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Barlet BD, Hauson AO, Pollard AA, Zhang EZ, Nemanim NM, Sarkissians S, Lackey NS, Stelmach NP, Walker AD, Carson BT, Flora-Tostado C, Reszegi K, Allen KE, Viglione DJ. Neuropsychological Performance in Alzheimer's Disease versus Late-Life Depression: A Systematic Review and Meta-Analysis. Arch Clin Neuropsychol 2023; 38:991-1016. [PMID: 37332152 DOI: 10.1093/arclin/acad036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 06/20/2023] Open
Abstract
OBJECTIVE Despite decades of research, neuropsychological tests (NPTs) that clearly differentiate between Alzheimer's disease (AD) and late-life depression (LLD) have yet to be agreed upon. Given this gap in knowledge and the rapid deployment of disease-modifying drugs for the two disorders, accurate clinical diagnosis using evidence-based assessment is essential. This study aims to systematically examine the literature to identify NPTs that would be able to differentiate AD and LLD. METHOD Databases and bibliographies were searched to identify articles for analysis. Two major inclusion criteria were that the studies compared neuropsychological functioning of AD versus LLD using normed NPTs and provided data for effect size calculation. Risk of bias was minimized by having independent coders for all steps in the review. RESULTS Forty-one studies met inclusion criteria (N = 2,797) and provided effect sizes for tests that were classified as belonging to 15 domains of functioning. The two groups were well differentiated by tasks of delayed contextual verbal memory as compared to immediate or non-contextual memory, recognition cueing, confrontation naming, visuospatial construction, and conceptualization. Specific NPTs that appear to be useful for differential diagnosis include the Rey Auditory Verbal Learning Test-Delayed Recognition; Boston Naming Test; the Dementia Rating Scale's memory, conceptualization, and construction subscales; and the CERAD Constructional Praxis. CONCLUSIONS The NPTs highlighted in this systematic review could be used as a relatively simple and cost-effective method to differentiate between patients with cognitive dysfunction due to AD versus LLD.
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Affiliation(s)
- Brianna D Barlet
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Alexander O Hauson
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Anna A Pollard
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Emily Z Zhang
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Natasha M Nemanim
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Sharis Sarkissians
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Nick S Lackey
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Nicholas P Stelmach
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Alyssa D Walker
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Bryce T Carson
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Christopher Flora-Tostado
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Katalin Reszegi
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Kenneth E Allen
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
- Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA
| | - Donald J Viglione
- Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA
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Koychev I, Marinov E, Young S, Lazarova S, Grigorova D, Palejev D. Identification of preclinical dementia according to ATN classification for stratified trial recruitment: A machine learning approach. PLoS One 2023; 18:e0288039. [PMID: 37856502 PMCID: PMC10586674 DOI: 10.1371/journal.pone.0288039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/19/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION The Amyloid/Tau/Neurodegeneration (ATN) framework was proposed to identify the preclinical biological state of Alzheimer's disease (AD). We investigated whether ATN phenotype can be predicted using routinely collected research cohort data. METHODS 927 EPAD LCS cohort participants free of dementia or Mild Cognitive Impairment were separated into 5 ATN categories. We used machine learning (ML) methods to identify a set of significant features separating each neurodegeneration-related group from controls (A-T-(N)-). Random Forest and linear-kernel SVM with stratified 5-fold cross validations were used to optimize model whose performance was then tested in the ADNI database. RESULTS Our optimal results outperformed ATN cross-validated logistic regression models by between 2.2% and 8.3%. The optimal feature sets were not consistent across the 4 models with the AD pathologic change vs controls set differing the most from the rest. Because of that we have identified a subset of 10 features that yield results very close or identical to the optimal. DISCUSSION Our study demonstrates the gains offered by ML in generating ATN risk prediction over logistic regression models among pre-dementia individuals.
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Affiliation(s)
- Ivan Koychev
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Evgeniy Marinov
- Big Data for Smart Society (GATE) Institute, Sofia University, Sofia, Bulgaria
| | - Simon Young
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Sophia Lazarova
- Big Data for Smart Society (GATE) Institute, Sofia University, Sofia, Bulgaria
| | - Denitsa Grigorova
- Big Data for Smart Society (GATE) Institute, Sofia University, Sofia, Bulgaria
- Faculty of Mathematics and Informatics, Sofia University, Sofia, Bulgaria
| | - Dean Palejev
- Big Data for Smart Society (GATE) Institute, Sofia University, Sofia, Bulgaria
- Institute of Mathematics and Informatics, Bulgarian Academy of Sciences, Sofia, Bulgaria
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Abbatantuono C, Alfeo F, Clemente L, Lancioni G, De Caro MF, Livrea P, Taurisano P. Current Challenges in the Diagnosis of Progressive Neurocognitive Disorders: A Critical Review of the Literature and Recommendations for Primary and Secondary Care. Brain Sci 2023; 13:1443. [PMID: 37891810 PMCID: PMC10605551 DOI: 10.3390/brainsci13101443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023] Open
Abstract
Screening for early symptoms of cognitive impairment enables timely interventions for patients and their families. Despite the advances in dementia diagnosis, the current nosography of neurocognitive disorders (NCDs) seems to overlook some clinical manifestations and predictors that could contribute to understanding the conversion from an asymptomatic stage to a very mild one, eventually leading to obvious disease. The present review examines different diagnostic approaches in view of neurophysiological and neuropsychological evidence of NCD progression, which may be subdivided into: (1) preclinical stage; (2) transitional stage; (3) prodromal or mild stage; (4) major NCD. The absence of univocal criteria and the adoption of ambiguous or narrow labels might complicate the diagnostic process. In particular, it should be noted that: (1) only neuropathological hallmarks characterize preclinical NCD; (2) transitional NCD must be assessed through proactive neuropsychological protocols; (3) prodromal/mild NCDs are based on cognitive functional indicators; (4) major NCD requires well-established tools to evaluate its severity stage; (5) insight should be accounted for by both patient and informants. Therefore, the examination of evolving epidemiological and clinical features occurring at each NCD stage may orient primary and secondary care, allowing for more targeted prevention, diagnosis, and/or treatment of both cognitive and functional impairment.
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Affiliation(s)
- Chiara Abbatantuono
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari “Aldo Moro”, 70121 Bari, Italy; (C.A.); (L.C.); (G.L.); (M.F.D.C.)
| | - Federica Alfeo
- Department of Education, Communication and Psychology (For.Psi.Com), University of Bari “Aldo Moro”, 70121 Bari, Italy;
| | - Livio Clemente
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari “Aldo Moro”, 70121 Bari, Italy; (C.A.); (L.C.); (G.L.); (M.F.D.C.)
| | - Giulio Lancioni
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari “Aldo Moro”, 70121 Bari, Italy; (C.A.); (L.C.); (G.L.); (M.F.D.C.)
- Lega F D’Oro Research Center, 60027 Osimo, Italy
| | - Maria Fara De Caro
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari “Aldo Moro”, 70121 Bari, Italy; (C.A.); (L.C.); (G.L.); (M.F.D.C.)
| | | | - Paolo Taurisano
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari “Aldo Moro”, 70121 Bari, Italy; (C.A.); (L.C.); (G.L.); (M.F.D.C.)
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Sadlon A, Takousis P, Ankli B, Alexopoulos P, Perneczky R. Association of Chronic Pain with Biomarkers of Neurodegeneration, Microglial Activation, and Inflammation in Cerebrospinal Fluid and Impaired Cognitive Function. Ann Neurol 2023; 95:10.1002/ana.26804. [PMID: 37787094 PMCID: PMC10987399 DOI: 10.1002/ana.26804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVE Debate surrounds the role of chronic pain as a risk factor for cognitive decline and dementia. This study aimed at examining the association of chronic pain with biomarkers of neurodegeneration using data from the Alzheimer's Disease Neuroimaging Initiative. METHODS Participants were classified using the ATN (amyloid, tau, neurodegeneration) classification. Chronic pain was defined as persistent or recurrent pain reported at baseline. For each ATN group, analysis of covariance models identified differences in cerebrospinal fluid (CSF) levels of amyloid β1-42 , phosphorylated tau 181 (ptau181 ), total tau (t-tau), soluble triggering receptor expressed on myeloid cells 2 (sTREM2), and cognitive function between chronic pain states. Differences in CSF levels of inflammatory markers between chronic pain states were further analyzed. Linear mixed effect models examined longitudinal changes. RESULTS The study included 995 individuals, with 605 (60.81%) reporting chronic pain at baseline. At baseline, individuals with suspected non-Alzheimer pathophysiology and chronic pain showed increased CSF levels of t-tau and sTREM2. Chronic pain was associated with increased tumor necrosis factor α levels, irrespective of the ATN group. Longitudinally, an increase in ptau181 CSF levels was observed in chronic pain patients with negative amyloid and neurodegeneration markers. Amyloid-positive and neurodegeneration-negative chronic pain patients showed higher memory function cross-sectionally. No significant longitudinal decline in cognitive function was observed for any ATN group. INTERPRETATION Our study suggests that chronic pain induces neuronal damage and microglial activation in particular subgroups of patients along the AD spectrum. Further studies are needed to confirm these findings. ANN NEUROL 2023.
