic.
| | - Teodorico C Ramalho
- Laboratory of Molecular Modeling, Department of Chemistry, Federal University of Lavras, Lavras/MG, 37200-000, Brazil.
- Department of Chemistry, Faculty of Science, University of Hradec Kralove, Hradec Kralove, 500 03, Czech Republic..
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Bousiges O, Blanc F. Diagnostic value of cerebro-spinal fluid biomarkers in dementia with lewy bodies. Clin Chim Acta 2019; 490:222-228. [DOI: 10.1016/j.cca.2018.11.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/20/2018] [Accepted: 11/20/2018] [Indexed: 12/17/2022]
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Cerebrospinal Fluid and Plasma Tau as a Biomarker for Brain Tauopathy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1184:393-405. [PMID: 32096052 DOI: 10.1007/978-981-32-9358-8_29] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Cerebrospinal fluid (CSF) tau and phosphorylated tau (ptau) are definite biomarkers of Alzheimer's disease (AD). After discovery of presence and increased levels tau in CSF from AD patients using specific ELISA, numerous reports revealed that CSF levels of tau are increased in AD and brain injury, phosphorylated tau are specifically increased in AD. Many large cohort studies also confirmed that natural course of CSF tau and ptau levels initiated from cognitively unimpaired AD stage after longstanding progress of brain Aß amyloidosis. Close correlation with neuroimaging findings of Tau PET and with deterioration of cognitive function domains have been elucidated. CSF tau also increase in neurodegeneration and acute brain injury. Global standardization, assay technology inventions, and research of tau kinetics from brain synthesis and clearance into CSF are developing. Trace amount of plasma p-tau assay are also validated. Development of these studies provide that CSF tau is the biomarker of CNS neurodegeneration and CSF ptau is the specific biomarker of CNS tauopathy. Assays of CSF and plasma tau and ptau are essential tools not only for prediction and diagnosis of AD and but for newly developing disease modified therapies of AD.
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Ba M, Yu G, Kong M, Liang H, Yu L. CSF Aβ 1-42 level is associated with cognitive decline in early Parkinson's disease with rapid eye movement sleep behavior disorder. Transl Neurodegener 2018; 7:22. [PMID: 30338062 PMCID: PMC6174574 DOI: 10.1186/s40035-018-0129-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 09/20/2018] [Indexed: 12/27/2022] Open
Abstract
Background Rapid eye movement sleep behavior disorder (RBD) is associated with cognitive decline in early Parkinson's disease (PD). However, the underlyling basis for this association remains unclear. Methods Parkinson's Progression Marker's Initiative (PPMI) subjects underwent baseline RBD testing with RBD sleep questionnaire (RBDSQ). Serial assessments included measures of motor symptoms, non-motor symptoms (NMS), neuropsychological assessment, blood and cerebrospinal fluid (CSF) biomarkers. Up to three years follow-up data were included. We stratified early PD subjects into PD with RBD (RBDSQ score > 5) and PD without RBD groups. Then, we evaluated baseline biomarkers in each group as a predictor of cognitive decline using Montreal Cognitive Assessment (MoCA) score changes over three years in regression models. Results Four hundred twenty-three PD subjects were enrolled at baseline, and a total of 350 PD subjects had completed 3 years of study follow-up with completely serial assessments. We found that at baseline, only CSF β-amyloid 1-42 (Aβ1-42) was significantly lower in PD subjects with RBD. On three years follow-up analysis, PD subjects with RBD were more likely to develop incident mild cognitive impairment (MCI) and presented greater cognitive decline in MoCA score. Lower baseline CSF Aβ1-42 predicted cognitive decline over 3 years only in PD subjects with RBD (β = - 0.03, P = 0.003). A significant interaction between Aβ1-42 and the 2 groups confirmed that this effect was indeed higher in PD with RBD than the other individual (β = - 2.85, P = 0.014). Conclusion These findings indicate that CSF Aβ1-42 level is associated with global cognitive decline in early PD with RBD. The addition of CSF Aβ1-42 to RBD testing increase the likelihood of identifying those at high risk for cognitive decline in early PD.
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Affiliation(s)
- Maowen Ba
- 1Department of Neurology, the Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai City, Shandong 264000 People's Republic of China
| | - Guoping Yu
- 1Department of Neurology, the Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai City, Shandong 264000 People's Republic of China
| | - Min Kong
- 2Department of Neurology, Yantaishan Hospital, Yantai City, Shandong 264000 People's Republic of China
| | - Hui Liang
- 2Department of Neurology, Yantaishan Hospital, Yantai City, Shandong 264000 People's Republic of China
| | - Ling Yu
- 2Department of Neurology, Yantaishan Hospital, Yantai City, Shandong 264000 People's Republic of China
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Lindemer ER, Greve DN, Fischl B, Salat DH, Gomez-Isla T. White matter abnormalities and cognition in patients with conflicting diagnoses and CSF profiles. Neurology 2018; 90:e1461-e1469. [PMID: 29572277 DOI: 10.1212/wnl.0000000000005353] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 02/01/2018] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To determine whether white matter changes influence progression of cognitive decline in individuals with clinically diagnosed Alzheimer disease (AD) and differing biomarker profiles. METHODS Two hundred thirty-six individuals from the Alzheimer's Disease Neuroimaging Initiative database with clinical diagnoses of cognitively normal older adult (older controls [OCs]), mild cognitive impairment, and AD were studied. Support vector machine experiments were first performed to determine the utility of various biomarkers for classifying individuals by clinical diagnosis. General linear models were implemented to assess the relationships between CSF measures of β-amyloid 1-42, phosphorylated tau181p, and MRI-based white matter signal abnormality (WMSA) volumes and cognitive decline. Analyses were performed across all patients as well as within subgroups of individuals that were defined by clinical cutoff points for both CSF measures. RESULTS CSF biomarkers alone classified individuals with AD vs OCs with 82% accuracy, and the addition of WMSA did not enhance this. Both CSF biomarkers as well as WMSA volume significantly contributed to predicting cognitive decline in executive and memory domains when assessed across all 236 individuals. In individuals with pathologic levels of both CSF biomarkers, WMSA only significantly contributed to models of future executive function decline. In individuals with subpathologic CSF biomarker levels (levels similar to those in OC individuals), WMSA significantly contributed to prediction of memory decline and were the sole significant predictor of executive function decline. CONCLUSIONS WMSA hold additional predictive power regarding cognitive progression in older individuals and are most effective as biomarkers in individuals who are cognitively impaired but do not fit the expected CSF biomarker profile of AD.
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Affiliation(s)
- Emily R Lindemer
- From the Division of Health Sciences and Technology (E.R.L.), Massachusetts Institute of Technology/Harvard Medical School, Boston; Athinoula A. Martinos Center for Biomedical Imaging (E.R.L., D.N.G., D.H.S.), Massachusetts General Hospital, Charlestown; Department of Neurology (T.G.-I.), Massachusetts General Hospital (B.F.), Boston; Department of Radiology (D.N.G., D.H.S.), Harvard Medical School (B.F.), Charlestown; Health Sciences and Technology/Electrical Engineering and Computer Science (B.F.), Massachusetts Institute of Technology, Boston; and NeRVe Neuroimaging Center for Veterans (D.H.S.), Boston VA Healthcare System, MA.
| | - Douglas N Greve
- From the Division of Health Sciences and Technology (E.R.L.), Massachusetts Institute of Technology/Harvard Medical School, Boston; Athinoula A. Martinos Center for Biomedical Imaging (E.R.L., D.N.G., D.H.S.), Massachusetts General Hospital, Charlestown; Department of Neurology (T.G.-I.), Massachusetts General Hospital (B.F.), Boston; Department of Radiology (D.N.G., D.H.S.), Harvard Medical School (B.F.), Charlestown; Health Sciences and Technology/Electrical Engineering and Computer Science (B.F.), Massachusetts Institute of Technology, Boston; and NeRVe Neuroimaging Center for Veterans (D.H.S.), Boston VA Healthcare System, MA
| | - Bruce Fischl
- From the Division of Health Sciences and Technology (E.R.L.), Massachusetts Institute of Technology/Harvard Medical School, Boston; Athinoula A. Martinos Center for Biomedical Imaging (E.R.L., D.N.G., D.H.S.), Massachusetts General Hospital, Charlestown; Department of Neurology (T.G.-I.), Massachusetts General Hospital (B.F.), Boston; Department of Radiology (D.N.G., D.H.S.), Harvard Medical School (B.F.), Charlestown; Health Sciences and Technology/Electrical Engineering and Computer Science (B.F.), Massachusetts Institute of Technology, Boston; and NeRVe Neuroimaging Center for Veterans (D.H.S.), Boston VA Healthcare System, MA
| | - David H Salat
- From the Division of Health Sciences and Technology (E.R.L.), Massachusetts Institute of Technology/Harvard Medical School, Boston; Athinoula A. Martinos Center for Biomedical Imaging (E.R.L., D.N.G., D.H.S.), Massachusetts General Hospital, Charlestown; Department of Neurology (T.G.-I.), Massachusetts General Hospital (B.F.), Boston; Department of Radiology (D.N.G., D.H.S.), Harvard Medical School (B.F.), Charlestown; Health Sciences and Technology/Electrical Engineering and Computer Science (B.F.), Massachusetts Institute of Technology, Boston; and NeRVe Neuroimaging Center for Veterans (D.H.S.), Boston VA Healthcare System, MA
| | - Teresa Gomez-Isla
- From the Division of Health Sciences and Technology (E.R.L.), Massachusetts Institute of Technology/Harvard Medical School, Boston; Athinoula A. Martinos Center for Biomedical Imaging (E.R.L., D.N.G., D.H.S.), Massachusetts General Hospital, Charlestown; Department of Neurology (T.G.-I.), Massachusetts General Hospital (B.F.), Boston; Department of Radiology (D.N.G., D.H.S.), Harvard Medical School (B.F.), Charlestown; Health Sciences and Technology/Electrical Engineering and Computer Science (B.F.), Massachusetts Institute of Technology, Boston; and NeRVe Neuroimaging Center for Veterans (D.H.S.), Boston VA Healthcare System, MA
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Rivero-Santana A, Ferreira D, Perestelo-Pérez L, Westman E, Wahlund LO, Sarría A, Serrano-Aguilar P. Cerebrospinal Fluid Biomarkers for the Differential Diagnosis between Alzheimer's Disease and Frontotemporal Lobar Degeneration: Systematic Review, HSROC Analysis, and Confounding Factors. J Alzheimers Dis 2018; 55:625-644. [PMID: 27716663 DOI: 10.3233/jad-160366] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Differential diagnosis in dementia is at present one of the main challenges both in clinical practice and research. Cerebrospinal fluid (CSF) biomarkers are included in the current diagnostic criteria of Alzheimer's disease (AD) but their clinical utility is still unclear. OBJECTIVE We performed a systematic review of studies analyzing the diagnostic performance of CSF Aβ42, total tau (t-tau), and phosphorylated tau (p-tau) in the discrimination between AD and frontotemporal lobar degeneration (FTLD) dementias. METHODS The following electronic databases were consulted until May 2016: Medline and PreMedline, EMBASE, PsycInfo, CINAHL, Cochrane Library, and CRD. For the first-time in the field, a Hierarchical Summary Receiver Operating Characteristic (HRSOC) model was applied, which avoids methodological problems of meta-analyses based on summary points of sensitivity and specificity values. We also investigated relevant confounders of CSF biomarkers' diagnostic performance such as age, disease duration, and global cognitive impairment. RESULTS The p-tau/Aβ42 ratio showed the best diagnostic performance. No statistically significant effects of the confounders were observed. Nonetheless, the p-tau/Aβ42 ratio may be especially indicated for younger patients. P-tau may be preferable for less cognitively impaired patients (high MMSE scores) and the t-tau/Aβ42 ratio for more cognitively impaired patients (low MMSE scores). CONCLUSION The p-tau/Aβ42 ratio has potential for being implemented in the clinical routine for the differential diagnosis between AD and FTLD. It is of utmost importance that future studies report information on confounders such as age, disease duration, and cognitive impairment, which should also stimulate understanding of the role of these factors in disease mechanisms and pathophysiology.
