101
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Frölich L, Peters O, Lewczuk P, Gruber O, Teipel SJ, Gertz HJ, Jahn H, Jessen F, Kurz A, Luckhaus C, Hüll M, Pantel J, Reischies FM, Schröder J, Wagner M, Rienhoff O, Wolf S, Bauer C, Schuchhardt J, Heuser I, Rüther E, Henn F, Maier W, Wiltfang J, Kornhuber J. Incremental value of biomarker combinations to predict progression of mild cognitive impairment to Alzheimer's dementia. ALZHEIMERS RESEARCH & THERAPY 2017; 9:84. [PMID: 29017593 PMCID: PMC5634868 DOI: 10.1186/s13195-017-0301-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 08/30/2017] [Indexed: 01/24/2023]
Abstract
Background The progression of mild cognitive impairment (MCI) to Alzheimer’s disease (AD) dementia can be predicted by cognitive, neuroimaging, and cerebrospinal fluid (CSF) markers. Since most biomarkers reveal complementary information, a combination of biomarkers may increase the predictive power. We investigated which combination of the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR)-sum-of-boxes, the word list delayed free recall from the Consortium to Establish a Registry of Dementia (CERAD) test battery, hippocampal volume (HCV), amyloid-beta1–42 (Aβ42), amyloid-beta1–40 (Aβ40) levels, the ratio of Aβ42/Aβ40, phosphorylated tau, and total tau (t-Tau) levels in the CSF best predicted a short-term conversion from MCI to AD dementia. Methods We used 115 complete datasets from MCI patients of the “Dementia Competence Network”, a German multicenter cohort study with annual follow-up up to 3 years. MCI was broadly defined to include amnestic and nonamnestic syndromes. Variables known to predict progression in MCI patients were selected a priori. Nine individual predictors were compared by receiver operating characteristic (ROC) curve analysis. ROC curves of the five best two-, three-, and four-parameter combinations were analyzed for significant superiority by a bootstrapping wrapper around a support vector machine with linear kernel. The incremental value of combinations was tested for statistical significance by comparing the specificities of the different classifiers at a given sensitivity of 85%. Results Out of 115 subjects, 28 (24.3%) with MCI progressed to AD dementia within a mean follow-up period of 25.5 months. At baseline, MCI-AD patients were no different from stable MCI in age and gender distribution, but had lower educational attainment. All single biomarkers were significantly different between the two groups at baseline. ROC curves of the individual predictors gave areas under the curve (AUC) between 0.66 and 0.77, and all single predictors were statistically superior to Aβ40. The AUC of the two-parameter combinations ranged from 0.77 to 0.81. The three-parameter combinations ranged from AUC 0.80–0.83, and the four-parameter combination from AUC 0.81–0.82. None of the predictor combinations was significantly superior to the two best single predictors (HCV and t-Tau). When maximizing the AUC differences by fixing sensitivity at 85%, the two- to four-parameter combinations were superior to HCV alone. Conclusion A combination of two biomarkers of neurodegeneration (e.g., HCV and t-Tau) is not superior over the single parameters in identifying patients with MCI who are most likely to progress to AD dementia, although there is a gradual increase in the statistical measures across increasing biomarker combinations. This may have implications for clinical diagnosis and for selecting subjects for participation in clinical trials.
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Affiliation(s)
- Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Zentralinstitut für Seelische Gesundheit, Quadrat J5, D-68159, Mannheim, Germany.
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité, Berlin, Germany
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Nuremberg, Germany.,Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Oliver Gruber
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, and German Center for Neurodegenerative Diseases (DZNE), Research Site Göttingen, Göttingen, Germany
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.,Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Hermann J Gertz
- Department of Psychiatry, University of Leipzig, Leipzig, Germany
| | - Holger Jahn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Cologne/Bonn, Germany.,Department of Psychiatry and Psychotherapy, Medical Faculty University of Cologne, Cologne, Germany
| | - Alexander Kurz
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Christian Luckhaus
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany
| | - Michael Hüll
- Center for Psychiatry, Clinic for Geriatric Psychiatry and Psychotherapy Emmendingen and Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg, Germany
| | - Johannes Pantel
- Institute of General Medicine University of Frankfurt, Frankfurt am Main, Germany
| | - Friedel M Reischies
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité, Berlin, Germany
| | - Johannes Schröder
- Section for Geriatric Psychiatry Research, Department for Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Otto Rienhoff
- Department of Medical Informatics, University of Göttingen, Göttingen, Germany
| | - Stefanie Wolf
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, and German Center for Neurodegenerative Diseases (DZNE), Research Site Göttingen, Göttingen, Germany
| | | | | | - Isabella Heuser
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité, Berlin, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, and German Center for Neurodegenerative Diseases (DZNE), Research Site Göttingen, Göttingen, Germany
| | - Fritz Henn
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Zentralinstitut für Seelische Gesundheit, Quadrat J5, D-68159, Mannheim, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, and German Center for Neurodegenerative Diseases (DZNE), Research Site Göttingen, Göttingen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Nuremberg, Germany.,Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland
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102
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van Waalwijk van Doorn LJC, Kulic L, Koel-Simmelink MJA, Kuiperij HB, Versleijen AAM, Struyfs H, Twaalfhoven HAM, Fourier A, Engelborghs S, Perret-Liaudet A, Lehmann S, Verbeek MM, Vanmechelen EJM, Teunissen CE. Multicenter Analytical Validation of Aβ40 Immunoassays. Front Neurol 2017; 8:310. [PMID: 28725210 PMCID: PMC5497061 DOI: 10.3389/fneur.2017.00310] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 06/14/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Before implementation in clinical practice, biomarker assays need to be thoroughly analytically validated. There is currently a strong interest in implementation of the ratio of amyloid-β peptide 1-42 and 1-40 (Aβ42/Aβ40) in clinical routine. Therefore, in this study, we compared the analytical performance of six assays detecting Aβ40 in cerebrospinal fluid (CSF) in six laboratories according to a recently standard operating procedure (SOP) developed for implementation of ELISA assays for clinical routine. METHODS Aβ40 assays of six vendors were validated in up to three centers per assay according to recently proposed international consensus validation protocols. The performance parameters included sensitivity, precision, dilutional linearity, recovery, and parallelism. Inter-laboratory variation was determined using a set of 20 CSF samples. In addition, test results were used to critically evaluate the SOPs that were used to validate the assays. RESULTS Most performance parameters of the different Aβ40 assays were similar between labs and within the predefined acceptance criteria. The only exceptions were the out-of-range results of recovery for the majority of experiments and of parallelism by three laboratories. Additionally, experiments to define the dilutional linearity and hook-effect were not executed correctly in part of the centers. The inter-laboratory variation showed acceptable low levels for all assays. Absolute concentrations measured by the assays varied by a factor up to 4.7 for the extremes. CONCLUSION All validated Aβ40 assays appeared to be of good technical quality and performed generally well according to predefined criteria. A novel version of the validation SOP is developed based on these findings, to further facilitate implementation of novel immunoassays in clinical practice.
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Affiliation(s)
- Linda J C van Waalwijk van Doorn
- Department of Neurology, Radboud University Medical Center, Radboud Alzheimer Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands.,Department of Laboratory Medicine, Radboud University Medical Center, Radboud Alzheimer Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Luka Kulic
- Institute for Regenerative Medicine (IREM), University of Zurich, Schlieren, Switzerland
| | - Marleen J A Koel-Simmelink
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, VU University Medical Center, Neurocampus, Amsterdam, Netherlands
| | - H Bea Kuiperij
- Department of Neurology, Radboud University Medical Center, Radboud Alzheimer Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands.,Department of Laboratory Medicine, Radboud University Medical Center, Radboud Alzheimer Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Alexandra A M Versleijen
- Department of Laboratory Medicine, Radboud University Medical Center, Radboud Alzheimer Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Hanne Struyfs
- Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Harry A M Twaalfhoven
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, VU University Medical Center, Neurocampus, Amsterdam, Netherlands
| | - Anthony Fourier
- Neurobiology Laboratory, Centre for Memory Resources and Research (CMRR), Groupement Hospitalier Est (GHE), Hôpitaux de Lyon, Université Lyon 1, CNRS UMR5292, INSERM U1028, Lyon, France
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.,Memory Clinic and Department of Neurology, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium
| | - Armand Perret-Liaudet
- Neurobiology Laboratory, Centre for Memory Resources and Research (CMRR), Groupement Hospitalier Est (GHE), Hôpitaux de Lyon, Université Lyon 1, CNRS UMR5292, INSERM U1028, Lyon, France
| | - Sylvain Lehmann
- CHU de Montpellier and Université de Montpellier, IRMB, Laboratoire de Biochimie Protéomique Clinique, Montpellier, France
| | - Marcel M Verbeek
- Department of Neurology, Radboud University Medical Center, Radboud Alzheimer Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands.,Department of Laboratory Medicine, Radboud University Medical Center, Radboud Alzheimer Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | | | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, VU University Medical Center, Neurocampus, Amsterdam, Netherlands
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103
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Olsson B, Schott JM, Blennow K, Zetterberg H. The use of cerebrospinal fluid biomarkers to measure change in neurodegeneration in Alzheimer’s disease clinical trials. Expert Rev Neurother 2017; 17:767-775. [DOI: 10.1080/14737175.2017.1341311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Bob Olsson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Jonathan M. Schott
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, United Kingdom
- UK Dementia Research Institute, London, UK
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104
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Abstract
Aggregation of the amyloid-β (Aβ) peptide is strongly correlated with Alzheimer's disease (AD). Recent research has improved our understanding of the kinetics of amyloid fibril assembly and revealed new details regarding different stages in plaque formation. Presently, interest is turning toward studying this process in a holistic context, focusing on cellular components which interact with the Aβ peptide at various junctures during aggregation, from monomer to cross-β amyloid fibrils. However, even in isolation, a multitude of factors including protein purity, pH, salt content, and agitation affect Aβ fibril formation and deposition, often producing complicated and conflicting results. The failure of numerous inhibitors in clinical trials for AD suggests that a detailed examination of the complex interactions that occur during plaque formation, including binding of carbohydrates, lipids, nucleic acids, and metal ions, is important for understanding the diversity of manifestations of the disease. Unraveling how a variety of key macromolecular modulators interact with the Aβ peptide and change its aggregation properties may provide opportunities for developing therapies. Since no protein acts in isolation, the interplay of these diverse molecules may differentiate disease onset, progression, and severity, and thus are worth careful consideration.
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Affiliation(s)
- Katie L Stewart
- Astbury Centre for Structural Molecular Biology, School of Molecular and Cellular Biology, University of Leeds, Leeds, LS2 9JT, UK.
| | - Sheena E Radford
- Astbury Centre for Structural Molecular Biology, School of Molecular and Cellular Biology, University of Leeds, Leeds, LS2 9JT, UK.
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105
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Prion-specific and surrogate CSF biomarkers in Creutzfeldt-Jakob disease: diagnostic accuracy in relation to molecular subtypes and analysis of neuropathological correlates of p-tau and Aβ42 levels. Acta Neuropathol 2017; 133:559-578. [PMID: 28205010 PMCID: PMC5348556 DOI: 10.1007/s00401-017-1683-0] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/26/2017] [Accepted: 01/29/2017] [Indexed: 01/28/2023]
Abstract
The differential diagnosis of Creutzfeldt-Jakob disease (CJD) from other, sometimes treatable, neurological disorders is challenging, owing to the wide phenotypic heterogeneity of the disease. Real-time quaking-induced prion conversion (RT-QuIC) is a novel ultrasensitive in vitro assay, which, at variance with surrogate neurodegenerative biomarker assays, specifically targets the pathological prion protein (PrPSc). In the studies conducted to date in CJD, cerebrospinal fluid (CSF) RT-QuIC showed good diagnostic sensitivity (82–96%) and virtually full specificity. In the present study, we investigated the diagnostic value of both prion RT-QuIC and surrogate protein markers in a large patient population with suspected CJD and then evaluated the influence on CSF findings of the CJD type, and the associated amyloid-β (Aβ) and tau neuropathology. RT-QuIC showed an overall diagnostic sensitivity of 82.1% and a specificity of 99.4%. However, sensitivity was lower in CJD types linked to abnormal prion protein (PrPSc) type 2 (VV2, MV2K and MM2C) than in typical CJD (MM1). Among surrogate proteins markers (14-3-3, total (t)-tau, and t-tau/phosphorylated (p)-tau ratio) t-tau performed best in terms of both specificity and sensitivity for all sCJD types. Sporadic CJD VV2 and MV2K types demonstrated higher CSF levels of p-tau when compared to other sCJD types and this positively correlated with the amount of tiny tau deposits in brain areas showing spongiform change. CJD patients showed moderately reduced median Aβ42 CSF levels, with 38% of cases having significantly decreased protein levels in the absence of Aβ brain deposits. Our results: (1) support the use of both RT-QuIC and t-tau assays as first line laboratory investigations for the clinical diagnosis of CJD; (2) demonstrate a secondary tauopathy in CJD subtypes VV2 and MV2K, correlating with increased p-tau levels in the CSF and (3) provide novel insight into the issue of the accuracy of CSF p-tau and Aβ42 as markers of brain tauopathy and β-amyloidosis.
