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McKay NS, Dincer A, Mehrotra V, Aschenbrenner AJ, Balota D, Hornbeck RC, Hassenstab J, Morris JC, Benzinger TLS, Gordon BA. Beta-amyloid moderates the relationship between cortical thickness and attentional control in middle- and older-aged adults. Neurobiol Aging 2022; 112:181-190. [PMID: 35227946 PMCID: PMC9208719 DOI: 10.1016/j.neurobiolaging.2021.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 12/13/2021] [Accepted: 12/28/2021] [Indexed: 12/13/2022]
Abstract
Although often unmeasured in studies of cognition, many older adults possess Alzheimer disease (AD) pathologies such as beta-amyloid (Aβ) deposition, despite being asymptomatic. We were interested in examining whether the behavior-structure relationship observed in later life was altered by the presence of preclinical AD pathology. A total of 511 cognitively unimpaired adults completed magnetic resonance imaging and three attentional control tasks; a subset (n = 396) also underwent Aβ-positron emissions tomography. A vertex-wise model was conducted to spatially represent the relationship between cortical thickness and average attentional control accuracy, while moderation analysis examined whether Aβ deposition impacted this relationship. First, we found that reduced cortical thickness in temporal, medial- and lateral-parietal, and dorsolateral prefrontal cortex, predicted worse performance on the attention task composite. Subsequent moderation analyses observed that levels of Aβ significantly influence the relationship between cortical thickness and attentional control. Our results support the hypothesis that preclinical AD, as measured by Aβ deposition, is partially driving what would otherwise be considered general aging in a cognitively normal adult population.
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Affiliation(s)
- Nicole S McKay
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO; Knight Alzheimer's Disease Research Center, Washington University in St. Louis, MO.
| | - Aylin Dincer
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO; Knight Alzheimer's Disease Research Center, Washington University in St. Louis, MO
| | | | - Andrew J Aschenbrenner
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, MO; Department of Neurology, Washington School of Medicine, St. Louis, MO
| | - David Balota
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, MO; Department of Psychological and Brain Sciences, Washington University in St. Louis, MO
| | - Russ C Hornbeck
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO; Knight Alzheimer's Disease Research Center, Washington University in St. Louis, MO
| | - Jason Hassenstab
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, MO; Department of Neurology, Washington School of Medicine, St. Louis, MO; Department of Psychological and Brain Sciences, Washington University in St. Louis, MO
| | - John C Morris
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, MO; Department of Neurology, Washington School of Medicine, St. Louis, MO
| | - Tammie L S Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO; Knight Alzheimer's Disease Research Center, Washington University in St. Louis, MO
| | - Brian A Gordon
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO; Knight Alzheimer's Disease Research Center, Washington University in St. Louis, MO; Department of Psychological and Brain Sciences, Washington University in St. Louis, MO
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52
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Rahmani F, Nguyen M, Chen CD, McKay N, Dincer A, Joseph-Mathurin N, Chen G, Liu J, Orlowski HLP, Morris JC, Benzinger TLS. Intracranial internal carotid artery calcification is not predictive of future cognitive decline. Alzheimers Res Ther 2022; 14:32. [PMID: 35148796 PMCID: PMC8832765 DOI: 10.1186/s13195-022-00972-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/31/2022] [Indexed: 12/26/2022]
Abstract
Background Intracranial internal carotid artery (ICA) calcification is a common incidental finding in non-contrast head CT. We evaluated the predictive value of ICAC (ICAC) for future risk of cognitive decline and compared the results with conventional imaging biomarkers of dementia. Methods In a retrospective observational cohort, we included 230 participants with a PET-CT scan within 18 months of a baseline clinical assessment and longitudinal imaging assessments. Intracranial ICAC was quantified on baseline CT scans using the Agatson calcium score, and the association between baseline ICA calcium scores and the risk of conversion from a CDR of zero in baseline to a persistent CDR > 0 at any follow-up visit, as well as longitudinal changes in cognitive scores, were evaluated through linear and mixed regression models. We also evaluated the association of conventional imaging biomarkers of dementia with longitudinal changes in cognitive scores and a potential indirect effect of ICAC on cognition through these biomarkers. Results Baseline ICA calcium score could not distinguish participants who converted to CDR > 0. ICA calcium score was also unable to predict longitudinal changes in cognitive scores, imaging biomarkers of small vessel disease such as white matter hyperintensities (WMH) volume, or AD such as hippocampal volume, AD cortical signature thickness, and amyloid burden. Severity of intracranial ICAC increased with age and in men. Higher WMH volume and amyloid burden as well as lower hippocampal volume and AD cortical signature thickness at baseline predicted lower Mini-Mental State Exam scores at longitudinal follow-up. Baseline ICAC was indirectly associated with longitudinal cognitive decline, fully mediated through WMH volume. Conclusions In elderly and preclinical AD populations, atherosclerosis of large intracranial vessels as demonstrated through ICAC is not directly associated with a future risk of cognitive impairment, or progression of imaging biomarkers of AD or small vessel disease.
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Affiliation(s)
- Farzaneh Rahmani
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, 510 South Kingshighway Boulevard, Campus Box 8131, St. Louis, MO, 63110, USA.,Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, MO, USA
| | - Marina Nguyen
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, 510 South Kingshighway Boulevard, Campus Box 8131, St. Louis, MO, 63110, USA.,Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, MO, USA
| | - Charles D Chen
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, 510 South Kingshighway Boulevard, Campus Box 8131, St. Louis, MO, 63110, USA.,Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, MO, USA
| | - Nicole McKay
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, 510 South Kingshighway Boulevard, Campus Box 8131, St. Louis, MO, 63110, USA.,Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, MO, USA
| | - Aylin Dincer
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, 510 South Kingshighway Boulevard, Campus Box 8131, St. Louis, MO, 63110, USA.,Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, MO, USA
| | - Nelly Joseph-Mathurin
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, 510 South Kingshighway Boulevard, Campus Box 8131, St. Louis, MO, 63110, USA.,Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, MO, USA
| | - Gengsheng Chen
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, 510 South Kingshighway Boulevard, Campus Box 8131, St. Louis, MO, 63110, USA.,Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, MO, USA
| | - Jingxia Liu
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA.,Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine (WUSM), St. Louis, MO, USA
| | - Hilary L P Orlowski
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, 510 South Kingshighway Boulevard, Campus Box 8131, St. Louis, MO, 63110, USA
| | - John C Morris
- Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, MO, USA.,Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Tammie L S Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, 510 South Kingshighway Boulevard, Campus Box 8131, St. Louis, MO, 63110, USA. .,Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, MO, USA.
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Koenig LN, LaMontagne P, Glasser MF, Bateman R, Holtzman D, Yakushev I, Chhatwal J, Day GS, Jack C, Mummery C, Perrin RJ, Gordon BA, Morris JC, Shimony JS, Benzinger TL. Regional age-related atrophy after screening for preclinical alzheimer disease. Neurobiol Aging 2022; 109:43-51. [PMID: 34655980 PMCID: PMC9009406 DOI: 10.1016/j.neurobiolaging.2021.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/15/2021] [Accepted: 09/07/2021] [Indexed: 01/03/2023]
Abstract
Brain atrophy occurs in aging even in the absence of dementia, but it is unclear to what extent this is due to undetected preclinical Alzheimer disease. Here we examine a cross-sectional cohort (ages 18-88) free from confounding influence of preclinical Alzheimer disease, as determined by amyloid PET scans and three years of clinical evaluation post-imaging. We determine the regional strength of age-related atrophy using linear modeling of brain volumes and cortical thicknesses with age. Age-related atrophy was seen in nearly all regions, with greatest effects in the temporal lobe and subcortical regions. When modeling age with the estimated derivative of smoothed aging curves, we found that the temporal lobe declined linearly with age, subcortical regions declined faster at later ages, and frontal regions declined slower at later ages than during midlife. This age-derivative pattern was distinct from the linear measure of age-related atrophy and significantly associated with a measure of myelin. Atrophy did not detectably differ from a preclinical Alzheimer disease cohort when age ranges were matched.
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Affiliation(s)
- Lauren N. Koenig
- Department of Radiology, Washington Universit, St Louis, MO, USA
| | | | - Matthew F. Glasser
- Department of Radiology, Washington Universit, St Louis, MO, USA,Department of Neuroscience, Washington University School of Medicine, St Louis, MO USA
| | - Randall Bateman
- Department of Neurology, Washington University, St. Louis, MO, USA,Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, School of Medicine, St. Louis, MO, USA
| | - David Holtzman
- Department of Neurology, Washington University, St. Louis, MO, USA,Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, School of Medicine, St. Louis, MO, USA,Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - Igor Yakushev
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany
| | - Jasmeer Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gregory S Day
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Clifford Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Catherine Mummery
- Dementia Research Center, UCL Queen Square Institute of Neurology, London, UK
| | - Richard J. Perrin
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, School of Medicine, St. Louis, MO, USA,Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian A. Gordon
- Department of Neurology, Washington University, St. Louis, MO, USA,Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, School of Medicine, St. Louis, MO, USA,Department of Psychological & Brain Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - John C. Morris
- Department of Neurology, Washington University, St. Louis, MO, USA,Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, School of Medicine, St. Louis, MO, USA
| | | | - Tammie L.S. Benzinger
- Department of Radiology, Washington Universit, St Louis, MO, USA,Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, School of Medicine, St. Louis, MO, USA,Corresponding author at: University School of Medicine, 660 South Euclid, Campus 8131, St. Louis, MO 63110, Tel.: (314) 362-1558, fax: (314) 362-6110. (T.L.S. Benzinger)
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Rahmani F, Wang Q, McKay NS, Keefe S, Hantler N, Hornbeck R, Wang Y, Hassenstab J, Schindler S, Xiong C, Morris JC, Benzinger TL, Raji CA. Sex-Specific Patterns of Body Mass Index Relationship with White Matter Connectivity. J Alzheimers Dis 2022; 86:1831-1848. [PMID: 35180116 PMCID: PMC9108572 DOI: 10.3233/jad-215329] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Obesity is an increasingly recognized modifiable risk factor for Alzheimer's disease (AD). Increased body mass index (BMI) is related to distinct changes in white matter (WM) fiber density and connectivity. OBJECTIVE We investigated whether sex differentially affects the relationship between BMI and WM structural connectivity. METHODS A cross-sectional sample of 231 cognitively normal participants were enrolled from the Knight Alzheimer Disease Research Center. Connectome analyses were done with diffusion data reconstructed using q-space diffeomorphic reconstruction to obtain the spin distribution function and tracts were selected using a deterministic fiber tracking algorithm. RESULTS We identified an inverse relationship between higher BMI and lower connectivity in the associational fibers of the temporal lobe in overweight and obese men. Normal to overweight women showed a significant positive association between BMI and connectivity in a wide array of WM fibers, an association that reversed in obese and morbidly obese women. Interaction analyses revealed that with increasing BMI, women showed higher WM connectivity in the bilateral frontoparietal and parahippocampal parts of the cingulum, while men showed lower connectivity in right sided corticostriatal and corticopontine tracts. Subgroup analyses demonstrated comparable results in participants with and without positron emission tomography or cerebrospinal fluid evidence of brain amyloidosis, indicating that the relationship between BMI and structural connectivity in men and women is independent of AD biomarker status. CONCLUSION BMI influences structural connectivity of WM differently in men and women across BMI categories and this relationship does not vary as a function of preclinical AD.
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Affiliation(s)
- Farzaneh Rahmani
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Qing Wang
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Nicole S. McKay
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Sarah Keefe
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Nancy Hantler
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Russ Hornbeck
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Yong Wang
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Jason Hassenstab
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Suzanne Schindler
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Chengjie Xiong
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA
| | - John C. Morris
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, MO, USA
| | - Tammie L.S. Benzinger
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA
- Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, MO, USA
| | - Cyrus A. Raji
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
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Schindler SE, Li Y, Buckles VD, Gordon BA, Benzinger TLS, Wang G, Coble D, Klunk WE, Fagan AM, Holtzman DM, Bateman RJ, Morris JC, Xiong C. Predicting Symptom Onset in Sporadic Alzheimer Disease With Amyloid PET. Neurology 2021; 97:e1823-e1834. [PMID: 34504028 PMCID: PMC8610624 DOI: 10.1212/wnl.0000000000012775] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/12/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To predict when cognitively normal individuals with brain amyloidosis will develop symptoms of Alzheimer disease (AD). METHODS Brain amyloid burden was measured by amyloid PET with Pittsburgh compound B. The mean cortical standardized uptake value ratio (SUVR) was transformed into a timescale with the use of longitudinal data. RESULTS Amyloid accumulation was evaluated in 236 individuals who underwent >1 amyloid PET scan. The average age was 66.5 ± 9.2 years, and 12 individuals (5%) had cognitive impairment at their baseline amyloid PET scan. A tipping point in amyloid accumulation was identified at a low level of amyloid burden (SUVR 1.2), after which nearly all individuals accumulated amyloid at a relatively consistent rate until reaching a high level of amyloid burden (SUVR 3.0). The average time between levels of amyloid burden was used to estimate the age at which an individual reached SUVR 1.2. Longitudinal clinical diagnoses for 180 individuals were aligned by the estimated age at SUVR 1.2. In the 22 individuals who progressed from cognitively normal to a typical AD dementia syndrome, the estimated age at which an individual reached SUVR 1.2 predicted the age at symptom onset (R 2 = 0.54, p < 0.0001, root mean square error [RMSE] 4.5 years); the model was more accurate after exclusion of 3 likely misdiagnoses (R 2 = 0.84, p < 0.0001, RMSE 2.8 years). CONCLUSION The age at symptom onset in sporadic AD is strongly correlated with the age at which an individual reaches a tipping point in amyloid accumulation.