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Affiliation(s)
- Amado Rivero-Santana
- Canarian Foundation for Health Research (FUNCANIS), Tenerife, Spain.,Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Tenerife, Spain.,Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lilisbeth Perestelo-Pérez
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Tenerife, Spain.,Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain.,Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lars-Olof Wahlund
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Antonio Sarría
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Tenerife, Spain.,Agency for Health Technology Assessment (AETS), Institute of Health Carlos III, Madrid, Spain
| | - Pedro Serrano-Aguilar
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Tenerife, Spain.,Center for Biomedical Research of the Canary Islands (CIBICAN), Tenerife, Spain.,Evaluation Unit of the Canary Islands Health Service (SESCS), Tenerife, Spain
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60
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Sancesario GM, Toniolo S, Chiasserini D, Di Santo SG, Zegeer J, Bernardi G, Musicco M, Caltagirone C, Parnetti L, Bernardini S. The Clinical Use of Cerebrospinal Fluid Biomarkers for Alzheimer's Disease Diagnosis: The Italian Selfie. J Alzheimers Dis 2018; 55:1659-1666. [PMID: 27911328 DOI: 10.3233/jad-160975] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Although the use of cerebrospinal fluid (CSF) amyloid β1-42 (Aβ42), tau (T-tau), and phosphorylated tau (p-tau181) gives added diagnostic and prognostic values, the diffusion is still limited in clinical practice and only a restricted number of patients receive an integrated clinico-biological diagnosis. By a survey, we aimed to do a "selfie" of the use and diffusion of CSF biomarkers of dementia in Italy, the standardization of pre-analytical procedures, the harmonization of ranges, and the participation to Quality Control programs. An online questionnaire was sent to the members of SIBioC and SINdem-ITALPLANED and to main neurological clinics all over Italy. In Italy, 25 laboratories provide biomarkers analysis in addition to a network of 15 neighboring hospitals. In sum, 40 neurological centers require CSF analyses. 7/20 regions (35%) lack CSF laboratories. Standardization of pre-analytical procedures is present in 62.02% of the laboratories; only 56.00% of the laboratories participate in International Quality Control. There is no harmonization of cut-offs. In Italy, the use of CSF biomarkers is still limited in clinical practice. Standardization and harmonization of normal ranges are needed. To optimize and expand the use of CSF biomarkers, a cost-benefit analysis should be promoted by scientific societies and national health services.
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Affiliation(s)
- Giulia M Sancesario
- Department of Clinical and Behavioural Neurology, Santa Lucia Foundation, Rome, Italy
| | - Sofia Toniolo
- Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Davide Chiasserini
- Department of Medicine, Center for Memory Disturbances, University of Perugia, Italy
| | - Simona G Di Santo
- Department of Clinical and Behavioural Neurology, Santa Lucia Foundation, Rome, Italy.,Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Josh Zegeer
- Department of Experimental Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy
| | | | | | - Massimo Musicco
- Epidemiology and Biostatistics Unit, Institute of Biomedical Technologies, National Research Council, Milan, Italy
| | | | - Carlo Caltagirone
- Department of Clinical and Behavioural Neurology, Santa Lucia Foundation, Rome, Italy.,Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Lucilla Parnetti
- Department of Medicine, Center for Memory Disturbances, University of Perugia, Italy
| | - Sergio Bernardini
- Department of Experimental Medicine and Surgery, Tor Vergata University of Rome, Rome, Italy
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Jang H, Park SB, Kim Y, Kim KW, Lee JI, Kim ST, Lee KH, Kang ES, Choe YS, Seo SW, Kim HJ, Kim YJ, Yoon CW, Na DL. Prognostic value of amyloid PET scan in normal pressure hydrocephalus. J Neurol 2017; 265:63-73. [PMID: 29128930 DOI: 10.1007/s00415-017-8650-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 10/09/2017] [Accepted: 10/11/2017] [Indexed: 11/27/2022]
Abstract
Amyloid positron emission tomography ([18F] florbetaben (FBB) PET) can be used to determine concomitant Alzheimer's disease (AD) in idiopathic normal pressure hydrocephalus (iNPH) patients. FBB PET scans and the tap test were performed in 31 patients with clinically suspected iNPH, and amyloid positive (iNPH/FBB+) and negative (iNPH/FBB-) groups were compared with respect to clinical characteristics. We evaluated prognostic value of FBB PET scans by analyzing the response to the tap test using a linear mixed model. We also performed a multivariable regression analysis to investigate whether amyloid PET positivity can predict the positive tap test response independent of other AD biomarkers. The results showed that the iNPH/FBB+ group (7/31, 22.6%) had a higher percentage of APOE4 carriers, lower Aβ42, higher CSF t-tau, and p-tau/Aβ42 ratio than the iNPH/FBB- group (24/31, 77.4%), while the two groups did not differ in imaging characteristics. The iNPH/FBB- group had a higher percentage of tap responders and showed a greater improvement in gait scores after the tap test than the iNPH/FBB+ group (group-tap test effect interaction, p = 0.035). A multivariable logistic regression analysis showed that amyloid positivity on PET scans (OR 0.03, p = 0.029) and CSF p-tau (OR 0.87, p = 0.044) were independently associated with the positive tap test response. Among 21 tap responders in the iNPH/FBB- group, 14 patients received shunt surgery and 12/14 (85.7%) patients showed symptom improvement. Our findings suggest that amyloid PET scans can help determine which iNPH patients will benefit from shunt surgery by discriminating concomitant AD.
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Affiliation(s)
- Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Seong Beom Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Yeshin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Ko Woon Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Jung Il Lee
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Tae Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung Han Lee
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Suk Kang
- Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeong Sim Choe
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Yeo Jin Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Cindy W Yoon
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-dong, Gangnam-gu, Seoul, 06351, Republic of Korea.
- Neuroscience Center, Samsung Medical Center, Seoul, Korea.
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.
- Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Seoul, Korea.
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62
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Tariq S, Barber PA. Dementia risk and prevention by targeting modifiable vascular risk factors. J Neurochem 2017; 144:565-581. [PMID: 28734089 DOI: 10.1111/jnc.14132] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/23/2017] [Accepted: 07/15/2017] [Indexed: 01/04/2023]
Abstract
The incidence of dementia is expected to double in the next 20 years and will contribute to heavy social and economic burden. Dementia is caused by neuronal loss that leads to brain atrophy years before symptoms manifest. Currently, no cure exists and extensive efforts are being made to mitigate cognitive impairment in late life in order to reduce the burden on patients, caregivers, and society. The most common type of dementia, Alzheimer's disease (AD), and vascular dementia (VaD) often co-exists in the brain and shares common, modifiable risk factors, which are targeted in numerous secondary prevention trials. There is a growing need for non-pharmacological interventions and infrastructural support from governments to encourage psychosocial and behavioral interventions. Secondary prevention trials need to be redesigned based on the risk profile of individual subjects, which require the use of validated and standardized clinical, biological, and neuroimaging biomarkers. Multi-domain approaches have been proposed in high-risk populations that target optimal treatment; clinical trials need to recruit individuals at the highest risk of dementia before symptoms develop, thereby identifying an enriched disease group to test preventative and disease modifying strategies. The underlying aim should be to reduce microscopic brain tissue loss by modifying vascular and lifestyle risk factors over a relatively short period of time, thus optimizing the opportunity for preventing dementia in the future. Collaboration between international research groups is of key importance to the optimal use and allocation of existing resources, and the development of new techniques in preventing dementia. This article is part of the Special Issue "Vascular Dementia".
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Affiliation(s)
- Sana Tariq
- Seaman Family MR Center, Foothills Medical Centre, Calgary, AB, Canada.,Hotchkiss Brain Institute, Foothills Medical Center, Room 1A10 Health Research Innovation Center, Calgary, AB, Canada
| | - Philip A Barber
- Hotchkiss Brain Institute, Foothills Medical Center, Room 1A10 Health Research Innovation Center, Calgary, AB, Canada.,Calgary Stroke Program, Department of Clinical Neurosciences, Foothills Medical Centre, Calgary, AB, Canada
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63
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Ovod V, Ramsey KN, Mawuenyega KG, Bollinger JG, Hicks T, Schneider T, Sullivan M, Paumier K, Holtzman DM, Morris JC, Benzinger T, Fagan AM, Patterson BW, Bateman RJ. Amyloid β concentrations and stable isotope labeling kinetics of human plasma specific to central nervous system amyloidosis. Alzheimers Dement 2017; 13:841-849. [PMID: 28734653 PMCID: PMC5567785 DOI: 10.1016/j.jalz.2017.06.2266] [Citation(s) in RCA: 378] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 06/20/2017] [Accepted: 06/21/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Cerebrospinal fluid analysis and other measurements of amyloidosis, such as amyloid-binding positron emission tomography studies, are limited by cost and availability. There is a need for a more practical amyloid β (Aβ) biomarker for central nervous system amyloid deposition. METHODS We adapted our previously reported stable isotope labeling kinetics protocol to analyze the turnover kinetics and concentrations of Aβ38, Aβ40, and Aβ42 in human plasma. RESULTS Aβ isoforms have a half-life of approximately 3 hours in plasma. Aβ38 demonstrated faster turnover kinetics compared with Aβ40 and Aβ42. Faster fractional turnover of Aβ42 relative to Aβ40 and lower Aβ42 and Aβ42/Aβ40 concentrations in amyloid-positive participants were observed. DISCUSSION Blood plasma Aβ42 shows similar amyloid-associated alterations as we have previously reported in cerebrospinal fluid, suggesting a blood-brain transportation mechanism of Aβ. The stability and sensitivity of plasma Aβ measurements suggest this may be a useful screening test for central nervous system amyloidosis.
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Affiliation(s)
- Vitaliy Ovod
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Kara N Ramsey
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Kwasi G Mawuenyega
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jim G Bollinger
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Terry Hicks
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Theresa Schneider
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Melissa Sullivan
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Katrina Paumier
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - David M Holtzman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Bruce W Patterson
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA.
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Vergallo A, Carlesi C, Pagni C, Giorgi FS, Baldacci F, Petrozzi L, Ceravolo R, Tognoni G, Siciliano G, Bonuccelli U. A single center study: Aβ42/p-Tau181 CSF ratio to discriminate AD from FTD in clinical setting. Neurol Sci 2017; 38:1791-1797. [DOI: 10.1007/s10072-017-3053-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 06/30/2017] [Indexed: 12/20/2022]
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65
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Mattsson N, Lönneborg A, Boccardi M, Blennow K, Hansson O. Clinical validity of cerebrospinal fluid Aβ42, tau, and phospho-tau as biomarkers for Alzheimer's disease in the context of a structured 5-phase development framework. Neurobiol Aging 2017; 52:196-213. [DOI: 10.1016/j.neurobiolaging.2016.02.034] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 02/09/2016] [Accepted: 02/10/2016] [Indexed: 01/01/2023]
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66
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Blanco-Cantó ME, Monge-Argilés JA, Pérez-Cejuela C, Badía C, Gabaldón L, Muñoz-Ruíz C, Sánchez-Payá J, Gasparini-Berenguer R, Leiva-Santana C. Diagnostic Validity Comparison Between Criteria Based on CSF Alzheimer's Disease Biomarkers. Am J Alzheimers Dis Other Demen 2017; 32:101-107. [PMID: 28191798 PMCID: PMC10852644 DOI: 10.1177/1533317516688298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To compare the diagnostic validity of NIA-AA criteria, for AD CSF biomarkers, with our own new criteria. MATERIALS AND METHODS Between 2008 and 2011, 170 patients with Mild Cognitive Impairment (MCI) were included. CSF levels of Aβ1-42, T-tau, P-tau181, and ratios of T-tau/Aβ1-42 and P-tau181/Aβ1-42 were analyzed. In our criteria, we considered 3 or more abnormal variables indicative of a high likelihood of MCI due to AD. RESULTS After a clinical follow-up of 4.5 ± 1.2 years, 44 patients remained stable, 95 developed AD, 15 other forms of dementia, 7 died and 9 received other diagnoses. Using the NIA-AA criteria and our own criteria, the diagnostic validity of the CSF biomarkers was 58% versus 85%, specificity 84% versus 72%, PPV 82% versus 79% and NPV 61% versus 79%. CONCLUSION The inclusion of the ratios in diagnostic criteria increases sensitivity and NPV for the diagnosis of MCI due to AD.