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106
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Gervaise-Henry C, Watfa G, Albuisson E, Kolodziej A, Dousset B, Olivier JL, Jonveaux TR, Malaplate-Armand C. Cerebrospinal Fluid Aβ42/Aβ40 as a Means to Limiting Tube- and Storage-Dependent Pre-Analytical Variability in Clinical Setting. J Alzheimers Dis 2017; 57:437-445. [DOI: 10.3233/jad-160865] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Christelle Gervaise-Henry
- Laboratoire de Biochimie et Biologie Moléculaire, UF Oncologie-Endocrinologie-Neurobiologie, Hôpital Central, Centre Hospitalier Universitaire, Nancy, France
| | - Gasshan Watfa
- CMRR de Lorraine Hôpital de Brabois CHU Nancy, Vandoeuvre lès Nancy, Nancy, France
| | - Eliane Albuisson
- Unité ESPRI-BioBase, CHRU Nancy, Vandoeuvre lès Nancy, Nancy, France
| | - Allan Kolodziej
- Laboratoire de Biochimie et Biologie Moléculaire, UF Oncologie-Endocrinologie-Neurobiologie, Hôpital Central, Centre Hospitalier Universitaire, Nancy, France
| | - Brigitte Dousset
- Laboratoire de Biochimie et Biologie Moléculaire, UF Oncologie-Endocrinologie-Neurobiologie, Hôpital Central, Centre Hospitalier Universitaire, Nancy, France
| | - Jean-Luc Olivier
- Laboratoire de Biochimie et Biologie Moléculaire, UF Oncologie-Endocrinologie-Neurobiologie, Hôpital Central, Centre Hospitalier Universitaire, Nancy, France
- UR AFPA–USC 340, Equipe BFLA, Université de Lorraine, Nancy, France
| | | | - Catherine Malaplate-Armand
- Laboratoire de Biochimie et Biologie Moléculaire, UF Oncologie-Endocrinologie-Neurobiologie, Hôpital Central, Centre Hospitalier Universitaire, Nancy, France
- UR AFPA–USC 340, Equipe BFLA, Université de Lorraine, Nancy, France
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107
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Willemse E, van Uffelen K, Brix B, Engelborghs S, Vanderstichele H, Teunissen C. How to handle adsorption of cerebrospinal fluid amyloid β (1-42) in laboratory practice? Identifying problematic handlings and resolving the issue by use of the Aβ42
/Aβ40
ratio. Alzheimers Dement 2017; 13:885-892. [DOI: 10.1016/j.jalz.2017.01.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 12/21/2016] [Accepted: 01/07/2017] [Indexed: 01/03/2023]
Affiliation(s)
- Eline Willemse
- Neurochemistry Laboratory, Department of Clinical Chemistry, Neuroscience Campus Amsterdam; VU University Medical Center; Amsterdam The Netherlands
- Department of Neurology, Alzheimer Center, Neuroscience Campus Amsterdam; VU University Medical Center; Amsterdam The Netherlands
| | - Kees van Uffelen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Neuroscience Campus Amsterdam; VU University Medical Center; Amsterdam The Netherlands
| | - Britta Brix
- Neurodegenerative Diseases Department, EUROIMMUN Medizinische Labordiagnostika AG; Lübeck Germany
| | - Sebastiaan Engelborghs
- Department of Biomedical Sciences, Reference Centre for Biological Markers of Dementia (BIODEM); University of Antwerp; Antwerpen Belgium
- Department of Neurology and Memory Clinic; Hospital Network Antwerp; Antwerpen Belgium
| | | | - Charlotte Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Neuroscience Campus Amsterdam; VU University Medical Center; Amsterdam The Netherlands
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108
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Bousiges O, Cretin B, Lavaux T, Philippi N, Jung B, Hezard S, Heitz C, Demuynck C, Gabel A, Martin-Hunyadi C, Blanc F. Diagnostic Value of Cerebrospinal Fluid Biomarkers (Phospho-Tau181, total-Tau, Aβ42, and Aβ40) in Prodromal Stage of Alzheimer's Disease and Dementia with Lewy Bodies. J Alzheimers Dis 2016; 51:1069-83. [PMID: 26923009 DOI: 10.3233/jad-150731] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Dementia with Lewy bodies (DLB) symptoms are close to those of Alzheimer's disease (AD), and the differential diagnosis is difficult especially early in the disease. Unfortunately, AD biomarkers in cerebrospinal fluid (CSF), and more particularly Aβ1 - 42, appear to be altered in dementia with Lewy bodies (DLB). However, the level of these biomarkers has never been studied in the prodromal stage of the disease. OBJECTIVE To compare these biomarkers between DLB and AD, with a particular focus on the prodromal stage. METHODS A total of 166 CSF samples were collected at the memory clinic of Strasbourg. They were obtained from prodromal DLB (pro-DLB), DLB dementia, prodromal AD (pro-AD), and AD dementia patients, and elderly controls. Phospho-Tau181, total-Tau, Aβ42, and Aβ40 were measured in the CSF. RESULTS At the prodromal stage, contrary to AD patients, DLB patients' biomarker levels in the CSF were not altered. At the demented stage of DLB, Aβ42 levels were reduced as well as Aβ40 levels. Thus, the Aβ42/Aβ40 ratio remained unchanged between the prodromal and demented stages, contrary to what was observed in AD. Tau and Phospho-Tau181 levels were unaltered in DLB patients. CONCLUSIONS We have shown that at the prodromal stage the DLB patients had no pathological profile. Consequently, CSF AD biomarkers are extremely useful for differentiating AD from DLB patients particularly at this stage when the clinical diagnosis is difficult. Thus, these results open up new perspectives on the interpretation of AD biomarkers in DLB.
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Affiliation(s)
- Olivier Bousiges
- University Hospital of Strasbourg, Laboratory of Biochemistry and Molecular Biology, Strasbourg, France.,University of Strasbourg and CNRS, Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA), UMR7364, Strasbourg, France
| | - Benjamin Cretin
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France.,University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Thomas Lavaux
- University Hospital of Strasbourg, Laboratory of Biochemistry and Molecular Biology, Strasbourg, France
| | - Nathalie Philippi
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France.,University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France.,University Hospital of Strasbourg, Geriatrics Day Hospital, Geriatrics Service, Strasbourg, France
| | - Barbara Jung
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France.,University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France.,University Hospital of Strasbourg, Geriatrics Day Hospital, Geriatrics Service, Strasbourg, France
| | - Sylvie Hezard
- University Hospital of Strasbourg, Laboratory of Biochemistry and Molecular Biology, Strasbourg, France
| | - Camille Heitz
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France.,University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Catherine Demuynck
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France.,University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France.,University Hospital of Strasbourg, Geriatrics Day Hospital, Geriatrics Service, Strasbourg, France
| | - Aurelia Gabel
- University Hospital of Strasbourg, Laboratory of Biochemistry and Molecular Biology, Strasbourg, France
| | - Catherine Martin-Hunyadi
- University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France.,University Hospital of Strasbourg, Geriatrics Day Hospital, Geriatrics Service, Strasbourg, France
| | - Frédéric Blanc
- University Hospital of Strasbourg, Neuropsychology Unit, Neurology Service, Strasbourg, France.,University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto, Strasbourg, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France.,University Hospital of Strasbourg, Geriatrics Day Hospital, Geriatrics Service, Strasbourg, France
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109
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Electroconvulsive therapy selectively enhances amyloid β 1-42 in the cerebrospinal fluid of patients with major depression: A prospective pilot study. Eur Neuropsychopharmacol 2016; 26:1877-1884. [PMID: 27876183 DOI: 10.1016/j.euroneuro.2016.11.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/31/2016] [Accepted: 11/08/2016] [Indexed: 12/13/2022]
Abstract
A complex interplay between β-amyloid (Aβ), Alzheimer׳s disease (AD) and major depression disorder (MDD) suggests that patients with MDD have an altered cerebral Aβ metabolism and an increased risk of developing AD. In order to elucidate the relationship between antidepressant treatment and Aβ metabolism in humans, we performed a study on Aβ peptides in the cerebrospinal fluid (CSF) in patients with MDD during electroconvulsive therapy (ECT) as an effective antidepressant treatment. We measured the levels of Aβ1-42, Aβ1-40 and of tau proteins in the CSF in 12 patients with MDD before and after a course of ECT. Aβ1-42 was significantly elevated after the ECT treatment compared to baseline, whereas no difference was found for other peptides and proteins such as Aβ1-40, Aβ ratio, total tau protein or its phosphorylated form. The most salient finding was, that the increase of Aβ1-42 after ECT was found in all patients with clinical response to the treatment, but not in those who did not respond. The number of ECT sessions of each responding patient correlated with the increase of Aβ1-42 in the CSF. Our data point towards to a specific antidepressant mechanism which is not based on a general increase of Aβ, but seems to involve merely Aβ1-42, the isoform with highest amyloidogenic potential. We present the first study in humans demonstrating an isolated mobilization of Aβ1-42 in the CSF of patients with depression who respond to an ECT treatment.
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110
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Pistono A, Jucla M, Barbeau EJ, Saint-Aubert L, Lemesle B, Calvet B, Köpke B, Puel M, Pariente J. Pauses During Autobiographical Discourse Reflect Episodic Memory Processes in Early Alzheimer's Disease. J Alzheimers Dis 2016; 50:687-98. [PMID: 26757034 PMCID: PMC4927846 DOI: 10.3233/jad-150408] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There is a large body of research on discourse production in Alzheimer’s disease (AD). Some studies have focused on pause production, revealing that patients make extensive use of pauses during speech. This has been attributed to lexical retrieval difficulties, but pausing may also reflect other forms of cognitive impairment as it increases with cognitive load. The aim of the present study was to analyze autobiographical discourse impairment in AD from a broad perspective, looking at pausing behavior (frequency, duration, and location). Our first objective was to characterize discourse changes in mild cognitive impairment (MCI) due to AD. Our second objective was to determine the cognitive and neuroanatomical correlates of these changes. Fifteen patients with MCI due to AD and 15 matched cognitively normal controls underwent an ecological episodic memory task, a full neuropsychological assessment, and a 3D T1-weighted MRI scans. Autobiographical discourse collected from the ecological episodic memory task was recorded, transcribed, and analyzed, focusing on pausing. Intergroup comparisons showed that although patients did not produce more pauses than controls overall, they did make more between-utterance pauses. The number of these specific pauses was positively correlated with patients’ episodic memory performance. Furthermore, neuroimaging analysis showed that, in the patient group, their use was negatively correlated with frontopolar area (BA 10) grey matter density. This region may therefore play an important role in the planning of autobiographical discourse production. These findings demonstrate that pauses in early AD may reflect a compensatory mechanism for improving mental time travel and memory retrieval.
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Affiliation(s)
- Aurélie Pistono
- "Brain Imaging and Neurological Disabilities" joint research unit (UMR 825), INSERM, Toulouse University Hospital, Toulouse, France.,"Brain Imaging and Neurological Disabilities" joint research unit (UMR 825), University of Toulouse III - Paul Sabatier, Toulouse University Hospital, Toulouse, France.,Octogone-Lordat interdisciplinary research unit (EA 4156), University of Toulouse II - Jean Jaurès, Toulouse, France
| | - Mélanie Jucla
- Octogone-Lordat interdisciplinary research unit (EA 4156), University of Toulouse II - Jean Jaurès, Toulouse, France
| | - Emmanuel J Barbeau
- Centre for Brain Research and Cognition (CerCo), CNRS - University of Toulouse III - Paul Sabatier, Toulouse, France
| | - Laure Saint-Aubert
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Translational Alzheimer Neurobiology, Karolinska Institutet, Novum, Stockholm, Sweden
| | - Béatrice Lemesle
- Neurology Department, Neuroscience Centre, Toulouse University Hospital, Toulouse, France
| | - Benjamin Calvet
- Adult and elder psychiatry Department, Limoges Hospital, Limoges, France
| | - Barbara Köpke
- Octogone-Lordat interdisciplinary research unit (EA 4156), University of Toulouse II - Jean Jaurès, Toulouse, France
| | - Michèle Puel
- "Brain Imaging and Neurological Disabilities" joint research unit (UMR 825), INSERM, Toulouse University Hospital, Toulouse, France.,"Brain Imaging and Neurological Disabilities" joint research unit (UMR 825), University of Toulouse III - Paul Sabatier, Toulouse University Hospital, Toulouse, France.,Neurology Department, Neuroscience Centre, Toulouse University Hospital, Toulouse, France
| | - Jérémie Pariente
- "Brain Imaging and Neurological Disabilities" joint research unit (UMR 825), INSERM, Toulouse University Hospital, Toulouse, France.,"Brain Imaging and Neurological Disabilities" joint research unit (UMR 825), University of Toulouse III - Paul Sabatier, Toulouse University Hospital, Toulouse, France.,Neurology Department, Neuroscience Centre, Toulouse University Hospital, Toulouse, France
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111
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Pannee J, Portelius E, Minthon L, Gobom J, Andreasson U, Zetterberg H, Hansson O, Blennow K. Reference measurement procedure for CSF amyloid beta (Aβ) 1-42 and the CSF Aβ 1-42 /Aβ 1-40 ratio - a cross-validation study against amyloid PET. J Neurochem 2016; 139:651-658. [PMID: 27579672 DOI: 10.1111/jnc.13838] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 08/12/2016] [Accepted: 08/22/2016] [Indexed: 01/14/2023]
Abstract
A clinical diagnosis of Alzheimer's disease is currently made on the basis of results from cognitive tests in combination with medical history and general clinical evaluation, but the peptide amyloid-beta (Aβ) in cerebrospinal fluid (CSF) is increasingly used as a biomarker for amyloid pathology in clinical trials and in recently proposed revised clinical criteria for Alzheimer's disease. Recent analytical developments have resulted in mass spectrometry (MS) reference measurement procedures for absolute quantification of Aβ1-42 in CSF. The CSF Aβ1-42 /Aβ1-40 ratio has been suggested to improve the detection of cerebral amyloid deposition, by compensating for inter-individual variations in total Aβ production. Our aim was to cross-validate the reference measurement procedure as well as the Aβ1-42 /Aβ1-40 and Aβ1-42 /Aβ1-38 ratios in CSF, measured by high-resolution MS, with the cortical level of Aβ fibrils as measured by amyloid (18 F-flutemetamol) positron emission tomography (PET). We included 100 non-demented patients with cognitive symptoms from the Swedish BioFINDER study, all of whom had undergone both lumbar puncture and 18 F-flutemetamol PET. Comparing CSF Aβ1-42 concentrations with 18 F-flutemetamol PET showed high concordance with an area under the receiver operating characteristic curve of 0.85 and a sensitivity and specificity of 82% and 81%, respectively. The ratio of Aβ1-42 /Aβ1-40 or Aβ1-42 /Aβ1-38 significantly improved concordance with an area under the receiver operating characteristic curve of 0.95 and a sensitivity and specificity of 96% and 91%, respectively. These results show that the CSF Aβ1-42 /Aβ1-40 and Aβ1-42 /Aβ1-38 ratios using the described MS method are strongly associated with cortical Aβ fibrils measured by 18 F-flutemetamol PET.