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Affiliation(s)
- Angélique Sadlon
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom (UK)
- Department of Clinical Chemistry, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
- Pain Clinic Basel, Basel, Switzerland
| | - Petros Takousis
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom (UK)
| | - Barbara Ankli
- Pain Clinic Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Panagiotis Alexopoulos
- Global Βrain Health Institute, School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Republic of Ireland
- Department of Psychiatry, Patras University General Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
- Patras Dementia Day Care Centre, Patras, Greece
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Robert Perneczky
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom (UK)
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- German Centre for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Sheffield Institute for Translational Neurosciences (SITraN), University of Sheffield, Sheffield, United Kingdom (UK)
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Badhwar A, Hirschberg Y, Tamayo NV, Iulita MF, Udeh-Momoh CT, Matton A, Tarawneh RM, Rissman RA, Ledreux A, Winston CN, Haqqani AS. Assessment of brain-derived extracellular vesicle enrichment for blood biomarker analysis in age-related neurodegenerative diseases: An international overview. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.02.560210. [PMID: 37873207 PMCID: PMC10592861 DOI: 10.1101/2023.10.02.560210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
INTRODUCTION Brain-derived extracellular vesicles (BEVs) in blood allows for minimally- invasive investigations of CNS-specific markers of age-related neurodegenerative diseases (NDDs). Polymer-based EV- and immunoprecipitation (IP)-based BEV-enrichment protocols from blood have gained popularity. We systematically investigated protocol consistency across studies, and determined CNS-specificity of proteins associated with these protocols. METHODS NDD articles investigating BEVs in blood using polymer-based and/or IP-based BEV enrichment protocols were systematically identified, and protocols compared. Proteins used for BEV-enrichment and/or post-enrichment were assessed for CNS- and brain-cell-type- specificity; extracellular domains (ECD+); and presence in EV-databases. RESULTS 82.1% of studies used polymer-based (ExoQuick) EV-enrichment, and 92.3% used L1CAM for IP-based BEV-enrichment. Centrifugation times differed across studies. 26.8% of 82 proteins systematically identified were CNS-specific: 50% ECD+, 77.3% were listed in EV- databases. DISCUSSION We identified protocol steps requiring standardization, and recommend additional CNS-specific proteins that can be used for BEV-enrichment or as BEV-biomarkers.
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156
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Martínez-Dubarbie F, Guerra-Ruiz A, López-García S, Lage C, Fernández-Matarrubia M, Infante J, Pozueta-Cantudo A, García-Martínez M, Corrales-Pardo A, Bravo M, López-Hoyos M, Irure-Ventura J, Sánchez-Juan P, García-Unzueta MT, Rodríguez-Rodríguez E. Accuracy of plasma Aβ40, Aβ42, and p-tau181 to detect CSF Alzheimer's pathological changes in cognitively unimpaired subjects using the Lumipulse automated platform. Alzheimers Res Ther 2023; 15:163. [PMID: 37784138 PMCID: PMC10544460 DOI: 10.1186/s13195-023-01319-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 09/27/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND The arrival of new disease-modifying treatments for Alzheimer's disease (AD) requires the identification of subjects at risk in a simple, inexpensive, and non-invasive way. With tools allowing an adequate screening, it would be possible to optimize the use of these treatments. Plasma markers of AD are very promising, but it is necessary to prove that alterations in their levels are related to alterations in gold standard markers such as cerebrospinal fluid or PET imaging. With this research, we want to evaluate the performance of plasma Aβ40, Aβ42, and p-tau181 to detect the pathological changes in CSF using the automated Lumipulse platform. METHODS Both plasma and CSF Aβ40, Aβ42, and p-tau181 have been evaluated in a group of 208 cognitively unimpaired subjects with a 30.3% of ApoE4 carriers. We have correlated plasma and CSF values of each biomarker. Then, we have also assessed the differences in plasma marker values according to amyloid status (A - / +), AD status (considering AD + subjects to those A + plus Tau +), and ATN group defined by CSF. Finally, ROC curves have been performed, and the area under the curve has been measured using amyloid status and AD status as an outcome and different combinations of plasma markers as predictors. RESULTS Aβ42, amyloid ratio, p-tau181, and p-tau181/Aβ42 ratio correlated significantly between plasma and CSF. For these markers, the levels were significantly different in the A + / - , AD + / - , and ATN groups. Amyloid ratio predicts amyloid and AD pathology in CSF with an AUC of 0.89. CONCLUSIONS Plasma biomarkers of AD using the automated Lumipulse platform show good diagnostic performance in detecting Alzheimer's pathology in cognitively unimpaired subjects.
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Affiliation(s)
- Francisco Martínez-Dubarbie
- Neurology Service, Marqués de Valdecilla University Hospital, Avda. de Valdecilla 25, Santander, Cantabria, 39008, Spain.
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Cantabria, 39011, Spain.
| | - Armando Guerra-Ruiz
- Biochemistry and Clinical Analysis Department, Marqués de Valdecilla University Hospital, Santander, Cantabria, 39008, Spain
| | - Sara López-García
- Neurology Service, Marqués de Valdecilla University Hospital, Avda. de Valdecilla 25, Santander, Cantabria, 39008, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Cantabria, 39011, Spain
| | - Carmen Lage
- Neurology Service, Marqués de Valdecilla University Hospital, Avda. de Valdecilla 25, Santander, Cantabria, 39008, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Cantabria, 39011, Spain
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, University of California, San Francisco, San Francisco, USA
| | - Marta Fernández-Matarrubia
- Neurology Service, Marqués de Valdecilla University Hospital, Avda. de Valdecilla 25, Santander, Cantabria, 39008, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Cantabria, 39011, Spain
| | - Jon Infante
- Neurology Service, Marqués de Valdecilla University Hospital, Avda. de Valdecilla 25, Santander, Cantabria, 39008, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Cantabria, 39011, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, 28220, Spain
- Medicine and Psychiatry Department, University of Cantabria, Santander, Spain
| | - Ana Pozueta-Cantudo
- Neurology Service, Marqués de Valdecilla University Hospital, Avda. de Valdecilla 25, Santander, Cantabria, 39008, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Cantabria, 39011, Spain
| | - María García-Martínez
- Neurology Service, Marqués de Valdecilla University Hospital, Avda. de Valdecilla 25, Santander, Cantabria, 39008, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Cantabria, 39011, Spain
| | - Andrea Corrales-Pardo
- Neurology Service, Marqués de Valdecilla University Hospital, Avda. de Valdecilla 25, Santander, Cantabria, 39008, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Cantabria, 39011, Spain
- Universidad Europea del Atlántico, Santander, Spain
| | - María Bravo
- Neurology Service, Marqués de Valdecilla University Hospital, Avda. de Valdecilla 25, Santander, Cantabria, 39008, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Cantabria, 39011, Spain
| | - Marcos López-Hoyos
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Cantabria, 39011, Spain
- Immunology Department, Marqués de Valdecilla University Hospital, Santander, Spain
- Molecular Biology Department, University of Cantabria, Santander, Spain
| | - Juan Irure-Ventura
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Cantabria, 39011, Spain
- Immunology Department, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Pascual Sánchez-Juan
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, 28220, Spain
- CIEN Foundation/Queen Sofia Foundation Alzheimer Center, Madrid, 28220, Spain
| | - María Teresa García-Unzueta
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Cantabria, 39011, Spain
- Biochemistry and Clinical Analysis Department, Marqués de Valdecilla University Hospital, Santander, Cantabria, 39008, Spain
| | - Eloy Rodríguez-Rodríguez
- Neurology Service, Marqués de Valdecilla University Hospital, Avda. de Valdecilla 25, Santander, Cantabria, 39008, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Cantabria, 39011, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, 28220, Spain
- Medicine and Psychiatry Department, University of Cantabria, Santander, Spain
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Huang LK, Kuan YC, Lin HW, Hu CJ. Clinical trials of new drugs for Alzheimer disease: a 2020-2023 update. J Biomed Sci 2023; 30:83. [PMID: 37784171 PMCID: PMC10544555 DOI: 10.1186/s12929-023-00976-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/26/2023] [Indexed: 10/04/2023] Open
Abstract
Alzheimer's disease (AD) is the leading cause of dementia, presenting a significant unmet medical need worldwide. The pathogenesis of AD involves various pathophysiological events, including the accumulation of amyloid and tau, neuro-inflammation, and neuronal injury. Clinical trials focusing on new drugs for AD were documented in 2020, but subsequent developments have emerged since then. Notably, the US-FDA has approved Aducanumab and Lecanemab, both antibodies targeting amyloid, marking the end of a nearly two-decade period without new AD drugs. In this comprehensive report, we review all trials listed in clinicaltrials.gov, elucidating their underlying mechanisms and study designs. Ongoing clinical trials are investigating numerous promising new drugs for AD. The main trends in these trials involve pathophysiology-based, disease-modifying therapies and the recruitment of participants in earlier stages of the disease. These trends underscore the significance of conducting fundamental research on pathophysiology, prevention, and intervention prior to the occurrence of brain damage caused by AD.
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Affiliation(s)
- Li-Kai Huang
- PhD Program in Medical Neuroscience, College of Medical Science and Technology, Taipei Medical University, No. 291, Zhong Zheng Road, Zhonghe District, New Taipei City, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, New Taipei City, Taiwan
- Dementia Center and Department of Neurology, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yi-Chun Kuan
- Taipei Neuroscience Institute, Taipei Medical University, New Taipei City, Taiwan
- Dementia Center and Department of Neurology, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Ho-Wei Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chaur-Jong Hu
- PhD Program in Medical Neuroscience, College of Medical Science and Technology, Taipei Medical University, No. 291, Zhong Zheng Road, Zhonghe District, New Taipei City, Taiwan.
- Taipei Neuroscience Institute, Taipei Medical University, New Taipei City, Taiwan.
- Dementia Center and Department of Neurology, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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158
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Imbimbo BP, Watling M, Imbimbo C, Nisticò R. Plasma ATN(I) classification and precision pharmacology in Alzheimer's disease. Alzheimers Dement 2023; 19:4729-4734. [PMID: 37079778 DOI: 10.1002/alz.13084] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 04/22/2023]
Abstract
Evaluating potential therapies for Alzheimer's disease (AD) depends on use of biomarkers for appropriate subject selection and monitoring disease progression. Biomarkers that predict onset of clinical symptoms are particularly important for AD because they enable intervention before irreversible neurodegeneration occurs. The amyloid-β-tau-neurodegeneration (ATN) classification system is currently used as a biological staging model for AD and is based on three classes of biomarkers evaluating amyloid-β (Aβ), tau pathology and neurodegeneration or neuronal injury. Promising blood-based biomarkers for each of these categories have been identified (Aβ42/Aβ40 ratio, phosphorylated tau, neurofilament light chain), and this matrix is now being expanded toward an ATN(I) system, where "I" represents a neuroinflammatory biomarker. The plasma ATN(I) system, together with APOE genotyping, offers a basis for individualized evaluation and a move away from the classic "one size fits all" approach toward a biomarker-driven individualisation of therapy for patients with AD.