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Affiliation(s)
| | - J. A. Monge-Argilés
- Department of Neurology, General University Hospital of Alicante, Alicante, Spain
| | - C. Pérez-Cejuela
- Neurology Section, Baix Vinalopó hospital, Elche, Alicante, Spain
| | - C. Badía
- Denia Marina-Salud Regional Hospital, Alicante, Spain
| | - L. Gabaldón
- Denia Marina-Salud Regional Hospital, Alicante, Spain
| | - C. Muñoz-Ruíz
- Immunology Laboratory, General University Hospital of Alicante, Alicante, Spain
| | - J. Sánchez-Payá
- Department of Preventive Medicine, General University Hospital of Alicante, Alicante, Spain
| | | | - C. Leiva-Santana
- Department of Neurology, General University Hospital of Alicante, Alicante, Spain
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67
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Cerebrospinal fluid markers detect Alzheimer's disease in nonamnestic dementia. Alzheimers Dement 2017; 13:598-601. [PMID: 28196768 DOI: 10.1016/j.jalz.2017.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 10/18/2016] [Accepted: 01/03/2017] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The accuracy of cerebrospinal fluid (CSF) biomarkers for detecting Alzheimer's disease (AD) pathology has not been fully validated in autopsied nonamnestic dementias. METHODS We retrospectively evaluated CSF amyloid β 1-42, phosphorylated-tau, and amyloid-tau index as predictors of Alzheimer pathology in patients with primary progressive aphasia, frontotemporal dementia, and progressive supranuclear palsy. RESULTS Nineteen nonamnestic autopsied cases with relevant CSF values were included. At autopsy, nine had AD and 10 had non-AD pathologies. All six patients whose combined CSF phosphorylated-tau and amyloid β levels were "consistent with AD" had postmortem Alzheimer pathology. The two patients whose biomarker values were "not consistent with AD" had non-AD pathologies. The CSF values of the remaining eight non-AD cases were in conflicting or borderline ranges. DISCUSSION CSF biomarkers reliably identified Alzheimer pathology in nonamnestic dementias and may be useful as a screening measure for inclusion of nonamnestic cases into Alzheimer's trials.
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68
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Homovanillic acid and 5-hydroxyindole acetic acid as biomarkers for dementia with Lewy bodies and coincident Alzheimer's disease: An autopsy-confirmed study. PLoS One 2017; 12:e0171524. [PMID: 28166276 PMCID: PMC5293256 DOI: 10.1371/journal.pone.0171524] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 01/23/2017] [Indexed: 12/23/2022] Open
Abstract
Dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD) are the two most common causes of dementia. Both pathologies often coexist, and AD patients with concomitant neocortical LB pathology (referred to as the Lewy body variant of AD) generally show faster cognitive decline and accelerated mortality relative to patients with pure AD. Thus, discriminating among patients with DLB, AD, and coincident DLB and AD is important in clinical practice. We examined levels of homovanillic acid (HVA), 5-hydroxyindole acetic acid (5-HIAA), tau, phosphorylated tau (p-tau), and beta-amyloid (Aβ) 1–42 in cerebrospinal fluid (CSF) to evaluate their viability as biomarkers to discriminate among different forms of dementia. We obtained a total of 3498 CSF samples from patients admitted to our hospital during the period from 1996 to 2015. Of these patients, we were able to carry out a brain autopsy in 94 cases. Finally, 78 neuropathologically diagnosed cases (10 AD, six DLB, five DLB with AD, five controls without neurological diseases, and 52 cases with other neurological diseases) were studied. CSF levels of HVA and 5-HIAA were consistently decreased in pathologically advanced Lewy body disorder (LBD; Braak LB stages >3) compared with pathologically incipient LBD (Braak LB stages <2). These results suggest that if an individual has LB pathology in the central nervous system, CSF levels of HVA and 5-HIAA may decrease after the onset of clinical symptoms. In addition, CSF levels of HVA and 5-HIAA decreased with LB pathology, and were especially low in cases of DLB and DLB with AD. Furthermore, the combination of HVA, 5-HIAA, and brain specific proteins t-tau, p-tau, and Aβ 1–42 in CSF were useful for discriminating among DLB, DLB with AD, and AD with high diagnostic accuracy.
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Giacomelli C, Daniele S, Martini C. Potential biomarkers and novel pharmacological targets in protein aggregation-related neurodegenerative diseases. Biochem Pharmacol 2017; 131:1-15. [PMID: 28159621 DOI: 10.1016/j.bcp.2017.01.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 01/26/2017] [Indexed: 10/20/2022]
Abstract
The aggregation of specific proteins plays a pivotal role in the etiopathogenesis of several neurodegenerative diseases (NDs). β-Amyloid (Aβ) peptide-containing plaques and intraneuronal neurofibrillary tangles composed of hyperphosphorylated protein tau are the two main neuropathological lesions in Alzheimer's disease. Meanwhile, Parkinson's disease is defined by the presence of intraneuronal inclusions (Lewy bodies), in which α-synuclein (α-syn) has been identified as a major protein component. The current literature provides considerable insights into the mechanisms underlying oligomeric-related neurodegeneration, as well as the relationship between protein aggregation and ND, thus facilitating the development of novel putative biomarkers and/or pharmacological targets. Recently, α-syn, tau and Aβ have been shown to interact each other or with other "pathological proteins" to form toxic heteroaggregates. These latest findings are overcoming the concept that each neurodegenerative disease is related to the misfolding of a single specific protein. In this review, potential opportunities and pharmacological approaches targeting α-syn, tau and Aβ and their oligomeric forms are highlighted with examples from recent studies. Protein aggregation as a biomarker of NDs, in both the brain and peripheral fluids, is deeply explored. Finally, the relationship between biomarker establishment and assessment and their use as diagnostics or therapeutic targets are discussed.
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Affiliation(s)
- Chiara Giacomelli
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy
| | - Simona Daniele
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy
| | - Claudia Martini
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy.
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van Waalwijk van Doorn LJ, Gispert JD, Kuiperij HB, Claassen JA, Arighi A, Baldeiras I, Blennow K, Bozzali M, Castelo-Branco M, Cavedo E, Emek-Savaş DD, Eren E, Eusebi P, Farotti L, Fenoglio C, Ormaechea JF, Freund-Levi Y, Frisoni GB, Galimberti D, Genc S, Greco V, Hampel H, Herukka SK, Liu Y, Lladó A, Lleó A, Nobili FM, Oguz KK, Parnetti L, Pereira J, Picco A, Pikkarainen M, de Oliveira CR, Saka E, Salvadori N, Sanchez-Valle R, Santana I, Scarpini E, Scheltens P, Soininen H, Tarducci R, Teunissen C, Tsolaki M, Urbani A, Vilaplana E, Visser PJ, Wallin AK, Yener G, Molinuevo JL, Meulenbroek O, Verbeek MM. Improved Cerebrospinal Fluid-Based Discrimination between Alzheimer’s Disease Patients and Controls after Correction for Ventricular Volumes. J Alzheimers Dis 2017; 56:543-555. [DOI: 10.3233/jad-160668] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Linda J.C. van Waalwijk van Doorn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Juan D. Gispert
- Barcelona Beta Brain Research Centre, Pasqual Maragall Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain
- Pompeu Fabra University, Barcelona, Spain
| | - H. Bea Kuiperij
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jurgen A.H.R. Claassen
- Department of Geriatrics, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Andrea Arighi
- University of Milan, Fondazione Ca’ Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Inês Baldeiras
- Center for Neuroscience and Cell Biology (CNC.IBILI), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Marco Bozzali
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Miguel Castelo-Branco
- Institute for Biomedical Imaging and Life Sciences (CNC.IBILI) and ICNAS (Institute for Nuclear Sciences Applied to Health), University of Coimbra, Portugal
| | - Enrica Cavedo
- AXA Research Fund and UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Boulevard de l’hôpital, F-75013, Paris, France
| | - Derya D. Emek-Savaş
- Department of Psychology, The Faculty of Arts, Department of Neurosciences, The Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Erden Eren
- Izmir Biomedicine and Genome Institute, Department of Neurosciences, The Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Paolo Eusebi
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Lucia Farotti
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Chiara Fenoglio
- University of Milan, Fondazione Ca’ Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | | | - Yvonne Freund-Levi
- Department of Neurobiology, Caring Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
- Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Giovanni B. Frisoni
- Laboratory of Epidemiology, Neuroimaging and Telemedicine, IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- University Hospitals and University of Geneva, Geneva, Switzerland
| | - Daniela Galimberti
- University of Milan, Fondazione Ca’ Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Sermin Genc
- Izmir Biomedicine and Genome Institute, Department of Neurosciences, The Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Viviana Greco
- Proteomics and Metabolomics Unit, IRCCS-Fondazione Santa Lucia, Rome, Italy
| | - Harald Hampel
- AXA Research Fund and UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Boulevard de l’hôpital, F-75013, Paris, France
| | - Sanna-Kaisa Herukka
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Yawu Liu
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Albert Lladó
- Alzheimer’s disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Alberto Lleó
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | - Flavio M. Nobili
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Kader K. Oguz
- Hacettepe University, Faculty of Medicine, Department of Neurology, Sihhiye, Ankara, Turkey
| | - Lucilla Parnetti
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - João Pereira
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Agnese Picco
- Clinical Neurology, Department of Neuroscience (DINOGMI), University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Maria Pikkarainen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Catarina Resende de Oliveira
- Center for Neuroscience and Cell Biology (CNC.IBILI), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Esen Saka
- Hacettepe University, Faculty of Medicine, Department of Neurology, Sihhiye, Ankara, Turkey
| | - Nicola Salvadori
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Raquel Sanchez-Valle
- Alzheimer’s disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Isabel Santana
- Center for Neuroscience and Cell Biology (CNC.IBILI), Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Elio Scarpini
- University of Milan, Fondazione Ca’ Granda, IRCCS Ospedale Policlinico, Milan, Italy
| | - Philip Scheltens
- Alzheimer center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
- Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Roberto Tarducci
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Charlotte Teunissen
- Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Magda Tsolaki
- Aristotle University of Thessaloniki, Memory and Dementia Center, 3rd Department of Neurology, “G Papanicolaou” General Hospital, Thessaloniki, Greece
| | - Andrea Urbani
- Proteomics and Metabolomics Unit, IRCCS-Fondazione Santa Lucia, Rome, Italy
- Istituto di Biochimica e Biochimica Clinica, Universitá Cattolica, Roma, Italy
| | | | - Pieter Jelle Visser
- Alzheimer center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
- Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, the Netherlands
| | - Asa K. Wallin
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Görsev Yener
- Department of Neurology, Medical School Izmir, Biomedicine and Genome Institute, Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, Izmir, Turkey
| | - José L. Molinuevo
- Barcelona Beta Brain Research Centre, Pasqual Maragall Foundation, Barcelona, Spain
- Alzheimer’s disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, IDIBAPS, Barcelona, Spain
| | - Olga Meulenbroek
- Department of Geriatrics, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcel M. Verbeek
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, The Netherlands
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Seripa D, Solfrizzi V, Imbimbo BP, Daniele A, Santamato A, Lozupone M, Zuliani G, Greco A, Logroscino G, Panza F. Tau-directed approaches for the treatment of Alzheimer's disease: focus on leuco-methylthioninium. Expert Rev Neurother 2016; 16:259-77. [PMID: 26822031 DOI: 10.1586/14737175.2016.1140039] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Small molecular weight compounds able to inhibit formation of tau oligomers and fibrils have already been tested for Alzheimer's disease (AD) treatment. The most advanced tau aggregation inhibitor (TAI) is methylthioninium (MT), a drug existing in equilibrium between a reduced (leuco-methylthioninium) and oxidized form (MT(+)). MT chloride (also known as methylene blue) was investigated in a 24-week Phase II study in 321 mild-to-moderate AD patients at the doses of 69, 138, and 228 mg/day. This trial failed to show significant positive effects of MT in the overall patient population. The dose of 138 mg/day showed potential benefits on cognitive performance of moderately affected patients and cerebral blood flow in mildly affected patients. A follow-up compound (TRx0237) claimed to be more bioavailable and less toxic than MT, is now being developed. Phase III clinical trials on this novel TAI in AD and in the behavioral variant of frontotemporal dementia are underway.