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Affiliation(s)
- Josef Pannee
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Erik Portelius
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Lennart Minthon
- Department of Clinical Sciences, Lund University, Lund, Sweden.,Memory Clinic, Department of Neurology, Skåne University Hospital, Malmö, Sweden
| | - Johan Gobom
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Ulf Andreasson
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden.,UCL Institute of Neurology, London, UK
| | - Oskar Hansson
- Department of Clinical Sciences, Lund University, Lund, Sweden.,Memory Clinic, Department of Neurology, Skåne University Hospital, Malmö, Sweden
| | - Kaj Blennow
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
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Leuzy A, Chiotis K, Hasselbalch SG, Rinne JO, de Mendonça A, Otto M, Lleó A, Castelo-Branco M, Santana I, Johansson J, Anderl-Straub S, von Arnim CAF, Beer A, Blesa R, Fortea J, Herukka SK, Portelius E, Pannee J, Zetterberg H, Blennow K, Nordberg A. Pittsburgh compound B imaging and cerebrospinal fluid amyloid-β in a multicentre European memory clinic study. Brain 2016; 139:2540-53. [PMID: 27401520 PMCID: PMC4995359 DOI: 10.1093/brain/aww160] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 05/02/2016] [Accepted: 05/20/2016] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to assess the agreement between data on cerebral amyloidosis, derived using Pittsburgh compound B positron emission tomography and (i) multi-laboratory INNOTEST enzyme linked immunosorbent assay derived cerebrospinal fluid concentrations of amyloid-β42; (ii) centrally measured cerebrospinal fluid amyloid-β42 using a Meso Scale Discovery enzyme linked immunosorbent assay; and (iii) cerebrospinal fluid amyloid-β42 centrally measured using an antibody-independent mass spectrometry-based reference method. Moreover, we examined the hypothesis that discordance between amyloid biomarker measurements may be due to interindividual differences in total amyloid-β production, by using the ratio of amyloid-β42 to amyloid-β40 Our study population consisted of 243 subjects from seven centres belonging to the Biomarkers for Alzheimer's and Parkinson's Disease Initiative, and included subjects with normal cognition and patients with mild cognitive impairment, Alzheimer's disease dementia, frontotemporal dementia, and vascular dementia. All had Pittsburgh compound B positron emission tomography data, cerebrospinal fluid INNOTEST amyloid-β42 values, and cerebrospinal fluid samples available for reanalysis. Cerebrospinal fluid samples were reanalysed (amyloid-β42 and amyloid-β40) using Meso Scale Discovery electrochemiluminescence enzyme linked immunosorbent assay technology, and a novel, antibody-independent, mass spectrometry reference method. Pittsburgh compound B standardized uptake value ratio results were scaled using the Centiloid method. Concordance between Meso Scale Discovery/mass spectrometry reference measurement procedure findings and Pittsburgh compound B was high in subjects with mild cognitive impairment and Alzheimer's disease, while more variable results were observed for cognitively normal and non-Alzheimer's disease groups. Agreement between Pittsburgh compound B classification and Meso Scale Discovery/mass spectrometry reference measurement procedure findings was further improved when using amyloid-β42/40 Agreement between Pittsburgh compound B visual ratings and Centiloids was near complete. Despite improved agreement between Pittsburgh compound B and centrally analysed cerebrospinal fluid, a minority of subjects showed discordant findings. While future studies are needed, our results suggest that amyloid biomarker results may not be interchangeable in some individuals.
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Affiliation(s)
- Antoine Leuzy
- 1 Department of Neurobiology, Care Science, and Society, Centre for Alzheimer Research, Division of Translational Alzheimer Neurobiology, Karolinska Institutet, Stockholm, Sweden
| | - Konstantinos Chiotis
- 1 Department of Neurobiology, Care Science, and Society, Centre for Alzheimer Research, Division of Translational Alzheimer Neurobiology, Karolinska Institutet, Stockholm, Sweden
| | - Steen G Hasselbalch
- 2 Danish Dementia Research Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Juha O Rinne
- 3 Division of Clinical Neurosciences, Turku University Hospital, University of Turku, Turku, Finland 4 Turku PET Centre, University of Turku, Turku, Finland
| | - Alexandre de Mendonça
- 5 Department of Neurology and Laboratory of Neurosciences, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Markus Otto
- 6 Department of Neurology, Ulm University Hospital, Ulm, Germany
| | - Alberto Lleó
- 7 Department of Neurology, Institut d'Investigacions Biomèdiques, Hospital de Sant Pau, Barcelona, Spain 8 Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Miguel Castelo-Branco
- 9 Institute for Nuclear Sciences Applied to Health (ICNAS), Brain Imaging Network of Portugal, Coimbra, Portugal 10 Institute for Biomedical Imaging and Life Sciences (IBILI) and Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Isabel Santana
- 11 Department of Neurology, Coimbra University Hospital, Coimbra, Portugal 12 Centre for Neuroscience and Cell Biology (CNC), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | | | | | - Ambros Beer
- 13 Department of Nuclear Medicine, Ulm University Hospital, Ulm, Germany
| | - Rafael Blesa
- 7 Department of Neurology, Institut d'Investigacions Biomèdiques, Hospital de Sant Pau, Barcelona, Spain 8 Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Juan Fortea
- 7 Department of Neurology, Institut d'Investigacions Biomèdiques, Hospital de Sant Pau, Barcelona, Spain 8 Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Sanna-Kaisa Herukka
- 14 Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Erik Portelius
- 15 Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - Josef Pannee
- 15 Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- 15 Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden 16 Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - Kaj Blennow
- 15 Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - Agneta Nordberg
- 1 Department of Neurobiology, Care Science, and Society, Centre for Alzheimer Research, Division of Translational Alzheimer Neurobiology, Karolinska Institutet, Stockholm, Sweden 17 Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
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113
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Pusswald G, Tropper E, Kryspin-Exner I, Moser D, Klug S, Auff E, Dal-Bianco P, Lehrner J. Health-Related Quality of Life in Patients with Subjective Cognitive Decline and Mild Cognitive Impairment and its Relation to Activities of Daily Living. J Alzheimers Dis 2016; 47:479-86. [PMID: 26401569 DOI: 10.3233/jad-150284] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Health related quality of life (HRQOL) is an important issue in the context of dementia care. OBJECTIVES The purpose of this study was to investigate HRQOL in patients with subjective cognitive decline (SCD) and mild cognitive impairment (MCI) and its relation to Activity of Daily Living (ADL). METHODS In this cross sectional study, four experimental groups (each n = 98), controls, SCD, naMCI and aMCI, were compared. For data collection, neuropsychological methods (NTBV) and psychological questionnaires (SF-36 and B-ADL) were used. Multivariate analysis of variance was calculated to detect differences in HRQOL between groups. Correlations between HRQOL and ADL were explored. RESULTS The dimensions of HRQOL showed mainly consistent differences between the control and the SCD group and MCI subgroups. In almost every dimension of HRQOL, the control group scored higher than subjects with SCD, naMCI, or aMCI. The controls showed low to moderate negative correlations between HQROL and B-ADL in some dimensions of the HRQOL. In the SCD group, low negative correlations with ADL were observed in some HRQOL scales. Low to moderate correlations were found between each scale of the SF-36 and the B-ADL in both MCI subtypes. We found gender differences in HRQOL. CONCLUSION In conclusion, we could demonstrate that patients with SCD report reduced quality of life. This knowledge is important to get a better understanding of the individuals with SCD and may pave the way for the development of early intervention.
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Affiliation(s)
- Gisela Pusswald
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Elisa Tropper
- Faculty of Psychology, University of Vienna, Vienna, Austria
| | | | - Doris Moser
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Stefanie Klug
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Eduard Auff
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Peter Dal-Bianco
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Johann Lehrner
- Department of Neurology, Medical University of Vienna, Vienna, Austria
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114
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Lin HC, Huang CL, Huang YJ, Hsiao IL, Yang CW, Chuang CY. Transcriptomic gene-network analysis of exposure to silver nanoparticle reveals potentially neurodegenerative progression in mouse brain neural cells. Toxicol In Vitro 2016; 34:289-299. [PMID: 27131904 DOI: 10.1016/j.tiv.2016.04.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 03/30/2016] [Accepted: 04/24/2016] [Indexed: 10/21/2022]
Abstract
Silver nanoparticles (AgNPs) are commonly used in daily living products. AgNPs can induce inflammatory response in neuronal cells, and potentially develop neurological disorders. The gene networks in response to AgNPs-induced neurodegenerative progression have not been clarified in various brain neural cells. This study found that 3-5nm AgNPs were detectable to enter the nuclei of mouse neuronal cells after 24-h of exposure. The differentially expressed genes in mouse brain neural cells exposure to AgNPs were further identified using Phalanx Mouse OneArray® chip, and permitted to explore the gene network pathway regulating in neurodegenerative progression according to Cytoscape analysis. In focal adhesion pathway of ALT astrocytes, AgNPs induced the gene expression of RasGRF1 and reduced its downstream BCL2 gene for apoptosis. In cytosolic DNA sensing pathway of microglial BV2 cells, AgNPs reduced the gene expression of TREX1 and decreased IRF7 to release pro-inflammatory cytokines for inflammation and cellular activation. In MAPK pathway of neuronal N2a cells, AgNPs elevated GADD45α gene expression, and attenuated its downstream PTPRR gene to interfere with neuron growth and differentiation. Moreover, AgNPs induced beta amyloid deposition in N2a cells, and decreased PSEN1 and PSEN2, which may disrupt calcium homeostasis and presynaptic dysfunction for Alzheimer's disease development. These findings suggested that AgNPs exposure reveals the potency to induce the progression of neurodegenerative disorder.
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Affiliation(s)
- Ho-Chen Lin
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, 101, Section 2, Kuang-Fu Road, Hsinchu 30013, Taiwan
| | - Chin-Lin Huang
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, 101, Section 2, Kuang-Fu Road, Hsinchu 30013, Taiwan
| | - Yuh-Jeen Huang
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, 101, Section 2, Kuang-Fu Road, Hsinchu 30013, Taiwan
| | - I-Lun Hsiao
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, 101, Section 2, Kuang-Fu Road, Hsinchu 30013, Taiwan
| | - Chung-Wei Yang
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, 101, Section 2, Kuang-Fu Road, Hsinchu 30013, Taiwan
| | - Chun-Yu Chuang
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, 101, Section 2, Kuang-Fu Road, Hsinchu 30013, Taiwan.
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Peters O, Heuser I, Frölich L, Rüther E, Rienhoff O, Kornhuber J, Wiltfang J, Maier W. [Dementia Competence Network. Results and outlook]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 59:438-43. [PMID: 26979717 DOI: 10.1007/s00103-016-2314-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The Dementia Competence Network (DCN) is represented by academic memory clinics and has three major aims: (1) To facilitate the development of diagnostic tools including neuropsychology, biomarkers, imaging and genetics. (2) To implement clinical trials in mild cognitive impairment and dementia and (3) to improve standard care for dementia in Germany. AIMS This article summarizes the achievements of the DCN so far and highlights future perspectives. METHODS The DCN has built up two multicentre cohorts. Within the first cohort, patients with mild cognitive impairment or mild dementia were examined longitudinally using multiple neuropsychological assessments and numerous different biomarkers. In a subgroup of the first cohort, patients were treated with antidementive drugs in two placebo-controlled clinical trials. The second cohort included cognitively healthy older people and examined repetitively clinical, neuropsychological and psychosocial parameters for ten years. RESULTS AND DISCUSSION The DCN has generated a large data and biomaterial bank. Numerous publications have helped to develop further diagnostic procedures and treatment of cognitive disorders and dementia. The DCN has contributed to end stigmatisation of dementia.
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Affiliation(s)
- Oliver Peters
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin - CBF, Berlin, Deutschland.
| | - Isabella Heuser
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin - CBF, Berlin, Deutschland
| | - Lutz Frölich
- Zentralinstitut für Seelische Gesundheit Mannheim, Mannheim, Deutschland
| | - Eckart Rüther
- Institut für Medizinische Informatik, Universitätsklinik Göttingen, Göttingen, Deutschland
| | - Otto Rienhoff
- Institut für Medizinische Informatik, Universitätsklinik Göttingen, Göttingen, Deutschland
| | - Johannes Kornhuber
- Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - Jens Wiltfang
- Institut für Medizinische Informatik, Universitätsklinik Göttingen, Göttingen, Deutschland
| | - Wolfgang Maier
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Bonn, Deutschland
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116
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CSF biomarkers in neurodegenerative and vascular dementias. Prog Neurobiol 2016; 138-140:36-53. [DOI: 10.1016/j.pneurobio.2016.03.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/12/2016] [Accepted: 03/14/2016] [Indexed: 12/14/2022]
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Adamczuk K, Schaeverbeke J, Vanderstichele HMJ, Lilja J, Nelissen N, Van Laere K, Dupont P, Hilven K, Poesen K, Vandenberghe R. Diagnostic value of cerebrospinal fluid Aβ ratios in preclinical Alzheimer's disease. Alzheimers Res Ther 2015; 7:75. [PMID: 26677842 PMCID: PMC4683859 DOI: 10.1186/s13195-015-0159-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 10/22/2015] [Indexed: 12/31/2022]
Abstract
INTRODUCTION In this study of preclinical Alzheimer's disease (AD) we assessed the added diagnostic value of using cerebrospinal fluid (CSF) Aβ ratios rather than Aβ42 in isolation for detecting individuals who are positive on amyloid positron emission tomography (PET). METHODS Thirty-eight community-recruited cognitively intact older adults (mean age 73, range 65-80 years) underwent (18)F-flutemetamol PET and CSF measurement of Aβ1-42, Aβ1-40, Aβ1-38, and total tau (ttau). (18)F-flutemetamol retention was quantified using standardized uptake value ratios in a composite cortical region (SUVRcomp) with reference to cerebellar grey matter. Based on a prior autopsy validation study, the SUVRcomp cut-off was 1.57. Sensitivities, specificities and cut-offs were defined based on receiver operating characteristic analysis with CSF analytes as variables of interest and (18)F-flutemetamol positivity as the classifier. We also determined sensitivities and CSF cut-off values at fixed specificities of 90 % and 95 %. RESULTS Seven out of 38 subjects (18 %) were positive on amyloid PET. Aβ42/ttau, Aβ42/Aβ40, Aβ42/Aβ38, and Aβ42 had the highest accuracy to identify amyloid-positive subjects (area under the curve (AUC) ≥ 0.908). Aβ40 and Aβ38 had significantly lower discriminative power (AUC = 0.571). When specificity was fixed at 90 % and 95 %, Aβ42/ttau had the highest sensitivity among the different CSF markers (85.71 % and 71.43 %, respectively). Sensitivity of Aβ42 alone was significantly lower under these conditions (57.14 % and 42.86 %, respectively). CONCLUSION For the CSF-based definition of preclinical AD, if a high specificity is required, our data support the use of Aβ42/ttau rather than using Aβ42 in isolation.