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Affiliation(s)
- Suzanne E Schindler
- From the Department of Neurology (S.E.S., Y.L., V.D.B., A.M.F., D.M.H., R.J.B., J.C.M.), Knight Alzheimer Disease Research Center (S.E.S., V.D.B., B.A.G., T.L.S.B., G.W., D.C., A.M.F., D.M.H., R.J.B., J.C.M., C.X.), Division of Biostatistics (Y.L., G.W., D.C., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (A.M.F., D.M.H., R.J.B.), Washington University School of Medicine, St. Louis, MO; and Department of Neurology and Psychiatry (W.E.K.), University of Pittsburgh, PA.
| | - Yan Li
- From the Department of Neurology (S.E.S., Y.L., V.D.B., A.M.F., D.M.H., R.J.B., J.C.M.), Knight Alzheimer Disease Research Center (S.E.S., V.D.B., B.A.G., T.L.S.B., G.W., D.C., A.M.F., D.M.H., R.J.B., J.C.M., C.X.), Division of Biostatistics (Y.L., G.W., D.C., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (A.M.F., D.M.H., R.J.B.), Washington University School of Medicine, St. Louis, MO; and Department of Neurology and Psychiatry (W.E.K.), University of Pittsburgh, PA
| | - Virginia D Buckles
- From the Department of Neurology (S.E.S., Y.L., V.D.B., A.M.F., D.M.H., R.J.B., J.C.M.), Knight Alzheimer Disease Research Center (S.E.S., V.D.B., B.A.G., T.L.S.B., G.W., D.C., A.M.F., D.M.H., R.J.B., J.C.M., C.X.), Division of Biostatistics (Y.L., G.W., D.C., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (A.M.F., D.M.H., R.J.B.), Washington University School of Medicine, St. Louis, MO; and Department of Neurology and Psychiatry (W.E.K.), University of Pittsburgh, PA
| | - Brian A Gordon
- From the Department of Neurology (S.E.S., Y.L., V.D.B., A.M.F., D.M.H., R.J.B., J.C.M.), Knight Alzheimer Disease Research Center (S.E.S., V.D.B., B.A.G., T.L.S.B., G.W., D.C., A.M.F., D.M.H., R.J.B., J.C.M., C.X.), Division of Biostatistics (Y.L., G.W., D.C., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (A.M.F., D.M.H., R.J.B.), Washington University School of Medicine, St. Louis, MO; and Department of Neurology and Psychiatry (W.E.K.), University of Pittsburgh, PA
| | - Tammie L S Benzinger
- From the Department of Neurology (S.E.S., Y.L., V.D.B., A.M.F., D.M.H., R.J.B., J.C.M.), Knight Alzheimer Disease Research Center (S.E.S., V.D.B., B.A.G., T.L.S.B., G.W., D.C., A.M.F., D.M.H., R.J.B., J.C.M., C.X.), Division of Biostatistics (Y.L., G.W., D.C., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (A.M.F., D.M.H., R.J.B.), Washington University School of Medicine, St. Louis, MO; and Department of Neurology and Psychiatry (W.E.K.), University of Pittsburgh, PA
| | - Guoqiao Wang
- From the Department of Neurology (S.E.S., Y.L., V.D.B., A.M.F., D.M.H., R.J.B., J.C.M.), Knight Alzheimer Disease Research Center (S.E.S., V.D.B., B.A.G., T.L.S.B., G.W., D.C., A.M.F., D.M.H., R.J.B., J.C.M., C.X.), Division of Biostatistics (Y.L., G.W., D.C., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (A.M.F., D.M.H., R.J.B.), Washington University School of Medicine, St. Louis, MO; and Department of Neurology and Psychiatry (W.E.K.), University of Pittsburgh, PA
| | - Dean Coble
- From the Department of Neurology (S.E.S., Y.L., V.D.B., A.M.F., D.M.H., R.J.B., J.C.M.), Knight Alzheimer Disease Research Center (S.E.S., V.D.B., B.A.G., T.L.S.B., G.W., D.C., A.M.F., D.M.H., R.J.B., J.C.M., C.X.), Division of Biostatistics (Y.L., G.W., D.C., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (A.M.F., D.M.H., R.J.B.), Washington University School of Medicine, St. Louis, MO; and Department of Neurology and Psychiatry (W.E.K.), University of Pittsburgh, PA
| | - William E Klunk
- From the Department of Neurology (S.E.S., Y.L., V.D.B., A.M.F., D.M.H., R.J.B., J.C.M.), Knight Alzheimer Disease Research Center (S.E.S., V.D.B., B.A.G., T.L.S.B., G.W., D.C., A.M.F., D.M.H., R.J.B., J.C.M., C.X.), Division of Biostatistics (Y.L., G.W., D.C., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (A.M.F., D.M.H., R.J.B.), Washington University School of Medicine, St. Louis, MO; and Department of Neurology and Psychiatry (W.E.K.), University of Pittsburgh, PA
| | - Anne M Fagan
- From the Department of Neurology (S.E.S., Y.L., V.D.B., A.M.F., D.M.H., R.J.B., J.C.M.), Knight Alzheimer Disease Research Center (S.E.S., V.D.B., B.A.G., T.L.S.B., G.W., D.C., A.M.F., D.M.H., R.J.B., J.C.M., C.X.), Division of Biostatistics (Y.L., G.W., D.C., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (A.M.F., D.M.H., R.J.B.), Washington University School of Medicine, St. Louis, MO; and Department of Neurology and Psychiatry (W.E.K.), University of Pittsburgh, PA
| | - David M Holtzman
- From the Department of Neurology (S.E.S., Y.L., V.D.B., A.M.F., D.M.H., R.J.B., J.C.M.), Knight Alzheimer Disease Research Center (S.E.S., V.D.B., B.A.G., T.L.S.B., G.W., D.C., A.M.F., D.M.H., R.J.B., J.C.M., C.X.), Division of Biostatistics (Y.L., G.W., D.C., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (A.M.F., D.M.H., R.J.B.), Washington University School of Medicine, St. Louis, MO; and Department of Neurology and Psychiatry (W.E.K.), University of Pittsburgh, PA
| | - Randall J Bateman
- From the Department of Neurology (S.E.S., Y.L., V.D.B., A.M.F., D.M.H., R.J.B., J.C.M.), Knight Alzheimer Disease Research Center (S.E.S., V.D.B., B.A.G., T.L.S.B., G.W., D.C., A.M.F., D.M.H., R.J.B., J.C.M., C.X.), Division of Biostatistics (Y.L., G.W., D.C., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (A.M.F., D.M.H., R.J.B.), Washington University School of Medicine, St. Louis, MO; and Department of Neurology and Psychiatry (W.E.K.), University of Pittsburgh, PA
| | - John C Morris
- From the Department of Neurology (S.E.S., Y.L., V.D.B., A.M.F., D.M.H., R.J.B., J.C.M.), Knight Alzheimer Disease Research Center (S.E.S., V.D.B., B.A.G., T.L.S.B., G.W., D.C., A.M.F., D.M.H., R.J.B., J.C.M., C.X.), Division of Biostatistics (Y.L., G.W., D.C., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (A.M.F., D.M.H., R.J.B.), Washington University School of Medicine, St. Louis, MO; and Department of Neurology and Psychiatry (W.E.K.), University of Pittsburgh, PA
| | - Chengjie Xiong
- From the Department of Neurology (S.E.S., Y.L., V.D.B., A.M.F., D.M.H., R.J.B., J.C.M.), Knight Alzheimer Disease Research Center (S.E.S., V.D.B., B.A.G., T.L.S.B., G.W., D.C., A.M.F., D.M.H., R.J.B., J.C.M., C.X.), Division of Biostatistics (Y.L., G.W., D.C., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (A.M.F., D.M.H., R.J.B.), Washington University School of Medicine, St. Louis, MO; and Department of Neurology and Psychiatry (W.E.K.), University of Pittsburgh, PA
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56
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Chen CD, Joseph-Mathurin N, Sinha N, Zhou A, Li Y, Friedrichsen K, McCullough A, Franklin EE, Hornbeck R, Gordon B, Sharma V, Cruchaga C, Goate A, Karch C, McDade E, Xiong C, Bateman RJ, Ghetti B, Ringman JM, Chhatwal J, Masters CL, McLean C, Lashley T, Su Y, Koeppe R, Jack C, Klunk WE, Morris JC, Perrin RJ, Cairns NJ, Benzinger TLS. Comparing amyloid-β plaque burden with antemortem PiB PET in autosomal dominant and late-onset Alzheimer disease. Acta Neuropathol 2021; 142:689-706. [PMID: 34319442 PMCID: PMC8815340 DOI: 10.1007/s00401-021-02342-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/29/2021] [Accepted: 07/01/2021] [Indexed: 12/31/2022]
Abstract
Pittsburgh compound B (PiB) radiotracer for positron emission tomography (PET) imaging can bind to different types of amyloid-β plaques and blood vessels (cerebral amyloid angiopathy). However, the relative contributions of different plaque subtypes (diffuse versus cored/compact) to in vivo PiB PET signal on a region-by-region basis are incompletely understood. Of particular interest is whether the same staging schemes for summarizing amyloid-β burden are appropriate for both late-onset and autosomal dominant forms of Alzheimer disease (LOAD and ADAD). Here, we compared antemortem PiB PET with follow-up postmortem estimation of amyloid-β burden using stereologic methods to estimate the relative area fraction of diffuse and cored/compact amyloid-β plaques across 16 brain regions in 15 individuals with ADAD and 14 individuals with LOAD. In ADAD, we found that PiB PET correlated with diffuse plaques in the frontal, parietal, temporal, and striatal regions commonly used to summarize amyloid-β burden in PiB PET, and correlated with both diffuse and cored/compact plaques in the occipital lobe and parahippocampal gyrus. In LOAD, we found that PiB PET correlated with both diffuse and cored/compact plaques in the anterior cingulate, frontal lobe (middle frontal gyrus), and parietal lobe, and showed additional correlations with diffuse plaque in the amygdala and occipital lobe, and with cored/compact plaque in the temporal lobe. Thus, commonly used PiB PET summary regions predominantly reflect diffuse plaque burden in ADAD and a mixture of diffuse and cored/compact plaque burden in LOAD. In direct comparisons of ADAD and LOAD, postmortem stereology identified much greater mean amyloid-β plaque burdens in ADAD versus LOAD across almost all brain regions studied. However, standard PiB PET did not recapitulate these stereologic findings, likely due to non-trivial amyloid-β plaque burdens in ADAD within the cerebellum and brainstem-commonly used reference regions in PiB PET. Our findings suggest that PiB PET summary regions correlate with amyloid-β plaque burden in both ADAD and LOAD; however, they might not be reliable in direct comparisons of regional amyloid-β plaque burden between the two forms of AD.
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Affiliation(s)
- Charles D Chen
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Nelly Joseph-Mathurin
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Namita Sinha
- Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, USA
- Department of Pathology, University of Manitoba, Shared Health, Winnipeg, MB, Canada
| | - Aihong Zhou
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yan Li
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Karl Friedrichsen
- Department of Ophthalmology and Visual Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Austin McCullough
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Erin E Franklin
- Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, USA
| | - Russ Hornbeck
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Brian Gordon
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Vijay Sharma
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Alison Goate
- Department of Genetics and Genomic Sciences, Ichan School of Medicine at Mount Sinai, New York, NY, USA
| | - Celeste Karch
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Eric McDade
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Chengjie Xiong
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Randall J Bateman
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Bernardino Ghetti
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - John M Ringman
- Department of Neurology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Jasmeer Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Catriona McLean
- Department of Anatomic Pathology, Alfred Hospital, Melbourne, VIC, Australia
| | - Tammaryn Lashley
- UCL Queen Square Institute of Neurology, University College London, London, UK
- Queen Square Brain Bank for Neurological Disorders, University College London, London, UK
| | - Yi Su
- Banner Alzheimer's Institute, Banner Health, Phoenix, AZ, USA
- Arizona Alzheimer's Consortium, Banner Health, Phoenix, AZ, USA
| | - Robert Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Clifford Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - William E Klunk
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - John C Morris
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Richard J Perrin
- Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, USA
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Nigel J Cairns
- Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, USA
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Tammie L S Benzinger
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA.