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Affiliation(s)
- Davide Seripa
- a Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences , IRCCS 'Casa Sollievo della Sofferenza' , San Giovanni Rotondo , Foggia , Italy
| | - Vincenzo Solfrizzi
- b Geriatric Medicine-Memory Unit and Rare Disease Centre , University of Bari Aldo Moro , Bari , Italy
| | - Bruno P Imbimbo
- c Research & Development Department , Chiesi Farmaceutici , Parma , Italy
| | - Antonio Daniele
- d Institute of Neurology , Catholic University of Sacred Heart , Rome , Italy
| | - Andrea Santamato
- e Physical Medicine and Rehabilitation Section, 'OORR' Hospital , University of Foggia , Foggia , Italy
| | - Madia Lozupone
- f Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs , University of Bari Aldo Moro , Bari , Italy
| | - Giovanni Zuliani
- g Department of Medical Science, Section of Internal and Cardiopulmonary Medicine , University of Ferrara
| | - Antonio Greco
- a Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences , IRCCS 'Casa Sollievo della Sofferenza' , San Giovanni Rotondo , Foggia , Italy
| | - Giancarlo Logroscino
- f Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs , University of Bari Aldo Moro , Bari , Italy.,h Department of Clinical Research in Neurology , University of Bari Aldo Moro, 'Pia Fondazione Cardinale G. Panico' , Tricase , Lecce , Italy
| | - Francesco Panza
- a Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences , IRCCS 'Casa Sollievo della Sofferenza' , San Giovanni Rotondo , Foggia , Italy.,f Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs , University of Bari Aldo Moro , Bari , Italy.,h Department of Clinical Research in Neurology , University of Bari Aldo Moro, 'Pia Fondazione Cardinale G. Panico' , Tricase , Lecce , Italy
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Le Bouc R, Marelli C, Beaufils E, Berr C, Hommet C, Touchon J, Pasquier F, Deramecourt V. Limiting Factors of Brain Donation in Neurodegenerative Diseases: The Example of French Memory Clinics. J Alzheimers Dis 2016; 49:1075-83. [PMID: 26756326 DOI: 10.3233/jad-150825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Postmortem neuropathological examination of the brain is essential in neurodegenerative diseases, to ensure accurate diagnosis, to obtain an a posteriori critical assessment of the adequacy of clinical care, and to validate new biomarkers, but is only rarely performed. The purpose of this study was to assess factors limiting brain donation, such as reluctance of physicians to seek donation consent, opposition from patients and families, and organizational constraints. We conducted a survey across French memory clinics and major neuropathological centers. Few postmortem examinations were performed annually, as less than one third of the centers had performed at least five autopsies, and 41% had performed none. The main limiting factor was the lack of donation requests made by physicians, as half of them never approach patients for brain donation. Reasons for not seeking donation consent often include discomfort broaching the subject and lack of awareness of the medical and scientific benefit of postmortems (77%), organizational constraints (61%), and overestimation of families' negative reaction (51%). Family refusals represented a second major obstacle, and were often caused by misconceptions. Identifying and addressing these biases early could help improve physicians' rate of making requests and the public's awareness about the importance of brain donation.
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Affiliation(s)
- Raphael Le Bouc
- Memory Clinic, French National Reference Centre for Young Onset Alzheimer's disease, Lille University Hospital, INSERM U1171, LabEx DISTALZ, Lille, France
| | - Cecilia Marelli
- Department of Neurology, CHRU Gui de Chauliac, Montpellier, France
| | - Emilie Beaufils
- Regional Memory Center, CHU Hôpital Bretonneau, Tours, France
| | - Claudine Berr
- INSERM E361, Pathologies of the Nervous System, Clinical and Epidemiological Research, Hôpital La Colombiére, Montpellier, France
| | - Caroline Hommet
- Regional Memory Center, CHU Hôpital Bretonneau, Tours, France
| | - Jacques Touchon
- Department of Neurology, CHRU Gui de Chauliac, Montpellier, France
| | - Florence Pasquier
- Memory Clinic, French National Reference Centre for Young Onset Alzheimer's disease, Lille University Hospital, INSERM U1171, LabEx DISTALZ, Lille, France
| | - Vincent Deramecourt
- Memory Clinic, French National Reference Centre for Young Onset Alzheimer's disease, Lille University Hospital, INSERM U1171, LabEx DISTALZ, Lille, France
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73
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Probing amyloid beta-induced cell death using a fluorescence-peptide conjugate in Alzheimer's disease mouse model. Brain Res 2016; 1646:514-521. [DOI: 10.1016/j.brainres.2016.06.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 05/03/2016] [Accepted: 06/28/2016] [Indexed: 12/18/2022]
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74
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Schönecker S, Brendel M, Huber M, Vollmar C, Huppertz HJ, Teipel S, Okamura N, Levin J, Rominger A, Danek A. Applied multimodal diagnostics in a case of presenile dementia. BMC Neurol 2016; 16:131. [PMID: 27506761 PMCID: PMC4977691 DOI: 10.1186/s12883-016-0647-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 07/26/2016] [Indexed: 12/14/2022] Open
Abstract
Background Alzheimer’s disease (AD) is the most common cause of dementia in the elderly. The possibility of disease-modifying strategies has evoked a need for early and accurate diagnosis. To improve the accuracy of the clinical diagnosis of AD, biomarkers like cerebrospinal fluid (CSF) and neuroimaging techniques like magnetic resonance imaging (MRI) and positron emission tomography (PET) have been incorporated into the diagnostic guidelines of AD. Case presentation In this case report we outline in reference to one of our patients with presenile dementia the current approaches to the diagnosis of AD. The patient was a 59-year old woman presenting with progressive memory decline. CSF-Aβ42 was normal while P-tau was slightly increased. FDG-PET indicated a pattern typical for AD, amyloid-PET showed an extensive global amyloid load, and tau-PET depicted a pronounced hippocampal tracer accumulation. The MRI scan was rated as normal at routine diagnostics, however quantitative volumetric analysis revealed significant atrophy especially of the parietal lobe. The combination of biomarkers and neuroimaging techniques was therefore suggestive of an underlying AD pathology. Conclusions To enable early and accurate diagnosis of AD and thereby also patient recruitment for anti-tau or anti-β-amyloid therapeutic trials, a combination of biomarkers and neuroimaging techniques seems useful.
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Affiliation(s)
- Sonja Schönecker
- Department of Neurology, Ludwig-Maximilians University, Munich, Germany.
| | - Matthias Brendel
- Department of Nuclear Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Marion Huber
- Department of Neurology, Ludwig-Maximilians University, Munich, Germany
| | - Christian Vollmar
- Department of Neurology, Ludwig-Maximilians University, Munich, Germany
| | | | - Stefan Teipel
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany.,German Center for Neurodegenerative Diseases, Rostock, Germany
| | - Nobuyuki Okamura
- Department of Pharmacology, Tohoku University School of Medicine, Sendai, Japan
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians University, Munich, Germany.,German Center for Neurodegenerative Diseases, Munich, Germany
| | - Axel Rominger
- Department of Nuclear Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians University, Munich, Germany
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75
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Weise D, Tiepolt S, Awissus C, Hoffmann KT, Lobsien D, Kaiser T, Barthel H, Sabri O, Gertz HJ. Critical Comparison of Different Biomarkers for Alzheimer's Disease in a Clinical Setting. J Alzheimers Dis 2016; 48:425-32. [PMID: 26402006 DOI: 10.3233/jad-150229] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Biomarkers of neuronal injury and amyloid pathology play a pivotal role in the diagnosis of Alzheimer's disease (AD). The degree of AD biomarker congruence is still unclear in clinical practice. OBJECTIVE Diagnosis of AD with regard to the congruence of the clinical diagnosis and different biomarkers. METHODS In this prospective cross-sectional observational study, 54 patients with mild cognitive impairment or dementia due to AD or not due to AD were investigated. Biomarkers of neuronal injury were medial temporal lobe atrophy (MTA) on magnetic resonance imaging (MRI) and tau concentration in the cerebrospinal fluid (CSF). CSF Aβ(1-42) and amyloid-targeting positron emission tomography (PET) were considered as biomarkers of amyloid pathology. RESULTS Forty cases were diagnosed as AD and 14 cases were diagnosed as non-AD based on clinical and routine MRI assessment. AD cases had higher MTA scores, higher levels of CSF tau and lower levels of CSF Aβ(1- 42), and higher amyloid load on PET compared to the non-AD group. In the AD group, completely consistently pathological biomarkers were found in 32.5% , non-pathological in 5% . In 62.5% the findings were inconsistent. Congruence of biomarkers was 67.5% for neuronal injury and for amyloid dysfunction, respectively. In two patients, clinical diagnosis switched to non-AD due to completely consistent non-pathological biomarker findings. The criteria of the international working group were met in 75.0% . CONCLUSION Surprisingly, the number of completely congruent biomarkers was relatively low. Interpretation of AD biomarkers is complicated by multiple biomarker constellations. However, the level of biomarker consistency required to reliably diagnose AD remains uncertain.
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Affiliation(s)
- David Weise
- Department of Psychiatry, University of Leipzig, Leipzig, Germany.,Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Solveig Tiepolt
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Carolin Awissus
- Department of Psychiatry, University of Leipzig, Leipzig, Germany
| | | | - Donald Lobsien
- Department of Neuroradiology, University of Leipzig, Leipzig, Germany
| | - Thorsten Kaiser
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
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Suárez-Calvet M, Kleinberger G, Araque Caballero MÁ, Brendel M, Rominger A, Alcolea D, Fortea J, Lleó A, Blesa R, Gispert JD, Sánchez-Valle R, Antonell A, Rami L, Molinuevo JL, Brosseron F, Traschütz A, Heneka MT, Struyfs H, Engelborghs S, Sleegers K, Van Broeckhoven C, Zetterberg H, Nellgård B, Blennow K, Crispin A, Ewers M, Haass C. sTREM2 cerebrospinal fluid levels are a potential biomarker for microglia activity in early-stage Alzheimer's disease and associate with neuronal injury markers. EMBO Mol Med 2016; 8:466-76. [PMID: 26941262 PMCID: PMC5120370 DOI: 10.15252/emmm.201506123] [Citation(s) in RCA: 347] [Impact Index Per Article: 43.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
TREM2 is an innate immune receptor expressed on the surface of microglia. Loss‐of‐function mutations of TREM2 are associated with increased risk of Alzheimer's disease (AD). TREM2 is a type‐1 protein with an ectodomain that is proteolytically cleaved and released into the extracellular space as a soluble variant (sTREM2), which can be measured in the cerebrospinal fluid (CSF). In this cross‐sectional multicenter study, we investigated whether CSF levels of sTREM2 are changed during the clinical course of AD, and in cognitively normal individuals with suspected non‐AD pathology (SNAP). CSF sTREM2 levels were higher in mild cognitive impairment due to AD than in all other AD groups and controls. SNAP individuals also had significantly increased CSF sTREM2 compared to controls. Moreover, increased CSF sTREM2 levels were associated with higher CSF total tau and phospho‐tau181P, which are markers of neuronal degeneration and tau pathology. Our data demonstrate that CSF sTREM2 levels are increased in the early symptomatic phase of AD, probably reflecting a corresponding change of the microglia activation status in response to neuronal degeneration.
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Affiliation(s)
- Marc Suárez-Calvet
- BioMedical Center (BMC), Biochemistry, Ludwig-Maximilians-University Munich, Munich, Germany German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
| | - Gernot Kleinberger
- BioMedical Center (BMC), Biochemistry, Ludwig-Maximilians-University Munich, Munich, Germany Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Miguel Ángel Araque Caballero
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, Klinikum der Universität München, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Axel Rominger
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany Department of Nuclear Medicine, Klinikum der Universität München, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Daniel Alcolea
- Department of Neurology, Institut d'Investigacions Biomèdiques Hospital de la Santa Creu i Sant Pau Universitat Autònoma de Barcelona, Barcelona, Spain Center for Networked Biomedical Research for Neurodegenerative Diseases, CIBERNED, Madrid, Spain
| | - Juan Fortea
- Department of Neurology, Institut d'Investigacions Biomèdiques Hospital de la Santa Creu i Sant Pau Universitat Autònoma de Barcelona, Barcelona, Spain Center for Networked Biomedical Research for Neurodegenerative Diseases, CIBERNED, Madrid, Spain
| | - Alberto Lleó
- Department of Neurology, Institut d'Investigacions Biomèdiques Hospital de la Santa Creu i Sant Pau Universitat Autònoma de Barcelona, Barcelona, Spain Center for Networked Biomedical Research for Neurodegenerative Diseases, CIBERNED, Madrid, Spain
| | - Rafael Blesa
- Department of Neurology, Institut d'Investigacions Biomèdiques Hospital de la Santa Creu i Sant Pau Universitat Autònoma de Barcelona, Barcelona, Spain Center for Networked Biomedical Research for Neurodegenerative Diseases, CIBERNED, Madrid, Spain
| | - Juan Domingo Gispert
- Clinical and Neuroimaging Departments, Barcelona Beta Brain Research Center Pasqual Maragall Foundation, Barcelona, Spain Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, ICN Hospital Clinic i Universitari, Barcelona, Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Anna Antonell
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, ICN Hospital Clinic i Universitari, Barcelona, Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, ICN Hospital Clinic i Universitari, Barcelona, Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - José L Molinuevo
- Clinical and Neuroimaging Departments, Barcelona Beta Brain Research Center Pasqual Maragall Foundation, Barcelona, Spain Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, ICN Hospital Clinic i Universitari, Barcelona, Spain Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | | | - Michael T Heneka
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany Neurology Department, Universitätsklinikum Bonn, Bonn, Germany
| | - Hanne Struyfs
- Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, Institute Born-Bunge University of Antwerp, Antwerp, Belgium Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, Institute Born-Bunge University of Antwerp, Antwerp, Belgium Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium
| | - Kristel Sleegers
- Neurodegenerative Brain Diseases Group, Department of Molecular Genetics, VIB, Antwerp, Belgium Laboratory of Neurogenetics, Institute Born-Bunge University of Antwerp, Antwerp, Belgium
| | - Christine Van Broeckhoven
- Neurodegenerative Brain Diseases Group, Department of Molecular Genetics, VIB, Antwerp, Belgium Laboratory of Neurogenetics, Institute Born-Bunge University of Antwerp, Antwerp, Belgium
| | - Henrik Zetterberg
- Clinical Neurochemistry Lab, Institute of Neuroscience and Physiology The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden Reta Lila Weston Laboratories and Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Bengt Nellgård
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences Sahlgrenska Academy Gothenburg University, Gothenburg, Sweden
| | - Kaj Blennow
- Clinical Neurochemistry Lab, Institute of Neuroscience and Physiology The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Alexander Crispin
- Institute of Medical Informatics, Biometry, and Epidemiology, Munich, Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Christian Haass
- BioMedical Center (BMC), Biochemistry, Ludwig-Maximilians-University Munich, Munich, Germany German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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A First Tetraplex Assay for the Simultaneous Quantification of Total α-Synuclein, Tau, β-Amyloid42 and DJ-1 in Human Cerebrospinal Fluid. PLoS One 2016; 11:e0153564. [PMID: 27116005 PMCID: PMC4846093 DOI: 10.1371/journal.pone.0153564] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 03/31/2016] [Indexed: 01/17/2023] Open
Abstract
The quantification of four distinct proteins (α-synuclein, β-amyloid1-42, DJ-1, and total tau) in cerebrospinal fluid (CSF) has been proposed as a laboratory-based platform for the diagnosis of Parkinson’s disease (PD) and Alzheimer’s disease (AD). While there is some clinical utility in measuring these markers individually, their usage in routine clinical testing remains challenging, in part due to substantial overlap of concentrations between healthy controls and diseased subjects. In contrast, measurement of different analytes in a single sample from individual patients in parallel appears to considerably improve the accuracy of AD or PD diagnosis. Here, we report the development and initial characterization of a first, electrochemiluminescence-based multiplex immunoassay for the simultaneous quantification of all four proteins (‘tetraplex’) in as little as 50 μl of CSF. In analytical performance experiments, we assessed its sensitivity, spike-recovery rate, parallelism and dilution linearity as well as the intra- and inter-assay variability. Using our in-house calibrators, we recorded a lower limit of detection for α-synuclein, β-amyloid42, DJ-1, and t-tau of 1.95, 1.24, 5.63, and 4.05 pg/ml, respectively. The corresponding, linear concentration range covered >3 orders of magnitude. In diluted CSF samples (up to 1:4), spike-recovery rates ranged from a low of 55% for β-amyloid42 to a high of 98% for DJ-1. Hillslopes ranged from 1.03 to 1.30, and inter-assay variability demonstrated very high reproducibility. Our newly established tetraplex assay represents a significant technical advance for fluid-based biomarker studies in neurodegenerative disorders allowing the simultaneous measurement of four pivotal makers in single CSF specimens. It provides exceptional sensitivity, accuracy and speed.