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Affiliation(s)
- Katarzyna Adamczuk
- Laboratory for Cognitive Neurology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
- Alzheimer Research Centre KU Leuven, Leuven Institute of Neuroscience and Disease, Herestraat 49, 3000, Leuven, Belgium.
| | - Jolien Schaeverbeke
- Laboratory for Cognitive Neurology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
- Alzheimer Research Centre KU Leuven, Leuven Institute of Neuroscience and Disease, Herestraat 49, 3000, Leuven, Belgium.
| | | | - Johan Lilja
- GE Healthcare, Björkgatan 30, 751 25, Uppsala, Sweden.
- Nuclear Medicine and PET, Department of Surgical Sciences, Uppsala University, 751 85, Uppsala, Sweden.
| | - Natalie Nelissen
- Laboratory for Cognitive Neurology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
- Department of Psychiatry, Oxford University, Oxford, OX3 7JX, UK.
| | - Koen Van Laere
- Alzheimer Research Centre KU Leuven, Leuven Institute of Neuroscience and Disease, Herestraat 49, 3000, Leuven, Belgium.
- Nuclear Medicine and Molecular Imaging Department, KU Leuven and University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Patrick Dupont
- Laboratory for Cognitive Neurology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
- Alzheimer Research Centre KU Leuven, Leuven Institute of Neuroscience and Disease, Herestraat 49, 3000, Leuven, Belgium.
| | - Kelly Hilven
- Laboratory for Neuroimmunology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Koen Poesen
- Laboratory for Molecular Neurobiomarker Research, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
- Laboratory Medicine, UZ Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
- Alzheimer Research Centre KU Leuven, Leuven Institute of Neuroscience and Disease, Herestraat 49, 3000, Leuven, Belgium.
- Neurology Department, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
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Sutphen CL, Jasielec MS, Shah AR, Macy EM, Xiong C, Vlassenko AG, Benzinger TLS, Stoops EEJ, Vanderstichele HMJ, Brix B, Darby HD, Vandijck MLJ, Ladenson JH, Morris JC, Holtzman DM, Fagan AM. Longitudinal Cerebrospinal Fluid Biomarker Changes in Preclinical Alzheimer Disease During Middle Age. JAMA Neurol 2015; 72:1029-42. [PMID: 26147946 DOI: 10.1001/jamaneurol.2015.1285] [Citation(s) in RCA: 216] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
IMPORTANCE Individuals in the presymptomatic stage of Alzheimer disease (AD) are increasingly being targeted for AD secondary prevention trials. How early during the normal life span underlying AD pathologies begin to develop, their patterns of change over time, and their relationship with future cognitive decline remain to be determined. OBJECTIVE To characterize the within-person trajectories of cerebrospinal fluid (CSF) biomarkers of AD over time and their association with changes in brain amyloid deposition and cognitive decline in cognitively normal middle-aged individuals. DESIGN, SETTING, AND PARTICIPANTS As part of a cohort study, cognitively normal (Clinical Dementia Rating [CDR] of 0) middle-aged research volunteers (n = 169) enrolled in the Adult Children Study at Washington University, St Louis, Missouri, had undergone serial CSF collection and longitudinal clinical assessment (mean, 6 years; range, 0.91-11.3 years) at 3-year intervals at the time of analysis, between January 2003 and November 2013. A subset (n = 74) had also undergone longitudinal amyloid positron emission tomographic imaging with Pittsburgh compound B (PiB) in the same period. Serial CSF samples were analyzed for β-amyloid 40 (Aβ40), Aβ42, total tau, tau phosphorylated at threonine 181 (P-tau181), visinin-like protein 1 (VILIP-1), and chitinase-3-like protein 1 (YKL-40). Within-person measures were plotted according to age and AD risk defined by APOE genotype (ε4 carriers vs noncarriers). Linear mixed models were used to compare estimated biomarker slopes among middle-age bins at baseline (early, 45-54 years; mid, 55-64 years; late, 65-74 years) and between risk groups. Within-person changes in CSF biomarkers were also compared with changes in cortical PiB binding and progression to a CDR higher than 0 at follow-up. MAIN OUTCOMES AND MEASURES Changes in Aβ40, Aβ42, total tau, P-tau181, VILIP-1, and YKL-40 and, in a subset of participants, changes in cortical PiB binding. RESULTS While there were no consistent longitudinal patterns in Aβ40 (P = .001-.97), longitudinal reductions in Aβ42 were observed in some individuals as early as early middle age (P ≤ .05) and low Aβ42 levels were associated with the development of cortical PiB-positive amyloid plaques (area under receiver operating characteristic curve = 0.9352; 95% CI, 0.8895-0.9808), especially in mid middle age (P < .001). Markers of neuronal injury (total tau, P-tau181, and VILIP-1) dramatically increased in some individuals in mid and late middle age (P ≤ .02), whereas the neuroinflammation marker YKL-40 increased consistently throughout middle age (P ≤ .003). These patterns were more apparent in at-risk ε4 carriers (Aβ42 in an allele dose-dependent manner) and appeared to be associated with future cognitive deficits as determined by CDR. CONCLUSIONS AND RELEVANCE Longitudinal CSF biomarker patterns consistent with AD are first detectable during early middle age and are associated with later amyloid positivity and cognitive decline. Such measures may be useful for targeting middle-aged, asymptomatic individuals for therapeutic trials designed to prevent cognitive decline.
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Affiliation(s)
- Courtney L Sutphen
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri2Department of Neurology, Washington University, St Louis, Missouri3Hope Center for Neurodegenerative Disorders, Washington University, St Louis, Missouri
| | - Mateusz S Jasielec
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri4Division of Biostatistics, Washington University, St Louis, Missouri
| | - Aarti R Shah
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri2Department of Neurology, Washington University, St Louis, Missouri3Hope Center for Neurodegenerative Disorders, Washington University, St Louis, Missouri
| | - Elizabeth M Macy
- Department of Pathology and Immunology, Washington University, St Louis, Missouri
| | - Chengjie Xiong
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri4Division of Biostatistics, Washington University, St Louis, Missouri
| | - Andrei G Vlassenko
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri6Department of Radiology, Washington University, St Louis, Missouri
| | - Tammie L S Benzinger
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri6Department of Radiology, Washington University, St Louis, Missouri
| | | | | | | | | | | | - Jack H Ladenson
- Department of Pathology and Immunology, Washington University, St Louis, Missouri
| | - John C Morris
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri2Department of Neurology, Washington University, St Louis, Missouri3Hope Center for Neurodegenerative Disorders, Washington University, St Louis, Missouri
| | - David M Holtzman
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri2Department of Neurology, Washington University, St Louis, Missouri3Hope Center for Neurodegenerative Disorders, Washington University, St Louis, Missouri
| | - Anne M Fagan
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri2Department of Neurology, Washington University, St Louis, Missouri3Hope Center for Neurodegenerative Disorders, Washington University, St Louis, Missouri
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Dorey A, Perret-Liaudet A, Tholance Y, Fourier A, Quadrio I. Cerebrospinal Fluid Aβ40 Improves the Interpretation of Aβ42 Concentration for Diagnosing Alzheimer's Disease. Front Neurol 2015; 6:247. [PMID: 26640457 PMCID: PMC4661235 DOI: 10.3389/fneur.2015.00247] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 11/11/2015] [Indexed: 01/01/2023] Open
Abstract
The combination of decreased amyloid β42 (Aβ42) and increased total tau proteins (T-Tau) and phosphorylated tau (P-Tau) in cerebrospinal fluid (CSF) has recently been considered as a biological diagnostic criterion of Alzheimer’s disease (AD). Previous studies showed significant heterogeneity in CSF Aβ42 levels to discriminate AD from non-AD patients. It was also suggested that the CSF amyloid peptide β42/β40 ratio has better diagnostic performance than Aβ42 alone. The objective of the present study was to investigate the potential added value of determining CSF amyloid β40 peptide (Aβ40) for biological diagnosis of AD when CSF Aβ42 levels failed. CSF AD biomarkers were run in 2,171 samples from 1,499 AD and 672 non-AD patients. The following pathologic thresholds were used to define an AD-positive CSF biomarker profile: T-Tau ≥ 400 ng/L, P-Tau181 ≥ 60 ng/L, and Aβ42 ≤ 700 ng/L. CSF Aβ40 was assayed in AD patients with CSF Aβ42 levels above 700 ng/L and non-AD patients with CSF Aβ42 levels below 700 ng/L. CSF Aβ40 levels were higher in AD than non-AD patients. The receiver operator characteristic curves of CSF Aβ40 and the Aβ42/Aβ40 ratio defined AD cut-off values at 12,644 ng/L and 0.06, respectively. In AD patients with non-pathological CSF Aβ42, CSF Aβ40 concentration was able to correct 76.2% of cases when expressed as CSF Aβ42/Aβ40 ratio and 94.7% of cases when used alone. Using CSF Aβ42 and then CSF Aβ40, the percentage of misinterpreted AD patients fell to 1.0%. CSF Aβ40 concentration improved interpretation of Aβ42 level for the diagnosis of AD. CSF Aβ40 alone showed better diagnostic performance than the amyloid peptide Aβ42/Aβ40 ratio. The added value of determining CSF Aβ40 in AD diagnosis now needs confirming in a cohort of definite AD patients and to be completed with novel amyloid cascade biomarkers.
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Affiliation(s)
- Aline Dorey
- Center for Memory Resources and Research, Hospices Civils de Lyon, Charpennes Hospital, Lyon 1 University , Villeurbanne , France ; Neurochemistry Unit, Biochemistry Department, Hospices Civils de Lyon, Groupement Hospitalier Est , Bron , France
| | - Armand Perret-Liaudet
- Center for Memory Resources and Research, Hospices Civils de Lyon, Charpennes Hospital, Lyon 1 University , Villeurbanne , France ; Neurochemistry Unit, Biochemistry Department, Hospices Civils de Lyon, Groupement Hospitalier Est , Bron , France ; BioRaN Team, Lyon Neuroscience Research Center, CNRS UMR 5292, INSERM U1028, Lyon 1 University , Bron , France
| | - Yannick Tholance
- Neurochemistry Unit, Biochemistry Department, Hospices Civils de Lyon, Groupement Hospitalier Est , Bron , France ; WAKE Team, Lyon Neuroscience Research Center, CNRS UMR5292, INSERM U1028, Lyon 1 University , Lyon , France
| | - Anthony Fourier
- Neurochemistry Unit, Biochemistry Department, Hospices Civils de Lyon, Groupement Hospitalier Est , Bron , France ; BioRaN Team, Lyon Neuroscience Research Center, CNRS UMR 5292, INSERM U1028, Lyon 1 University , Bron , France
| | - Isabelle Quadrio
- Neurochemistry Unit, Biochemistry Department, Hospices Civils de Lyon, Groupement Hospitalier Est , Bron , France ; BioRaN Team, Lyon Neuroscience Research Center, CNRS UMR 5292, INSERM U1028, Lyon 1 University , Bron , France
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[Clinically validated molecular biomarkers of neurodegenerative dementia]. DER NERVENARZT 2015; 85:1372-81. [PMID: 25331214 DOI: 10.1007/s00115-014-4086-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
As cerebrospinal fluid-based neurochemical dementia diagnostics (CSF-NDD) has now been validated at the S3 evidence level, the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) and the German Society for Neurology (DGN) recommend CSF-NDD in the recent joint dementia guidelines for improved early and differential diagnostics of multigenic (sporadic) Alzheimer's dementia (AD). The CSF-NDD also provides a predictive diagnosis of incipient AD for high-risk patients when they are still in the prodromal stage of mild cognitive impairment (MCI) but as no (secondary) preventive therapy of AD is currently available, the use of CSF-NDD for the predictive molecular diagnosis of AD is not recommended in the neuropsychiatry guidelines (http://www.DGPPN.de). However, molecular diagnostics of preclinical AD by CSF-NDD and/or [18F]-amyloid positron emission tomography (PET) has meanwhile gained high clinical relevance for therapeutic clinical research, as this novel clinical model allows systematic screening for promising (secondary) preventive therapy options. Moreover, it has now become apparent that blood-based neurochemical diagnostics of preclinical and early AD will be possible by means of various formats of multiplex assays. However, so far promising blood assays have not been consistently validated by independent research groups and in contrast to CSF-NDD a blood-based diagnosis of AD is not yet available.
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121
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What is the potential of dried matrix spot sampling for cerebrospinal fluid analysis? Bioanalysis 2015; 7:2849-51. [DOI: 10.4155/bio.15.201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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122
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Slemmon JR, Shapiro A, Mercken M, Streffer J, Romano G, Andreasen N, Zetterberg H, Blennow K. Impact of cerebrospinal fluid matrix on the detection of Alzheimer's disease with Aβ42 and influence of disease on the total-Aβ42/Aβ40 ratio. J Neurochem 2015; 135:1049-58. [PMID: 26332787 DOI: 10.1111/jnc.13297] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/07/2015] [Accepted: 08/10/2015] [Indexed: 11/30/2022]
Abstract
The 42-amino acid fragment of amyloid β (Aβ1-42) in cerebrospinal fluid has continued to be important for detecting cerebral β-amyloidosis in Alzheimer's disease (AD). However, there are impediments to our ability to fully understand this measurement, including matrix interference and changes linked to apolipoprotein E (APOE) ε4 genotype. This study investigated matrix interference as a contributing factor for detecting AD in APOE ε4-negative patients by comparing total extractable Aβ1-42 to free Aβ1-42. It also examined the ratio of total Aβ1-42 to Aβ1-40, since changes relative to other Aβ peptides may provide a measurement of cerebral β-amyloidosis that is neutral to changes in APP metabolism. Total Aβ1-42 lost the diagnostic power for detecting AD, confirming a role for matrix in the diagnostic. However, when total Aβ1-42/Aβ1-40 was examined, the separation between groups was reestablished. This result was confirmed in a second sample set of unknown APOE status. These results confirmed that matrix interference in some cerebrospinal fluid samples appears to contribute to identifying AD patients and this can be compensated by using a total extracted Aβ1-42/Aβ1-40 ratio when matrix interference is small. It may be preferable to employ a total Aβ1-42/Aβ1-40 measurement, since this could minimize variability because of matrix and compensate for across patient differences. Aβ1-42 measurement in CSF has provided an important tool for early detection of AD. However, it appears that most assays measure a free fraction of Aβ1-42. This study examined total extracted Aβ1-42, since this would provide a more accurate assessment of Aβ1-42 in AD CSF. Total Aβ1-42 measurements alone were not good for detecting AD but total Aβ1-42/Aβ1-40 performed well.