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Hassenstab J, Nicosia J, LaRose M, Aschenbrenner AJ, Gordon BA, Benzinger TLS, Xiong C, Morris JC. Is comprehensiveness critical? Comparing short and long format cognitive assessments in preclinical Alzheimer disease. Alzheimers Res Ther 2021; 13:153. [PMID: 34517889 PMCID: PMC8436865 DOI: 10.1186/s13195-021-00894-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/24/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Comprehensive testing of cognitive functioning is standard practice in studies of Alzheimer disease (AD). Short-form tests like the Montreal Cognitive Assessment (MoCA) use a "sampling" of measures, administering key items in a shortened format to efficiently assess cognition while reducing time requirements, participant burden, and administrative costs. We compared the MoCA to a commonly used long-form cognitive battery in predicting AD symptom onset and sensitivity to AD neuroimaging biomarkers. METHODS Survival, area under the receiver operating characteristic (ROC) curve (AUC), and multiple regression analyses compared the MoCA and long-form measures in predicting time to symptom onset in cognitively normal older adults (n = 6230) from the National Alzheimer's Coordinating Center (NACC) cohort who had, on average, 2.3 ± 1.2 annual assessments. Multiple regression models in a separate sample (n = 416) from the Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC) compared the sensitivity of the MoCA and long-form measures to neuroimaging biomarkers including amyloid PET, tau PET, and cortical thickness. RESULTS Hazard ratios suggested that both the MoCA and the long-form measures are similarly and modestly efficacious in predicting symptomatic conversion, although model comparison analyses indicated that the long-form measures slightly outperformed the MoCA (HRs > 1.57). AUC analyses indicated no difference between the measures in predicting conversion (DeLong's test, Z = 1.48, p = 0.13). Sensitivity to AD neuroimaging biomarkers was similar for the two measures though there were only modest associations with tau PET (rs = - 0.13, ps < 0.02) and cortical thickness in cognitively normal participants (rs = 0.15-0.16, ps < 0.007). CONCLUSIONS Both test formats showed weak associations with symptom onset, AUC analyses indicated low diagnostic accuracy, and biomarker correlations were modest in cognitively normal participants. Alternative assessment approaches are needed to improve how clinicians and researchers monitor cognitive changes and disease progression prior to symptom onset.
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Affiliation(s)
- Jason Hassenstab
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA.
| | - Jessica Nicosia
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Megan LaRose
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrew J Aschenbrenner
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian A Gordon
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Chengjie Xiong
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
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58
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Pegueroles J, Montal V, Bejanin A, Vilaplana E, Aranha M, Santos‐Santos MA, Alcolea D, Carrió I, Camacho V, Blesa R, Lleó A, Fortea J. AMYQ: An index to standardize quantitative amyloid load across PET tracers. Alzheimers Dement 2021; 17:1499-1508. [PMID: 33797846 PMCID: PMC8519100 DOI: 10.1002/alz.12317] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/21/2021] [Accepted: 01/31/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Positron emission tomography (PET) amyloid quantification methods require magnetic resonance imaging (MRI) for spatial registration and a priori reference region to scale the images. Furthermore, different tracers have distinct thresholds for positivity. We propose the AMYQ index, a new measure of amyloid burden, to overcome these limitations. METHODS We selected 18F-amyloid scans from ADNI and Australian Imaging, Biomarker & Lifestyle Flagship Study of Ageing (AIBL) with the corresponding T1-MRI. A subset also had neuropathological data. PET images were normalized, and the AMYQ was calculated based on an adaptive template. We compared AMYQ with the Centiloid scale on clinical and neuropathological diagnostic performance. RESULTS AMYQ was related with amyloid neuropathological burden and had excellent diagnostic performance to discriminate controls from patients with Alzheimer's disease (AD) (area under the curve [AUC] = 0.86). AMYQ had a high agreement with the Centiloid scale (intraclass correlation coefficient [ICC] = 0.88) and AUC between 0.94 and 0.99 to discriminate PET positivity when using different Centiloid cutoffs. DISCUSSION AMYQ is a new MRI-independent index for standardizing and quantifying amyloid load across tracers.
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Affiliation(s)
- Jordi Pegueroles
- Sant Pau Memory Unit, Department of NeurologyHospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)MadridSpain
| | - Victor Montal
- Sant Pau Memory Unit, Department of NeurologyHospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)MadridSpain
| | - Alexandre Bejanin
- Sant Pau Memory Unit, Department of NeurologyHospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)MadridSpain
| | - Eduard Vilaplana
- Sant Pau Memory Unit, Department of NeurologyHospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)MadridSpain
| | - Mateus Aranha
- Sant Pau Memory Unit, Department of NeurologyHospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)MadridSpain
| | - Miguel Angel Santos‐Santos
- Sant Pau Memory Unit, Department of NeurologyHospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)MadridSpain
| | - Daniel Alcolea
- Sant Pau Memory Unit, Department of NeurologyHospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)MadridSpain
| | - Ignasi Carrió
- Department of Nuclear MedicineHospital de la Santa Creu i Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - Valle Camacho
- Department of Nuclear MedicineHospital de la Santa Creu i Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
| | - Rafael Blesa
- Sant Pau Memory Unit, Department of NeurologyHospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)MadridSpain
| | - Alberto Lleó
- Sant Pau Memory Unit, Department of NeurologyHospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)MadridSpain
| | - Juan Fortea
- Sant Pau Memory Unit, Department of NeurologyHospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)MadridSpain
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Wu J, Dong Q, Gui J, Zhang J, Su Y, Chen K, Thompson PM, Caselli RJ, Reiman EM, Ye J, Wang Y. Predicting Brain Amyloid Using Multivariate Morphometry Statistics, Sparse Coding, and Correntropy: Validation in 1,101 Individuals From the ADNI and OASIS Databases. Front Neurosci 2021; 15:669595. [PMID: 34421510 PMCID: PMC8377280 DOI: 10.3389/fnins.2021.669595] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/15/2021] [Indexed: 01/04/2023] Open
Abstract
Biomarker assisted preclinical/early detection and intervention in Alzheimer’s disease (AD) may be the key to therapeutic breakthroughs. One of the presymptomatic hallmarks of AD is the accumulation of beta-amyloid (Aβ) plaques in the human brain. However, current methods to detect Aβ pathology are either invasive (lumbar puncture) or quite costly and not widely available (amyloid PET). Our prior studies show that magnetic resonance imaging (MRI)-based hippocampal multivariate morphometry statistics (MMS) are an effective neurodegenerative biomarker for preclinical AD. Here we attempt to use MRI-MMS to make inferences regarding brain Aβ burden at the individual subject level. As MMS data has a larger dimension than the sample size, we propose a sparse coding algorithm, Patch Analysis-based Surface Correntropy-induced Sparse-coding and Max-Pooling (PASCS-MP), to generate a low-dimensional representation of hippocampal morphometry for each individual subject. Then we apply these individual representations and a binary random forest classifier to predict brain Aβ positivity for each person. We test our method in two independent cohorts, 841 subjects from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) and 260 subjects from the Open Access Series of Imaging Studies (OASIS). Experimental results suggest that our proposed PASCS-MP method and MMS can discriminate Aβ positivity in people with mild cognitive impairment (MCI) [Accuracy (ACC) = 0.89 (ADNI)] and in cognitively unimpaired (CU) individuals [ACC = 0.79 (ADNI) and ACC = 0.81 (OASIS)]. These results compare favorably relative to measures derived from traditional algorithms, including hippocampal volume and surface area, shape measures based on spherical harmonics (SPHARM) and our prior Patch Analysis-based Surface Sparse-coding and Max-Pooling (PASS-MP) methods.
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Affiliation(s)
- Jianfeng Wu
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - Qunxi Dong
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, United States.,Institute of Engineering Medicine, Beijing Institute of Technology, Beijing, China
| | - Jie Gui
- School of Cyber Science and Engineering, Southeast University, Nanjing, China
| | - Jie Zhang
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - Yi Su
- Banner Alzheimer's Institute, Phoenix, AZ, United States
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ, United States
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, University of Southern California, Marina del Rey, CA, United States
| | - Richard J Caselli
- Department of Neurology, Mayo Clinic Arizona, Scottsdale, AZ, United States
| | - Eric M Reiman
- Banner Alzheimer's Institute, Phoenix, AZ, United States
| | - Jieping Ye
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, United States
| | - Yalin Wang
- School of Computing, Informatics, and Decision Systems Engineering, Arizona State University, Tempe, AZ, United States
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A trial of gantenerumab or solanezumab in dominantly inherited Alzheimer's disease. Nat Med 2021; 27:1187-1196. [PMID: 34155411 PMCID: PMC8988051 DOI: 10.1038/s41591-021-01369-8] [Citation(s) in RCA: 176] [Impact Index Per Article: 58.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/23/2021] [Indexed: 02/06/2023]
Abstract
Dominantly inherited Alzheimer's disease (DIAD) causes predictable biological changes decades before the onset of clinical symptoms, enabling testing of interventions in the asymptomatic and symptomatic stages to delay or slow disease progression. We conducted a randomized, placebo-controlled, multi-arm trial of gantenerumab or solanezumab in participants with DIAD across asymptomatic and symptomatic disease stages. Mutation carriers were assigned 3:1 to either drug or placebo and received treatment for 4-7 years. The primary outcome was a cognitive end point; secondary outcomes included clinical, cognitive, imaging and fluid biomarker measures. Fifty-two participants carrying a mutation were assigned to receive gantenerumab, 52 solanezumab and 40 placebo. Both drugs engaged their Aβ targets but neither demonstrated a beneficial effect on cognitive measures compared to controls. The solanezumab-treated group showed a greater cognitive decline on some measures and did not show benefits on downstream biomarkers. Gantenerumab significantly reduced amyloid plaques, cerebrospinal fluid total tau, and phospho-tau181 and attenuated increases of neurofilament light chain. Amyloid-related imaging abnormalities edema was observed in 19.2% (3 out of 11 were mildly symptomatic) of the gantenerumab group, 2.5% of the placebo group and 0% of the solanezumab group. Gantenerumab and solanezumab did not slow cognitive decline in symptomatic DIAD. The asymptomatic groups showed no cognitive decline; symptomatic participants had declined before reaching the target doses.
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61
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Butt OH, Long JM, Henson RL, Herries E, Sutphen CL, Fagan AM, Cruchaga C, Ladenson JH, Holtzman DM, Morris JC, Ances BM, Schindler SE. Cognitively normal APOE ε4 carriers have specific elevation of CSF SNAP-25. Neurobiol Aging 2021; 102:64-72. [PMID: 33765432 PMCID: PMC8793109 DOI: 10.1016/j.neurobiolaging.2021.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/08/2021] [Accepted: 02/08/2021] [Indexed: 01/22/2023]
Abstract
Cerebrospinal fluid (CSF) synaptosomal-associated protein 25 (SNAP-25) and neurogranin (Ng) are recently described biomarkers for pre- and postsynaptic integrity known to be elevated in symptomatic Alzheimer disease (AD). Their relationship with Apolipoprotein E (APOE) ε4 carrier status, the major genetic risk factor for AD, remains unclear. In this study, CSF SNAP-25 and Ng were compared in cognitively normal APOE ε4 carriers and noncarriers (n = 274, mean age 65 ± 9.0 years, 39% APOE ε4 carriers, 58% female). CSF SNAP-25, not CSF Ng, was specifically elevated in APOE ε4 carriers versus noncarriers (5.95 ± 1.72 pg/mL, 4.44 ± 1.40 pg/mL, p < 0.0001), even after adjusting for age, sex, years of education, and amyloid status (p < 0.0001). CSF total tau (t-tau), phosphorylated-tau-181 (ptau181), and neurofilament light chain (NfL) also did not vary by APOE ε4 status. Our findings suggest APOE ε4 carriers have amyloid-related and amyloid-independent presynaptic disruption as reflected by elevated CSF SNAP-25 levels. In contrast, postsynaptic disruption as reflected by elevations in CSF neurogranin is related to amyloid status.