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Affiliation(s)
- Bruno P Imbimbo
- Department of Research & Development, Chiesi Farmaceutici, Parma, Italy
| | - Mark Watling
- Independent Scholar (formerly at TranScrip Ltd, Reading, UK), Ruthin, UK
| | - Camillo Imbimbo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Robert Nisticò
- Department of Biology, School of Pharmacy, University of Tor Vergata, and European Brain Research Institute (EBRI), Rome, Italy
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159
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Forno G, Parra MA, Thumala D, Villagra R, Cerda M, Zitko P, Ibañez A, Lillo P, Slachevsky A. The "when" matters: Evidence from memory markers in the clinical continuum of Alzheimer's disease. Neuropsychology 2023; 37:753-768. [PMID: 37227845 PMCID: PMC10522796 DOI: 10.1037/neu0000891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE Cognitive assessment able to detect impairments in the early neuropathological stages of Alzheimer's disease (AD) is urgently needed. The visual short-term memory binding task (VSTMBT) and the Free and Cued Selective Reminding Test (FCSRT) have been recommended by the neurodegenerative disease working group as promising tests to aid in the early detection of AD. In this study, we investigated their complementary value across the clinical stages of the AD continuum. METHOD One hundred and seventeen older adults with subjective cognitive complaint (SCC), 79 with mild cognitive impairment (MCI), 31 patients with AD dementia (ADD), and 37 cognitively unimpaired (CU) subjects, underwent assessment with the VSTMBT and the picture version of the Spanish FCSRT. RESULTS After controlling for multiple comparisons, significant differences were found across groups. The VSTMBT was the only test that "marginally" differentiated between CU and SCC (d = 0.47, p = .052). Moreover, whereas the FCSRT showed a gradient (CU = SCC) > MCI > ADD, the VSTMBT gradient was CU > SCC > (MCI = ADD) suggesting that conjunctive binding deficits assessed by the latter may be sensitive to the very early stages of the disease. CONCLUSIONS Our results suggest that the VSTMBT and the FCSRT are sensitive to the clinical continuum of AD. Whereas the former detects changes in the early prodromal stages, the latter is more sensitive to the advanced prodromal stages of AD. These novel tests can aid in the early detection, monitor disease progression and response to treatment, and thus support drug development programs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Gonzalo Forno
- School of Psychology, Universidad de los Andes, Santiago, Chile
- Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Mario A. Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Daniela Thumala
- Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Psychology Department, Faculty of Social Sciences, University of Chile, Santiago, Chile
- Interuniversity Center on Healthy Aging (Plan to Strengthen State Universities, Chilean Ministry of Education RED21993). Santiago, Chile
| | - Roque Villagra
- Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Centro de Parkinson (CENPAR), Santiago, Chile
| | - Mauricio Cerda
- Programa de Biología Integrativa, Instituto de Ciencias Biomédicas y Centro de Informática Médica y Telemedicina, Facultad de Medicina, Universidad de Chile
| | - Pedro Zitko
- Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Departamento de Salud Global, Escuela de Salud Pública, Universidad de Chile
- Department of Health Services & Population Research, IoPPN, King’s College London
| | - Agustín Ibañez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, and National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), California, US; & Trinity College Dublin (TCD), Dublin, Ireland
| | - Patricia Lillo
- Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Departamento de Neurología Sur, Facultad de Medicina, Universidad de Chile
- Unidad de Neurología, Hospital San José, Santiago, Chile
| | - Andrea Slachevsky
- Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, Institute of Biomedical Science (ICBM), Neuroscience and East Neuroscience Department, Faculty of Medicine, University of Chile, Santiago, Chile
- Memory and Neuropsychiatric Clinic, Neurology Department, Hospital del Salvador, SSMO & Faculty of Medicine, University of Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
- East Neuroscience Department, Faculty of Medicine, University of Chile, Santiago, Chile
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Chouliaras L, O'Brien JT. The use of neuroimaging techniques in the early and differential diagnosis of dementia. Mol Psychiatry 2023; 28:4084-4097. [PMID: 37608222 PMCID: PMC10827668 DOI: 10.1038/s41380-023-02215-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
Dementia is a leading cause of disability and death worldwide. At present there is no disease modifying treatment for any of the most common types of dementia such as Alzheimer's disease (AD), Vascular dementia, Lewy Body Dementia (LBD) and Frontotemporal dementia (FTD). Early and accurate diagnosis of dementia subtype is critical to improving clinical care and developing better treatments. Structural and molecular imaging has contributed to a better understanding of the pathophysiology of neurodegenerative dementias and is increasingly being adopted into clinical practice for early and accurate diagnosis. In this review we summarise the contribution imaging has made with particular focus on multimodal magnetic resonance imaging (MRI) and positron emission tomography imaging (PET). Structural MRI is widely used in clinical practice and can help exclude reversible causes of memory problems but has relatively low sensitivity for the early and differential diagnosis of dementia subtypes. 18F-fluorodeoxyglucose PET has high sensitivity and specificity for AD and FTD, while PET with ligands for amyloid and tau can improve the differential diagnosis of AD and non-AD dementias, including recognition at prodromal stages. Dopaminergic imaging can assist with the diagnosis of LBD. The lack of a validated tracer for α-synuclein or TAR DNA-binding protein 43 (TDP-43) imaging remain notable gaps, though work is ongoing. Emerging PET tracers such as 11C-UCB-J for synaptic imaging may be sensitive early markers but overall larger longitudinal multi-centre cross diagnostic imaging studies are needed.
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Affiliation(s)
- Leonidas Chouliaras
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Specialist Dementia and Frailty Service, Essex Partnership University NHS Foundation Trust, St Margaret's Hospital, Epping, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK.
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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Bartsch T, Berg D, Heneka M, Leypoldt F. [Parkinson's and Alzheimer's disease as system-wide neurodegenerative disorders]. DER NERVENARZT 2023; 94:875-884. [PMID: 37672086 DOI: 10.1007/s00115-023-01542-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Parkinson's and Alzheimer's disease (PD/AD) are characterized by cellular pathological changes that precede clinical manifestation and symptom onset by decades (prodromal period) as well as by a heterogeneity of clinical symptoms. Both diseases are recognized as system-wide diseases with organ-transgressing dysregulation and involvement of immunological and neuroinflammatory mechanisms facilitating pathological protein aggregation and neurodegeneration. OBJECTIVES Overview of natural course, phenotypes and classification of PD/AD with a focus on underlying (system-wide) immunological and neuroinflammatory mechanisms. METHODS Literature research and consideration of expert opinions. RESULTS The accumulation of misfolded proteins such as amyloid‑β and synuclein in the course of neurodegenerative processes forms the basis of the current biological classifications, understanding of course and subtypes. Protein aggregation in PD/AD induces an innate immune response by activating microglia and the release of inflammatory mediators such as cytokines and chemokines and leading to further spread of neurodegeneration and accumulation of intracellular neurofibrillary tangles (NFTs). There is also growing evidence that adaptive immune responses involving auto-antibodies or auto-antigen-specific T‑/B-cell reactions involving tau, amyloid‑β or synuclein might be involved in the disease progression or subtypes of PD/AD. CONCLUSIONS Both innate and adaptive immune responses seem to be substantially involved in the pathological cascade leading to neurodegeneration in PD/AD and may contribute to disease progression and clinical subtypes. Thus, future targeted interventions should not only focus on protein aggregation but also on neuroinflammatory and immunological mechanisms.
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Affiliation(s)
- Thorsten Bartsch
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland.
- Klinik für Neurologie, AG Gedächtnis und Plastizität, Gedächtnis- und Demenzsprechstunde, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland.
| | - Daniela Berg
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - Michael Heneka
- Luxembourg Centre for Systems Biomedicine, Université du Luxembourg, Belvaux, Luxemburg
| | - Frank Leypoldt
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
- Institut für Klinische Chemie, Universitätsklinikum Schleswig-Holstein, Campus Kiel und Lübeck, Kiel, Deutschland
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Ally M, Sugarman MA, Zetterberg H, Blennow K, Ashton NJ, Karikari TK, Aparicio HJ, Frank B, Tripodis Y, Martin B, Palmisano JN, Steinberg EG, Simkin I, Farrer LA, Jun GR, Turk KW, Budson AE, O'Connor MK, Au R, Goldstein LE, Kowall NW, Killiany R, Stern RA, Stein TD, McKee AC, Qiu WQ, Mez J, Alosco ML. Cross-sectional and longitudinal evaluation of plasma glial fibrillary acidic protein to detect and predict clinical syndromes of Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12492. [PMID: 37885919 PMCID: PMC10599277 DOI: 10.1002/dad2.12492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/15/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023]
Abstract
Introduction This study examined plasma glial fibrillary acidic protein (GFAP) as a biomarker of cognitive impairment due to Alzheimer's disease (AD) with and against plasma neurofilament light chain (NfL), and phosphorylated tau (p-tau)181+231. Methods Plasma samples were analyzed using Simoa platform for 567 participants spanning the AD continuum. Cognitive diagnosis, neuropsychological testing, and dementia severity were examined for cross-sectional and longitudinal outcomes. Results Plasma GFAP discriminated AD dementia from normal cognition (adjusted mean difference = 0.90 standard deviation [SD]) and mild cognitive impairment (adjusted mean difference = 0.72 SD), and demonstrated superior discrimination compared to alternative plasma biomarkers. Higher GFAP was associated with worse dementia severity and worse performance on 11 of 12 neuropsychological tests. Longitudinally, GFAP predicted decline in memory, but did not predict conversion to mild cognitive impairment or dementia. Discussion Plasma GFAP was associated with clinical outcomes related to suspected AD and could be of assistance in a plasma biomarker panel to detect in vivo AD.