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Affiliation(s)
- J Randall Slemmon
- Neurosciences Biomarkers, Janssen Pharmaceutical Companies, Raritan, New Jersey, USA
| | - Alice Shapiro
- Neurosciences Biomarkers, Janssen Pharmaceutical Companies, Raritan, New Jersey, USA
| | - Marc Mercken
- Neurosciences Discovery, Janssen Pharmaceutical Companies, Beerse, Belgium
| | - Johannes Streffer
- Experimental Medicine, Janssen Pharmaceutical Companies, Beerse, Belgium
| | - Gary Romano
- Neuroscience Therapeutic Area, Janssen Research and Development, Titusville, New Jersey, USA
| | - Niels Andreasen
- Memory clinic, M51, Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Henrik Zetterberg
- Institute of Neurology, University College London, Queen Square, London, UK.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
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123
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Paterson RW, Toombs J, Slattery CF, Nicholas JM, Andreasson U, Magdalinou NK, Blennow K, Warren JD, Mummery CJ, Rossor MN, Lunn MP, Crutch SJ, Fox NC, Zetterberg H, Schott JM. Dissecting IWG-2 typical and atypical Alzheimer's disease: insights from cerebrospinal fluid analysis. J Neurol 2015; 262:2722-30. [PMID: 26410752 DOI: 10.1007/s00415-015-7904-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/10/2015] [Accepted: 09/11/2015] [Indexed: 10/23/2022]
Abstract
Pathobiological factors underlying phenotypic diversity in Alzheimer's disease (AD) are incompletely understood. We used an extended cerebrospinal fluid (CSF) panel to explore differences between "typical" with "atypical" AD and between amnestic, posterior cortical atrophy, logopenic aphasia and frontal variants. We included 97 subjects fulfilling International Working Group-2 research criteria for AD of whom 61 had "typical" AD and 36 "atypical" syndromes, and 30 controls. CSF biomarkers included total tau (T-tau), phosphorylated tau (P-tau), amyloid β1-42, amyloid βX-38/40/42, YKL-40, neurofilament light (NFL), and amyloid precursor proteins α and β. The typical and atypical groups were matched for age, sex, severity and rate of cognitive decline and had similar biomarker profiles, with the exception of NFL which was higher in the atypical group (p = 0.03). Sub-classifying the atypical group into its constituent clinical syndromes, posterior cortical atrophy was associated with the lowest T-tau [604.4 (436.8-675.8) pg/mL], P-tau (79.8 ± 21.8 pg/L), T-tau/Aβ1-42 ratio [2.3 (1.4-2.6)], AβX-40/X-42 ratio (22.1 ± 5.8) and rate of cognitive decline [1.9 (0.75-4.25) MMSE points/year]. Conversely, the frontal variant group had the highest levels of T-tau [1185.4 (591.7-1329.3) pg/mL], P-tau (116.4 ± 45.4 pg/L), T-tau/Aβ1-42 ratio [5.2 (3.3-6.9)] and AβX-40/X-42 ratio (27.9 ± 7.5), and rate of cognitive decline. Whilst on a group level IWG-2 "typical" and "atypical" AD share similar CSF profiles, which are very different from controls, atypical AD is a heterogeneous entity with evidence for subtle differences in amyloid processing and neurodegeneration between different clinical syndromes. These findings also have practical implications for the interpretation of clinical CSF biomarker results.
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Affiliation(s)
- Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, London, UK.
| | - Jamie Toombs
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | | | - Jennifer M Nicholas
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Ulf Andreasson
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | | | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Cath J Mummery
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Martin N Rossor
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Michael P Lunn
- Department of Clinical Neuroimmunology, National Hospital for Neurology and Neurosurgery, London, UK
| | | | - Nick C Fox
- Dementia Research Centre, UCL Institute of Neurology, London, UK
| | - Henrik Zetterberg
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jonathan M Schott
- Dementia Research Centre, UCL Institute of Neurology, London, UK. .,Box 16 National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK.
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Sancesario GM, Bernardini S. How many biomarkers to discriminate neurodegenerative dementia? Crit Rev Clin Lab Sci 2015; 52:314-26. [PMID: 26292074 DOI: 10.3109/10408363.2015.1051658] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A number of cerebrospinal fluid (CSF) biomarkers are currently used for the diagnosis of dementia. Opposite changes in the level of amyloid-β(1-42) versus total tau and phosphorylated-tau181 in the CSF reflect the specific pathology of Alzheimer's disease (AD) in the brain. This panel of biomarkers has proven to be effective to differentiate AD from controls and from the major types of neurodegenerative dementia, and to evaluate the progression from mild cognitive impairment to AD. In the absence of specific biomarkers reflecting the pathologies of the other most common forms of dementia, such as Lewy Body disease, Frontotemporal lobar degeneration, Creutzfeldt-Jakob disease, etc., the evaluation of biomarkers of AD pathology is used, attempting to exclude rather than to confirm AD. Other biomarkers included in the common clinical practice do not clearly relate to the underlying pathology: progranulin (PGRN) is a selective marker of frontotemporal dementia with mutations in the PGRN gene; the 14-3-3 protein is a highly sensitive and specific marker for Creutzfeldt-Jakob disease, but has to be used carefully in differentiating rapid progressive dementia; and α-synuclein is an emerging candidate biomarker of the different forms of synucleinopathy. This review summarizes several biomarkers of neurodegenerative dementia validated based on the neuropathological processes occurring in brain tissue. Notwithstanding the paucity of pathologically validated biomarkers and their high analytical variability, the combinations of these biomarkers may well represent a key and more precise analytical and diagnostic tool in the complex plethora of degenerative dementia.
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Affiliation(s)
- Giulia M Sancesario
- a Department of Clinical and Behavioural Neurology , Santa Lucia Foundation, IRCCS , Rome , Italy and
| | - Sergio Bernardini
- b Department of Experimental Medicine and Surgery , Tor Vergata University of Rome , Rome , Italy
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Arimon M, Takeda S, Post KL, Svirsky S, Hyman BT, Berezovska O. Oxidative stress and lipid peroxidation are upstream of amyloid pathology. Neurobiol Dis 2015; 84:109-19. [PMID: 26102023 DOI: 10.1016/j.nbd.2015.06.013] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 06/11/2015] [Accepted: 06/17/2015] [Indexed: 10/25/2022] Open
Abstract
Oxidative stress is a common feature of the aging process and of many neurodegenerative disorders, including Alzheimer's disease. Understanding the direct causative relationship between oxidative stress and amyloid pathology, and determining the underlying molecular mechanisms is crucial for the development of more effective therapeutics for the disease. By employing microdialysis technique, we report local increase in the amyloid-β42 levels and elevated amyloid-β42/40 ratio in the interstitial fluid within 6h of direct infusion of oxidizing agents into the hippocampus of living and awake wild type mice. The increase in the amyloid-β42/40 ratio correlated with the pathogenic conformational change of the amyloid precursor protein-cleaving enzyme, presenilin1/γ-secretase. Furthermore, we found that the product of lipid peroxidation 4-hydroxynonenal, binds to both nicastrin and BACE, differentially affecting γ- and β-secretase activity, respectively. The present study demonstrates a direct cause-and-effect correlation between oxidative stress and altered amyloid-β production, and provides a molecular mechanism by which naturally occurring product of lipid peroxidation may trigger generation of toxic amyloid-β42 species.
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Affiliation(s)
- Muriel Arimon
- MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, CNY 114, 16th Street, Charlestown 02129, MA, USA
| | - Shuko Takeda
- MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, CNY 114, 16th Street, Charlestown 02129, MA, USA
| | - Kathryn L Post
- MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, CNY 114, 16th Street, Charlestown 02129, MA, USA
| | - Sarah Svirsky
- MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, CNY 114, 16th Street, Charlestown 02129, MA, USA
| | - Bradley T Hyman
- MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, CNY 114, 16th Street, Charlestown 02129, MA, USA
| | - Oksana Berezovska
- MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, CNY 114, 16th Street, Charlestown 02129, MA, USA.
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C-terminal neurogranin is increased in cerebrospinal fluid but unchanged in plasma in Alzheimer's disease. Alzheimers Dement 2015; 11:1461-1469. [PMID: 26092348 DOI: 10.1016/j.jalz.2015.05.012] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 01/27/2015] [Accepted: 05/09/2015] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Biomarkers monitoring synaptic degeneration/loss would be valuable for Alzheimer's disease (AD) diagnosis. Postsynaptic protein neurogranin may be a promising cerebrospinal fluid (CSF) biomarker but has not yet been evaluated as a plasma biomarker. METHODS Using an in-house designed prototype enzyme-linked immunosorbent assay (ELISA) targeting neurogranin C-terminally, we studied neurogranin in paired CSF/plasma samples of controls (n = 29) versus patients experiencing MCI, or dementia, due to AD (in total n = 59). RESULTS CSF neurogranin was increased in AD and positively correlated with CSF tau, whereas there was a negative relationship between CSF neurogranin (and tau) and CSF Aβ1-42/Aβ1-40. No differences were detected in plasma neurogranin between controls and AD. Also, there was no correlation between CSF and plasma neurogranin, excluding confounding effects of the latter. DISCUSSION This study strengthens the potential of neurogranin as an AD CSF biomarker, which now needs validation in larger studies. As tools, straightforward immunoassays can be used, as demonstrated by the described ELISA.
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Dumurgier J, Schraen S, Gabelle A, Vercruysse O, Bombois S, Laplanche JL, Peoc'h K, Sablonnière B, Kastanenka KV, Delaby C, Pasquier F, Touchon J, Hugon J, Paquet C, Lehmann S. Cerebrospinal fluid amyloid-β 42/40 ratio in clinical setting of memory centers: a multicentric study. ALZHEIMERS RESEARCH & THERAPY 2015; 7:30. [PMID: 26034513 PMCID: PMC4450486 DOI: 10.1186/s13195-015-0114-5] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 03/05/2015] [Indexed: 11/13/2022]
Abstract
Introduction The cerebrospinal fluid (CSF) biomarkers amyloid-β (Aβ), tau and phosphorylated tau (p-tau181) are now used for the diagnosis of Alzheimer’s disease (AD). Aβ40 is the most abundant Aβ peptide isoform in the CSF, and the Aβ 42/40 ratio has been proposed to better reflect brain amyloid production. However, its additional value in the clinical setting remains uncertain. Methods A total of 367 subjects with cognitive disorders who underwent a lumbar puncture were prospectively included at three French memory centers (Paris-North, Lille and Montpellier; the PLM Study). The frequency of positive, negative and indeterminate CSF profiles were assessed by various methods, and their adequacies with the diagnosis of clinicians were tested using net reclassification improvement (NRI) analyses. Results On the basis of local optimum cutoffs for Aβ42 and p-tau181, 22% of the explored patients had indeterminate CSF profiles. The systematic use of Aβ 42/40 ratio instead of Aβ42 levels alone decreased the number of indeterminate profiles (17%; P = 0.03), but it failed to improve the classification of subjects (NRI = −2.1%; P = 0.64). In contrast, the use of Aβ 42/40 ratio instead of Aβ42 levels alone in patients with a discrepancy between p-tau181 and Aβ42 led to a reduction by half of the number of indeterminate profiles (10%; P < 0.001) and was further in agreement with clinician diagnosis (NRI = 10.5%; P = 0.003). Conclusions In patients with a discrepancy between CSF p-tau181 and CSF Aβ42, the assessment of Aβ 42/40 ratio led to a reliable biological conclusion in over 50% of cases that agreed with a clinician’s diagnosis. Electronic supplementary material The online version of this article (doi:10.1186/s13195-015-0114-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julien Dumurgier
- Centre Mémoire Ressources Recherche (CM2R), Paris Nord Ile-de-France, Saint Louis, Lariboisière, Fernand-Widal Hospital, AP-HP, 200 rue du Faubourg Saint-Denis, 75010 Paris, France ; INSERM U942, Biomarkers in CardioNeuroVascular diseases (Bio-CANVAS), University of Paris 7-Denis Diderot, Paris, France
| | - Susanna Schraen
- Inserm, UMR 1172, JPArc, Faculté de Médecine, Université de Lille, 59045 Lille, France ; Centre de Biologie-Pathologie, Centre Hospitalier Régional Universitaire, 59037 Lille, France
| | - Audrey Gabelle
- Centre Mémoire Ressources Recherche de Montpellier, Université de Montpellier, Montpellier, France ; Biochimie-Protéomique Clinique - IRB - CCBHM, INSERM U1040, Université de Montpellier, Montpellier, France
| | - Olivier Vercruysse
- Centre Mémoire Ressources Recherche, EA 1046, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - Stéphanie Bombois
- Centre Mémoire Ressources Recherche, EA 1046, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - Jean-Louis Laplanche
- Service de Biochimie et Biologie Moléculaire, Hôpitaux universitaires Saint-Louis, Lariboisière, Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), PRES Sorbonne Paris Cité, Paris, France
| | - Katell Peoc'h
- Service de Biochimie et Biologie Moléculaire, Hôpitaux universitaires Saint-Louis, Lariboisière, Fernand-Widal, Assistance Publique-Hôpitaux de Paris (AP-HP), PRES Sorbonne Paris Cité, Paris, France
| | - Bernard Sablonnière
- Inserm, UMR 1172, JPArc, Faculté de Médecine, Université de Lille, 59045 Lille, France ; Centre de Biologie-Pathologie, Centre Hospitalier Régional Universitaire, 59037 Lille, France
| | - Ksenia V Kastanenka
- Department of Neurology, MassGeneral Institute for Neurodegenerative Disease, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129 USA
| | - Constance Delaby
- Biochimie-Protéomique Clinique - IRB - CCBHM, INSERM U1040, Université de Montpellier, Montpellier, France
| | - Florence Pasquier
- Centre Mémoire Ressources Recherche, EA 1046, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - Jacques Touchon
- Centre Mémoire Ressources Recherche de Montpellier, Université de Montpellier, Montpellier, France
| | - Jacques Hugon
- Centre Mémoire Ressources Recherche (CM2R), Paris Nord Ile-de-France, Saint Louis, Lariboisière, Fernand-Widal Hospital, AP-HP, 200 rue du Faubourg Saint-Denis, 75010 Paris, France ; INSERM U942, Biomarkers in CardioNeuroVascular diseases (Bio-CANVAS), University of Paris 7-Denis Diderot, Paris, France
| | - Claire Paquet
- Centre Mémoire Ressources Recherche (CM2R), Paris Nord Ile-de-France, Saint Louis, Lariboisière, Fernand-Widal Hospital, AP-HP, 200 rue du Faubourg Saint-Denis, 75010 Paris, France ; INSERM U942, Biomarkers in CardioNeuroVascular diseases (Bio-CANVAS), University of Paris 7-Denis Diderot, Paris, France
| | - Sylvain Lehmann
- Biochimie-Protéomique Clinique - IRB - CCBHM, INSERM U1040, Université de Montpellier, Montpellier, France
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Qiu T, Liu Q, Chen YX, Zhao YF, Li YM. Aβ42 and Aβ40: similarities and differences. J Pept Sci 2015; 21:522-9. [PMID: 26018760 DOI: 10.1002/psc.2789] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 05/05/2015] [Accepted: 05/06/2015] [Indexed: 01/03/2023]
Abstract
The abnormal accumulation of amyloid-β (Aβ) peptide in the brain is one of the most important hallmarks of Alzheimer's disease. Aβ is an aggregation-prone and toxic polypeptide with 39-43 residues, derived from the amyloid precursor protein proteolysis process. According to the amyloid hypothesis, abnormal accumulation of Aβ in the brain is the primary influence driving Alzheimer's disease pathologies. Among all kinds of Aβ isoforms, Aβ40 and Aβ42 are believed to be the most important ones. Although these two kinds of Aβ differ only in two amino acid residues, recent studies show that they differ significantly in their metabolism, physiological functions, toxicities, and aggregation mechanism. In this review, we mainly summarize the similarities and differences between Aβ42 and Aβ40, recent studies on selective inhibitors as well as probes will also be mentioned.