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Affiliation(s)
- Omar H Butt
- Department of Neurology, Washington University, Saint Louis, MO, USA
| | - Justin M Long
- Department of Neurology, Washington University, Saint Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University, St. Louis, MO, USA
| | - Rachel L Henson
- Department of Neurology, Washington University, Saint Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA
| | - Elizabeth Herries
- Department of Neurology, Washington University, Saint Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA
| | - Courtney L Sutphen
- Department of Neurology, Washington University, Saint Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA
| | - Anne M Fagan
- Department of Neurology, Washington University, Saint Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University, St. Louis, MO, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University, Saint Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University, St. Louis, MO, USA
| | - Jack H Ladenson
- Department of Pathology and Immunology, Washington University, Saint Louis, MO, USA
| | - David M Holtzman
- Department of Neurology, Washington University, Saint Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University, St. Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University, Saint Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University, St. Louis, MO, USA; Department of Pathology and Immunology, Washington University, Saint Louis, MO, USA
| | - Beau M Ances
- Department of Neurology, Washington University, Saint Louis, MO, USA; Department of Radiology, Washington University, Saint Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University, St. Louis, MO, USA
| | - Suzanne E Schindler
- Department of Neurology, Washington University, Saint Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA.
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62
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Babulal GM, Roe CM, Stout SH, Rajasekar G, Wisch JK, Benzinger TLS, Morris JC, Ances BM. Depression is Associated with Tau and Not Amyloid Positron Emission Tomography in Cognitively Normal Adults. J Alzheimers Dis 2021; 74:1045-1055. [PMID: 32144985 DOI: 10.3233/jad-191078] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Depression is also common with older age. Alzheimer's disease (AD) studies suggest that both cerebrospinal fluid and positron emission tomography (PET) amyloid biomarkers are associated with more depressive symptoms in cognitively normal older adults. The recent availability of tau radiotracers offers the ability to examine in vivo tauopathy. It is unclear if the tau biomarker is associated with depression diagnosis. OBJECTIVE We examined if tau and amyloid imaging were associated with a depression diagnosis among cognitively normal adults (Clinical Dementia Rating = 0) and whether antidepressants modified this relationship. METHODS Among 301 participants, logistic regression models evaluated whether in vivo PET tau was associated with depression, while another model tested the interaction between PET tau and antidepressant use. A second set of models substituted PET amyloid for PET tau. A diagnosis of depression (yes/no) was made during an annual clinical assessment by a clinician. Antidepressant use (yes/no) was determined by comparing medications the participants used to a list of 30 commonly used antidepressants. All models adjusted for age, sex, education, race, and apolipoprotein ɛ4. Similar models explored the association between the biomarkers and depressive symptoms. RESULTS Participants with elevated tau were twice as likely to be depressed. Antidepressant use modified this relationship where participants with elevated tau who were taking antidepressants had greater odds of being depressed. Relatedly, elevated amyloid was not associated with depression. CONCLUSIONS Our results demonstrate that tau, not amyloid, was associated with a depression diagnosis. Additionally, antidepressant use interacts with tau to increase the odds of depression among cognitively normal adults.
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Affiliation(s)
- Ganesh M Babulal
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Catherine M Roe
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Sarah H Stout
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Ganesh Rajasekar
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Julie K Wisch
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L S Benzinger
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA.,Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA.,Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA.,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA.,Department of Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA.,Department of Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Beau M Ances
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
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Lopes Alves I, Heeman F, Collij LE, Salvadó G, Tolboom N, Vilor-Tejedor N, Markiewicz P, Yaqub M, Cash D, Mormino EC, Insel PS, Boellaard R, van Berckel BNM, Lammertsma AA, Barkhof F, Gispert JD. Strategies to reduce sample sizes in Alzheimer's disease primary and secondary prevention trials using longitudinal amyloid PET imaging. Alzheimers Res Ther 2021; 13:82. [PMID: 33875021 PMCID: PMC8056524 DOI: 10.1186/s13195-021-00819-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/26/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Detecting subtle-to-moderate biomarker changes such as those in amyloid PET imaging becomes increasingly relevant in the context of primary and secondary prevention of Alzheimer's disease (AD). This work aimed to determine if and when distribution volume ratio (DVR; derived from dynamic imaging) and regional quantitative values could improve statistical power in AD prevention trials. METHODS Baseline and annualized % change in [11C]PIB SUVR and DVR were computed for a global (cortical) and regional (early) composite from scans of 237 cognitively unimpaired subjects from the OASIS-3 database ( www.oasis-brains.org ). Bland-Altman and correlation analyses were used to assess the relationship between SUVR and DVR. General linear models and linear mixed effects models were used to determine effects of age, sex, and APOE-ε4 carriership on baseline and longitudinal amyloid burden. Finally, differences in statistical power of SUVR and DVR (cortical or early composite) were assessed considering three anti-amyloid trial scenarios: secondary prevention trials including subjects with (1) intermediate-to-high (Centiloid > 20.1), or (2) intermediate (20.1 < Centiloid ≤ 49.4) amyloid burden, and (3) a primary prevention trial focusing on subjects with low amyloid burden (Centiloid ≤ 20.1). Trial scenarios were set to detect 20% reduction in accumulation rates across the whole population and in APOE-ε4 carriers only. RESULTS Although highly correlated to DVR (ρ = .96), cortical SUVR overestimated DVR cross-sectionally and in annual % change. In secondary prevention trials, DVR required 143 subjects per arm, compared with 176 for SUVR. Both restricting inclusion to individuals with intermediate amyloid burden levels or to APOE-ε4 carriers alone further reduced sample sizes. For primary prevention, SUVR required less subjects per arm (n = 855) compared with DVR (n = 1508) and the early composite also provided considerable sample size reductions (n = 855 to n = 509 for SUVR, n = 1508 to n = 734 for DVR). CONCLUSION Sample sizes in AD secondary prevention trials can be reduced by the acquisition of dynamic PET scans and/or by restricting inclusion to subjects with intermediate amyloid burden or to APOE-ε4 carriers only. Using a targeted early composite only leads to reductions of sample size requirements in primary prevention trials. These findings support strategies to enable smaller Proof-of-Concept Phase II clinical trials to better streamline drug development.
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Affiliation(s)
- Isadora Lopes Alves
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Fiona Heeman
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lyduine E Collij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Nelleke Tolboom
- Imaging Division, Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Natàlia Vilor-Tejedor
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
- Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Barcelona, Spain
- Department of Clinical Genetics, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Pawel Markiewicz
- Centre for Medical Image Computing, Medical Physics and Biomedical Engineering, UCL, London, UK
| | - Maqsood Yaqub
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - David Cash
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Elizabeth C Mormino
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Philip S Insel
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Adriaan A Lammertsma
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Centre for Medical Image Computing, Medical Physics and Biomedical Engineering, UCL, London, UK
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
- Universitat Pompeu Fabra, Barcelona, Spain.
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina, Madrid, Spain.
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Schwarz AJ. The Use, Standardization, and Interpretation of Brain Imaging Data in Clinical Trials of Neurodegenerative Disorders. Neurotherapeutics 2021; 18:686-708. [PMID: 33846962 PMCID: PMC8423963 DOI: 10.1007/s13311-021-01027-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 12/11/2022] Open
Abstract
Imaging biomarkers play a wide-ranging role in clinical trials for neurological disorders. This includes selecting the appropriate trial participants, establishing target engagement and mechanism-related pharmacodynamic effect, monitoring safety, and providing evidence of disease modification. In the early stages of clinical drug development, evidence of target engagement and/or downstream pharmacodynamic effect-especially with a clear relationship to dose-can provide confidence that the therapeutic candidate should be advanced to larger and more expensive trials, and can inform the selection of the dose(s) to be further tested, i.e., to "de-risk" the drug development program. In these later-phase trials, evidence that the therapeutic candidate is altering disease-related biomarkers can provide important evidence that the clinical benefit of the compound (if observed) is grounded in meaningful biological changes. The interpretation of disease-related imaging markers, and comparability across different trials and imaging tools, is greatly improved when standardized outcome measures are defined. This standardization should not impinge on scientific advances in the imaging tools per se but provides a common language in which the results generated by these tools are expressed. PET markers of pathological protein aggregates and structural imaging of brain atrophy are common disease-related elements across many neurological disorders. However, PET tracers for pathologies beyond amyloid β and tau are needed, and the interpretability of structural imaging can be enhanced by some simple considerations to guard against the possible confound of pseudo-atrophy. Learnings from much-studied conditions such as Alzheimer's disease and multiple sclerosis will be beneficial as the field embraces rarer diseases.
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Affiliation(s)
- Adam J Schwarz
- Takeda Pharmaceuticals Ltd., 40 Landsdowne Street, Cambridge, MA, 02139, USA.
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65
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Collij LE, Salvadó G, Shekari M, Lopes Alves I, Reimand J, Wink AM, Zwan M, Niñerola-Baizán A, Perissinotti A, Scheltens P, Ikonomovic MD, Smith APL, Farrar G, Molinuevo JL, Barkhof F, Buckley CJ, van Berckel BNM, Gispert JD. Visual assessment of [ 18F]flutemetamol PET images can detect early amyloid pathology and grade its extent. Eur J Nucl Med Mol Imaging 2021; 48:2169-2182. [PMID: 33615397 PMCID: PMC8175297 DOI: 10.1007/s00259-020-05174-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 12/20/2020] [Indexed: 11/08/2022]
Abstract
Purpose To investigate the sensitivity of visual read (VR) to detect early amyloid pathology and the overall utility of regional VR. Methods [18F]Flutemetamol PET images of 497 subjects (ALFA+ N = 352; ADC N = 145) were included. Scans were visually assessed according to product guidelines, recording the number of positive regions (0–5) and a final negative/positive classification. Scans were quantified using the standard and regional Centiloid (CL) method. The agreement between VR-based classification and published CL-based cut-offs for early (CL = 12) and established (CL = 30) pathology was determined. An optimal CL cut-off maximizing Youden’s index was derived. Global and regional CL quantification was compared to VR. Finally, 28 post-mortem cases from the [18F]flutemetamol phase III trial were included to assess the percentage agreement between VR and neuropathological classification of neuritic plaque density. Results VR showed excellent agreement against CL = 12 (κ = .89, 95.2%) and CL = 30 (κ = .88, 95.4%) cut-offs. ROC analysis resulted in an optimal CL = 17 cut-off against VR (sensitivity = 97.9%, specificity = 97.8%). Each additional positive VR region corresponded to a clear increase in global CL. Regional VR was also associated with regional CL quantification. Compared to mCERADSOT-based classification (i.e., any region mCERADSOT > 1.5), VR was in agreement in 89.3% of cases, with 13 true negatives, 12 true positives, and 3 false positives (FP). Regional sparse-to-moderate neuritic and substantial diffuse Aβ plaque was observed in all FP cases. Regional VR was also associated with regional plaque density. Conclusion VR is an appropriate method for assessing early amyloid pathology and that grading the extent of visual amyloid positivity could present clinical value. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-020-05174-2.
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Affiliation(s)
- Lyduine E Collij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Mahnaz Shekari
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Isadora Lopes Alves
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Juhan Reimand
- Alzheimer Center and department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands.,Department of Health Technologies, Tallinn University of Technology, Tallinn, Estonia.,Radiology Centre, North Estonia Medical Centre, Tallinn, Estonia
| | - Alle Meije Wink
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Marissa Zwan
- Alzheimer Center and department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Aida Niñerola-Baizán
- Nuclear Medicine Department, Hospital Clínic Barcelona & Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - Andrés Perissinotti
- Nuclear Medicine Department, Hospital Clínic Barcelona & Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain
| | - Philip Scheltens
- Alzheimer Center and department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Milos D Ikonomovic
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Geriatric Research Education and Clinical Center, VA Pittsburgh HS, Pittsburgh, PA, USA
| | | | | | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.,Universitat Pompeu Fabra, Barcelona, Spain.,CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands.,Centre for Medical Image Computing, and Queen Square Institute of Neurology, UCL, London, UK
| | | | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands. .,Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, 1108 HV, Amsterdam, The Netherlands.
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain. .,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. .,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA. .,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain. .,Alzheimer Prevention Program, BarcelonaBeta Brain Research Center (BBRC), C/ Wellington, 30, 08005, Barcelona, Spain.
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66
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Babulal GM, Johnson A, Fagan AM, Morris JC, Roe CM. Identifying Preclinical Alzheimer's Disease Using Everyday Driving Behavior: Proof of Concept. J Alzheimers Dis 2021; 79:1009-1014. [PMID: 33361605 DOI: 10.3233/jad-201294] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We examined whether driving behavior can predict preclinical Alzheimer's disease (AD). Data from 131 cognitively normal older adults with cerebrospinal fluid (CSF) and/or positron emission tomography (PET) biomarkers were examined with naturalistic driving behavior. Receiver operating characteristic curves were used to predict the highest 10%, 25%, and 50% of values for CSF tau/Aβ42, ptau181/Aβ42, or amyloid PET. Six in vivo driving variables alone yielded area under the curves (AUC) from 0.64-0.82. Addition of age, Apolipoprotein ɛ4, and neuropsychological measures to the models improved the AUC (0.81 to 0.90). Driving can be used as novel neurobehavioral marker to identify presence of preclinical AD.