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Affiliation(s)
- Madeline Ally
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of PsychologyUniversity of ArizonaTucsonArizonaUSA
| | - Michael A. Sugarman
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Henrik Zetterberg
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK
- UK Dementia Research Institute at UCL, UCL Institute of NeurologyUniversity College LondonLondonUK
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and PhysiologyThe Sahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Kaj Blennow
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and PhysiologyThe Sahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Nicholas J. Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and PhysiologyThe Sahlgrenska Academy at the University of GothenburgGothenburgSweden
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and MaudsleyNHS FoundationLondonUK
- Centre for Age‐Related MedicineStavanger University HospitalStavangerNorway
| | - Thomas K. Karikari
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and PhysiologyThe Sahlgrenska Academy at the University of GothenburgGothenburgSweden
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Hugo J. Aparicio
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Brandon Frank
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Boston Healthcare SystemJamaica PlainMassachusettsUSA
| | - Yorghos Tripodis
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
| | - Brett Martin
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Biostatistics and Epidemiology Data Analytics CenterBoston University School of Public HealthBostonMassachusettsUSA
| | - Joseph N. Palmisano
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Biostatistics and Epidemiology Data Analytics CenterBoston University School of Public HealthBostonMassachusettsUSA
| | - Eric G. Steinberg
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Irene Simkin
- Department of MedicineBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Lindsay A. Farrer
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
- Department of MedicineBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- The Framingham Heart StudyFraminghamMassachusettsUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
- Department of OphthalmologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Gyungah R. Jun
- Department of MedicineBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Katherine W. Turk
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Boston Healthcare SystemJamaica PlainMassachusettsUSA
| | - Andrew E. Budson
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Boston Healthcare SystemJamaica PlainMassachusettsUSA
| | - Maureen K. O'Connor
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeuropsychologyEdith Nourse Rogers Memorial Veterans HospitalBedfordMassachusettsUSA
| | - Rhoda Au
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- The Framingham Heart StudyFraminghamMassachusettsUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Lee E. Goldstein
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Biostatistics and Epidemiology Data Analytics CenterBoston University School of Public HealthBostonMassachusettsUSA
- Department of OphthalmologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of Biomedical, Electrical, and Computer EngineeringBoston University College of EngineeringBostonMassachusettsUSA
| | - Neil W. Kowall
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Boston Healthcare SystemJamaica PlainMassachusettsUSA
- Department of Pathology and Laboratory MedicineBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Ronald Killiany
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Center for Biomedical ImagingBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Robert A. Stern
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurosurgeryBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Thor D. Stein
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Boston Healthcare SystemJamaica PlainMassachusettsUSA
- Department of Pathology and Laboratory MedicineBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Bedford Healthcare SystemBedfordMassachusettsUSA
| | - Ann C. McKee
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Boston Healthcare SystemJamaica PlainMassachusettsUSA
- Department of Pathology and Laboratory MedicineBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- US Department of Veterans AffairsVA Bedford Healthcare SystemBedfordMassachusettsUSA
| | - Wei Qiao Qiu
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of PsychiatryBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of Pharmacology and Experimental TherapeuticsBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Jesse Mez
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Michael L. Alosco
- Boston University Alzheimer's Disease Research Center and CTE CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
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Lew CO, Zhou L, Mazurowski MA, Doraiswamy PM, Petrella JR. MRI-based Deep Learning Assessment of Amyloid, Tau, and Neurodegeneration Biomarker Status across the Alzheimer Disease Spectrum. Radiology 2023; 309:e222441. [PMID: 37815445 PMCID: PMC10623183 DOI: 10.1148/radiol.222441] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 09/03/2023] [Accepted: 09/11/2023] [Indexed: 10/11/2023]
Abstract
Background PET can be used for amyloid-tau-neurodegeneration (ATN) classification in Alzheimer disease, but incurs considerable cost and exposure to ionizing radiation. MRI currently has limited use in characterizing ATN status. Deep learning techniques can detect complex patterns in MRI data and have potential for noninvasive characterization of ATN status. Purpose To use deep learning to predict PET-determined ATN biomarker status using MRI and readily available diagnostic data. Materials and Methods MRI and PET data were retrospectively collected from the Alzheimer's Disease Imaging Initiative. PET scans were paired with MRI scans acquired within 30 days, from August 2005 to September 2020. Pairs were randomly split into subsets as follows: 70% for training, 10% for validation, and 20% for final testing. A bimodal Gaussian mixture model was used to threshold PET scans into positive and negative labels. MRI data were fed into a convolutional neural network to generate imaging features. These features were combined in a logistic regression model with patient demographics, APOE gene status, cognitive scores, hippocampal volumes, and clinical diagnoses to classify each ATN biomarker component as positive or negative. Area under the receiver operating characteristic curve (AUC) analysis was used for model evaluation. Feature importance was derived from model coefficients and gradients. Results There were 2099 amyloid (mean patient age, 75 years ± 10 [SD]; 1110 male), 557 tau (mean patient age, 75 years ± 7; 280 male), and 2768 FDG PET (mean patient age, 75 years ± 7; 1645 male) and MRI pairs. Model AUCs for the test set were as follows: amyloid, 0.79 (95% CI: 0.74, 0.83); tau, 0.73 (95% CI: 0.58, 0.86); and neurodegeneration, 0.86 (95% CI: 0.83, 0.89). Within the networks, high gradients were present in key temporal, parietal, frontal, and occipital cortical regions. Model coefficients for cognitive scores, hippocampal volumes, and APOE status were highest. Conclusion A deep learning algorithm predicted each component of PET-determined ATN status with acceptable to excellent efficacy using MRI and other available diagnostic data. © RSNA, 2023 Supplemental material is available for this article.
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Affiliation(s)
- Christopher O. Lew
- From the Department of Radiology, Division of Neuroradiology,
Alzheimer Disease Imaging Research Laboratory (C.O.L., J.R.P.), and
Neurocognitive Disorders Program, Departments of Psychiatry and Medicine
(P.M.D.), Duke University Medical Center, DUMC-Box 3808, Durham, NC 27710-3808;
and Duke Institute for Brain Sciences (P.M.D.) and Department of Electrical and
Computer Engineering, Department of Computer Science, Department of
Biostatistics and Bioinformatics (L.Z., M.A.M.), Duke University, Durham,
NC
| | - Longfei Zhou
- From the Department of Radiology, Division of Neuroradiology,
Alzheimer Disease Imaging Research Laboratory (C.O.L., J.R.P.), and
Neurocognitive Disorders Program, Departments of Psychiatry and Medicine
(P.M.D.), Duke University Medical Center, DUMC-Box 3808, Durham, NC 27710-3808;
and Duke Institute for Brain Sciences (P.M.D.) and Department of Electrical and
Computer Engineering, Department of Computer Science, Department of
Biostatistics and Bioinformatics (L.Z., M.A.M.), Duke University, Durham,
NC
| | - Maciej A. Mazurowski
- From the Department of Radiology, Division of Neuroradiology,
Alzheimer Disease Imaging Research Laboratory (C.O.L., J.R.P.), and
Neurocognitive Disorders Program, Departments of Psychiatry and Medicine
(P.M.D.), Duke University Medical Center, DUMC-Box 3808, Durham, NC 27710-3808;
and Duke Institute for Brain Sciences (P.M.D.) and Department of Electrical and
Computer Engineering, Department of Computer Science, Department of
Biostatistics and Bioinformatics (L.Z., M.A.M.), Duke University, Durham,
NC
| | - P. Murali Doraiswamy
- From the Department of Radiology, Division of Neuroradiology,
Alzheimer Disease Imaging Research Laboratory (C.O.L., J.R.P.), and
Neurocognitive Disorders Program, Departments of Psychiatry and Medicine
(P.M.D.), Duke University Medical Center, DUMC-Box 3808, Durham, NC 27710-3808;
and Duke Institute for Brain Sciences (P.M.D.) and Department of Electrical and
Computer Engineering, Department of Computer Science, Department of
Biostatistics and Bioinformatics (L.Z., M.A.M.), Duke University, Durham,
NC
| | - Jeffrey R. Petrella
- From the Department of Radiology, Division of Neuroradiology,
Alzheimer Disease Imaging Research Laboratory (C.O.L., J.R.P.), and
Neurocognitive Disorders Program, Departments of Psychiatry and Medicine
(P.M.D.), Duke University Medical Center, DUMC-Box 3808, Durham, NC 27710-3808;
and Duke Institute for Brain Sciences (P.M.D.) and Department of Electrical and
Computer Engineering, Department of Computer Science, Department of
Biostatistics and Bioinformatics (L.Z., M.A.M.), Duke University, Durham,
NC
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Maxouri O, Bodalal Z, Daal M, Rostami S, Rodriguez I, Akkari L, Srinivas M, Bernards R, Beets-Tan R. How to 19F MRI: applications, technique, and getting started. BJR Open 2023; 5:20230019. [PMID: 37953866 PMCID: PMC10636348 DOI: 10.1259/bjro.20230019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 11/14/2023] Open
Abstract
Magnetic resonance imaging (MRI) plays a significant role in the routine imaging workflow, providing both anatomical and functional information. 19F MRI is an evolving imaging modality where instead of 1H, 19F nuclei are excited. As the signal from endogenous 19F in the body is negligible, exogenous 19F signals obtained by 19F radiofrequency coils are exceptionally specific. Highly fluorinated agents targeting particular biological processes (i.e., the presence of immune cells) have been visualised using 19F MRI, highlighting its potential for non-invasive and longitudinal molecular imaging. This article aims to provide both a broad overview of the various applications of 19F MRI, with cancer imaging as a focus, as well as a practical guide to 19F imaging. We will discuss the essential elements of a 19F system and address common pitfalls during acquisition. Last but not least, we will highlight future perspectives that will enhance the role of this modality. While not an exhaustive exploration of all 19F literature, we endeavour to encapsulate the broad themes of the field and introduce the world of 19F molecular imaging to newcomers. 19F MRI bridges several domains, imaging, physics, chemistry, and biology, necessitating multidisciplinary teams to be able to harness this technology effectively. As further technical developments allow for greater sensitivity, we envision that 19F MRI can help unlock insight into biological processes non-invasively and longitudinally.