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Abstract
PURPOSE OF REVIEW This article discusses the recent advances in the diagnosis and treatment of Alzheimer disease (AD). RECENT FINDINGS In recent years, significant advances have been made in the fields of genetics, neuroimaging, clinical diagnosis, and staging of AD. One of the most important recent advances in AD is our ability to visualize amyloid pathology in the living human brain. The newly revised criteria for diagnosis of AD dementia embrace the use for biomarkers as supportive evidence for the underlying pathology. Guidelines for the responsible use of amyloid positron emission tomography (PET) have been developed, and the clinical and economic implications of amyloid PET imaging are actively being explored. SUMMARY Our improved understanding of the clinical onset, progression, neuroimaging, pathologic features, genetics, and other risk factors for AD impacts the approaches to clinical diagnosis and future therapeutic interventions.
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Batarseh YS, Duong QV, Mousa YM, Al Rihani SB, Elfakhri K, Kaddoumi A. Amyloid-β and Astrocytes Interplay in Amyloid-β Related Disorders. Int J Mol Sci 2016; 17:338. [PMID: 26959008 PMCID: PMC4813200 DOI: 10.3390/ijms17030338] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 02/14/2016] [Accepted: 02/24/2016] [Indexed: 12/17/2022] Open
Abstract
Amyloid-β (Aβ) pathology is known to promote chronic inflammatory responses in the brain. It was thought previously that Aβ is only associated with Alzheimer's disease and Down syndrome. However, studies have shown its involvement in many other neurological disorders. The role of astrocytes in handling the excess levels of Aβ has been highlighted in the literature. Astrocytes have a distinctive function in both neuronal support and protection, thus its involvement in Aβ pathological process may tip the balance toward chronic inflammation and neuronal death. In this review we describe the involvement of astrocytes in Aβ related disorders including Alzheimer's disease, Down syndrome, cerebral amyloid angiopathy, and frontotemporal dementia.
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Affiliation(s)
- Yazan S Batarseh
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, University of Louisiana at Monroe, Monroe, LA 70504, USA.
| | - Quoc-Viet Duong
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, University of Louisiana at Monroe, Monroe, LA 70504, USA.
| | - Youssef M Mousa
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, University of Louisiana at Monroe, Monroe, LA 70504, USA.
| | - Sweilem B Al Rihani
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, University of Louisiana at Monroe, Monroe, LA 70504, USA.
| | - Khaled Elfakhri
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, University of Louisiana at Monroe, Monroe, LA 70504, USA.
| | - Amal Kaddoumi
- Department of Basic Pharmaceutical Sciences, School of Pharmacy, University of Louisiana at Monroe, Monroe, LA 70504, USA.
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80
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CSF biomarkers in neurodegenerative and vascular dementias. Prog Neurobiol 2016; 138-140:36-53. [DOI: 10.1016/j.pneurobio.2016.03.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/12/2016] [Accepted: 03/14/2016] [Indexed: 12/14/2022]
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Mollenhauer B, Parnetti L, Rektorova I, Kramberger MG, Pikkarainen M, Schulz-Schaeffer WJ, Aarsland D, Svenningsson P, Farotti L, Verbeek MM, Schlossmacher MG. Biological confounders for the values of cerebrospinal fluid proteins in Parkinson's disease and related disorders. J Neurochem 2016; 139 Suppl 1:290-317. [DOI: 10.1111/jnc.13390] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 09/11/2015] [Accepted: 09/21/2015] [Indexed: 12/26/2022]
Affiliation(s)
- Brit Mollenhauer
- Paracelsus-Elena-Klinik; Kassel Germany
- University Medical Center (Department of Neuropathology); Georg-August University Goettingen; Goettingen Germany
| | - Lucilla Parnetti
- Centro Disturbi della Memoria- Unità Valutativa Alzheimer; Clinica Neurologica; Università di Perugia; Perugia Italy
| | - Irena Rektorova
- Applied Neuroscience Group; CEITEC MU; Masaryk University; Brno Czech Republic
| | - Milica G. Kramberger
- Department of Neurology; University Medical Center Ljubljana; Ljubljana Slovenia
- Division for Neurogeriatrics; Department of NVS; Karolinska Institutet; Center for Alzheimer Research; Stockholm Sweden
- Centre for Age-Related Medicine; Stavanger University Hospital; Stavanger Norway
| | - Maria Pikkarainen
- Institute of Clinical Medicine / Neurology; University of Eastern Finland; Kuopio Finland
| | - Walter J. Schulz-Schaeffer
- University Medical Center (Department of Neuropathology); Georg-August University Goettingen; Goettingen Germany
| | - Dag Aarsland
- Division for Neurogeriatrics; Department of NVS; Karolinska Institutet; Center for Alzheimer Research; Stockholm Sweden
- Centre for Age-Related Medicine; Stavanger University Hospital; Stavanger Norway
| | - Per Svenningsson
- Department for Clinical Neuroscience; Karolinska Institute; Stockholm Sweden
| | - Lucia Farotti
- Centro Disturbi della Memoria- Unità Valutativa Alzheimer; Clinica Neurologica; Università di Perugia; Perugia Italy
| | - Marcel M. Verbeek
- Department of Neurology; Department of Laboratory Medicine; Donders Institute for Brain, Cognition and Behaviour; Radboud University Medical Centre; Nijmegen The Netherlands
| | - Michael G. Schlossmacher
- Program in Neuroscience and Division of Neurology; The Ottawa Hospital; University of Ottawa Brain & Mind Research Institute; Ottawa Ontario Canada
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Di Domenico F, Pupo G, Giraldo E, Badìa MC, Monllor P, Lloret A, Schininà ME, Giorgi A, Cini C, Tramutola A, Butterfield DA, Viña J, Perluigi M. Oxidative signature of cerebrospinal fluid from mild cognitive impairment and Alzheimer disease patients. Free Radic Biol Med 2016; 91:1-9. [PMID: 26675344 DOI: 10.1016/j.freeradbiomed.2015.12.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/26/2015] [Accepted: 12/05/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND Several studies suggest that pathological changes in Alzheimer's disease (AD) brain begin around 10-20 years before the onset of cognitive impairment. Biomarkers that can support early diagnosis and predict development of dementia would, therefore, be crucial for patient care and evaluation of drug efficacy. Although cerebrospinal fluid (CSF) levels of Aβ42, tau, and p-tau are well-established diagnostic biomarkers of AD, there is an urgent need to identify additional molecular alterations of neuronal function that can be evaluated at the systemic level. OBJECTIVES This study was focused on the analysis of oxidative stress-related modifications of the CSF proteome, from subjects with AD and amnestic mild cognitive impairment (aMCI). METHODS A targeted proteomics approach has been employed to discover novel CSF biomarkers that can augment the diagnostic and prognostic accuracy of current leading CSF biomarkers. CSF samples from aMCI, AD and control individuals (CTR) were collected and analyzed using a combined redox proteomics approach to identify the specific oxidatively modified proteins in AD and aMCI compared with controls. RESULTS The majority of carbonylated proteins identified by redox proteomics are found early in the progression of AD, i.e., oxidatively modified CSF proteins were already present in aMCI compared with controls and remain oxidized in AD, thus suggesting that dysfunction of selected proteins initiate many years before severe dementia is diagnosed. CONCLUSIONS The above findings highlight the presence of early oxidative damage in aMCI before clinical dementia of AD is manifested. The identification of early markers of AD that may be detected peripherally may open new prospective for biomarker studies.
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Affiliation(s)
- Fabio Di Domenico
- Department of Biochemical Sciences, Sapienza University of Rome, Italy
| | - Gilda Pupo
- Department of Biochemical Sciences, Sapienza University of Rome, Italy
| | - Esther Giraldo
- Department of Physiology, Faculty of Medicine, University of Valencia, Spain
| | - Mari-Carmen Badìa
- Department of Physiology, Faculty of Medicine, University of Valencia, Spain
| | - Paloma Monllor
- Department of Physiology, Faculty of Medicine, University of Valencia, Spain
| | - Ana Lloret
- Department of Physiology, Faculty of Medicine, University of Valencia, Spain
| | | | - Alessandra Giorgi
- Department of Biochemical Sciences, Sapienza University of Rome, Italy
| | - Chiara Cini
- Department of Biochemical Sciences, Sapienza University of Rome, Italy
| | | | - D Allan Butterfield
- Sanders-Brown Centre of Aging, Department of Chemistry, University of Kentucky, Lexington, KY, USA
| | - José Viña
- Department of Physiology, Faculty of Medicine, University of Valencia, Spain
| | - Marzia Perluigi
- Department of Biochemical Sciences, Sapienza University of Rome, Italy.
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Jung IY, Lee EH, Suh AY, Lee SJ, Lee H. Oligonucleotide-based biosensors for in vitro diagnostics and environmental hazard detection. Anal Bioanal Chem 2016; 408:2383-406. [PMID: 26781106 DOI: 10.1007/s00216-015-9212-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 10/19/2015] [Accepted: 11/23/2015] [Indexed: 02/06/2023]
Abstract
Oligonucleotide-based biosensors have drawn much attention because of their broad applications in in vitro diagnostics and environmental hazard detection. They are particularly of interest to many researchers because of their high specificity as well as excellent sensitivity. Recently, oligonucleotide-based biosensors have been used to achieve not only genetic detection of targets but also the detection of small molecules, peptides, and proteins. This has further broadened the applications of these sensors in the medical and health care industry. In this review, we highlight various examples of oligonucleotide-based biosensors for the detection of diseases, drugs, and environmentally hazardous chemicals. Each example is provided with detailed schematics of the detection mechanism in addition to the supporting experimental results. Furthermore, future perspectives and new challenges in oligonucleotide-based biosensors are discussed.
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Affiliation(s)
- Il Young Jung
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 03760, Republic of Korea
| | - Eun Hee Lee
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 03760, Republic of Korea
| | - Ah Young Suh
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 03760, Republic of Korea
| | - Seung Jin Lee
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 03760, Republic of Korea
| | - Hyukjin Lee
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, 03760, Republic of Korea.