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Affiliation(s)
- Ganesh M Babulal
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Ann Johnson
- Center for Clinical Studies, Washington University School of Medicine, St. Louis, MO, USA
| | - Anne M Fagan
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA.,Departments of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA.,Department of Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA.,Department of Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Catherine M Roe
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
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67
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Goyal MS, Gordon BA, Couture LE, Flores S, Xiong C, Morris JC, Raichle ME, L-S Benzinger T, Vlassenko AG. Spatiotemporal relationship between subthreshold amyloid accumulation and aerobic glycolysis in the human brain. Neurobiol Aging 2020; 96:165-175. [PMID: 33011615 PMCID: PMC7894981 DOI: 10.1016/j.neurobiolaging.2020.08.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 08/11/2020] [Accepted: 08/25/2020] [Indexed: 01/16/2023]
Abstract
In Alzheimer's disease, brain amyloid deposition has a distinct topography that correlates with aerobic glycolysis (AG), that is, the use of glucose beyond that predicted by oxygen consumption. The causes for this relationship remain unclear but might provide crucialinsight into how amyloid deposition begins. Here we develop methods to study the earliest topography of amyloid deposition based on amyloid imaging and investigate its spatiotemporal evolution with respect to the topography of AG in adults. We find that the spatiotemporal dynamics of amyloid deposition are largely explained by 1 factor, defined here as the amyloid topography dissimilarity index (ATDI). ATDI is bimodal, more highly dynamic during early amyloid accumulation, and predicts which individuals will cross a conservative quantitative threshold at least 3-5 years in advance. Using ATDI, we demonstrate that subthreshold amyloid accumulates primarily in regions that have high AG during early adulthood. Our findings suggest that early on-target subthreshold amyloid deposition mirrors its later regional pattern, which best corresponds to the topography of young adult brain AG.
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Affiliation(s)
- Manu S Goyal
- Neuroimaging Laboratories, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA.
| | - Brian A Gordon
- Neuroimaging Laboratories, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Lars E Couture
- Neuroimaging Laboratories, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Shaney Flores
- Neuroimaging Laboratories, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Chengjie Xiong
- 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; Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Marcus E Raichle
- Neuroimaging Laboratories, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L-S Benzinger
- Neuroimaging Laboratories, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrei G Vlassenko
- Neuroimaging Laboratories, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
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68
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Farrell ME, Jiang S, Schultz AP, Properzi MJ, Price JC, Becker JA, Jacobs HIL, Hanseeuw BJ, Rentz DM, Villemagne VL, Papp KV, Mormino EC, Betensky RA, Johnson KA, Sperling RA, Buckley RF. Defining the Lowest Threshold for Amyloid-PET to Predict Future Cognitive Decline and Amyloid Accumulation. Neurology 2020; 96:e619-e631. [PMID: 33199430 DOI: 10.1212/wnl.0000000000011214] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/21/2020] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION As clinical trials move toward earlier intervention, we sought to redefine the β-amyloid (Aβ)-PET threshold based on the lowest point in a baseline distribution that robustly predicts future Aβ accumulation and cognitive decline in 3 independent samples of clinically normal individuals. METHODS Sequential Aβ cutoffs were tested to identify the lowest cutoff associated with future change in cognition (Preclinical Alzheimer Cognitive Composite [PACC]) and Aβ-PET in clinically normal participants from the Harvard Aging Brain Study (n = 342), Australian Imaging, Biomarker and Lifestyle study of aging (n = 157), and Alzheimer's Disease Neuroimaging Initiative (n = 356). RESULTS Within samples, cutoffs derived from future Aβ-PET accumulation and PACC decline converged on the same inflection point, beyond which trajectories diverged from normal. Across samples, optimal cutoffs fell within a short range (Centiloid 15-18.5). DISCUSSION These optimized thresholds can help to inform future research and clinical trials targeting early Aβ. Threshold convergence raises the possibility of contemporaneous early changes in Aβ and cognition. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that among clinically normal individuals a specific Aβ-PET threshold is predictive of cognitive decline.
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Affiliation(s)
- Michelle E Farrell
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Shu Jiang
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Aaron P Schultz
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Michael J Properzi
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Julie C Price
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - J Alex Becker
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Heidi I L Jacobs
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Bernard J Hanseeuw
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Dorene M Rentz
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Victor L Villemagne
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Kathryn V Papp
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Elizabeth C Mormino
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Rebecca A Betensky
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Keith A Johnson
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Reisa A Sperling
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia
| | - Rachel F Buckley
- From the Departments of Neurology (M.E.F., S.J., A.P.S., M.J.P., D.M.R., K.V.P., R.A.B., K.A.J., R.A.S., R.F.B.) and Radiology (J.C.P., J.A.B., H.I.L.J., B.J.H., K.A.J.), Massachusetts General Hospital, Harvard Medical School; Department of Biostatistics (S.J., R.A.B.), Harvard T.H. Chan School of Public Health, Boston, MA; Division of Public Health Sciences (S.J.), Department of Surgery, Washington University School of Medicine in St. Louis, MO; Faculty of Health (H.I.L.J.), Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, the Netherlands; Cliniques Universitaires Saint-Luc (B.J.H.), Université Catholique de Louvain, Brussels, Belgium; Center for Alzheimer Research and Treatment (D.M.R., K.V.P., R.A.S., R.F.B.), Brigham and Women's Hospital, Boston, MA; Department of Molecular Imaging & Therapy (V.L.V.), Austin Health, Melbourne, Australia; Department of Neuroscience (E.C.M.), Stanford University, Palo Alto, CA; Department of Biostatistics (R.A.B.), New York University School of Global Public Health, NY; Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA; and Melbourne School of Psychological Sciences (R.F.B.), University of Melbourne, Australia.
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Dincer A, Gordon BA, Hari-Raj A, Keefe SJ, Flores S, McKay NS, Paulick AM, Shady Lewis KE, Feldman RL, Hornbeck RC, Allegri R, Ances BM, Berman SB, Brickman AM, Brooks WS, Cash DM, Chhatwal JP, Farlow MR, la Fougère C, Fox NC, Fulham MJ, Jack CR, Joseph-Mathurin N, Karch CM, Lee A, Levin J, Masters CL, McDade EM, Oh H, Perrin RJ, Raji C, Salloway SP, Schofield PR, Su Y, Villemagne VL, Wang Q, Weiner MW, Xiong C, Yakushev I, Morris JC, Bateman RJ, L S Benzinger T. Comparing cortical signatures of atrophy between late-onset and autosomal dominant Alzheimer disease. NEUROIMAGE-CLINICAL 2020; 28:102491. [PMID: 33395982 PMCID: PMC7689410 DOI: 10.1016/j.nicl.2020.102491] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/18/2020] [Accepted: 10/30/2020] [Indexed: 11/30/2022]
Abstract
Cortical signatures selective to AD could provide an early MRI biomarker. Autosomal dominant Alzheimer disease (ADAD) may model an ideal AD signature. ADAD and late-onset maps overlap in parietal cortex but contain unique features. Signatures predicted increasing amyloid within their own, but not across cohorts. These results indicate atrophy in AD can take multiple spatial patterns.
Defining a signature of cortical regions of interest preferentially affected by Alzheimer disease (AD) pathology may offer improved sensitivity to early AD compared to hippocampal volume or mesial temporal lobe alone. Since late-onset Alzheimer disease (LOAD) participants tend to have age-related comorbidities, the younger-onset age in autosomal dominant AD (ADAD) may provide a more idealized model of cortical thinning in AD. To test this, the goals of this study were to compare the degree of overlap between the ADAD and LOAD cortical thinning maps and to evaluate the ability of the ADAD cortical signature regions to predict early pathological changes in cognitively normal individuals. We defined and analyzed the LOAD cortical maps of cortical thickness in 588 participants from the Knight Alzheimer Disease Research Center (Knight ADRC) and the ADAD cortical maps in 269 participants from the Dominantly Inherited Alzheimer Network (DIAN) observational study. Both cohorts were divided into three groups: cognitively normal controls (nADRC = 381; nDIAN = 145), preclinical (nADRC = 153; nDIAN = 76), and cognitively impaired (nADRC = 54; nDIAN = 48). Both cohorts underwent clinical assessments, 3T MRI, and amyloid PET imaging with either 11C-Pittsburgh compound B or 18F-florbetapir. To generate cortical signature maps of cortical thickness, we performed a vertex-wise analysis between the cognitively normal controls and impaired groups within each cohort using six increasingly conservative statistical thresholds to determine significance. The optimal cortical map among the six statistical thresholds was determined from a receiver operating characteristic analysis testing the performance of each map in discriminating between the cognitively normal controls and preclinical groups. We then performed within-cohort and cross-cohort (e.g. ADAD maps evaluated in the Knight ADRC cohort) analyses to examine the sensitivity of the optimal cortical signature maps to the amyloid levels using only the cognitively normal individuals (cognitively normal controls and preclinical groups) in comparison to hippocampal volume. We found the optimal cortical signature maps were sensitive to early increases in amyloid for the asymptomatic individuals within their respective cohorts and were significant beyond the inclusion of hippocampus volume, but the cortical signature maps performed poorly when analyzing across cohorts. These results suggest the cortical signature maps are a useful MRI biomarker of early AD-related neurodegeneration in preclinical individuals and the pattern of decline differs between LOAD and ADAD.
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Affiliation(s)
- Aylin Dincer
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Brian A Gordon
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Amrita Hari-Raj
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sarah J Keefe
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Shaney Flores
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Nicole S McKay
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Angela M Paulick
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Kristine E Shady Lewis
- Sanders Brown Center on Aging & Alzheimer's, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Rebecca L Feldman
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Russ C Hornbeck
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Ricardo Allegri
- Department of Cognitive Neurology, Neuropsychology and Neuropsychiatry, FLENI, Buenos Aires, Argentina
| | - Beau M Ances
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Sarah B Berman
- Department of Neurology and Clinical & Translational Science, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain and Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - William S Brooks
- Neuroscience Research Australia, Sydney, NSW, Australia; Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - David M Cash
- Dementia Research Centre and UK Dementia Research Institute, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Jasmeer P Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Martin R Farlow
- Department of Neurology, Department of Radiology and Imaging Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Christian la Fougère
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany; Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital of Tübingen, Tübingen, Germany
| | - Nick C Fox
- Dementia Research Centre and UK Dementia Research Institute, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Michael J Fulham
- Department of Molecular Imaging, Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW, Australia
| | | | - Nelly Joseph-Mathurin
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Celeste M Karch
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Athene Lee
- Department of Psychiatry and Human Behavior, Department of Neurology, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany; Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Eric M McDade
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Hwamee Oh
- Department of Psychiatry and Human Behavior, Department of Neurology, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Richard J Perrin
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Cyrus Raji
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Stephen P Salloway
- Department of Psychiatry and Human Behavior, Department of Neurology, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Yi Su
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Victor L Villemagne
- Department of Molecular Imaging and Therapy, Department of Medicine, Austin Health, University of Melbourne, Melbourne, VIC, Australia
| | - Qing Wang
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Michael W Weiner
- Department of Radiology and Biomedical Imaging, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Chengjie Xiong
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Igor Yakushev
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany
| | - John C Morris
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Randall J Bateman
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Tammie L S Benzinger
- Department of Radiology, Department of Neurology, Department of Psychiatry, Department of Pathology and Immunology, Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA.