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Affiliation(s)
| | | | | | | | | | - Leila Akkari
- Division of Tumor Biology and Immunology, Oncode Institute, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - René Bernards
- Division of Molecular Carcinogenesis, Oncode Institute, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Hickman LB, Stern JM, Silverman DHS, Salamon N, Vossel K. Clinical, imaging, and biomarker evidence of amyloid- and tau-related neurodegeneration in late-onset epilepsy of unknown etiology. Front Neurol 2023; 14:1241638. [PMID: 37830092 PMCID: PMC10565489 DOI: 10.3389/fneur.2023.1241638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 09/05/2023] [Indexed: 10/14/2023] Open
Abstract
Accumulating evidence suggests amyloid and tau-related neurodegeneration may play a role in development of late-onset epilepsy of unknown etiology (LOEU). In this article, we review recent evidence that epilepsy may be an initial manifestation of an amyloidopathy or tauopathy that precedes development of Alzheimer's disease (AD). Patients with LOEU demonstrate an increased risk of cognitive decline, and patients with AD have increased prevalence of preceding epilepsy. Moreover, investigations of LOEU that use CSF biomarkers and imaging techniques have identified preclinical neurodegeneration with evidence of amyloid and tau deposition. Overall, findings to date suggest a relationship between acquired, non-lesional late-onset epilepsy and amyloid and tau-related neurodegeneration, which supports that preclinical or prodromal AD is a distinct etiology of late-onset epilepsy. We propose criteria for assessing elevated risk of developing dementia in patients with late-onset epilepsy utilizing clinical features, available imaging techniques, and biomarker measurements. Further research is needed to validate these criteria and assess optimal treatment strategies for patients with probable epileptic preclinical AD and epileptic prodromal AD.
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Affiliation(s)
- L. Brian Hickman
- Mary S. Easton Center for Alzheimer’s Research and Care, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Neurology, UCLA Seizure Disorder Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - John M. Stern
- Department of Neurology, UCLA Seizure Disorder Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Daniel H. S. Silverman
- Mary S. Easton Center for Alzheimer’s Research and Care, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Noriko Salamon
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Keith Vossel
- Mary S. Easton Center for Alzheimer’s Research and Care, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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Kunach P, Vaquer-Alicea J, Smith MS, Hopewell R, Monistrol J, Moquin L, Therriault J, Tissot C, Rahmouni N, Massarweh G, Soucy JP, Guiot MC, Shoichet BK, Rosa-Neto P, Diamond MI, Shahmoradian SH. Cryo-EM structure of Alzheimer's disease tau filaments with PET ligand MK-6240. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.22.558671. [PMID: 37790438 PMCID: PMC10542181 DOI: 10.1101/2023.09.22.558671] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Positron Emission Tomography (PET) ligands have advanced Alzheimer's disease (AD) diagnosis and treatment. Using autoradiography and cryo-EM, we identified AD brain tissue with elevated tau burden, purified filaments, and determined the structure of second-generation high avidity PET ligand MK-6240 at 2.31 Å resolution, which bound at a 1:1 ratio within the cleft of tau paired-helical filament (PHF), engaging with glutamine 351, lysine K353, and isoleucine 360. This information elucidates the basis of MK-6240 PET in quantifying PHF deposits in AD and may facilitate the structure-based design of superior ligands against tau amyloids.
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Affiliation(s)
- Peter Kunach
- Department of Neurology, McGill University, Montreal, Quebec, Canada
- Center for Alzheimer’s and Neurodegenerative Diseases, Peter O’Donnell Jr. Brain Institute, Dallas, TX, United States
| | - Jaime Vaquer-Alicea
- Center for Alzheimer’s and Neurodegenerative Diseases, Peter O’Donnell Jr. Brain Institute, Dallas, TX, United States
| | - Matthew S. Smith
- Department of Pharmaceutical Chemistry, UCSF, San Francisco, CA, United States
- Program of Biophysics, UCSF, San Francisco, CA, United States
| | | | - Jim Monistrol
- Center for Alzheimer’s and Neurodegenerative Diseases, Peter O’Donnell Jr. Brain Institute, Dallas, TX, United States
| | - Luc Moquin
- Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Joseph Therriault
- Department of Neurology, McGill University, Montreal, Quebec, Canada
| | - Cecile Tissot
- Department of Neurology, McGill University, Montreal, Quebec, Canada
| | - Nesrine Rahmouni
- Department of Neurology, McGill University, Montreal, Quebec, Canada
| | | | | | - Marie-Christine Guiot
- Department of Neurology, McGill University, Montreal, Quebec, Canada
- Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Brian K. Shoichet
- Department of Pharmaceutical Chemistry, UCSF, San Francisco, CA, United States
| | - Pedro Rosa-Neto
- Department of Neurology, McGill University, Montreal, Quebec, Canada
| | - Marc I. Diamond
- Center for Alzheimer’s and Neurodegenerative Diseases, Peter O’Donnell Jr. Brain Institute, Dallas, TX, United States
| | - Sarah H. Shahmoradian
- Center for Alzheimer’s and Neurodegenerative Diseases, Peter O’Donnell Jr. Brain Institute, Dallas, TX, United States
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167
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Hampel H, Hu Y, Cummings J, Mattke S, Iwatsubo T, Nakamura A, Vellas B, O'Bryant S, Shaw LM, Cho M, Batrla R, Vergallo A, Blennow K, Dage J, Schindler SE. Blood-based biomarkers for Alzheimer's disease: Current state and future use in a transformed global healthcare landscape. Neuron 2023; 111:2781-2799. [PMID: 37295421 PMCID: PMC10720399 DOI: 10.1016/j.neuron.2023.05.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 03/03/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
Timely detection of the pathophysiological changes and cognitive impairment caused by Alzheimer's disease (AD) is increasingly pressing because of the advent of biomarker-guided targeted therapies that may be most effective when provided early in the disease. Currently, diagnosis and management of early AD are largely guided by clinical symptoms. FDA-approved neuroimaging and cerebrospinal fluid biomarkers can aid detection and diagnosis, but the clinical implementation of these testing modalities is limited because of availability, cost, and perceived invasiveness. Blood-based biomarkers (BBBMs) may enable earlier and faster diagnoses as well as aid in risk assessment, early detection, prognosis, and management. Herein, we review data on BBBMs that are closest to clinical implementation, particularly those based on measures of amyloid-β peptides and phosphorylated tau species. We discuss key parameters and considerations for the development and potential deployment of these BBBMs under different contexts of use and highlight challenges at the methodological, clinical, and regulatory levels.
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Affiliation(s)
- Harald Hampel
- Alzheimer's Disease and Brain Health, Eisai Inc., Nutley, NJ, USA.
| | - Yan Hu
- Alzheimer's Disease and Brain Health, Eisai Inc., Nutley, NJ, USA.
| | - Jeffrey Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Pam Quirk Brain Health and Biomarker Laboratory, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas (UNLV), Las Vegas, NV, USA
| | - Soeren Mattke
- Center for Improving Chronic Illness Care, University of Southern California, Los Angeles, CA, USA
| | - Takeshi Iwatsubo
- Department of Neuropathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akinori Nakamura
- Department of Biomarker Research, National Center for Geriatrics and Gerontology, Obu, Japan; Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Bruno Vellas
- University Paul Sabatier, Gérontopôle, Toulouse University Hospital, UMR INSERM 1285, Toulouse, France
| | - Sid O'Bryant
- Institute for Translational Research, Texas College of Osteopathic Medicine, Department of Family Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Leslie M Shaw
- Perelman School of Medicine, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Min Cho
- Alzheimer's Disease and Brain Health, Eisai Inc., Nutley, NJ, USA
| | - Richard Batrla
- Alzheimer's Disease and Brain Health, Eisai Inc., Nutley, NJ, USA
| | - Andrea Vergallo
- Alzheimer's Disease and Brain Health, Eisai Inc., Nutley, NJ, USA
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jeffrey Dage
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Suzanne E Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
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Chang YH, Yanckello LM, Chlipala GE, Green SJ, Aware C, Runge A, Xing X, Chen A, Wenger K, Flemister A, Wan C, Lin AL. Prebiotic inulin enhances gut microbial metabolism and anti-inflammation in apolipoprotein E4 mice with sex-specific implications. Sci Rep 2023; 13:15116. [PMID: 37704738 PMCID: PMC10499887 DOI: 10.1038/s41598-023-42381-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/09/2023] [Indexed: 09/15/2023] Open
Abstract
Gut dysbiosis has been identified as a crucial factor of Alzheimer's disease (AD) development for apolipoprotein E4 (APOE4) carriers. Inulin has shown the potential to mitigate dysbiosis. However, it remains unclear whether the dietary response varies depending on sex. In the study, we fed 4-month-old APOE4 mice with inulin for 16 weeks and performed shotgun metagenomic sequencing to determine changes in microbiome diversity, taxonomy, and functional gene pathways. We also formed the same experiments with APOE3 mice to identify whether there are APOE-genotype dependent responses to inulin. We found that APOE4 female mice fed with inulin had restored alpha diversity, significantly reduced Escherichia coli and inflammation-associated pathway responses. However, compared with APOE4 male mice, they had less metabolic responses, including the levels of short-chain fatty acids-producing bacteria and the associated kinases, especially those related to acetate and Erysipelotrichaceae. These diet- and sex- effects were less pronounced in the APOE3 mice, indicating that different APOE variants also play a significant role. The findings provide insights into the higher susceptibility of APOE4 females to AD, potentially due to inefficient energy production, and imply the importance of considering precision nutrition for mitigating dysbiosis and AD risk in the future.
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Affiliation(s)
- Ya-Hsuan Chang
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, 40536, USA
- Sanders Brown Center on Aging, University of Kentucky, Lexington, KY, 40536, USA
- Department of Radiology, University of Missouri, Columbia, MO, 65212, USA
- NextGen Precision Health, University of Missouri, Columbia, MO, 65212, USA
| | - Lucille M Yanckello
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, 40536, USA
- Sanders Brown Center on Aging, University of Kentucky, Lexington, KY, 40536, USA
| | - George E Chlipala
- Research Informatics Core, University of Illinois Chicago, Chicago, IL, 60612, USA
| | - Stefan J Green
- Genomics and Microbiome Core Facility, Rush University, Chicago, IL, 60612, USA
| | - Chetan Aware
- Department of Radiology, University of Missouri, Columbia, MO, 65212, USA
- NextGen Precision Health, University of Missouri, Columbia, MO, 65212, USA
| | - Amelia Runge
- Department of Biological Sciences, University of Missouri, Columbia, MO, 65211, USA
| | - Xin Xing
- Department of Radiology, University of Missouri, Columbia, MO, 65212, USA
- NextGen Precision Health, University of Missouri, Columbia, MO, 65212, USA
- Department of Computer Science, University of Kentucky, Lexington, KY, 40506, USA
| | - Anna Chen
- Sanders Brown Center on Aging, University of Kentucky, Lexington, KY, 40536, USA
| | - Kathryn Wenger
- Department of Biochemistry, University of Missouri, Columbia, MO, 65211, USA
| | - Abeoseh Flemister
- Department of Radiology, University of Missouri, Columbia, MO, 65212, USA
- NextGen Precision Health, University of Missouri, Columbia, MO, 65212, USA
| | - Caixia Wan
- Department of Biological and Biomedical Engineering, University of Missouri, Columbia, MO, 65211, USA
| | - Ai-Ling Lin
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, 40536, USA.