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Pijnenburg YA, Verwey NA, van der Flier WM, Scheltens P, Teunissen CE. Discriminative and prognostic potential of cerebrospinal fluid phosphoTau/tau ratio and neurofilaments for frontotemporal dementia subtypes. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2015; 1:505-12. [PMID: 27239528 PMCID: PMC4879490 DOI: 10.1016/j.dadm.2015.11.001] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION A decreased cerebrospinal fluid (CSF) p-Tau181 to total tau ratio (p/t-tau) is a biomarker for frontotemporal lobar degeneration with TDP43 inclusions (FTLD-TDP) and for amyotrophic lateral sclerosis (ALS). CSF light chain neurofilaments (NfL) are increased in ALS. We examined whether CSF p/t-tau and NfL are related to ALS status in FTLD-TDP. METHODS We compared CSF p/t-tau and NfL levels between patients with FTLD-TDP with ALS (n = 15), FTLD-TDP without ALS (n = 17), FTLD-Tau (n = 6), Alzheimer's disease (AD; n = 25), and subjective memory complaints (SMC, n = 24). RESULTS Apart from FTLD-Tau, all groups differed significantly with increasing p/t-tau ratios from FTLD-TDP with ALS to FTLD-TDP without ALS to AD and SMC. CSF NfL was very high in FTLD-TDP with ALS followed by FTLD-TDP without ALS, AD, and SMC. Both biomarkers correlated with survival. DISCUSSION CSF p/t-tau ratio and NfL levels are strongly driven by ALS status. These markers, therefore, appear to be more of prognostic than diagnostic significance.
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Affiliation(s)
- Yolande A.L. Pijnenburg
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Nicolaas A. Verwey
- Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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Suzuki I, Noguchi M, Arito M, Sato T, Omoteyama K, Maedomari M, Hasegawa H, Suematsu N, Okamoto K, Kato T, Yamaguchi N, Kurokawa MS. Serum peptides as candidate biomarkers for dementia with Lewy bodies. Int J Geriatr Psychiatry 2015; 30:1195-206. [PMID: 25754375 DOI: 10.1002/gps.4274] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 01/28/2015] [Accepted: 01/29/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE For diagnosis of dementia with Lewy bodies (DLB), we tried to find blood biomarkers for the disease. METHODS Serum peptides were comprehensively detected by mass spectrometry. Peptides of interest were identified by tandem mass spectrometry. RESULTS One hundred forty-six peptides were detected in a training set consisting of 30 DLB patients, 30 patients with Alzheimer's disease (AD), and 28 healthy control (HC) subjects. Multivariate analysis for discriminating the DLB group from the non-DLB (AD and HC) group using ion intensity of four peptides (2898, 4052, 4090, and 5002 m/z) showed sensitivity of 93.3% and specificity of 87.9% (DLB/nonDLB-4P model). In a testing set consisting of 20 DLB patients, 30 AD patients, and 14 HC subjects, this model showed sensitivity of 90.0% and specificity of 88.6%. DLB/nonDLB-4P model detected 86.7% and 90.0% of the AD patients as non-DLB in the training and testing sets, respectively, and discriminated all the 15 patients with amnestic mild cognitive impairment as non-DLB. Notably, a combination of two peptides (1737 and 5002 m/z) showed sensitivity of 95.0% and specificity of 93.3% for discriminating the DLB group from the AD group (DLB/nonDLB-2P model) in the testing set. The peptides used in these models included fragments from complement 4b, Wnt-2b, and lipopolysaccharide-binding protein, which were reported to be involved in the pathology of DLB or Parkinson's disease and hippocampal neurogenesis. CONCLUSIONS Serum peptide profiles would provide useful DLB biomarker candidates, which may be implicated in the pathophysiology of the disease.
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Affiliation(s)
- Itsuku Suzuki
- Department of Neuropsychiatry, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Miwa Noguchi
- Department of Neuropsychiatry, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Mitsumi Arito
- Clinical Proteomics and Molecular Medicine, St. Marianna University Graduate School of Medicine, Kawasaki, Japan
| | - Toshiyuki Sato
- Clinical Proteomics and Molecular Medicine, St. Marianna University Graduate School of Medicine, Kawasaki, Japan
| | - Kazuki Omoteyama
- Clinical Proteomics and Molecular Medicine, St. Marianna University Graduate School of Medicine, Kawasaki, Japan
| | - Mioto Maedomari
- Department of Neuropsychiatry, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hiroshi Hasegawa
- Department of Neuropsychiatry, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Naoya Suematsu
- Clinical Proteomics and Molecular Medicine, St. Marianna University Graduate School of Medicine, Kawasaki, Japan
| | - Kazuki Okamoto
- Clinical Proteomics and Molecular Medicine, St. Marianna University Graduate School of Medicine, Kawasaki, Japan
| | - Tomohiro Kato
- Clinical Proteomics and Molecular Medicine, St. Marianna University Graduate School of Medicine, Kawasaki, Japan
| | - Noboru Yamaguchi
- Department of Neuropsychiatry, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Manae S Kurokawa
- Disease Biomarker Analysis and Molecular Regulation, St. Marianna University Graduate School of Medicine, Kawasaki, Japan
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Sancesario GM, Bernardini S. How many biomarkers to discriminate neurodegenerative dementia? Crit Rev Clin Lab Sci 2015; 52:314-26. [PMID: 26292074 DOI: 10.3109/10408363.2015.1051658] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A number of cerebrospinal fluid (CSF) biomarkers are currently used for the diagnosis of dementia. Opposite changes in the level of amyloid-β(1-42) versus total tau and phosphorylated-tau181 in the CSF reflect the specific pathology of Alzheimer's disease (AD) in the brain. This panel of biomarkers has proven to be effective to differentiate AD from controls and from the major types of neurodegenerative dementia, and to evaluate the progression from mild cognitive impairment to AD. In the absence of specific biomarkers reflecting the pathologies of the other most common forms of dementia, such as Lewy Body disease, Frontotemporal lobar degeneration, Creutzfeldt-Jakob disease, etc., the evaluation of biomarkers of AD pathology is used, attempting to exclude rather than to confirm AD. Other biomarkers included in the common clinical practice do not clearly relate to the underlying pathology: progranulin (PGRN) is a selective marker of frontotemporal dementia with mutations in the PGRN gene; the 14-3-3 protein is a highly sensitive and specific marker for Creutzfeldt-Jakob disease, but has to be used carefully in differentiating rapid progressive dementia; and α-synuclein is an emerging candidate biomarker of the different forms of synucleinopathy. This review summarizes several biomarkers of neurodegenerative dementia validated based on the neuropathological processes occurring in brain tissue. Notwithstanding the paucity of pathologically validated biomarkers and their high analytical variability, the combinations of these biomarkers may well represent a key and more precise analytical and diagnostic tool in the complex plethora of degenerative dementia.
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Affiliation(s)
- Giulia M Sancesario
- a Department of Clinical and Behavioural Neurology , Santa Lucia Foundation, IRCCS , Rome , Italy and
| | - Sergio Bernardini
- b Department of Experimental Medicine and Surgery , Tor Vergata University of Rome , Rome , Italy
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Galozzi S, Marcus K, Barkovits K. Amyloid-β as a biomarker for Alzheimer’s disease: quantification methods in body fluids. Expert Rev Proteomics 2015; 12:343-54. [DOI: 10.1586/14789450.2015.1065183] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Schindler SE, Fagan AM. Autosomal Dominant Alzheimer Disease: A Unique Resource to Study CSF Biomarker Changes in Preclinical AD. Front Neurol 2015; 6:142. [PMID: 26175713 PMCID: PMC4483518 DOI: 10.3389/fneur.2015.00142] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 06/12/2015] [Indexed: 12/27/2022] Open
Abstract
Our understanding of the pathogenesis of Alzheimer disease (AD) has been greatly influenced by investigation of rare families with autosomal dominant mutations that cause early onset AD. Mutations in the genes coding for amyloid precursor protein (APP), presenilin 1 (PSEN-1), and presenilin 2 (PSEN-2) cause over-production of the amyloid-β peptide (Aβ) leading to early deposition of Aβ in the brain, which in turn is hypothesized to initiate a cascade of processes, resulting in neuronal death, cognitive decline, and eventual dementia. Studies of cerebrospinal fluid (CSF) from individuals with the common form of AD, late-onset AD (LOAD), have revealed that low CSF Aβ42 and high CSF tau are associated with AD brain pathology. Herein, we review the literature on CSF biomarkers in autosomal dominant AD (ADAD), which has contributed to a detailed road map of AD pathogenesis, especially during the preclinical period, prior to the appearance of any cognitive symptoms. Current drug trials are also taking advantage of the unique characteristics of ADAD and utilizing CSF biomarkers to accelerate development of effective therapies for AD.
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Affiliation(s)
- Suzanne Elizabeth Schindler
- Department of Neurology, Knight Alzheimer's Disease Research Center, Hope Center for Neurological Disorders, Washington University School of Medicine , St. Louis, MO , USA
| | - Anne M Fagan
- Department of Neurology, Knight Alzheimer's Disease Research Center, Hope Center for Neurological Disorders, Washington University School of Medicine , St. Louis, MO , USA
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Marelli C, Gutierrez LA, Menjot de Champfleur N, Charroud C, De Verbizier D, Touchon J, Douillet P, Berr C, Lehmann S, Gabelle A. Late-onset behavioral variant of frontotemporal lobar degeneration versus Alzheimer's disease: Interest of cerebrospinal fluid biomarker ratios. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2015; 1:371-9. [PMID: 27239517 PMCID: PMC4878372 DOI: 10.1016/j.dadm.2015.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Cerebrospinal fluid (CSF) biomarker ratios were never evaluated in late-onset (>65 years) behavioral variant of frontotemporal lobar degeneration (bvFTLD) versus Alzheimer's disease (AD). METHODS A retrospective monocentric study on 44 clinically suspected amnestic AD or bvFTLD patients with onset after 65 years and available CSF and clinical data. RESULTS The final clinical diagnosis was AD (n = 28; 64%), late-onset bvFTLD (n = 14; 32%), and others (n = 2; 4%). Applying the CSF cutoff total-tau/Aβ1-42 of 1.06, all the bvFTLD were in the FTLD range (<1.06, bvFTLD/FTLD), whereas the AD patients were either in the AD (>1.06, AD/AD) or in the FTLD range (<1.06, AD/FTLD); CSF biomarkers were significantly different in these three groups, but not neuroradiological features or presence of episodic memory deficit. DISCUSSION Late-onset bvFTLD is underdiagnosed. The available CSF biomarker ratio cutoff need further improvement and overestimated late-onset bvFTLD but could potentially differentiate it from AD, notably in case of conflicting results.