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Davis JD, Babulal GM, Papandonatos GD, Burke EM, Rosnick CB, Ott BR, Roe CM. Evaluation of Naturalistic Driving Behavior Using In-Vehicle Monitoring Technology in Preclinical and Early Alzheimer's Disease. Front Psychol 2020; 11:596257. [PMID: 33192943 PMCID: PMC7653196 DOI: 10.3389/fpsyg.2020.596257] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/05/2020] [Indexed: 11/13/2022] Open
Abstract
Cognitive impairment is a significant risk factor for hazardous driving among older drivers with Alzheimer's dementia, but little is known about how the driving behavior of mildly symptomatic compares with those in the preclinical, asymptomatic phase of Alzheimer's disease (AD). This study utilized two in-car technologies to characterize driving behavior in symptomatic and preclinical AD. The goals of this pilot study were to (1) describe unsafe driving behaviors in individuals with symptomatic early AD using G-force triggered video capture and (2) compare the driving habits of these symptomatic AD drivers to two groups of cognitively normal drivers, those with and those without evidence of cerebral amyloidosis (CN/A+ and CN/A-) using a global positioning system (GPS) datalogger. Thirty-three drivers (aged 60+ years) were studied over 3 months. G-force triggered video events captured instances of near-misses/collisions, traffic violations, risky driver conduct, and driving fundamentals. GPS data were sampled every 30 s and all instances of speeding, hard braking, and sudden acceleration were recorded. For the early AD participants, video capture identified driving unbelted, late response, driving too fast for conditions, traffic violations, poor judgment, and not scanning intersections as the most frequently occurring safety errors. When evaluating driving using the GPS datalogger, hard breaking events occurred most frequently on a per trip basis across all three groups. The CN/A+ group had the lowest event rate across all three event types with lower instances of speeding. Slower psychomotor speed (Trail Making Part A) was associated with fewer speeding events, more hard acceleration events, and more overall events. GPS tracked instances of speeding were correlated with total number of video-captured near-collisions/collisions and driving fundamentals. Results demonstrate the utility of electronic monitoring to identify potentially unsafe driving events in symptomatic and preclinical AD. Results suggest that drivers with preclinical AD may compensate for early, subtle cognitive changes by driving more slowly and cautiously than healthy older drivers or those with cognitive impairment. Self-regulatory changes in driving behavior appear to occur in the preclinical phase of AD, but safety concerns may not arise until symptoms of cognitive impairment emerge and the ability to self-monitor declines.
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Affiliation(s)
- Jennifer D. Davis
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, United States
- Neuropsychology Program, Department of Psychiatry, Rhode Island Hospital, Providence, RI, United States
| | - Ganesh M. Babulal
- Department of Neurology, Charles F. and Joanne Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO, United States
| | | | - Erin M. Burke
- Neuropsychology Program, Department of Psychiatry, Rhode Island Hospital, Providence, RI, United States
| | - Christopher B. Rosnick
- Department of Neurology, Charles F. and Joanne Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO, United States
| | - Brian R. Ott
- Department of Neurology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Catherine M. Roe
- Department of Neurology, Charles F. and Joanne Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO, United States
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71
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Young PNE, Estarellas M, Coomans E, Srikrishna M, Beaumont H, Maass A, Venkataraman AV, Lissaman R, Jiménez D, Betts MJ, McGlinchey E, Berron D, O'Connor A, Fox NC, Pereira JB, Jagust W, Carter SF, Paterson RW, Schöll M. Imaging biomarkers in neurodegeneration: current and future practices. Alzheimers Res Ther 2020; 12:49. [PMID: 32340618 PMCID: PMC7187531 DOI: 10.1186/s13195-020-00612-7] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 04/01/2020] [Indexed: 12/12/2022]
Abstract
There is an increasing role for biological markers (biomarkers) in the understanding and diagnosis of neurodegenerative disorders. The application of imaging biomarkers specifically for the in vivo investigation of neurodegenerative disorders has increased substantially over the past decades and continues to provide further benefits both to the diagnosis and understanding of these diseases. This review forms part of a series of articles which stem from the University College London/University of Gothenburg course "Biomarkers in neurodegenerative diseases". In this review, we focus on neuroimaging, specifically positron emission tomography (PET) and magnetic resonance imaging (MRI), giving an overview of the current established practices clinically and in research as well as new techniques being developed. We will also discuss the use of machine learning (ML) techniques within these fields to provide additional insights to early diagnosis and multimodal analysis.
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Affiliation(s)
- Peter N E Young
- Wallenberg Centre for Molecular and Translational Medicine and the Department of Psychiatry and Neurochemistry, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mar Estarellas
- Centre for Medical Image Computing (CMIC), Department of Computer Science & Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Emma Coomans
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Meera Srikrishna
- Wallenberg Centre for Molecular and Translational Medicine and the Department of Psychiatry and Neurochemistry, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helen Beaumont
- Neuroscience and Aphasia Research Unit, Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
| | - Anne Maass
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Ashwin V Venkataraman
- Division of Brain Sciences, Imperial College London, London, UK
- United Kingdom Dementia Research Institute, Imperial College London, London, UK
| | - Rikki Lissaman
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff, UK
| | - Daniel Jiménez
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
- Department of Neurological Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Matthew J Betts
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | | | - David Berron
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Antoinette O'Connor
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Joana B Pereira
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - William Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, USA
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Stephen F Carter
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Wolfson Molecular Imaging Centre, Division of Neuroscience and Experimental Psychology, MAHSC, University of Manchester, Manchester, UK
| | - Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Michael Schöll
- Wallenberg Centre for Molecular and Translational Medicine and the Department of Psychiatry and Neurochemistry, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK.
- Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
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72
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Zammit MD, Laymon CM, Betthauser TJ, Cody KA, Tudorascu DL, Minhas DS, Sabbagh MN, Johnson SC, Zaman SH, Mathis CA, Klunk WE, Handen BL, Cohen AD, Christian BT. Amyloid accumulation in Down syndrome measured with amyloid load. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12020. [PMID: 32435686 PMCID: PMC7233422 DOI: 10.1002/dad2.12020] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Individuals with Down syndrome (DS) show enhanced amyloid beta (Aβ) deposition in the brain. A new positron emission tomography (PET) index of amyloid load (AβL ) was recently developed as an alternative to standardized uptake value ratios (SUVrs) to quantify Aβ burden with high sensitivity for detecting and tracking Aβ change.1. METHODS AβL was calculated in a DS cohort (N = 169, mean age ± SD = 39.6 ± 8.7 years) using [C-11]Pittsburgh compound B (PiB) PET imaging. DS-specific PiB templates were created for Aβ carrying capacity (K) and non-specific binding (NS). RESULTS The highest values of Aβ carrying capacity were found in the striatum and precuneus. Longitudinal changes in AβL displayed less variability when compared to SUVrs. DISCUSSION These results highlight the utility of AβL for characterizing Aβ deposition in DS. Rates of Aβ accumulation in DS were found to be similar to that observed in late-onset Alzheimer's disease (AD; ≈3% to 4% per year), suggesting that AD progression in DS is of earlier onset but not accelerated.
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Affiliation(s)
| | - Charles M. Laymon
- Department of RadiologyUniversity of PittsburghPittsburghPennsylvania
| | - Tobey J. Betthauser
- Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsin
| | - Karly A. Cody
- Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsin
| | - Dana L. Tudorascu
- Department of Internal MedicineUniversity of PittsburghPittsburghPennsylvania
| | - Davneet S. Minhas
- Department of RadiologyUniversity of PittsburghPittsburghPennsylvania
| | | | - Sterling C. Johnson
- Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsin
| | - Shahid H. Zaman
- Cambridge Intellectual Disability Research GroupUniversity of CambridgeCambridgeUK
| | - Chester A. Mathis
- Department of RadiologyUniversity of PittsburghPittsburghPennsylvania
| | - William E. Klunk
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvania
| | | | - Ann D. Cohen
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvania
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73
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Morris JC, Schindler SE, McCue LM, Moulder KL, Benzinger TLS, Cruchaga C, Fagan AM, Grant E, Gordon BA, Holtzman DM, Xiong C. Assessment of Racial Disparities in Biomarkers for Alzheimer Disease. JAMA Neurol 2020; 76:264-273. [PMID: 30615028 DOI: 10.1001/jamaneurol.2018.4249] [Citation(s) in RCA: 197] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Importance Racial differences in molecular biomarkers for Alzheimer disease may suggest race-dependent biological mechanisms. Objective To ascertain whether there are racial disparities in molecular biomarkers for Alzheimer disease. Design, Setting, and Participants A total of 1255 participants (173 African Americans) were enrolled from January 1, 2004, through December 31, 2015, in longitudinal studies at the Knight Alzheimer Disease Research Center at Washington University and completed a magnetic resonance imaging study of the brain and/or positron emission tomography of the brain with Pittsburgh compound B (radioligand for aggregated amyloid-β) and/or cerebrospinal fluid (CSF) assays for the concentrations of amyloid-β42, total tau, and phosphorylated tau181. Independent cross-sectional analyses were conducted from April 22, 2016, to August 27, 2018, for each biomarker modality with an analysis of variance or analysis of covariance including age, sex, educational level, race, apolipoprotein E (APOE) ε4 allele status, and clinical status (normal cognition or dementia). All biomarker assessments were conducted without knowledge of the clinical status of the participants. Main Outcomes and Measures The primary outcomes were hippocampal volumes adjusted for differences in intracranial volumes, global cerebral amyloid burden as transformed into standardized uptake value ratios (partial volume corrected), and CSF concentrations of amyloid-β42, total tau, and phosphorylated tau181. Results Of the 1255 participants (707 women and 548 men; mean [SD] age, 70.8 [9.9] years), 116 of 173 African American participants (67.1%) and 724 of 1082 non-Hispanic white participants (66.9%) had normal cognition. There were no racial differences in the frequency of cerebral ischemic lesions noted on results of brain magnetic resonance imaging, mean cortical standardized uptake value ratios for Pittsburgh compound B, or for amyloid-β42 concentrations in CSF. However, in individuals with a reported family history of dementia, mean (SE) total hippocampal volumes were lower for African American participants than for white participants (6418.26 [138.97] vs 6990.50 [44.10] mm3). Mean (SE) CSF concentrations of total tau were lower in African American participants than in white participants (293.65 [34.61] vs 443.28 [18.20] pg/mL; P < .001), as were mean (SE) concentrations of phosphorylated tau181 (53.18 [4.91] vs 70.73 [2.46] pg/mL; P < .001). There was a significant race by APOE ε4 interaction for both CSF total tau and phosphorylated tau181 such that only APOE ε4-positive participants showed the racial differences. Conclusions and Relevance The results of this study suggest that analyses of molecular biomarkers of Alzheimer disease should adjust for race. The lower CSF concentrations of total tau and phosphorylated tau181 in African American individuals appear to reflect a significant race by APOE ε4 interaction, suggesting a differential effect of this Alzheimer risk variant in African American individuals compared with white individuals.
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Affiliation(s)
- John C Morris
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri
| | - Suzanne E Schindler
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri
| | - Lena M McCue
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri.,Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri
| | - Krista L Moulder
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri
| | - Tammie L S Benzinger
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri.,Department of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Carlos Cruchaga
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri.,Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri
| | - Elizabeth Grant
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri.,Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri
| | - Brian A Gordon
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri.,Department of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - David M Holtzman
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri
| | - Chengjie Xiong
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri.,Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri
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74
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Chandra A, Valkimadi PE, Pagano G, Cousins O, Dervenoulas G, Politis M. Applications of amyloid, tau, and neuroinflammation PET imaging to Alzheimer's disease and mild cognitive impairment. Hum Brain Mapp 2019; 40:5424-5442. [PMID: 31520513 PMCID: PMC6864887 DOI: 10.1002/hbm.24782] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 07/29/2019] [Accepted: 08/18/2019] [Indexed: 02/06/2023] Open
Abstract
Alzheimer's disease (AD) is a devastating and progressive neurodegenerative disease for which there is no cure. Mild cognitive impairment (MCI) is considered a prodromal stage of the disease. Molecular imaging with positron emission tomography (PET) allows for the in vivo visualisation and tracking of pathophysiological changes in AD and MCI. PET is a very promising methodology for differential diagnosis and novel targets of PET imaging might also serve as biomarkers for disease-modifying therapeutic interventions. This review provides an overview of the current status and applications of in vivo molecular imaging of AD pathology, specifically amyloid, tau, and microglial activation. PET imaging studies were included and evaluated as potential biomarkers and for monitoring disease progression. Although the majority of radiotracers showed the ability to discriminate AD and MCI patients from healthy controls, they had various limitations that prevent the recommendation of a single technique or tracer as an optimal biomarker. Newer research examining amyloid, tau, and microglial PET imaging in combination suggest an alternative approach in studying the disease process.