- Sanders Brown Center on Aging, University of Kentucky, Lexington, KY, 40536, USA.
- Department of Radiology, University of Missouri, Columbia, MO, 65212, USA.
- NextGen Precision Health, University of Missouri, Columbia, MO, 65212, USA.
- Department of Biological Sciences, University of Missouri, Columbia, MO, 65211, USA.
- Institute for Data Science and Informatics, University of Missouri, Columbia, MO, 65211, USA.
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169
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Mastrangelo A, Vacchiano V, Zenesini C, Ruggeri E, Baiardi S, Cherici A, Avoni P, Polischi B, Santoro F, Capellari S, Liguori R, Parchi P. Amyloid-Beta Co-Pathology Is a Major Determinant of the Elevated Plasma GFAP Values in Amyotrophic Lateral Sclerosis. Int J Mol Sci 2023; 24:13976. [PMID: 37762278 PMCID: PMC10531493 DOI: 10.3390/ijms241813976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/29/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Recent studies reported increased plasma glial acidic fibrillary protein (GFAP) levels in amyotrophic lateral sclerosis (ALS) patients compared to controls. We expanded these findings in a larger cohort, including 156 ALS patients and 48 controls, and investigated the associations of plasma GFAP with clinical variables and other biofluid biomarkers. Plasma GFAP and Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers were assessed by the single molecule array and the Lumipulse platforms, respectively. In ALS patients, plasma GFAP was higher than in controls (p < 0.001) and associated with measures of cognitive decline. Twenty ALS patients (12.8%) showed a positive amyloid status (A+), of which nine also exhibited tau pathology (A+T+, namely ALS-AD). ALS-AD patients showed higher plasma GFAP than A- ALS participants (p < 0.001) and controls (p < 0.001), whereas the comparison between A- ALS and controls missed statistical significance (p = 0.07). Plasma GFAP distinguished ALS-AD subjects more accurately (area under the curve (AUC) 0.932 ± 0.027) than plasma p-tau181 (AUC 0.692 ± 0.058, p < 0.0001) and plasma neurofilament light chain protein (AUC, 0.548 ± 0.088, p < 0.0001). Cognitive measures differed between ALS-AD and other ALS patients. AD co-pathology deeply affects plasma GFAP values in ALS patients. Plasma GFAP is an accurate biomarker for identifying AD co-pathology in ALS, which can influence the cognitive phenotype.
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Affiliation(s)
- Andrea Mastrangelo
- Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum Università di Bologna, 40139 Bologna, Italy; (A.M.); (S.B.); (P.A.); (S.C.); (R.L.)
| | - Veria Vacchiano
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Corrado Zenesini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Edoardo Ruggeri
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Simone Baiardi
- Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum Università di Bologna, 40139 Bologna, Italy; (A.M.); (S.B.); (P.A.); (S.C.); (R.L.)
| | - Arianna Cherici
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Patrizia Avoni
- Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum Università di Bologna, 40139 Bologna, Italy; (A.M.); (S.B.); (P.A.); (S.C.); (R.L.)
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Barbara Polischi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Francesca Santoro
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Sabina Capellari
- Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum Università di Bologna, 40139 Bologna, Italy; (A.M.); (S.B.); (P.A.); (S.C.); (R.L.)
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Rocco Liguori
- Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum Università di Bologna, 40139 Bologna, Italy; (A.M.); (S.B.); (P.A.); (S.C.); (R.L.)
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
| | - Piero Parchi
- Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum Università di Bologna, 40139 Bologna, Italy; (A.M.); (S.B.); (P.A.); (S.C.); (R.L.)
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy; (V.V.); (C.Z.); (E.R.); (A.C.); (B.P.); (F.S.)
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170
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Mestre TA, Luo S, Stebbins GT, Sampaio C, Goetz CG. Reply to: "The Framework for Diagnostic Criteria in Movement Disorders: The Value of Methodological Tools and Combined Criteria". Mov Disord 2023; 38:1763-1764. [PMID: 37718268 DOI: 10.1002/mds.29588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 09/19/2023] Open
Affiliation(s)
- Tiago A Mestre
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada
- Division of Neurology, Department of Medicine, University of Ottawa, The Ottawa Hospital Ottawa, Ottawa, Ontario, Canada
| | - Sheng Luo
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
| | - Glenn T Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Cristina Sampaio
- CHDI Management/CHDI Foundation, Princeton, New Jersey, USA
- Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Christopher G Goetz
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
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171
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Xie F, Ni R. Collection on molecular imaging in neurodegeneration. Eur J Nucl Med Mol Imaging 2023; 50:3166-3167. [PMID: 37480370 DOI: 10.1007/s00259-023-06347-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Affiliation(s)
- Fang Xie
- Department of Nuclear Medicine & PET Center, Huashan Hospital, Fudan University, Shanghai, 200040, China.
| | - Ruiqing Ni
- Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
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172
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Jagust WJ, Teunissen CE, DeCarli C. The complex pathway between amyloid β and cognition: implications for therapy. Lancet Neurol 2023; 22:847-857. [PMID: 37454670 DOI: 10.1016/s1474-4422(23)00128-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/11/2023] [Accepted: 03/27/2023] [Indexed: 07/18/2023]
Abstract
For decades, the hypothesis that brain deposition of the amyloid β protein initiates Alzheimer's disease has dominated research and clinical trials. Targeting amyloid β is starting to produce therapeutic benefit, although whether amyloid-lowering drugs will be widely and meaningfully effective is still unclear. Despite extensive in-vivo biomarker evidence in humans showing the importance of an amyloid cascade that drives cognitive decline, the amyloid hypothesis does not fully account for the complexity of late-life cognitive impairment. Multiple brain pathological changes, inflammation, and host factors of resilience might also be involved in contributing to the development of dementia. This variability suggests that the benefits of lowering amyloid β might depend on how strongly an amyloid pathway is manifest in an individual in relation to other coexisting pathophysiological processes. A new approach to research and treatment, which fully considers the multiple factors that drive cognitive decline, is necessary.
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Affiliation(s)
- William J Jagust
- School of Public Health, and Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA.
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Program Neurodegeneration, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Charles DeCarli
- Department of Neurology, University of California, Davis, CA, USA
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173
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Brunelli S, Giannella E, Bizzaglia M, De Angelis D, Sancesario GM. Secondary neurodegeneration following Stroke: what can blood biomarkers tell us? Front Neurol 2023; 14:1198216. [PMID: 37719764 PMCID: PMC10502514 DOI: 10.3389/fneur.2023.1198216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Stroke is one of the leading causes of death and the primary source of disability in adults, resulting in neuronal necrosis of ischemic areas, and in possible secondary degeneration of regions surrounding or distant to the initial damaged area. Secondary neurodegeneration (SNDG) following stroke has been shown to have different pathogenetic origins including inflammation, neurovascular response and cytotoxicity, but can be associated also to regenerative processes. Aside from focal neuronal loss, ipsilateral and contralateral effects distal to the lesion site, disruptions of global functional connectivity and a transcallosal diaschisis have been reported in the chronic stages after stroke. Furthermore, SNDG can be observed in different areas not directly connected to the primary lesion, such as thalamus, hippocampus, amygdala, substantia nigra, corpus callosum, bilateral inferior fronto-occipital fasciculus and superior longitudinal fasciculus, which can be highlighted by neuroimaging techniques. Although the clinical relevance of SNDG following stroke has not been well understood, the identification of specific biomarkers that reflect the brain response to the damage, is of paramount importance to investigate in vivo the different phases of stroke. Actually, brain-derived markers, particularly neurofilament light chain, tau protein, S100b, in post-stroke patients have yielded promising results. This review focuses on cerebral morphological modifications occurring after a stroke, on associated cellular and molecular changes and on state-of-the-art of biomarkers in acute and chronic phase. Finally, we discuss new perspectives regarding the implementation of blood-based biomarkers in clinical practice to improve the rehabilitation approaches and post stroke recovery.
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Affiliation(s)
- Stefano Brunelli
- NeuroRehabilitation Unit 4, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Emilia Giannella
- Clinical Neurochemistry Unit and Biobank, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Mirko Bizzaglia
- Radiology and Diagnostic Imaging Unit, IRCCS Santa Lucia Foundation, Rome, Italy
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174
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Ekblad LL, Tuisku J, Koivumäki M, Helin S, Rinne JO, Snellman A. Insulin resistance and body mass index are associated with TSPO PET in cognitively unimpaired elderly. J Cereb Blood Flow Metab 2023; 43:1588-1600. [PMID: 37113066 PMCID: PMC10414007 DOI: 10.1177/0271678x231172519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/27/2023] [Accepted: 04/01/2023] [Indexed: 04/29/2023]
Abstract
Metabolic risk factors are associated with peripheral low-grade inflammation and an increased risk for dementia. We evaluated if metabolic risk factors i.e. insulin resistance, body mass index (BMI), serum cholesterol values, or high sensitivity C-reactive protein associate with central inflammation or beta-amyloid (Aβ) accumulation in the brain, and if these associations are modulated by APOE4 gene dose. Altogether 60 cognitively unimpaired individuals (mean age 67.7 years (SD 4.7); 63% women; 21 APOE3/3, 20 APOE3/4 and 19 APOE4/4) underwent positron emission tomography with [11C]PK11195 targeting TSPO (18 kDa translocator protein) and [11C]PIB targeting fibrillar Aβ. [11C]PK11195 distribution value ratios and [11C]PIB standardized uptake values were calculated in a cortical composite region of interest typical for Aβ accumulation in Alzheimer's disease. Associations between metabolic risk factors, [11C]PK11195, and [11C]PIB uptake were evaluated with linear models adjusted for age and sex. Higher logarithmic HOMA-IR (standardized beta 0.40, p = 0.002) and BMI (standardized beta 0.27, p = 0.048) were associated with higher TSPO availability. Voxel-wise analyses indicated that this association was mainly seen in the parietal cortex. Higher logarithmic HOMA-IR was associated with higher [11C]PIB (standardized beta 0.44, p = 0.02), but only in APOE4/4 homozygotes. BMI and HOMA-IR seem to influence TSPO availability in the brain.