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Affiliation(s)
- Tian Qiu
- Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China
| | - Qian Liu
- Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China
| | - Yong-Xiang Chen
- Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China
| | - Yu-Fen Zhao
- Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China
| | - Yan-Mei Li
- Key Laboratory of Bioorganic Phosphorus Chemistry and Chemical Biology (Ministry of Education), Department of Chemistry, Tsinghua University, Beijing, 100084, China.,Beijing Institute for Brain Disorders, Beijing, 100069, China
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Blennow K, Mattsson N, Schöll M, Hansson O, Zetterberg H. Amyloid biomarkers in Alzheimer's disease. Trends Pharmacol Sci 2015; 36:297-309. [PMID: 25840462 DOI: 10.1016/j.tips.2015.03.002] [Citation(s) in RCA: 335] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 03/02/2015] [Accepted: 03/05/2015] [Indexed: 02/06/2023]
Abstract
Aggregation of amyloid-β (Aβ) into oligomers, fibrils, and plaques is central in the molecular pathogenesis of Alzheimer's disease (AD), and is the main focus of AD drug development. Biomarkers to monitor Aβ metabolism and aggregation directly in patients are important for further detailed study of the involvement of Aβ in disease pathogenesis and to monitor the biochemical effect of drugs targeting Aβ in clinical trials. Furthermore, if anti-Aβ disease-modifying drugs prove to be effective clinically, amyloid biomarkers will be of special value in the clinic to identify patients with brain amyloid deposition at risk for progression to AD dementia, to enable initiation of treatment before neurodegeneration is too severe, and to monitor drug effects on Aβ metabolism or pathology to guide dosage. Two types of amyloid biomarker have been developed: Aβ-binding ligands for use in positron emission tomography (PET) and assays to measure Aβ42 in cerebrospinal fluid (CSF). In this review, we present the rationales behind these biomarkers and compare their ability to measure Aβ plaque load in the brain. We also review possible shortcomings and the need of standardization of both biomarkers, as well as their implementation in the clinic.
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Affiliation(s)
- Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; The Torsten Söderberg Professorship at the Royal Swedish Academy of Sciences.
| | - Niklas Mattsson
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Michael Schöll
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA; Department of Clinical Neuroscience and Rehabilitation, University of Gothenburg, Gothenburg, Sweden
| | - Oskar Hansson
- Department of Clinical Sciences, Lund University, Lund, Sweden; Clinical Memory Research unit, Clinical Sciences, Lund University, Lund, Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; UCL Institute of Neurology, Queen Square, London, UK
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131
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Lewczuk P, Mroczko B, Fagan A, Kornhuber J. Biomarkers of Alzheimer's disease and mild cognitive impairment: a current perspective. Adv Med Sci 2015; 60:76-82. [PMID: 25579841 DOI: 10.1016/j.advms.2014.11.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 09/12/2014] [Accepted: 11/28/2014] [Indexed: 11/16/2022]
Abstract
A growing body of evidence supports the application of the neurochemical dementia diagnostics (NDD) biomarkers for the diagnosis of dementing conditions. Biomarkers of Alzheimer's disease (AD) were recently classified as these reflecting amyloid β pathology (decreased CSF concentrations of Aβ42 and/or positive Aβ PET scan) and these reflecting neurodegeneration (increased CSF Tau concentrations, decreased uptake of FDG on FDG-PET, and cerebral atrophy on structural MRI). Particularly important seems the role of the biomarkers in the early diagnosis of AD, as the first pathophysiologic events observable in the CSF and amyloid β-PET occur years and perhaps decades before the onset of the earliest clinical symptoms. Therefore, the NDD tools enable the diagnosis of AD already in the early preclinical stage. This review summarizes pathophysiology underlying the CSF biomarkers, following a discussion of their role in the current guidelines for the diagnostic procedures.
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Affiliation(s)
- Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland; Department of Biochemical Diagnostics, University Hospital in Bialystok, Bialystok, Poland
| | - Anne Fagan
- The Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University, St. Louis, MO, USA
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
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Rémy F, Vayssière N, Saint-Aubert L, Barbeau E, Pariente J. White matter disruption at the prodromal stage of Alzheimer's disease: relationships with hippocampal atrophy and episodic memory performance. NEUROIMAGE-CLINICAL 2015; 7:482-92. [PMID: 25685715 PMCID: PMC4326466 DOI: 10.1016/j.nicl.2015.01.014] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 01/23/2015] [Accepted: 01/24/2015] [Indexed: 01/10/2023]
Abstract
White matter tract alterations have been consistently described in Alzheimer's disease (AD). In particular, limbic fronto-temporal connections, which are critical to episodic memory function, may degenerate early in the course of the disease. However the relation between white matter tract degeneration, hippocampal atrophy and episodic memory impairment at the earliest stages of AD is still unclear. In this magnetic resonance imaging study, white matter integrity and hippocampal volumes were evaluated in patients with amnestic mild cognitive impairment due to AD (Albert et al., 2011) (n = 22) and healthy controls (n = 15). Performance in various episodic memory tasks was also evaluated in each participant. Relative to controls, patients showed a significant reduction of white matter fractional anisotropy (FA) and increase of radial diffusivity (RD) in the bilateral uncinate fasciculus, parahippocampal cingulum and fornix. Within the patient group, significant intra-hemispheric correlations were notably found between hippocampal grey matter volume and FA in the uncinate fasciculus, suggesting a relationship between atrophy and disconnection of the hippocampus. Moreover, episodic recognition scores were related with uncinate fasciculus FA across patients. These results indicate that fronto-hippocampal connectivity is reduced from the earliest pre-demential stages of AD. Disruption of fronto-hippocampal connections may occur progressively, in parallel with hippocampal atrophy, and may specifically contribute to early initial impairment in episodic memory. Limbic fronto-temporal connections (cingulum, uncinate fasciculus and fornix) are altered from the prodromal stage of AD. In prodromal AD patients, intra-hemispheric correlations were found between uncinate fasciculus FA and hippocampal atrophy. In prodromal AD patients, uncinate fasciculus FA was correlated with scores on episodic recognition.
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Affiliation(s)
- Florence Rémy
- Centre de Recherche Cerveau et Cognition, Université de Toulouse, UPS, France ; CNRS, CerCo, Toulouse, France
| | - Nathalie Vayssière
- Centre de Recherche Cerveau et Cognition, Université de Toulouse, UPS, France ; CNRS, CerCo, Toulouse, France
| | - Laure Saint-Aubert
- Centre for Alzheimer Research, Department of Neurobiology, Division of Translational Alzheimer Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Emmanuel Barbeau
- Centre de Recherche Cerveau et Cognition, Université de Toulouse, UPS, France ; CNRS, CerCo, Toulouse, France
| | - Jérémie Pariente
- INSERM, Imagerie Cérébrale et Handicaps Neurologiques, Centre Hospitalier Universitaire de Toulouse, UMR 825, France
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133
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Lewczuk P, Kornhuber J, Toledo JB, Trojanowski JQ, Knapik-Czajka M, Peters O, Wiltfang J, Shaw LM. Validation of the Erlangen Score Algorithm for the Prediction of the Development of Dementia due to Alzheimer's Disease in Pre-Dementia Subjects. J Alzheimers Dis 2015; 48:433-41. [PMID: 26402007 PMCID: PMC5127395 DOI: 10.3233/jad-150342] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND In previous studies, a dichotomous stratification of subjects into "cerebrospinal fluid (CSF) normal" and "CSF pathologic" was used to investigate the role of biomarkers in the prediction of progression to dementia in pre-dementia/mild cognitive impairment subjects. With the previously published Erlangen Score Algorithm, we suggested a division of CSF patterns into five groups, covering all possible CSF result combinations based on the presence of pathologic tau and/or amyloid-β CSF values. OBJECTIVE This study aimed to validate the Erlangen Score diagnostic algorithm based on the results of biomarkers analyses obtained in different patients cohorts, with different pre-analytical protocols, and with different laboratory analytical platforms. METHODS We evaluated the algorithm in two cohorts of pre-dementia subjects: the US-Alzheimer's Disease Neuroimaging Initiative and the German Dementia Competence Network. RESULTS In both cohorts, the Erlangen scores were strongly associated with progression to Alzheimer's disease. Neither the scores of the progressors nor the scores of the non-progressors differed significantly between the two projects, in spite of significant differences in the cohorts, laboratory methods, and the samples treatment. CONCLUSIONS Our findings confirm the utility of the Erlangen Score algorithm as a useful tool in the early neurochemical diagnosis of Alzheimer's disease.
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Affiliation(s)
- Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jon B Toledo
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Malgorzata Knapik-Czajka
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Charité Berlin, Berlin, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, Georg-August Universität Göttingen, Göttingen, Germany
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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134
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Mattsson N, Insel PS, Donohue M, Landau S, Jagust WJ, Shaw LM, Trojanowski JQ, Zetterberg H, Blennow K, Weiner MW. Independent information from cerebrospinal fluid amyloid-β and florbetapir imaging in Alzheimer's disease. ACTA ACUST UNITED AC 2014; 138:772-83. [PMID: 25541191 DOI: 10.1093/brain/awu367] [Citation(s) in RCA: 184] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Reduced cerebrospinal fluid amyloid-β42 and increased retention of florbetapir positron emission tomography are biomarkers reflecting cortical amyloid load in Alzheimer's disease. However, these measurements do not always agree and may represent partly different aspects of the underlying Alzheimer's disease pathology. The goal of this study was therefore to test if cerebrospinal fluid and positron emission tomography amyloid-β biomarkers are independently related to other Alzheimer's disease markers, and to examine individuals who are discordantly classified by these two biomarker modalities. Cerebrospinal fluid and positron emission tomography amyloid-β were measured at baseline in 769 persons [161 healthy controls, 68 subjective memory complaints, 419 mild cognitive impairment and 121 Alzheimer's disease dementia, mean age 72 years (standard deviation 7 years), 47% females] and used to predict diagnosis, APOE ε4 carriage status, cerebral blood flow, cerebrospinal fluid total-tau and phosphorylated-tau levels (cross-sectionally); and hippocampal volume, fluorodeoxyglucose positron emission tomography results and Alzheimer's Disease Assessment Scale-cognitive subscale scores (longitudinally). Cerebrospinal fluid and positron emission tomography amyloid-β were highly correlated, but adjusting one of these predictors for the other revealed that they both provided partially independent information when predicting diagnosis, APOE ε4, hippocampal volume, metabolism, cognition, total-tau and phosphorylated-tau (the 95% confidence intervals of the adjusted effects did not include zero). Cerebrospinal fluid amyloid-β was more strongly related to APOE ε4 whereas positron emission tomography amyloid-β was more strongly related to tau levels (P < 0.05). Discordance (mainly isolated cerebrospinal fluid amyloid-β positivity) differed by diagnostic group (P < 0.001) and was seen in 21% of cognitively healthy people but only 6% in dementia patients. The finding that cerebrospinal fluid and positron emission tomography amyloid-β provide partially independent information about a wide range of Alzheimer's measures supports the theory that these modalities represent partly different aspects of Alzheimer's pathology. The fact that mismatch, with positive cerebrospinal fluid amyloid-β but normal positron emission tomography amyloid-β, is relatively common in cognitively healthy people may be considered when using these biomarkers to identify early stage Alzheimer's disease. Reduced cerebrospinal fluid amyloid-β may be more strongly related to early stage Alzheimer's disease, whereas increased positron emission tomography amyloid-β may be more strongly related to disease progression.