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Affiliation(s)
- Cecilia Marelli
- Department of Neurology and Memory Research and Resources Center, Gui de Chauliac University Hospital, Montpellier, France
| | - Laure-Anne Gutierrez
- Department of Neurology and Memory Research and Resources Center, Gui de Chauliac University Hospital, Montpellier, France; INSERM U 1061-Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Nicolas Menjot de Champfleur
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, Gui de Chauliac University Hospital, Montpellier, France; Department of Neuroradiology, Gui de Chauliac University Hospital, Montpellier, France; Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors," Institut National de la Santé et de la Recherche Médicale Unité 583, Institut of Neurosciences of Montpellier, Saint Eloi Hospital, Montpellier, France
| | - Celine Charroud
- INSERM U 1061-Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France; Institut d'Imagerie Fonctionnelle Humaine, I2FH, Gui de Chauliac University Hospital, Montpellier, France; Department of Neuroradiology, Gui de Chauliac University Hospital, Montpellier, France; INSERM U 1198 - Molecular Mechanisms in Neurodegenerative Diseases, Montpellier, France
| | - Delphine De Verbizier
- Department of Nuclear Medicine, Gui de Chauliac University Hospital, Montpellier, France
| | - Jacques Touchon
- Department of Neurology and Memory Research and Resources Center, Gui de Chauliac University Hospital, Montpellier, France
| | - Patrice Douillet
- Department of Neurology and Memory Research and Resources Center, Gui de Chauliac University Hospital, Montpellier, France
| | - Claudine Berr
- Department of Neurology and Memory Research and Resources Center, Gui de Chauliac University Hospital, Montpellier, France; INSERM U 1061-Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Sylvain Lehmann
- CHRU de Montpellier, Université de Montpellier, Institute of Regenerative Medicine and Bio-therapy (IRMB), INSERM U1183, CCBHM, Laboratoire de Biochimie Protéomique Clinique, Montpellier, France
| | - Audrey Gabelle
- Department of Neurology and Memory Research and Resources Center, Gui de Chauliac University Hospital, Montpellier, France; CHRU de Montpellier, Université de Montpellier, Institute of Regenerative Medicine and Bio-therapy (IRMB), INSERM U1183, CCBHM, Laboratoire de Biochimie Protéomique Clinique, Montpellier, France
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Spellman DS, Wildsmith KR, Honigberg LA, Tuefferd M, Baker D, Raghavan N, Nairn AC, Croteau P, Schirm M, Allard R, Lamontagne J, Chelsky D, Hoffmann S, Potter WZ. Development and evaluation of a multiplexed mass spectrometry based assay for measuring candidate peptide biomarkers in Alzheimer's Disease Neuroimaging Initiative (ADNI) CSF. Proteomics Clin Appl 2015; 9:715-31. [PMID: 25676562 DOI: 10.1002/prca.201400178] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 12/19/2014] [Accepted: 02/05/2015] [Indexed: 11/09/2022]
Abstract
PURPOSE We describe the outcome of the Biomarkers Consortium CSF Proteomics Project (where CSF is cerebral spinal fluid), a public-private partnership of government, academia, nonprofit, and industry. The goal of this study was to evaluate a multiplexed MS-based approach for the qualification of candidate Alzheimer's disease (AD) biomarkers using CSF samples from the AD Neuroimaging Initiative. EXPERIMENTAL DESIGN Reproducibility of sample processing, analytic variability, and ability to detect a variety of analytes of interest were thoroughly investigated. Multiple approaches to statistical analyses assessed whether panel analytes were associated with baseline pathology (mild cognitive impairment (MCI), AD) versus healthy controls or associated with progression for MCI patients, and included (i) univariate association analyses, (ii) univariate prediction models, (iii) exploratory multivariate analyses, and (iv) supervised multivariate analysis. RESULTS A robust targeted MS-based approach for the qualification of candidate AD biomarkers was developed. The results identified several peptides with potential diagnostic or predictive utility, with the most significant differences observed for the following peptides for differentiating (including peptides from hemoglobin A, hemoglobin B, and superoxide dismutase) or predicting (including peptides from neuronal pentraxin-2, neurosecretory protein VGF (VGF), and secretogranin-2) progression versus nonprogression from MCI to AD. CONCLUSIONS AND CLINICAL RELEVANCE These data provide potential insights into the biology of CSF in AD and MCI progression and provide a novel tool for AD researchers and clinicians working to improve diagnostic accuracy, evaluation of treatment efficacy, and early diagnosis.
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Affiliation(s)
- Daniel S Spellman
- Department of Pharmacokinetics, Pharmacodynamics and Drug Metabolism, Merck Research Laboratories, Pennsylvania, PA, USA
| | - Kristin R Wildsmith
- Department of Pharmacodynamic Biomarkers within Development Sciences, Genentech, Inc (a member of the Roche Group), South San Francisco, CA, USA
| | - Lee A Honigberg
- Department of Pharmacodynamic Biomarkers within Development Sciences, Genentech, Inc (a member of the Roche Group), South San Francisco, CA, USA
| | - Marianne Tuefferd
- Discovery Sciences, Janssen Research & Development LLC, Pharmaceutical Companies of Johnson & Johnson, Beerse, Belgium
| | - David Baker
- Janssen Research & Development LLC, Titusville, NJ, USA
| | | | - Angus C Nairn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | | | - Rene Allard
- Caprion Pharmaceuticals, Montreal, QC, Canada
| | | | | | - Steven Hoffmann
- Foundation for the National Institutes of Health, Inc, Bethesda, MD, USA
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91
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Ewers M, Mattsson N, Minthon L, Molinuevo JL, Antonell A, Popp J, Jessen F, Herukka SK, Soininen H, Maetzler W, Leyhe T, Bürger K, Taniguchi M, Urakami K, Lista S, Dubois B, Blennow K, Hampel H. CSF biomarkers for the differential diagnosis of Alzheimer's disease: A large-scale international multicenter study. Alzheimers Dement 2015; 11:1306-15. [PMID: 25804998 DOI: 10.1016/j.jalz.2014.12.006] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 12/02/2014] [Accepted: 12/05/2014] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The aim of this study was to test the diagnostic value of cerebrospinal fluid (CSF) beta-amyloid (Aβ1-42), phosphorylated tau, and total tau (tau) to discriminate Alzheimer's disease (AD) dementia from other forms of dementia. METHODS A total of 675 CSF samples collected at eight memory clinics were obtained from healthy controls, AD dementia, subjective memory impairment, mild cognitive impairment, vascular dementia, Lewy body dementia (LBD), fronto-temporal dementia (FTD), depression, or other neurological diseases. RESULTS CSF Aβ1-42 showed the best diagnostic accuracy among the CSF biomarkers. At a sensitivity of 85%, the specificity to differentiate AD dementia against other diagnoses ranged from 42% (for LBD, 95% confidence interval or CI = 32-62) to 77% (for FTD, 95% CI = 62-90). DISCUSSION CSF Aβ1-42 discriminates AD dementia from FTD, but shows significant overlap with other non-AD forms of dementia, possibly reflecting the underlying mixed pathologies.
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Affiliation(s)
- Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilian-University, Munich, Bayern, Germany.
| | - Niklas Mattsson
- Department of Radiology, University of California San Francisco, San Francisco, CA, USA; Institute of Neuroscience & Physiology, Department of Psychiatry & Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Lennart Minthon
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden; Neuropsychiatric Clinic, Malmö University Hospital, Malmö, Sweden
| | - José L Molinuevo
- Alzheimer's disease and other cognitive disorders unit, Neurology Service, ICN Hospital Clinic i Universitari and Pasqual Maragall Foundation, Barcelona, Spain
| | - Anna Antonell
- Alzheimer's disease and other cognitive disorders unit, Neurology Service, ICN Hospital Clinic i Universitari and Pasqual Maragall Foundation, Barcelona, Spain
| | - Julius Popp
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Nordrhein-Westfalen, Germany; Department of Psychiatry, University Hospital of Lausanne, Lausanne, Waadt, Switzerland
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Nordrhein-Westfalen, Germany
| | - Sanna-Kaisa Herukka
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Hilka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Walter Maetzler
- Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany; DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Thomas Leyhe
- Department of Psychiatry and Psychotherapy, University Hospital, Tübingen, Germany
| | - Katharina Bürger
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilian-University, Munich, Bayern, Germany
| | - Miyako Taniguchi
- Center of Old Age Psychiatry, Psychiatric University Hospital, Basel, Switzerland
| | - Katsuya Urakami
- Department of Biological Regulation, School of Health Science, Tottori University Faculty of Medicine, Yonago, Japan
| | - Simone Lista
- AXA Research Fund & UPMC Chair, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer & Institut du Cerveau et de la Moelle épinière (ICM), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France
| | - Bruno Dubois
- Sorbonne Universités, Université Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer & Institut du Cerveau et de la Moelle épinière (ICM), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France
| | - Kaj Blennow
- Institute of Neuroscience & Physiology, Department of Psychiatry & Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Harald Hampel
- AXA Research Fund & UPMC Chair, Paris, France; Sorbonne Universités, Université Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer & Institut du Cerveau et de la Moelle épinière (ICM), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France
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92
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Sattlecker M, Kiddle SJ, Newhouse S, Proitsi P, Nelson S, Williams S, Johnston C, Killick R, Simmons A, Westman E, Hodges A, Soininen H, Kłoszewska I, Mecocci P, Tsolaki M, Vellas B, Lovestone S, Dobson RJB. Alzheimer's disease biomarker discovery using SOMAscan multiplexed protein technology. Alzheimers Dement 2014; 10:724-34. [PMID: 24768341 DOI: 10.1016/j.jalz.2013.09.016] [Citation(s) in RCA: 144] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 09/06/2013] [Accepted: 09/24/2013] [Indexed: 12/26/2022]
Abstract
Blood proteins and their complexes have become the focus of a great deal of interest in the context of their potential as biomarkers of Alzheimer's disease (AD). We used a SOMAscan assay for quantifying 1001 proteins in blood samples from 331 AD, 211 controls, and 149 mild cognitive impaired (MCI) subjects. The strongest associations of protein levels with AD outcomes were prostate-specific antigen complexed to α1-antichymotrypsin (AD diagnosis), pancreatic prohormone (AD diagnosis, left entorhinal cortex atrophy, and left hippocampus atrophy), clusterin (rate of cognitive decline), and fetuin B (left entorhinal atrophy). Multivariate analysis found that a subset of 13 proteins predicted AD with an accuracy of area under the curve of 0.70. Our replication of previous findings provides further evidence that levels of these proteins in plasma are truly associated with AD. The newly identified proteins could be potential biomarkers and are worthy of further investigation.
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Affiliation(s)
- Martina Sattlecker
- King's College London, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust, London, UK
| | - Steven J Kiddle
- King's College London, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust, London, UK
| | - Stephen Newhouse
- King's College London, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust, London, UK
| | - Petroula Proitsi
- King's College London, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust, London, UK
| | | | | | - Caroline Johnston
- King's College London, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust, London, UK
| | - Richard Killick
- King's College London, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust, London, UK
| | - Andrew Simmons
- King's College London, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust, London, UK
| | - Eric Westman
- King's College London, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust, London, UK
| | - Angela Hodges
- King's College London, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust, London, UK
| | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | | | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Magda Tsolaki
- 3rd Department of Neurology, Aristotle University, Thessaloniki, Greece
| | - Bruno Vellas
- INSERM U 558, University of Toulouse, Toulouse, France
| | - Simon Lovestone
- King's College London, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust, London, UK
| | - Richard J B Dobson
- King's College London, Institute of Psychiatry, London, UK; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust, London, UK.
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93
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Fagan AM, Xiong C, Jasielec MS, Bateman RJ, Goate AM, Benzinger TLS, Ghetti B, Martins RN, Masters CL, Mayeux R, Ringman JM, Rossor MN, Salloway S, Schofield PR, Sperling RA, Marcus D, Cairns NJ, Buckles VD, Ladenson JH, Morris JC, Holtzman DM. Longitudinal change in CSF biomarkers in autosomal-dominant Alzheimer's disease. Sci Transl Med 2014; 6:226ra30. [PMID: 24598588 DOI: 10.1126/scitranslmed.3007901] [Citation(s) in RCA: 283] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Clinicopathological evidence suggests that the pathology of Alzheimer's disease (AD) begins many years before the appearance of cognitive symptoms. Biomarkers are required to identify affected individuals during this asymptomatic ("preclinical") stage to permit intervention with potential disease-modifying therapies designed to preserve normal brain function. Studies of families with autosomal-dominant AD (ADAD) mutations provide a unique and powerful means to investigate AD biomarker changes during the asymptomatic period. In this biomarker study, we collected cerebrospinal fluid (CSF), plasma, and in vivo amyloid imaging cross-sectional data at baseline in individuals from ADAD families enrolled in the Dominantly Inherited Alzheimer Network. Our study revealed reduced concentrations of CSF amyloid-β1-42 (Aβ1-42) associated with the presence of Aβ plaques, and elevated concentrations of CSF tau, ptau181 (phosphorylated tau181), and VILIP-1 (visinin-like protein-1), markers of neurofibrillary tangles and neuronal injury/death, in asymptomatic mutation carriers 10 to 20 years before their estimated age at symptom onset (EAO) and before the detection of cognitive deficits. When compared longitudinally, however, the concentrations of CSF biomarkers of neuronal injury/death within individuals decreased after their EAO, suggesting a slowing of acute neurodegenerative processes with symptomatic disease progression. These results emphasize the importance of longitudinal, within-person assessment when modeling biomarker trajectories across the course of the disease. If corroborated, this pattern may influence the definition of a positive neurodegenerative biomarker outcome in clinical trials.
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Affiliation(s)
- Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110, USA
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94
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Schade S, Mollenhauer B. Biomarkers in biological fluids for dementia with Lewy bodies. ALZHEIMERS RESEARCH & THERAPY 2014; 6:72. [PMID: 25478030 PMCID: PMC4255553 DOI: 10.1186/s13195-014-0072-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dementia with Lewy bodies (DLB) has become the second most common neurodegenerative dementia due to demographic ageing. Differential diagnosis is still troublesome especially in early stages of the disease, since there is a great clinical and neuropathological overlap primarily with Alzheimer's disease and Parkinson's disease. Therefore, more specific biomarkers, not only for scientific reasons but also for clinical therapeutic decision-making, are urgently needed. In this review, we summarize the knowledge on fluid biomarkers for DLB, derived predominantly from cerebrospinal fluid. We discuss the value of well-defined markers (β-amyloid, (phosphorylated) tau, α-synuclein) as well as some promising 'upcoming' substances, which still have to be further evaluated.