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Affiliation(s)
- Laura L Ekblad
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Jouni Tuisku
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Mikko Koivumäki
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Semi Helin
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Juha O Rinne
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
- InFLAMES Reseach Flagship Center, University of Turku, Turku, Finland
| | - Anniina Snellman
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
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175
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Rahman-Filipiak A, Bolton C, Grill JD, Rostamzadeh A, Chin N, Heidebrink J, Getz S, Fowler NR, Rosen A, Lingler J, Wijsman E, Clark L. Biomarker disclosure protocols in prodromal Alzheimer's disease clinical trials. Alzheimers Dement 2023; 19:4270-4275. [PMID: 37450489 PMCID: PMC10530125 DOI: 10.1002/alz.13380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION The development of biomarkers for Alzheimer's disease (AD) has allowed researchers to increase sample homogeneity and test candidate treatments earlier in the disease. The integration of biomarker "screening" criteria should be met with a parallel implementation of standardized methods to disclose biomarker testing results to research participants; however, the extent to which protocolized disclosure occurs in trials is unknown. METHODS We reviewed the literature to identify prodromal AD trials published in the past 10 years. From these, we quantified the frequency of biomarker disclosure reporting and the depth of descriptions provided. RESULTS Of 30 published trials using positron emission tomography or cerebrospinal fluid-based amyloid positivity as an eligibility criterion, only one mentioned disclosure, with no details on methods. DISCUSSION Possible reasons for and implications of this information gap are discussed. Recommendations are provided for trialists considering biomarker screening as part of intervention trials focused on prodromal AD. HIGHLIGHTS Few prodromal Alzheimer's disease (AD) trial papers discuss biomarker disclosure. Disclosure has implications for participants, family members, and trial success. Disclosure must be consistently integrated and reported in prodromal AD trials. Best practice guidelines and training resources for disclosure are needed.
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Affiliation(s)
- Annalise Rahman-Filipiak
- Research Program on Cognition & Neuromodulation Based Interventions, University of Michigan, 2101 Commonwealth Blvd, Suite C., Ann Arbor, MI, USA 48105
- Michigan Alzheimer’s Disease Research Center, University of Michigan, 2101 Commonwealth Blvd, Suite C., Ann Arbor, MI, USA 48105
| | - Corey Bolton
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, 1207 17th Ave. S, Suite 204, Nashville, TN, USA 37212
- Department of Neurology, Vanderbilt University Medical Center, 1301 Medical Center Dr. #3930, Nashville, TN, USA 37232
| | - Joshua D. Grill
- Departments of Psychiatry and Human Behavior and Neurobiology and Behavior, Institute for Memory Impairments and Neurological Disorders, University of California Irvine, 2642 Biological Sciences III, Irvine, CA, USA 92697-4545
| | - Ayda Rostamzadeh
- Department of Psychiatry and Psychotherapy, Center for Memory Disorders, Faculty of Medicine and University Hospital, University of Cologne, Albertus-Magnus-Platz, 50923 Köln, Germany
| | - Nathaniel Chin
- Wisconsin Alzheimer’s Disease Research Center, 600 Highland Ave J5/1 Mezzanine, Madison, WI, USA 53792
- Department of Medicine, Division of Geriatrics & Gerontology, University of Wisconsin-Madison School of Medicine and Public Health, 750 Highland Ave, Madison, WI, USA 53726
| | - Judith Heidebrink
- Michigan Alzheimer’s Disease Research Center, University of Michigan, 2101 Commonwealth Blvd, Suite C., Ann Arbor, MI, USA 48105
- Department of Neurology, University of Michigan, 1500 E Medical Center Dr # 1914, Ann Arbor, MI, USA 48109
| | - Sarah Getz
- Department of Neurology, University of Miami School of Medicine, 1150 NW 14 St Ste 609, Miami, FL, USA 33136
| | - Nicole R. Fowler
- Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, 340 West 10th Street, Fairbanks Hall, Suite 6200, Indianapolis, IN, USA 46202-3082
- Indiana University Center for Aging Research, Regenstrief Institute, Inc., 1101 W 10th St, Indianapolis, IN, USA 46202
| | - Allyson Rosen
- Palo Alto Veterans Affairs Medical Center, 3801 Miranda Avenue. Palo Alto, CA, USA 94304-1207
- School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA, USA 94305
| | - Jennifer Lingler
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, 3500 Victoria Street, 415 Victoria Building, Pittsburgh, PA, USA 15261
- University of Pittsburgh Alzheimer’s Disease Research Center, UPMC Montefiore, 4th floor, Suite 421, 200 Lothrop Street, Pittsburgh, PA, USA 15213
| | - Ellen Wijsman
- Division of Medical Genetics, Department of Medicine and Department of Biostatistics, University of Washington, Health Sciences Building, K253, Box 357720, Seattle, WA, USA 98195-7720
| | - Lindsay Clark
- Department of Medicine, Division of Geriatrics & Gerontology, University of Wisconsin-Madison School of Medicine and Public Health, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI, USA 53705-2281
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI, USA 53705
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Bruno D, Zinkunegi AJ, Pomara N, Zetterberg H, Blennow K, Koscik RL, Carlsson C, Bendlin B, Okonkwo O, Hermann BP, Johnson SC, Mueller KD. Cross-sectional associations of CSF tau levels with Rey's AVLT: A recency ratio study. Neuropsychology 2023; 37:628-635. [PMID: 35604714 PMCID: PMC9681933 DOI: 10.1037/neu0000821] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE The preeminent in vivo cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease (AD) are amyloid β 1-42 (Aβ42), phosphorylated Tau (p-tau), and total Tau (t-tau). The goal of this study was to examine how well traditional (total and delayed recall) and process-based (recency ratio [Rr]) measures derived from Rey's Auditory Verbal Learning test (AVLT) were associated with these biomarkers. METHOD Data from 235 participants (Mage = 65.5, SD = 6.9), who ranged from cognitively unimpaired to mild cognitive impairment, and for whom CSF values were available, were extracted from the Wisconsin Registry for Alzheimer's Prevention. Bayesian regression analyses were carried out using CSF scores as outcomes, AVLT scores as predictors, and controlling for demographic data and diagnosis. RESULTS We found moderate evidence that Rr was associated with both CSF p-tau (Bayesian factor [BFM] = 5.55) and t-tau (BFM = 7.28), above and beyond the control variables, while it did not correlate with CSF Aβ42 levels. In contrast, total and delayed recall scores were not linked with any of the AD biomarkers, in separate analyses. When comparing all memory predictors in a single regression, Rr remained the strongest predictor of CSF t-tau levels (BFM = 3.57). CONCLUSIONS Our findings suggest that Rr may be a better cognitive measure than commonly used AVLT scores to assess CSF levels of p-tau and t-tau in nondemented individuals. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Davide Bruno
- School of Psychology, Liverpool John Moores University
| | | | - Nunzio Pomara
- Geriatric Psychiatry Division, Nathan Kline Institute, Orangeburg, New York, United States
- School of Medicine, New York University
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology
- UK Dementia Research Institute at UCL, London, United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Rebecca Langhough Koscik
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin–Madison
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison
| | - Cynthia Carlsson
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin–Madison
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison
- Department of Medicine, University of Wisconsin–Madison
- Geriatric Research Education and Clinical Center, William S. Middleton Veterans Hospital, Madison, Wisconsin, United States
| | - Barbara Bendlin
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison
- Department of Medicine, University of Wisconsin–Madison
| | - Ozioma Okonkwo
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison
- Department of Medicine, University of Wisconsin–Madison
| | - Bruce P. Hermann
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin–Madison
- Department of Neurology, University of Wisconsin–Madison
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin–Madison
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison
- Department of Medicine, University of Wisconsin–Madison
- Geriatric Research Education and Clinical Center, William S. Middleton Veterans Hospital, Madison, Wisconsin, United States
| | - Kimberly D. Mueller
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin–Madison
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
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177
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Gao F, Dai L, Wang Q, Liu C, Deng K, Cheng Z, Lv X, Wu Y, Zhang Z, Tao Q, Yuan J, Li S, Wang Y, Su Y, Cheng X, Ni J, Wu Z, Zhang S, Shi J, Shen Y. Blood-based biomarkers for Alzheimer's disease: a multicenter-based cross-sectional and longitudinal study in China. Sci Bull (Beijing) 2023; 68:1800-1808. [PMID: 37500404 DOI: 10.1016/j.scib.2023.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/03/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023]
Abstract
Discrepancies in diagnostic biomarkers for Alzheimer's Disease (AD) may arise from racial disparities, risk factors, or lifestyle differences. Moreover, there has been a lack of systematic and multicenter studies to evaluate baselines of the AD biomarkers in Chinese populations. Thus, there is an urgent need for research to investigate the effectiveness of blood biomarkers for AD, specifically in the Chinese Han population, using a multicenter approach. In the present multicenter-based cross-sectional and longitudinal study, we evaluated 817 blood samples from 6 different clinical centers. We measured plasma amyloid beta (Aβ)-40, Aβ42, phosphorylated tau 181 (pTau), total tau (tTau), serum neurofilament light (NFL), and glial fibrillary acidic protein (GFAP). Additionally, 18F-florbetapir positron electron tomography and magnetic resonance imaging were also performed. A combination of the APOE genotype with plasma pTau and serum GFAP demonstrated exceptional performance in distinguishing Aβ status. Furthermore, baseline GFAP levels exhibited a strong association with cognitive decline over time and brain atrophy, with higher GFAP levels predicting a faster rate of neurodegeneration. In summary, these results validate the practicality of blood biomarkers in the Chinese Han population, encompassing various regions within China. Additionally, they emphasize the potential of pTau and GFAP as non-invasive methods for detecting and screening AD at an early stage.