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Affiliation(s)
- Niklas Mattsson
- 1 Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden 2 Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA 3 Department of Veterans Affairs Medical Centre, Centre for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - Philip S Insel
- 2 Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA 3 Department of Veterans Affairs Medical Centre, Centre for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - Michael Donohue
- 4 Division of Biostatistics and Bioinformatics, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Susan Landau
- 5 Helen Wills Neuroscience Institute and School of Public Health, University of California, Berkeley, CA, USA
| | - William J Jagust
- 5 Helen Wills Neuroscience Institute and School of Public Health, University of California, Berkeley, CA, USA
| | - Leslie M Shaw
- 6 Department of Pathology and Laboratory Medicine, Institute on Aging, Centre for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - John Q Trojanowski
- 6 Department of Pathology and Laboratory Medicine, Institute on Aging, Centre for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Henrik Zetterberg
- 1 Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden 7 UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Kaj Blennow
- 1 Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Michael W Weiner
- 2 Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA 3 Department of Veterans Affairs Medical Centre, Centre for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
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135
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Abstract
Alzheimer disease (AD) and Parkinson disease (PD) are the most common neurodegenerative disorders. For both diseases, early intervention is thought to be essential to the success of disease-modifying treatments. Cerebrospinal fluid (CSF) can reflect some of the pathophysiological changes that occur in the brain, and the number of CSF biomarkers under investigation in neurodegenerative conditions has grown rapidly in the past 20 years. In AD, CSF biomarkers are increasingly being used in clinical practice, and have been incorporated into the majority of clinical trials to demonstrate target engagement, to enrich or stratify patient groups, and to find evidence of disease modification. In PD, CSF biomarkers have not yet reached the clinic, but are being studied in patients with parkinsonism, and are being used in clinical trials either to monitor progression or to demonstrate target engagement and downstream effects of drugs. CSF biomarkers might also serve as surrogate markers of clinical benefit after a specific therapeutic intervention, although additional data are required. It is anticipated that CSF biomarkers will have an important role in trials aimed at disease modification in the near future. In this Review, we provide an overview of CSF biomarkers in AD and PD, and discuss their role in clinical trials.
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136
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Ahmed RM, Paterson RW, Warren JD, Zetterberg H, O'Brien JT, Fox NC, Halliday GM, Schott JM. Biomarkers in dementia: clinical utility and new directions. J Neurol Neurosurg Psychiatry 2014; 85:1426-34. [PMID: 25261571 PMCID: PMC4335455 DOI: 10.1136/jnnp-2014-307662] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 08/27/2014] [Accepted: 09/03/2014] [Indexed: 12/12/2022]
Abstract
Imaging, cerebrospinal fluid (CSF) and blood-based biomarkers have the potential to improve the accuracy by which specific causes of dementia can be diagnosed in vivo, provide insights into the underlying pathophysiology, and may be used as inclusion criteria and outcome measures for clinical trials. While a number of imaging and CSF biomarkers are currently used for each of these purposes, this is an evolving field, with numerous potential biomarkers in varying stages of research and development. We review the currently available biomarkers for the three most common forms of neurodegenerative dementia, and give an overview of research techniques that may in due course make their way into the clinic.
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Affiliation(s)
- R M Ahmed
- Neuroscience Research Australia and the University of NSW, Sydney, New South Wales, Australia
| | - R W Paterson
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - J D Warren
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - H Zetterberg
- Department of Molecular Neuroscience, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Institute of Neuroscience and Physiology, Mölndal, Sweden
| | - J T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - N C Fox
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - G M Halliday
- Neuroscience Research Australia and the University of NSW, Sydney, New South Wales, Australia
| | - J M Schott
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
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137
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Molinuevo JL, Blennow K, Dubois B, Engelborghs S, Lewczuk P, Perret-Liaudet A, Teunissen CE, Parnetti L. The clinical use of cerebrospinal fluid biomarker testing for Alzheimer's disease diagnosis: A consensus paper from the Alzheimer's Biomarkers Standardization Initiative. Alzheimers Dement 2014; 10:808-17. [DOI: 10.1016/j.jalz.2014.03.003] [Citation(s) in RCA: 140] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 02/28/2014] [Accepted: 03/18/2014] [Indexed: 11/16/2022]
Affiliation(s)
- José Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit; Hospital Clinic i Universitari, IDIBAPS and Barcelona Beta Research Centre; Pasqual Maragall Foundation Barcelona Spain
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry; Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg; Mölndal Sweden
| | - Bruno Dubois
- Centre des Maladies Cognitives et Comportementales, Hôpital de la Salpêtrière, AP-HP; Institute of Brain and Spinal Cord (ICM), UMR-S975; Université Pierre et Marie Curie-Paris 6 Paris France
| | - Sebastiaan Engelborghs
- Department of Neurology and Memory Clinic; Hospital Network Antwerp (ZNA); Middelheim and Hoge Beuken Antwerp Belgium
- Reference Centre for Biological Markers of Dementia (BIODEM); Institute Born-Bunge, University of Antwerp; Antwerp Belgium
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy; Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg; Erlangen Germany
| | - Armand Perret-Liaudet
- Centre for Memory Resources and Research (CMRR); Neurobiology Laboratory, GHE, Hôpitaux de Lyon; Université Lyon 1, CNRS UMR5292, INSERM U1028 Lyon France
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory and Biobank; Department of Clinical Chemistry, VU University Medical Center; Amsterdam The Netherlands
| | - Lucilla Parnetti
- Centre for Memory Disturbances and Alzheimer's Centre, Section of Neurology; University of Perugia; Perugia Italy
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138
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Van Assche R, Temmerman L, Dias DA, Boughton B, Boonen K, Braeckman BP, Schoofs L, Roessner U. Metabolic profiling of a transgenic Caenorhabditis elegans Alzheimer model. Metabolomics 2014; 11:477-486. [PMID: 25750603 PMCID: PMC4342517 DOI: 10.1007/s11306-014-0711-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/11/2014] [Indexed: 12/30/2022]
Abstract
Despite decades of research, no early-onset biomarkers are currently available for Alzheimer's disease, a cureless neurodegenerative disease afflicting millions worldwide. In this study, transgenic Caenorhabditis elegans were used to investigate changes in the metabolome after induced expression of amyloid-β. GC- and LC-MS-based platforms determined a total of 157 differential features. Some of these were identified using in-house (GC-MS) or public libraries (LC-MS), revealing changes in allantoin, cystathionine and tyrosine levels. Since C. elegans is far better suited to metabolomics studies than most other model systems, the accordance of these findings with vertebrate literature is promising and argues for further use of C. elegans as a model of human pathology in the study of AD.
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Affiliation(s)
- Roel Van Assche
- Functional Genomics and Proteomics, Department of Biology, KU Leuven, Leuven, Belgium
| | - Liesbet Temmerman
- Functional Genomics and Proteomics, Department of Biology, KU Leuven, Leuven, Belgium
| | - Daniel A Dias
- Metabolomics Australia, School of Botany, University of Melbourne, Melbourne, Australia
| | - Berin Boughton
- Metabolomics Australia, School of Botany, University of Melbourne, Melbourne, Australia
| | - Kurt Boonen
- Functional Genomics and Proteomics, Department of Biology, KU Leuven, Leuven, Belgium
| | - Bart P Braeckman
- Laboratory for Aging Physiology and Molecular Evolution, Department of Biology, Ghent University, Ghent, Belgium
| | - Liliane Schoofs
- Functional Genomics and Proteomics, Department of Biology, KU Leuven, Leuven, Belgium
| | - Ute Roessner
- Metabolomics Australia, School of Botany, University of Melbourne, Melbourne, Australia
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139
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Roy M, Cardoso C, Dorieux O, Malgorn C, Epelbaum S, Petit F, Kraska A, Brouillet E, Delatour B, Perret M, Aujard F, Dhenain M. Age-associated evolution of plasmatic amyloid in mouse lemur primates: relationship with intracellular amyloid deposition. Neurobiol Aging 2014; 36:149-56. [PMID: 25131002 DOI: 10.1016/j.neurobiolaging.2014.07.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 07/02/2014] [Accepted: 07/12/2014] [Indexed: 01/08/2023]
Abstract
Alzheimer's disease (AD) is the most common age-related neurodegenerative disorder. Amyloid-β peptide (Aβ) deposition in the brain is one of its hallmarks, and the measure of plasma Aβ is considered to be a biomarker for anti-amyloid drug efficacy in animal models of AD. However, age-associated plasmatic Aβ modulation in animal models is practically never addressed in the literature. Mouse lemur primates are used as a model of normal and AD-like cerebral aging. Here, we studied the effect of age on plasmatic Aβ in 58 mouse lemurs aged from 1 to 10 years. A subset of animals presented high plasmatic Aβ, and the proportion of animals with high plasmatic Aβ was higher in aged animals as compared with young ones. Histologic evaluation of the brain of some of these animals was carried out to assess extracellular and intracellular amyloid load. In aged lemurs, plasmatic Aβ was negatively correlated with the density of neurons accumulating deposits of Aβ.
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Affiliation(s)
- Maggie Roy
- CEA, DSV, I2BM, MIRCen, URA CEA CNRS 2210, Fontenay aux Roses, France; CNRS, URA 2210, Fontenay aux Roses, France; Research Center on Aging, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Cécile Cardoso
- CEA, DSV, I2BM, MIRCen, URA CEA CNRS 2210, Fontenay aux Roses, France; CNRS, URA 2210, Fontenay aux Roses, France
| | - Olène Dorieux
- CEA, DSV, I2BM, MIRCen, URA CEA CNRS 2210, Fontenay aux Roses, France; CNRS, URA 2210, Fontenay aux Roses, France; CNRS UMR 7179, MNHN, Brunoy, France
| | - Carole Malgorn
- CEA, DSV, I2BM, MIRCen, URA CEA CNRS 2210, Fontenay aux Roses, France; CNRS, URA 2210, Fontenay aux Roses, France
| | - Stéphane Epelbaum
- Sorbonne Universités, Paris, France; UPMC Univ Paris 06 UMR S 1127, Paris, France; Inserm, U 1127, Paris, France; CNRS UMR 7225, Paris, France; ICM, Paris, France
| | - Fanny Petit
- CEA, DSV, I2BM, MIRCen, URA CEA CNRS 2210, Fontenay aux Roses, France; CNRS, URA 2210, Fontenay aux Roses, France
| | - Audrey Kraska
- CEA, DSV, I2BM, MIRCen, URA CEA CNRS 2210, Fontenay aux Roses, France; CNRS, URA 2210, Fontenay aux Roses, France
| | - Emmanuel Brouillet
- CEA, DSV, I2BM, MIRCen, URA CEA CNRS 2210, Fontenay aux Roses, France; CNRS, URA 2210, Fontenay aux Roses, France
| | - Benoît Delatour
- Sorbonne Universités, Paris, France; UPMC Univ Paris 06 UMR S 1127, Paris, France; Inserm, U 1127, Paris, France; CNRS UMR 7225, Paris, France; ICM, Paris, France
| | | | | | - Marc Dhenain
- CEA, DSV, I2BM, MIRCen, URA CEA CNRS 2210, Fontenay aux Roses, France; CNRS, URA 2210, Fontenay aux Roses, France.
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140
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Peripheral blood mononuclear cells as a laboratory to study dementia in the elderly. BIOMED RESEARCH INTERNATIONAL 2014; 2014:169203. [PMID: 24877062 PMCID: PMC4022117 DOI: 10.1155/2014/169203] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 03/28/2014] [Indexed: 02/08/2023]
Abstract
The steady and dramatic increase in the incidence of Alzheimer's disease (AD) and the lack of effective treatments have stimulated the search for strategies to prevent or delay its onset and/or progression. Since the diagnosis of dementia requires a number of established features that are present when the disease is fully developed, but not always in the early stages, the need for a biological marker has proven to be urgent, in terms of both diagnosis and monitoring of AD. AD has been shown to affect peripheral blood mononuclear cells (PBMCs) that are a critical component of the immune system which provide defence against infection. Although studies are continuously supplying additional data that emphasize the central role of inflammation in AD, PBMCs have not been sufficiently investigated in this context. Delineating biochemical alterations in AD blood constituents may prove valuable in identifying accessible footprints that reflect degenerative processes within the Central Nervous System (CNS). In this review, we address the role of biomarkers in AD with a focus on the notion that PBMCs may serve as a peripheral laboratory to find molecular signatures that could aid in differential diagnosis with other forms of dementia and in monitoring of disease progression.
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141
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Dumurgier J, Laplanche JL, Mouton-Liger F, Lapalus P, Indart S, Prévot M, Peoc'h K, Hugon J, Paquet C. The screening of Alzheimer's patients with CSF biomarkers, modulates the distribution of APOE genotype: impact on clinical trials. J Neurol 2014; 261:1187-95. [PMID: 24728335 DOI: 10.1007/s00415-014-7335-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 03/26/2014] [Accepted: 03/27/2014] [Indexed: 01/23/2023]
Abstract
Polymorphism of the apolipoprotein E gene (APOE) plays a role in the level of neuropathological lesions and in drug response in Alzheimer's disease (AD). The aim of this study was to investigate whether the selection of AD patients based on cerebrospinal fluid (CSF) biomarkers assessment may be biased by their APOE distribution. We studied the relationships between APOE genotype and CSF biomarkers levels in a total of 432 patients (AD, n = 244; non-AD, n = 188) explored for cognitive disorders. We studied the distribution of APOE genotypes among AD patient subgroups selected by various cut-offs of CSF biomarkers. Strategies of screening based on CSF Aβ1-42 lead to overselection of ε4/ε4 patients in the AD group. Screening based on tau levels did not change Apoe4 distribution in the AD group. CSF Aβ1-42 discriminated better AD patients with at least one ε4 than AD patients with no ε4. A strong allele-effect relationship was detected between APOE genotype and CSF amyloid-β (Aβ1-42) in AD patients. Selecting AD patients on CSF amyloid levels only may create an overselection of ε4/ε4 carriers, and might potentially bias the population of patients included in clinical trial studies.