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Affiliation(s)
- Avinash Chandra
- Neurodegeneration Imaging Group (NIG), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), London, UK
| | - Polytimi-Eleni Valkimadi
- Neurodegeneration Imaging Group (NIG), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), London, UK
| | - Gennaro Pagano
- Neurodegeneration Imaging Group (NIG), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), London, UK
| | - Oliver Cousins
- Neurodegeneration Imaging Group (NIG), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), London, UK
| | - George Dervenoulas
- Neurodegeneration Imaging Group (NIG), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), London, UK
| | - Marios Politis
- Neurodegeneration Imaging Group (NIG), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL), London, UK
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75
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Schindler SE, Bollinger JG, Ovod V, Mawuenyega KG, Li Y, Gordon BA, Holtzman DM, Morris JC, Benzinger TLS, Xiong C, Fagan AM, Bateman RJ. High-precision plasma β-amyloid 42/40 predicts current and future brain amyloidosis. Neurology 2019; 93:e1647-e1659. [PMID: 31371569 PMCID: PMC6946467 DOI: 10.1212/wnl.0000000000008081] [Citation(s) in RCA: 461] [Impact Index Per Article: 92.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 06/17/2019] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE We examined whether plasma β-amyloid (Aβ)42/Aβ40, as measured by a high-precision assay, accurately diagnosed brain amyloidosis using amyloid PET or CSF p-tau181/Aβ42 as reference standards. METHODS Using an immunoprecipitation and liquid chromatography-mass spectrometry assay, we measured Aβ42/Aβ40 in plasma and CSF samples from 158 mostly cognitively normal individuals that were collected within 18 months of an amyloid PET scan. RESULTS Plasma Aβ42/Aβ40 had a high correspondence with amyloid PET status (receiver operating characteristic area under the curve [AUC] 0.88, 95% confidence interval [CI] 0.82-0.93) and CSF p-tau181/Aβ42 (AUC 0.85, 95% CI 0.79-0.92). The combination of plasma Aβ42/Aβ40, age, and APOE ε4 status had a very high correspondence with amyloid PET (AUC 0.94, 95% CI 0.90-0.97). Individuals with a negative amyloid PET scan at baseline and a positive plasma Aβ42/Aβ40 (<0.1218) had a 15-fold greater risk of conversion to amyloid PET-positive compared to individuals with a negative plasma Aβ42/Aβ40 (p = 0.01). CONCLUSIONS Plasma Aβ42/Aβ40, especially when combined with age and APOE ε4 status, accurately diagnoses brain amyloidosis and can be used to screen cognitively normal individuals for brain amyloidosis. Individuals with a negative amyloid PET scan and positive plasma Aβ42/Aβ40 are at increased risk for converting to amyloid PET-positive. Plasma Aβ42/Aβ40 could be used in prevention trials to screen for individuals likely to be amyloid PET-positive and at risk for Alzheimer disease dementia. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that plasma Aβ42/Aβ40 levels accurately determine amyloid PET status in cognitively normal research participants.
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Affiliation(s)
- Suzanne E Schindler
- From the Department of Neurology (S.E.S., J.G.B., V.O., K.G.M., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Knight Alzheimer's Disease Research Center (S.E.S., B.A.G., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Division of Biostatistics (Y.L., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (D.M.H., A.M.F., R.J.B.), Washington University School of Medicine, St. Louis, MO
| | - James G Bollinger
- From the Department of Neurology (S.E.S., J.G.B., V.O., K.G.M., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Knight Alzheimer's Disease Research Center (S.E.S., B.A.G., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Division of Biostatistics (Y.L., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (D.M.H., A.M.F., R.J.B.), Washington University School of Medicine, St. Louis, MO
| | - Vitaliy Ovod
- From the Department of Neurology (S.E.S., J.G.B., V.O., K.G.M., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Knight Alzheimer's Disease Research Center (S.E.S., B.A.G., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Division of Biostatistics (Y.L., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (D.M.H., A.M.F., R.J.B.), Washington University School of Medicine, St. Louis, MO
| | - Kwasi G Mawuenyega
- From the Department of Neurology (S.E.S., J.G.B., V.O., K.G.M., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Knight Alzheimer's Disease Research Center (S.E.S., B.A.G., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Division of Biostatistics (Y.L., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (D.M.H., A.M.F., R.J.B.), Washington University School of Medicine, St. Louis, MO
| | - Yan Li
- From the Department of Neurology (S.E.S., J.G.B., V.O., K.G.M., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Knight Alzheimer's Disease Research Center (S.E.S., B.A.G., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Division of Biostatistics (Y.L., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (D.M.H., A.M.F., R.J.B.), Washington University School of Medicine, St. Louis, MO
| | - Brian A Gordon
- From the Department of Neurology (S.E.S., J.G.B., V.O., K.G.M., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Knight Alzheimer's Disease Research Center (S.E.S., B.A.G., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Division of Biostatistics (Y.L., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (D.M.H., A.M.F., R.J.B.), Washington University School of Medicine, St. Louis, MO
| | - David M Holtzman
- From the Department of Neurology (S.E.S., J.G.B., V.O., K.G.M., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Knight Alzheimer's Disease Research Center (S.E.S., B.A.G., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Division of Biostatistics (Y.L., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (D.M.H., A.M.F., R.J.B.), Washington University School of Medicine, St. Louis, MO
| | - John C Morris
- From the Department of Neurology (S.E.S., J.G.B., V.O., K.G.M., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Knight Alzheimer's Disease Research Center (S.E.S., B.A.G., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Division of Biostatistics (Y.L., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (D.M.H., A.M.F., R.J.B.), Washington University School of Medicine, St. Louis, MO
| | - Tammie L S Benzinger
- From the Department of Neurology (S.E.S., J.G.B., V.O., K.G.M., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Knight Alzheimer's Disease Research Center (S.E.S., B.A.G., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Division of Biostatistics (Y.L., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (D.M.H., A.M.F., R.J.B.), Washington University School of Medicine, St. Louis, MO
| | - Chengjie Xiong
- From the Department of Neurology (S.E.S., J.G.B., V.O., K.G.M., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Knight Alzheimer's Disease Research Center (S.E.S., B.A.G., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Division of Biostatistics (Y.L., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (D.M.H., A.M.F., R.J.B.), Washington University School of Medicine, St. Louis, MO
| | - Anne M Fagan
- From the Department of Neurology (S.E.S., J.G.B., V.O., K.G.M., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Knight Alzheimer's Disease Research Center (S.E.S., B.A.G., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Division of Biostatistics (Y.L., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (D.M.H., A.M.F., R.J.B.), Washington University School of Medicine, St. Louis, MO
| | - Randall J Bateman
- From the Department of Neurology (S.E.S., J.G.B., V.O., K.G.M., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Knight Alzheimer's Disease Research Center (S.E.S., B.A.G., D.M.H., J.C.M., T.L.S.B., C.X., A.M.F., R.J.B.), Division of Biostatistics (Y.L., C.X.), Mallinckrodt Institute of Radiology (B.A.G., T.L.S.B.), and Hope Center for Neurological Disorders (D.M.H., A.M.F., R.J.B.), Washington University School of Medicine, St. Louis, MO.
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76
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Jack CR, Therneau TM, Weigand SD, Wiste HJ, Knopman DS, Vemuri P, Lowe VJ, Mielke MM, Roberts RO, Machulda MM, Graff-Radford J, Jones DT, Schwarz CG, Gunter JL, Senjem ML, Rocca WA, Petersen RC. Prevalence of Biologically vs Clinically Defined Alzheimer Spectrum Entities Using the National Institute on Aging-Alzheimer's Association Research Framework. JAMA Neurol 2019; 76:1174-1183. [PMID: 31305929 PMCID: PMC6632154 DOI: 10.1001/jamaneurol.2019.1971] [Citation(s) in RCA: 169] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/11/2019] [Indexed: 12/23/2022]
Abstract
Importance A National Institute on Aging-Alzheimer's Association (NIA-AA) workgroup recently published a research framework in which Alzheimer disease is defined by neuropathologic or biomarker evidence of β-amyloid plaques and tau tangles and not by clinical symptoms. Objectives To estimate the sex- and age-specific prevalence of 3 imaging biomarker-based definitions of the Alzheimer disease spectrum from the NIA-AA research framework and to compare these entities with clinically defined diagnostic entities commonly linked with Alzheimer disease. Design, Setting, and Participants The Mayo Clinic Study of Aging (MCSA) is a population-based cohort study of cognitive aging in Olmsted County, Minnesota. The MCSA in-person participants (n = 4660) and passively ascertained (ie, through the medical record rather than in-person) individuals with dementia (n = 553) aged 60 to 89 years were included. Subsets underwent amyloid positron emission tomography (PET) (n = 1524) or both amyloid and tau PET (n = 576). Therefore, this study included 3 nested cohorts examined between November 29, 2004, and June 5, 2018. Data were analyzed between February 19, 2018, and March 26, 2019. Main Outcomes and Measures The sex- and age-specific prevalence of the following 3 biologically defined diagnostic entities was estimated: Alzheimer continuum (abnormal amyloid regardless of tau status), Alzheimer pathologic change (abnormal amyloid but normal tau), and Alzheimer disease (abnormal amyloid and tau). These were compared with the prevalence of 3 clinically defined diagnostic groups (mild cognitive impairment or dementia, dementia, and clinically defined probable Alzheimer disease). Results The median (interquartile range) age was 77 (72-83) years in the clinical cohort (n = 5213 participants), 77 (70-83) years in the amyloid PET cohort (n = 1524 participants), and 77 (69-83) years in the tau PET cohort (n = 576 participants). There were roughly equal numbers of women and men. The prevalence of all diagnostic entities (biological and clinical) increased rapidly with age, with the exception of Alzheimer pathologic change. The prevalence of biological Alzheimer disease was greater than clinically defined probable Alzheimer disease for women and men. Among women, these values were 10% (95% CI, 6%-14%) vs 1% (95% CI, 1%-1%) at age 70 years and 33% (95% CI, 25%-41%) vs 10% (95% CI, 9%-12%) at age 85 years (P < .001). Among men, these values were 9% (95% CI, 5%-12%) vs 1% (95% CI, 0%-1%) at age 70 years and 31% (95% CI, 24%-38%) vs 9% (95% CI, 8%-11%) at age 85 years (P < .001). The only notable difference by sex was a greater prevalence of the mild cognitive impairment or dementia clinical category among men than women. Conclusions and Relevance Results of this study suggest that biologically defined Alzheimer disease is more prevalent than clinically defined probable Alzheimer disease at any age and is 3 times more prevalent at age 85 years among both women and men. This difference is mostly driven by asymptomatic individuals with biological Alzheimer disease. These findings illustrate the magnitude of the consequences on public health that potentially exist by intervening with disease-specific treatments to prevent symptom onset.
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Affiliation(s)
| | - Terry M. Therneau
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Stephen D. Weigand
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Heather J. Wiste
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | | | | | - Val J. Lowe
- Department of Nuclear Medicine, Mayo Clinic, Rochester, Minnesota
| | - Michelle M. Mielke
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | | | - Mary M. Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | | | - David T. Jones
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | | | | | | | - Walter A. Rocca
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Ronald C. Petersen
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
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77
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Melzer TR, Stark MR, Keenan RJ, Myall DJ, MacAskill MR, Pitcher TL, Livingston L, Grenfell S, Horne KL, Young BN, Pascoe MJ, Almuqbel MM, Wang J, Marsh SH, Miller DH, Dalrymple-Alford JC, Anderson TJ. Beta Amyloid Deposition Is Not Associated With Cognitive Impairment in Parkinson's Disease. Front Neurol 2019; 10:391. [PMID: 31105633 PMCID: PMC6492461 DOI: 10.3389/fneur.2019.00391] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/01/2019] [Indexed: 12/20/2022] Open
Abstract
The extent to which Alzheimer neuropathology, particularly the accumulation of misfolded beta-amyloid, contributes to cognitive decline and dementia in Parkinson's disease (PD) is unresolved. Here, we used Florbetaben PET imaging to test for any association between cerebral amyloid deposition and cognitive impairment in PD, in a sample enriched for cases with mild cognitive impairment. This cross-sectional study used Movement Disorders Society level II criteria to classify 115 participants with PD as having normal cognition (PDN, n = 23), mild cognitive impairment (PD-MCI, n = 76), or dementia (PDD, n = 16). We acquired 18F-Florbetaben (FBB) amyloid PET and structural MRI. Amyloid deposition was assessed between the three cognitive groups, and also across the whole sample using continuous measures of both global cognitive status and average performance in memory domain tests. Outcomes were cortical FBB uptake, expressed in centiloids and as standardized uptake value ratios (SUVR) using the Centiloid Project whole cerebellum region as a reference, and regional SUVR measurements. FBB binding was higher in PDD, but this difference did not survive adjustment for the older age of the PDD group. We established a suitable centiloid cut-off for amyloid positivity in Parkinson's disease (31.3), but there was no association of FBB binding with global cognitive or memory scores. The failure to find an association between PET amyloid deposition and cognitive impairment in a moderately large sample, particularly given that it was enriched with PD-MCI patients at risk of dementia, suggests that amyloid pathology is not the primary driver of cognitive impairment and dementia in most patients with PD.