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Affiliation(s)
- Sebastian Schade
- Paracelsus-Elena-Klinik, Klinikstraße 16, Kassel, D-34128, Germany ; Department of Clinical Neurophysiology, University Medical Center, Georg-August University, Robert-Koch Straße 40, Göttingen, 37075, Germany
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Klinikstraße 16, Kassel, D-34128, Germany ; Department of Neurosurgery, University Medical Center, Georg-August University, Robert-Koch Straße 40, Göttingen, 37075, Germany ; Department of Neuropathology, University Medical Center, Georg-August University, Robert-Koch Straße 40, Göttingen, 37075, Germany
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95
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Hussain M, Berger M, Eckenhoff RG, Seitz DP. General anesthetic and the risk of dementia in elderly patients: current insights. Clin Interv Aging 2014; 9:1619-28. [PMID: 25284995 PMCID: PMC4181446 DOI: 10.2147/cia.s49680] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
In this review, we aim to provide clinical insights into the relationship between surgery, general anesthesia (GA), and dementia, particularly Alzheimer’s disease (AD). The pathogenesis of AD is complex, involving specific disease-linked proteins (amyloid-beta [Aβ] and tau), inflammation, and neurotransmitter dysregulation. Many points in this complex pathogenesis can potentially be influenced by both surgery and anesthetics. It has been demonstrated in some in vitro, animal, and human studies that some anesthetics are associated with increased aggregation and oligomerization of Aβ peptide and enhanced accumulation and hyperphosphorylation of tau protein. Two neurocognitive syndromes that have been studied in relation to surgery and anesthesia are postoperative delirium and postoperative cognitive dysfunction, both of which occur more commonly in older adults after surgery and anesthesia. Neither the route of anesthesia nor the type of anesthetic appears to be significantly associated with the development of postoperative delirium or postoperative cognitive dysfunction. A meta-analysis of case-control studies found no association between prior exposure to surgery utilizing GA and incident AD (pooled odds ratio =1.05, P=0.43). The few cohort studies on this topic have shown varying associations between surgery, GA, and AD, with one showing an increased risk, and another demonstrating a decreased risk. A recent randomized trial has shown that patients who received sevoflurane during spinal surgery were more likely to have progression of preexisting mild cognitive impairment compared to controls and to patients who received propofol or epidural anesthesia. Given the inconsistent evidence on the association between surgery, anesthetic type, and AD, well-designed and adequately powered studies with longer follow-up periods are required to establish a clear causal association between surgery, GA, and AD.
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Affiliation(s)
- Maria Hussain
- Division of Geriatric Psychiatry, Department of Psychiatry, Queen's University, Durham, NC, USA
| | - Miles Berger
- Anesthesiology Department, Duke University Medical Center, Durham, NC, USA
| | - Roderic G Eckenhoff
- Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Dallas P Seitz
- Division of Geriatric Psychiatry, Department of Psychiatry, Queen's University, Durham, NC, USA
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96
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Qiu Y, Li L, Zhou TY, Lu W. Alzheimer's disease progression model based on integrated biomarkers and clinical measures. Acta Pharmacol Sin 2014; 35:1111-20. [PMID: 25088003 DOI: 10.1038/aps.2014.57] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Accepted: 05/16/2014] [Indexed: 12/15/2022] Open
Abstract
AIM Biomarkers and image markers of Alzheimer's disease (AD), such as cerebrospinal fluid Aβ42 and p-tau, are effective predictors of cognitive decline or dementia. The aim of this study was to integrate these markers with a disease progression model and to identify their abnormal ranges. METHODS The data of 395 participants, including 86 normal subjects, 108 early mild cognitive impairment (EMCI) subjects, 120 late mild cognitive impairment (LMCI) subjects, and 81 AD subjects were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. For the participants, baseline and long-term data on cerebrospinal fluid Aβ42 and p-tau, hippocampal volume, and ADAS-cog were available. Various linear and nonlinear models were tested to determine the associations among the ratio of Aβ42 to p-tau (the Ratio), hippocampal volume and ADAS-cog. RESULTS The most likely models for the Ratio, hippocampal volume, and ADAS-cog (logistic, Emax, and linear models, respectively) were used to construct the final model. Baseline disease state had an impact on all the 3 endpoints (the Ratio, hippocampal volume, and ADAS-cog), while APOEε4 genotype and age only influence the Ratio and hippocampal volume. CONCLUSION The Ratio can be used to identify the disease stage for an individual, and clinical measures integrated with the Ratio improve the accuracy of mild cognitive impairment (MCI) to AD conversion forecasting.
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97
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Koppel J, Jimenez H, Azose M, D'Abramo C, Acker C, Buthorn J, Greenwald BS, Lewis J, Lesser M, Liu Z, Davies P. Pathogenic tau species drive a psychosis-like phenotype in a mouse model of Alzheimer's disease. Behav Brain Res 2014; 275:27-33. [PMID: 25151619 DOI: 10.1016/j.bbr.2014.08.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 08/11/2014] [Accepted: 08/13/2014] [Indexed: 01/30/2023]
Abstract
Psychotic Alzheimer's disease (AD+P) is a rapidly progressive variant of AD associated with an increased burden of frontal tau pathology that affects up to 50% of those with AD, and is observed more commonly in females. To date, there are no safe and effective medication interventions with an indication for treatment in this condition, and there has been only very limited exploration of potential animal models for pre-clinical drug development. Pathogenic tau is over represented in the frontal cortex in AD+P, especially in females. In order to develop a candidate animal model of AD+P, we employed a tau mouse model with a heavy burden of frontal tau pathology, the rTg(tauP301L)4510 mouse, hereafter termed rTg4510. We explored deficits of prepulse inhibition of acoustic startle (PPI), a model of psychosis in rodents, and the correlation between pathogenic phospho-tau species associated with AD+P and PPI deficits in female mice. We found that female rTg4510 mice exhibit increasing PPI deficits relative to littermate controls from 4.5 to 5.5 months of age, and that these deficits are driven by insoluble fractions of the phospho-tau species pSer396/404, pSer202, and pThr231 found to be associated with human AD+P. This preliminary data suggests the utility of the rTg4510 mouse as a candidate disease model of human female AD+P. Further work expanded to include both genders and other behavioral outcome measures relevant to AD+P is necessary.
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Affiliation(s)
- J Koppel
- The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA.
| | - H Jimenez
- The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
| | - M Azose
- Touro College, Brooklyn, NY, USA
| | - C D'Abramo
- The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
| | - C Acker
- The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
| | - J Buthorn
- The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
| | - B S Greenwald
- The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
| | - J Lewis
- Center for Translational Research in Neurodegenerative Disease, University of Florida College of Medicine, Gainesville, FL, USA
| | - M Lesser
- The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
| | - Z Liu
- Hofstra University, Hempstead, LI, USA
| | - P Davies
- The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA
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98
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CSF Biomarkers of Alzheimer’s Disease: Impact on Disease Concept, Diagnosis, and Clinical Trial Design. ACTA ACUST UNITED AC 2014. [DOI: 10.1155/2014/302712] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Data from clinicopathologic and biomarker studies have converged to support the view of Alzheimer’s disease (AD) as a continuum, with pathology developing decades prior to the onset of cognitive symptoms which culminate as dementia at the end stage of the disease. This concept is impacting disease nomenclature, diagnostic criteria, prognostic potential, and clinical trial design. Revisions to diagnostic criteria to incorporate biomarker results have recently been proposed in order to increase the confidence of AD as the underlying etiology of a clinical impairment and to permit a diagnosis of AD across the disease continuum, eventually perhaps in the asymptomatic period. Individuals in this preclinical stage are receiving intense focus as a targeted population for secondary prevention trials aimed at identifying disease-modifying therapies that have the best chance of preserving normal cognitive function. The goal is to bring validated biomarkers to clinical practice for the purpose of disease diagnosis, prognosis, and evaluation of therapeutic efficacy once disease-modifying treatments become available. Realization of this goal requires worldwide biomarker standardization efforts, consensus among researchers and clinicians regarding the clinical utility of assessing biomarkers in patient care settings, and eventually the endorsement and adoption of such procedures and practices into global health care systems.
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Hohman TJ, Koran MEI, Thornton-Wells TA. Genetic variation modifies risk for neurodegeneration based on biomarker status. Front Aging Neurosci 2014; 6:183. [PMID: 25140149 PMCID: PMC4121544 DOI: 10.3389/fnagi.2014.00183] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 07/08/2014] [Indexed: 12/14/2022] Open
Abstract
Background: While a great deal of work has gone into understanding the relationship between Cerebrospinal fluid (CSF) biomarkers, brain atrophy, and disease progression, less work has attempted to investigate how genetic variation modifies these relationships. The goal of this study was two-fold. First, we sought to identify high-risk vs. low-risk individuals based on their CSF tau and Aβ load and characterize these individuals with regard to brain atrophy in an AD-relevant region of interest. Next, we sought to identify genetic variants that modified the relationship between biomarker classification and neurodegeneration. Methods: Participants were categorized based on established cut-points for biomarker positivity. Mixed model regression was used to quantify longitudinal change in the left inferior lateral ventricle. Interaction analyses between single nucleotide polymorphisms (SNPs) and biomarker group status were performed using a genome wide association study (GWAS) approach. Correction for multiple comparisons was performed using the Bonferroni procedure. Results: One intergenic SNP (rs4866650) and one SNP within the SPTLC1 gene (rs7849530) modified the association between amyloid positivity and neurodegeneration. A transcript variant of WDR11-AS1 gene (rs12261764) modified the association between tau positivity and neurodegeneration. These effects were consistent across the two sub-datasets and explained approximately 3% of variance in ventricular dilation. One additional SNP (rs6887649) modified the association between amyloid positivity and baseline ventricular volume, but was not observed consistently across the sub-datasets. Conclusions: Genetic variation modifies the association between AD biomarkers and neurodegeneration. Genes that regulate the molecular response in the brain to oxidative stress may be particularly relevant to neural vulnerability to the damaging effects of amyloid-β.
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Affiliation(s)
- Timothy J Hohman
- Department of Molecular Physiology and Biophysics, Center for Human Genetics and Research, Vanderbilt University School of Medicine Nashville, TN, USA
| | - Mary Ellen I Koran
- Department of Molecular Physiology and Biophysics, Center for Human Genetics and Research, Vanderbilt University School of Medicine Nashville, TN, USA
| | - Tricia A Thornton-Wells
- Department of Molecular Physiology and Biophysics, Center for Human Genetics and Research, Vanderbilt University School of Medicine Nashville, TN, USA
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Wildsmith KR, Schauer SP, Smith AM, Arnott D, Zhu Y, Haznedar J, Kaur S, Mathews WR, Honigberg LA. Identification of longitudinally dynamic biomarkers in Alzheimer's disease cerebrospinal fluid by targeted proteomics. Mol Neurodegener 2014; 9:22. [PMID: 24902845 PMCID: PMC4061120 DOI: 10.1186/1750-1326-9-22] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 05/13/2014] [Indexed: 01/01/2023] Open
Abstract
Background Alzheimer’s disease (AD) is the leading cause of dementia affecting greater than 26 million people worldwide. Although cerebrospinal fluid (CSF) levels of Aβ42, tau, and p-tau181 are well established as diagnostic biomarkers of AD, there is a need for additional CSF biomarkers of neuronal function that continue to change during disease progression and could be used as pharmacodynamic measures in clinical trials. Multiple proteomic discovery experiments have reported a range of CSF biomarkers that differ between AD and control subjects. These potential biomarkers represent multiple aspects of the disease pathology. The performance of these markers has not been compared with each other, and their performance has not been evaluated longitudinally. Results We developed a targeted-proteomic, multiple reaction monitoring (MRM) assay for the absolute quantitation of 39 peptides corresponding to 30 proteins. We evaluated the candidate biomarkers in longitudinal CSF samples collected from aged, cognitively-normal control (n = 10), MCI (n = 5), and AD (n = 45) individuals (age > 60 years). We evaluated each biomarker for diagnostic sensitivity, longitudinal consistency, and compared with CSF Aβ42, tau, and p-tau181. Four of 28 quantifiable CSF proteins were significantly different between aged, cognitively-normal controls and AD subjects including chitinase-3-like protein 1, reproducing published results. Four CSF markers demonstrated significant longitudinal change in AD: Amyloid precursor protein, Neuronal pentraxin receptor, NrCAM and Chromogranin A. Robust correlations were observed within some subgroups of proteins including the potential disease progression markers. Conclusion Using a targeted proteomics approach, we confirmed previous findings for a subset of markers, defined longitudinal performance of our panel of markers, and established a flexible proteomics method for robust multiplexed analyses.
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Affiliation(s)
- Kristin R Wildsmith
- Department of Phamacodynamic Biomarkers within Development Sciences, Genentech, Inc, (a member of the Roche Group), 1 DNA Way, South San Francisco, CA 94080, USA.
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