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Affiliation(s)
- Julien Dumurgier
- Memory Clinical Center CMRR Paris Nord Ile-de-France, Saint Louis-Lariboisiere, Fernand Widal Hospital, AP-HP, University Paris 7-Denis Diderot, Paris, France,
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142
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The cerebrospinal fluid "Alzheimer profile": easily said, but what does it mean? Alzheimers Dement 2014; 10:713-723.e2. [PMID: 24721526 DOI: 10.1016/j.jalz.2013.12.023] [Citation(s) in RCA: 232] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 12/06/2013] [Accepted: 12/07/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND We aimed to identify the most useful definition of the "cerebrospinal fluid Alzheimer profile," based on amyloid-ß1-42 (Aβ42), total tau, and phosphorylated tau (p-tau), for diagnosis and prognosis of Alzheimer's disease (AD). METHODS We constructed eight Alzheimer profiles with previously published combinations, including regression formulas and simple ratios. We compared their diagnostic accuracy and ability to predict dementia due to AD in 1385 patients from the Amsterdam Dementia Cohort. Results were validated in an independent cohort (n = 1442). RESULTS Combinations outperformed individual biomarkers. Based on the sensitivity of the best performing regression formulas, cutoffs were chosen at 0.52 for the tau/Aβ42 ratio and 0.08 for the p-tau/Aβ42 ratio. Ratios performed similar to formulas (sensitivity, 91%-93%; specificity, 81%-84%). The same combinations best predicted cognitive decline in mild cognitive impairment patients. Validation confirmed these results, especially regarding the tau/Aβ42 ratio. CONCLUSIONS A tau/Aβ42 ratio of >0.52 constitutes a robust cerebrospinal fluid Alzheimer profile. We recommend using this ratio to combine biomarkers.
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143
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Nutu M, Zetterberg H, Londos E, Minthon L, Nägga K, Blennow K, Hansson O, Ohrfelt A. Evaluation of the cerebrospinal fluid amyloid-β1-42/amyloid-β1-40 ratio measured by alpha-LISA to distinguish Alzheimer's disease from other dementia disorders. Dement Geriatr Cogn Disord 2014; 36:99-110. [PMID: 23860354 DOI: 10.1159/000353442] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The well-established core biomarkers used to identify Alzheimer's disease (AD) overlap with other dementia disorders such as dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD). This study aimed to evaluate whether the cerebrospinal fluid (CSF) amyloid-β (Aβ)1-42/Aβ1-40 ratio, measured by a novel method, could improve the differential diagnosis of AD, DLB and PDD. METHOD CSF levels of Aβ1-40 and Aβ1-42 in patients with PDD, DLB, AD, Parkinson's disease and controls were analyzed using an amplified luminescent proximity homogenous immunoassay along with conventional immunoassays. RESULTS The CSF Aβ1-42/Aβ1-40 ratio increased discrimination of AD from PDD and DLB compared with either of the two Aβ biomarkers individually. CONCLUSION The use of the Aβ1-42/Aβ1-40 ratio could improve the differentiation of AD from PDD and DLB.
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Affiliation(s)
- Magdalena Nutu
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.
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144
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Saint-Aubert L, Nemmi F, Péran P, Barbeau EJ, Payoux P, Chollet F, Pariente J. Comparison between PET template-based method and MRI-based method for cortical quantification of florbetapir (AV-45) uptake in vivo. Eur J Nucl Med Mol Imaging 2013; 41:836-43. [PMID: 24435769 PMCID: PMC3978219 DOI: 10.1007/s00259-013-2656-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 11/28/2013] [Indexed: 01/18/2023]
Abstract
PURPOSE Florbetapir (AV-45) has been shown to be a reliable tool for assessing in vivo amyloid load in patients with Alzheimer's disease from the early stages. However, nonspecific white matter binding has been reported in healthy subjects as well as in patients with Alzheimer's disease. To avoid this issue, cortical quantification might increase the reliability of AV-45 PET analyses. In this study, we compared two quantification methods for AV-45 binding, a classical method relying on PET template registration (route 1), and a MRI-based method (route 2) for cortical quantification. METHODS We recruited 22 patients at the prodromal stage of Alzheimer's disease and 17 matched controls. AV-45 binding was assessed using both methods, and target-to-cerebellum mean global standard uptake values (SUVr) were obtained for each of them, together with SUVr in specific regions of interest. Quantification using the two routes was compared between the clinical groups (intragroup comparison), and between groups for each route (intergroup comparison). Discriminant analysis was performed. RESULTS In the intragroup comparison, differences in uptake values were observed between route 1 and route 2 in both groups. In the intergroup comparison, AV-45 uptake was higher in patients than controls in all regions of interest using both methods, but the effect size of this difference was larger using route 2. In the discriminant analysis, route 2 showed a higher specificity (94.1 % versus 70.6 %), despite a lower sensitivity (77.3 % versus 86.4 %), and D-prime values were higher for route 2. CONCLUSION These findings suggest that, although both quantification methods enabled patients at early stages of Alzheimer's disease to be well discriminated from controls, PET template-based quantification seems adequate for clinical use, while the MRI-based cortical quantification method led to greater intergroup differences and may be more suitable for use in current clinical research.
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Affiliation(s)
- L Saint-Aubert
- Inserm, imagerie cérébrale et handicaps neurologiques UMR 825, Centre Hospitalier Universitaire de Toulouse, Pavillon Baudot CHU Purpan lace Dr Baylac, 31059, Toulouse, France,
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145
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Engelborghs S. Clinical indications for analysis of Alzheimer's disease CSF biomarkers. Rev Neurol (Paris) 2013; 169:709-14. [DOI: 10.1016/j.neurol.2013.07.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 07/12/2013] [Accepted: 07/16/2013] [Indexed: 11/25/2022]
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146
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Kumar P, Dezso Z, MacKenzie C, Oestreicher J, Agoulnik S, Byrne M, Bernier F, Yanagimachi M, Aoshima K, Oda Y. Circulating miRNA biomarkers for Alzheimer's disease. PLoS One 2013; 8:e69807. [PMID: 23922807 PMCID: PMC3726785 DOI: 10.1371/journal.pone.0069807] [Citation(s) in RCA: 265] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 06/12/2013] [Indexed: 12/13/2022] Open
Abstract
A minimally invasive diagnostic assay for early detection of Alzheimer's disease (AD) is required to select optimal patient groups in clinical trials, monitor disease progression and response to treatment, and to better plan patient clinical care. Blood is an attractive source for biomarkers due to minimal discomfort to the patient, encouraging greater compliance in clinical trials and frequent testing. MiRNAs belong to the class of non-coding regulatory RNA molecules of ∼22 nt length and are now recognized to regulate ∼60% of all known genes through post-transcriptional gene silencing (RNAi). They have potential as useful biomarkers for clinical use because of their stability and ease of detection in many tissues, especially blood. Circulating profiles of miRNAs have been shown to discriminate different tumor types, indicate staging and progression of the disease and to be useful as prognostic markers. Recently their role in neurodegenerative diseases, both as diagnostic biomarkers as well as explaining basic disease etiology has come into focus. Here we report the discovery and validation of a unique circulating 7-miRNA signature (hsa-let-7d-5p, hsa-let-7g-5p, hsa-miR-15b-5p, hsa-miR-142-3p, hsa-miR-191-5p, hsa-miR-301a-3p and hsa-miR-545-3p) in plasma, which could distinguish AD patients from normal controls (NC) with >95% accuracy (AUC of 0.953). There was a >2 fold difference for all signature miRNAs between the AD and NC samples, with p-values<0.05. Pathway analysis, taking into account enriched target mRNAs for these signature miRNAs was also carried out, suggesting that the disturbance of multiple enzymatic pathways including lipid metabolism could play a role in AD etiology.
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Affiliation(s)
- Pavan Kumar
- Eisai Inc, Biomarkers and Personalized Medicine Core Function Unit, Eisai Product Creation Systems, Andover, Massachusetts, United States of America.
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147
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Saint-Aubert L, Barbeau EJ, Péran P, Nemmi F, Vervueren C, Mirabel H, Payoux P, Hitzel A, Bonneville F, Gramada R, Tafani M, Vincent C, Puel M, Dechaumont S, Chollet F, Pariente J. Cortical florbetapir-PET amyloid load in prodromal Alzheimer's disease patients. EJNMMI Res 2013; 3:43. [PMID: 23731789 PMCID: PMC3733998 DOI: 10.1186/2191-219x-3-43] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 05/15/2013] [Indexed: 01/18/2023] Open
Abstract
Background Florbetapir (AV-45) has been shown to be a reliable tool to assess amyloid load in patients with Alzheimer's disease (AD) at demential stages. Longitudinal studies also suggest that AV-45 has the ability to bind amyloid in the early stages of AD. In this study, we investigated AV-45 binding and its relation with cognitive performance in a group of patients at the prodromal stage of Alzheimer's disease, recruited according to strict inclusion criteria. Methods We recruited patients at the prodromal stage of AD and matched control subjects. AV-45 binding was assessed using an innovative extraction method allowing quantifying uptake in the cortex only. AV-45 uptake was compared between groups in the precuneus, posterior cingulate, anterior cingulate, and orbito-frontal regions. Correlations between AV-45 uptake and cognitive performance were assessed. Results Twenty-two patients and 17 matched control subjects were included in the study. We report a significant increase of cortical AV-45 uptake in the patients compared to the control subjects in all regions of interest. Specific correlations were found within the patient group between mean global amyloid cortical load and cognitive performance in three different memory tests. Conclusions These findings suggest that at the prodromal stage of AD, memory decline is linked to an increase of cortical β-amyloid load.
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Affiliation(s)
- Laure Saint-Aubert
- INSERM, Imagerie Cérébrale et Handicaps Neurologiques UMR 825, Centre Hospitalier Universitaire de Toulouse, Place Dr Baylac, Pavillon Baudot, Toulouse CEDEX 9 31059, France.
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148
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Bibl M, Welge V, Schmidt H, Esselmann H, Mollenhauer B, Lewczuk P, Otto M, Kornhuber J, Wiltfang J. Plasma amyloid-beta peptides in acute cerebral ischemia: a pilot study. J Clin Lab Anal 2013; 26:238-45. [PMID: 22811355 DOI: 10.1002/jcla.21511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Blood-based tests for a rapid and valid diagnosis as well as outcome prognosis of acute stroke are desirable. Recently, plasma Aβ40 was suggested as an independent cerebrovascular risk factor candidate. METHODS We investigated eight plasma samples of patients with clinical signs of acute cerebral ischemia for derangements of plasma amyloid-beta (Aβ) peptide patterns as compared to 13 patients with other neuropsychiatric diseases. For the analysis of plasma, we used immunoprecipitation followed by the quantitative Aβ-SDS-PAGE/immunoblot. RESULTS The major outcome was a striking decrease of Aβ1-40 in plasma paralleled by an increase in the ratio of Aβ1-38/Aβ1-40 in two patients with acute stroke. Interestingly, these patients had an onset of symptoms within only 2-4 hr before venous puncture and there was a strong correlation of Aβ1-38/Aβ1-40 levels with the time span between onset of symptoms and venous puncture. CONCLUSION From these results, we suggest the ratio of plasma Aβ1-38/Aβ1-40 as a possible biomarker for the early diagnosis of acute stroke.
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Affiliation(s)
- Mirko Bibl
- Department of Psychiatry, Psychotherapy and Addiction Medicine, Kliniken Essen-Mitte, University of Duisburg-Essen, Henricistrasse 92, Essen, Germany.
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Wahlster L, Arimon M, Nasser-Ghodsi N, Post KL, Serrano-Pozo A, Uemura K, Berezovska O. Presenilin-1 adopts pathogenic conformation in normal aging and in sporadic Alzheimer's disease. Acta Neuropathol 2013; 125:187-99. [PMID: 23138650 PMCID: PMC3552123 DOI: 10.1007/s00401-012-1065-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 10/30/2012] [Accepted: 10/31/2012] [Indexed: 01/09/2023]
Abstract
Accumulation of amyloid-β (Aβ) and neurofibrillary tangles in the brain, inflammation and synaptic and neuronal loss are some of the major neuropathological hallmarks of Alzheimer's disease (AD). While genetic mutations in amyloid precursor protein and presenilin-1 and -2 (PS1 and PS2) genes cause early-onset familial AD, the etiology of sporadic AD is not fully understood. Our current study shows that changes in conformation of endogenous wild-type PS1, similar to those found with mutant PS1, occur in sporadic AD brain and during normal aging. Using a mouse model of Alzheimer's disease (Tg2576) that overexpresses the Swedish mutation of amyloid precursor protein but has normal levels of endogenous wild-type presenilin, we report that the percentage of PS1 in a pathogenic conformation increases with age. Importantly, we found that this PS1 conformational shift is associated with amyloid pathology and precedes amyloid-β deposition in the brain. Furthermore, we found that oxidative stress, a common stress characteristic of aging and AD, causes pathogenic PS1 conformational change in neurons in vitro, which is accompanied by increased Aβ42/40 ratio. The results of this study provide important information about the timeline of pathogenic changes in PS1 conformation during aging and suggest that structural changes in PS1/γ-secretase may represent a molecular mechanism by which oxidative stress triggers amyloid-β accumulation in aging and in sporadic AD brain.
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Affiliation(s)
- Lara Wahlster
- Department of Neurology, MassGeneral Institute for Neurodegenerative Disease (MIND), Massachusetts General Hospital, Harvard Medical School, CNY 114, 16th Street, Charlestown, MA 02129, USA.
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150
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Guzmán-Martínez L, Farías GA, Maccioni RB. Emerging noninvasive biomarkers for early detection of Alzheimer's disease. Arch Med Res 2012; 43:663-6. [PMID: 23142260 DOI: 10.1016/j.arcmed.2012.10.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 10/18/2012] [Indexed: 11/19/2022]
Abstract
Alzheimer's disease (AD) diagnosis still depends on the triad of clinical, imaging and neuropsychological testing. The development of accurate, easy to use and inexpensive biological markers for AD is a long-standing aspiration for researchers and the medical community. Here we describe some of the recent advances in the field of biomarkers, both in cerebrospinal fluid (CSF) and in peripheral blood.
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Affiliation(s)
- Leonardo Guzmán-Martínez
- Laboratory of Cellular and Molecular Neurosciences, Faculty of Science, University of Chile, Santiago, Chile.
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