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Affiliation(s)
- Tracy R Melzer
- New Zealand Brain Research Institute, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand.,Brain Research New Zealand Rangahau Roro Aotearoa Centre of Research Excellence, Christchurch, New Zealand
| | - Megan R Stark
- New Zealand Brain Research Institute, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Ross J Keenan
- New Zealand Brain Research Institute, Christchurch, New Zealand.,Pacific Radiology Group, Christchurch, New Zealand
| | - Daniel J Myall
- New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Michael R MacAskill
- New Zealand Brain Research Institute, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Toni L Pitcher
- New Zealand Brain Research Institute, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand.,Brain Research New Zealand Rangahau Roro Aotearoa Centre of Research Excellence, Christchurch, New Zealand
| | - Leslie Livingston
- New Zealand Brain Research Institute, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Sophie Grenfell
- New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Kyla-Louise Horne
- New Zealand Brain Research Institute, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Bob N Young
- New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Maddie J Pascoe
- New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Mustafa M Almuqbel
- New Zealand Brain Research Institute, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand.,Pacific Radiology Group, Christchurch, New Zealand
| | - Jian Wang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Steven H Marsh
- Department of Physics and Astronomy, University of Canterbury, Christchurch, New Zealand
| | - David H Miller
- New Zealand Brain Research Institute, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand.,Institute of Neurology, University College London, London, United Kingdom
| | - John C Dalrymple-Alford
- New Zealand Brain Research Institute, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand.,Brain Research New Zealand Rangahau Roro Aotearoa Centre of Research Excellence, Christchurch, New Zealand.,Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Tim J Anderson
- New Zealand Brain Research Institute, Christchurch, New Zealand.,Department of Medicine, University of Otago, Christchurch, New Zealand.,Brain Research New Zealand Rangahau Roro Aotearoa Centre of Research Excellence, Christchurch, New Zealand.,Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
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78
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Su Y, Flores S, Wang G, Hornbeck RC, Speidel B, Joseph-Mathurin N, Vlassenko AG, Gordon BA, Koeppe RA, Klunk WE, Jack CR, Farlow MR, Salloway S, Snider BJ, Berman SB, Roberson ED, Brosch J, Jimenez-Velazques I, van Dyck CH, Galasko D, Yuan SH, Jayadev S, Honig LS, Gauthier S, Hsiung GYR, Masellis M, Brooks WS, Fulham M, Clarnette R, Masters CL, Wallon D, Hannequin D, Dubois B, Pariente J, Sanchez-Valle R, Mummery C, Ringman JM, Bottlaender M, Klein G, Milosavljevic-Ristic S, McDade E, Xiong C, Morris JC, Bateman RJ, Benzinger TLS. Comparison of Pittsburgh compound B and florbetapir in cross-sectional and longitudinal studies. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2019; 11:180-190. [PMID: 30847382 PMCID: PMC6389727 DOI: 10.1016/j.dadm.2018.12.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction Quantitative in vivo measurement of brain amyloid burden is important for both research and clinical purposes. However, the existence of multiple imaging tracers presents challenges to the interpretation of such measurements. This study presents a direct comparison of Pittsburgh compound B–based and florbetapir-based amyloid imaging in the same participants from two independent cohorts using a crossover design. Methods Pittsburgh compound B and florbetapir amyloid PET imaging data from three different cohorts were analyzed using previously established pipelines to obtain global amyloid burden measurements. These measurements were converted to the Centiloid scale to allow fair comparison between the two tracers. The mean and inter-individual variability of the two tracers were compared using multivariate linear models both cross-sectionally and longitudinally. Results Global amyloid burden measured using the two tracers were strongly correlated in both cohorts. However, higher variability was observed when florbetapir was used as the imaging tracer. The variability may be partially caused by white matter signal as partial volume correction reduces the variability and improves the correlations between the two tracers. Amyloid burden measured using both tracers was found to be in association with clinical and psychometric measurements. Longitudinal comparison of the two tracers was also performed in similar but separate cohorts whose baseline amyloid load was considered elevated (i.e., amyloid positive). No significant difference was detected in the average annualized rate of change measurements made with these two tracers. Discussion Although the amyloid burden measurements were quite similar using these two tracers as expected, difference was observable even after conversion into the Centiloid scale. Further investigation is warranted to identify optimal strategies to harmonize amyloid imaging data acquired using different tracers.
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Affiliation(s)
- Yi Su
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Shaney Flores
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Guoqiao Wang
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA.,Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Russ C Hornbeck
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Benjamin Speidel
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Nelly Joseph-Mathurin
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Andrei G Vlassenko
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Brian A Gordon
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Robert A Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - William E Klunk
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Martin R Farlow
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Barbara J Snider
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Sarah B Berman
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erik D Roberson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jared Brosch
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | | | | | - Shauna H Yuan
- University of California-San Diego, San Diego, CA, USA
| | | | | | - Serge Gauthier
- McGill Center for Studies in Aging, Douglas Mental Health Research Institute, Montreal, Canada
| | | | - Mario Masellis
- Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | | | - Michael Fulham
- University of Sydney and Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | | | - Colin L Masters
- The University of Melbourne and the Florey Institute, Parkville, VIC, Australia
| | - David Wallon
- Inserm U1245, Department of Neurology and CNR-MAJ, Rouen, France.,Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | - Didier Hannequin
- Inserm U1245, Department of Neurology and CNR-MAJ, Rouen, France.,Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | - Bruno Dubois
- University Salpêtrière Hospital in Paris, Paris, France
| | | | | | | | - John M Ringman
- Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA
| | | | | | | | - Eric McDade
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Chengjie Xiong
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA.,Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - John C Morris
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Randall J Bateman
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA
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Properzi MJ, Buckley RF, Chhatwal JP, Donohue MC, Lois C, Mormino EC, Johnson KA, Sperling RA, Schultz AP. Nonlinear Distributional Mapping (NoDiM) for harmonization across amyloid-PET radiotracers. Neuroimage 2019; 186:446-454. [PMID: 30458305 PMCID: PMC6338495 DOI: 10.1016/j.neuroimage.2018.11.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/24/2018] [Accepted: 11/15/2018] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION There is a growing need in clinical research domains for direct comparability between amyloid-beta (Aβ) Positron Emission Tomography (PET) measures obtained via different radiotracers and processing methodologies. Previous efforts to provide a common measurement scale fail to account for non-linearities between measurement scales that can arise from these differences. We introduce a new application of distribution mapping, based on well established statistical orthodoxy, that we call Nonlinear Distribution Mapping (NoDiM). NoDiM uses cumulative distribution functions to derive mappings between Aβ-PET measurements from different tracers and processing streams that align data based on their location in their respective distributions. METHODS Utilizing large datasets of Florbetapir (FBP) from the Alzheimer's Disease Neuroimaging Initiative (n = 349 female (%) = 53) and Pittsburgh Compound B (PiB) from the Harvard Aging Brain Study (n = 305 female (%) = 59.3) and the Australian Imaging, Biomarker & Lifestyle Flagship Study of Ageing (n = 184 female (%) = 53.3), we fit explicit mathematical models of a mixture of two normal distributions, with parameter estimates from Gaussian Mixture Models, to each tracer's empirical data. We demonstrate the accuracy of these fits, and then show the ability of NoDiM to transform FBP measurements into PiB-like units. RESULTS A mixture of two normal distributions fit both the FBP and PiB empirical data and provides a strong basis for derivation of a transfer function. Transforming Aβ-PET data with NoDiM results in FBP and PiB distributions that are closely aligned throughout their entire range, while a linear transformation does not. Additionally the NoDiM transform better matches true positive and false positive profiles across tracers. DISCUSSION The NoDiM transformation provides a useful alternative to the linear mapping advocated in the Centiloid project, and provides improved correspondence between measurements from different tracers across the range of observed values. This improved alignment enables disparate measures to be merged on to continuous scale, and better enables the use of uniform thresholds across tracers.
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Affiliation(s)
- Michael J Properzi
- Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Rachel F Buckley
- Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; The Florey Institute, The University of Melbourne, Victoria, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Victoria, Australia
| | - Jasmeer P Chhatwal
- Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Michael C Donohue
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine, University of Southern California, San Diego, CA, USA
| | - Cristina Lois
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | | | - Keith A Johnson
- Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Reisa A Sperling
- Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Aaron P Schultz
- Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
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80
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Thirunavu V, McCullough A, Su Y, Flores S, Dincer A, Morris JC, Cruchaga C, Benzinger TL, Gordon BA. Higher Body Mass Index Is Associated with Lower Cortical Amyloid-β Burden in Cognitively Normal Individuals in Late-Life. J Alzheimers Dis 2019; 69:817-827. [PMID: 31156169 PMCID: PMC7047466 DOI: 10.3233/jad-190154] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Both low and high body mass index (BMI) have been associated with an increased risk of dementia, including that caused by Alzheimer's disease (AD). Specifically, high middle-age BMI or a low late-age BMI has been considered a predictor for the development of AD dementia. Less studied is the relationship between BMI and AD pathology. OBJECTIVE We explored the association between BMI and cortical amyloid-β (Aβ) burden in cognitively normal participants that were either in mid-life (45-60 years) or late-life (>60). METHODS We analyzed cross-sectional baseline data from the Knight Alzheimer Disease Research Center (ADRC) at Washington University. Aβ pathology was measured in 373 individuals with Aβ PET imaging and was quantified using Centiloid units. We split the cohort into mid- and late-life groups for analyses (n = 96 and n = 277, respectively). We ran general linear regression models to predict Aβ levels from BMI while controlling for age, sex, years of education, and APOE4 status. Analyses were also conducted to test the interaction between BMI and APOE4 genotype and between BMI and sex. RESULTS Higher BMI was associated with lower cortical Aβ burden in late-life (β= -0.81, p = 0.0066), but no relationship was found in mid-life (β= 0.04, p > 0.5). The BMI×APOE4+ and BMI×male interaction terms were not significant in the mid-life (β= 0.28, p = 0.41; β= 0.64, p = 0.13) or the late-life (β= 0.17, p > 0.5; β= 0.50, p = 0.43) groups. CONCLUSION Higher late-life BMI is associated with lower cortical Aβ burden in cognitively normal individuals.
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Affiliation(s)
| | - Austin McCullough
- Department of Radiology, Washington University in St. Louis, MO, USA
| | - Yi Su
- Banner Alzheimer’s Institute, Phoenix, AZ, USA
| | - Shaney Flores
- Department of Radiology, Washington University in St. Louis, MO, USA
| | - Aylin Dincer
- Department of Radiology, Washington University in St. Louis, MO, USA
| | - John C. Morris
- Knight Alzheimer Disease Research Center, Washington University in St. Louis, MO, USA
- Department of Neurology, Washington University in St. Louis, MO, USA
| | - Carlos Cruchaga
- Knight Alzheimer Disease Research Center, Washington University in St. Louis, MO, USA
- Department of Psychiatry, Washington University in St. Louis, MO, USA
| | - Tammie L.S. Benzinger
- Department of Radiology, Washington University in St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University in St. Louis, MO, USA
| | - Brian A. Gordon
- Department of Radiology, Washington University in St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University in St. Louis, MO, USA
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81
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Cohen AD, Landau SM, Snitz BE, Klunk WE, Blennow K, Zetterberg H. Fluid and PET biomarkers for amyloid pathology in Alzheimer's disease. Mol Cell Neurosci 2018; 97:3-17. [PMID: 30537535 DOI: 10.1016/j.mcn.2018.12.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 12/05/2018] [Indexed: 02/04/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by amyloid plaques and tau pathology (neurofibrillary tangles and neuropil threads). Amyloid plaques are primarily composed of aggregated and oligomeric β-amyloid (Aβ) peptides ending at position 42 (Aβ42). The development of fluid and PET biomarkers for Alzheimer's disease (AD), has allowed for detection of Aβ pathology in vivo and marks a major advancement in understanding the role of Aβ in Alzheimer's disease (AD). In the recent National Institute on Aging and Alzheimer's Association (NIA-AA) Research Framework, AD is defined by the underlying pathology as measured in patients during life by biomarkers (Jack et al., 2018), while clinical symptoms are used for staging of the disease. Therefore, sensitive, specific and robust biomarkers to identify brain amyloidosis are central in AD research. Here, we discuss fluid and PET biomarkers for Aβ and their application.
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Affiliation(s)
- Ann D Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America.
| | - Susan M Landau
- Neurology Helen Wills Neuroscience Institute, University of California, Berkeley, United States of America; Lawrence Berkeley National Laboratory, Molecular Biophysics and Integrated Bioimaging Functional Imaging Department, Life Sciences Division, United States of America
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, United States of America
| | - William E Klunk
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Molndal, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, University College, London, United Kingdom of Great Britain and Northern Ireland
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Molndal, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, University College, London, United Kingdom of Great Britain and Northern Ireland; Department of Molecular Neuroscience, UCL Institute of Neurology, United Kingdom of Great Britain and Northern Ireland; UK Dementia Research Institute at UCL, United Kingdom of Great Britain and Northern Ireland
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