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Affiliation(s)
- Feng Gao
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
| | - Linbin Dai
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
| | - Qiong Wang
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Chang Liu
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Kexue Deng
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Zhaozhao Cheng
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Xinyi Lv
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Yan Wu
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Ziyi Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qingqing Tao
- Department of Neurology and Research Center of Neurology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jing Yuan
- Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100006, China
| | - Shiping Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Yue Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Ya Su
- Department of Neurology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xin Cheng
- Department of Neurology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Jun Ni
- Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100006, China.
| | - Zhiying Wu
- Department of Neurology and Research Center of Neurology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Shuting Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China.
| | - Jiong Shi
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China.
| | - Yong Shen
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; Anhui Province Key Laboratory of Biomedical Aging Research, University of Science and Technology of China, Hefei 230001, China.
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178
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Mahzarnia A, Lutz MW, Badea A. A Continuous Extension of Gene Set Enrichment Analysis using the Likelihood Ratio Test Statistics Identifies VEGF as a Candidate Pathway for Alzheimer's disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.22.554319. [PMID: 37662249 PMCID: PMC10473614 DOI: 10.1101/2023.08.22.554319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Background Alzheimer's disease involves brain pathologies such as amyloid plaque depositions and hyperphosphorylated tau tangles and is accompanied by cognitive decline. Identifying the biological mechanisms underlying disease onset and progression based on quantifiable phenotypes will help understand the disease etiology and devise therapies. Objective Our objective was to identify molecular pathways associated with AD biomarkers (Amyloid-β and tau) and cognitive status (MMSE) accounting for variables such as age, sex, education, and APOE genotype. Methods We introduce a novel pathway-based statistical approach, extending the gene set likelihood ratio test to continuous phenotypes. We first analyzed independently each of the three phenotypes (Amyloid-β, tau, cognition), using continuous gene set likelihood ratio tests to account for covariates, including age, sex, education, and APOE genotype. The analysis involved a large sample size with data available for all three phenotypes, allowing for the identification of common pathways. Results We identified 14 pathways significantly associated with Amyloid-β, 5 associated with tau, and 174 associated with MMSE. Surprisingly, the MMSE outcome showed a larger number of significant pathways compared to biomarkers. A single pathway, vascular endothelial growth factor receptor binding (VEGF-RB), exhibited significant associations with all three phenotypes. Conclusions The study's findings highlight the importance of the VEGF signaling pathway in aging in AD. The complex interactions within the VEGF signaling family offer valuable insights for future therapeutic interventions.
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179
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Siegmann EM, Olm P, Lenz B, Mühle C, Oberstein TJ, Maler JM, Kornhuber J. Digit Ratio (2D:4D) Is Not Associated with Alzheimer's Disease in the Elderly. Brain Sci 2023; 13:1229. [PMID: 37759830 PMCID: PMC10526128 DOI: 10.3390/brainsci13091229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/15/2023] [Accepted: 08/19/2023] [Indexed: 09/29/2023] Open
Abstract
The development of Alzheimer's disease (AD) is influenced by sex hormones-estrogens and androgens in particular. However, the impact of prenatal sex hormone exposure is less clear; very few investigations have examined the relationship between the second-to-fourth digit length ratio (2D:4D), a putative proxy for the ratio of prenatal estrogens to androgens, and AD, with inconsistent results among the few that have. Therefore, we aimed to investigate this relationship using methodologically robust metrics. In a 2 (sex) × 4 (group) MANOVA incorporating 108 participants (30 AD patients, 19 patients with tauopathy but no amyloidopathy, 31 clinical and 28 healthy age- and education-matched controls), the effects of sex and group on the dependent variables right and left 2D:4D were examined. We also explored the association between 2D:4D and the severity of AD symptoms assessed via neuropsychological examination. We did not find any significant differences in the right- and left-hand 2D:4D between patients with AD and the other groups; no significant associations between 2D:4D and neuropsychological task performances were found in the dementia groups. The 2D:4D of healthy women was significantly lower than that of depressed women without AD, i.e., clinical controls, but not significantly different from depressed female patients with AD. This investigation does not support the role of 2D:4D in the development or severity of AD in general, but suggests a potential role of 2D:4D for depression in women. Future studies are warranted to clarify whether 2D:4D can distinguish between early- and late-onset depression in women.
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Affiliation(s)
- Eva-Maria Siegmann
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Pauline Olm
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Bernd Lenz
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany
| | - Christiane Mühle
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Timo Jan Oberstein
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Juan Manuel Maler
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
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180
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Li W, Jiang J, Zhang S, Yue L, Xiao S. Prospective association of general anesthesia with risk of cognitive decline in a Chinese elderly community population. Sci Rep 2023; 13:13458. [PMID: 37596302 PMCID: PMC10439205 DOI: 10.1038/s41598-023-39300-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 07/23/2023] [Indexed: 08/20/2023] Open
Abstract
As life expectancy increases and the population grows, the number of surgeries performed each year is likely to continue to increase. We evaluated whether surgery with general anesthesia increases risk for cognitive impairment in a Chinese elderly community population. The current data was obtained from the China Longitudinal Aging Study (cohort 1) and Shanghai Brain Aging study (cohort 2). Cohort 1 included 1545 elderly people with normal cognitive function, who underwent a screening process that included physical examination, medical history, baseline and 1-year follow-up assessments of cognitive function by a face-to-face interview. Cohort 2 included an additional 194 elderly people with normal cognitive function, all of whom, unlike cohort 1, underwent T1-phase MR imaging scans. In cohort 1, 127 elderly people with normal cognitive function transformed into mild cognitive impairment, 27 into dementia, while 1391 still maintained normal cognitive function. By using Cox regression analysis, we found that surgery with general anesthesia was a risk factor for cognitive impairment (p = 0.013, HR = 1.506, 95% CI 1.091-2.078); In cohort 2, we found that elderly people with a history of surgery with general anesthesia had lower Montreal Cognitive Assessment (MoCA) scores and smaller right amygdala volume (p < 0.05). Through correlation analysis, we found that the volume of the right amygdala was significantly correlated (p = 0.003, r = 0.212) with MoCA. Then by using the linear regression analysis (mediation model), we found that surgery with general anesthesia directly affected the MoCA score by affecting the volume of the right amygdala (B = 1.315, p = 0.036 95% CI 0.088-2.542). We confirm surgery with general anesthesia as a risk factor for cognitive impairment, and its mechanism may be related to its effect on the volume of the right amygdala.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
| | - Jianjun Jiang
- Department of Anorectal, KongJiang Hospital of Yangpu District, 480 Shuangyang Road, Shanghai, 200093, China
| | - Song Zhang
- Department of Anesthesiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Road, Shanghai, 200127, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
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181
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Matsuda H, Yamao T. Tau positron emission tomography in patients with cognitive impairment and suspected Alzheimer's disease. Fukushima J Med Sci 2023; 69:85-93. [PMID: 37302841 PMCID: PMC10480511 DOI: 10.5387/fms.2023-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/10/2023] [Indexed: 06/13/2023] Open
Abstract
Alzheimer's disease (AD) is diagnosed by the presence of both amyloid β and tau proteins. Recent advances in molecular PET imaging have made it possible to assess the accumulation of these proteins in the living brain. PET ligands have been developed that bind to 3R/4R tau in AD, but not to 3R tau or 4R tau alone. Of the first-generation PET ligands, 18F-flortaucipir has recently been approved by the Food and Drug Administration. Several second-generation PET probes with less off-target binding have been developed and are being applied clinically. Visual interpretation of tau PET should be based on neuropathological neurofibrillary tangle staging instead of a simple positive or negative classification. Four visual read classifications have been proposed: "no uptake," "medial temporal lobe (MTL) only," "MTL AND," and "outside MTL." As an adjunct to visual interpretation, quantitative analysis has been proposed using MRI-based native space FreeSurfer parcellations. The standardized uptake value ratio of the target area is measured using the cerebellar gray matter as a reference region. In the near future, the Centiloid scale of tau PET is expected to be used as a harmonized value for standardizing each analytical method or PET ligand used, similar to amyloid PET.
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Affiliation(s)
- Hiroshi Matsuda
- Department of Biofunctional Imaging, Fukushima Medical University
| | - Tensho Yamao
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University
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182
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Curiel Cid RE, Ortega A, Crocco EA, Hincapie D, McFarland KN, Duara R, Vaillancourt D, DeKosky ST, Smith G, Sfakianaki E, Rosselli M, Barker WW, Adjouadi M, Barreto Y, Feito Y, Loewenstein DA. Semantic intrusion errors are associated with plasma Ptau-181 among persons with amnestic mild cognitive impairment who are amyloid positive. Front Neurol 2023; 14:1179205. [PMID: 37602238 PMCID: PMC10436611 DOI: 10.3389/fneur.2023.1179205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/06/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Semantic intrusion errors (SI) have distinguished between those with amnestic Mild Cognitive Impairment (aMCI) who are amyloid positive (A+) versus negative (A-) on positron emission tomography (PET). Method This study examines the association between SI and plasma - based biomarkers. One hundred and twenty-eight participants received SiMoA derived measures of plasma pTau-181, ratio of two amyloid-β peptide fragments (Aβ42/Aβ40), Neurofilament Light protein (NfL), Glial Fibrillary Acidic Protein (GFAP), ApoE genotyping, and amyloid PET imaging. Results The aMCI A+ (n = 42) group had a higher percentage of ApoE ɛ4 carriers, and greater levels of pTau-181 and SI, than Cognitively Unimpaired (CU) A- participants (n = 25). CU controls did not differ from aMCI A- (n = 61) on plasma biomarkers or ApoE genotype. Logistic regression indicated that ApoE ɛ4 positivity, pTau-181, and SI were independent differentiating predictors (Correct classification = 82.0%; Sensitivity = 71.4%; Specificity = 90.2%) in identifying A+ from A- aMCI cases. Discussion A combination of plasma biomarkers, ApoE positivity and SI had high specificity in identifying A+ from A- aMCI cases.
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Affiliation(s)
- Rosie E. Curiel Cid
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Alexandra Ortega
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Elizabeth A. Crocco
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Diana Hincapie
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Karen N. McFarland
- Department of Neurology and the Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL, United States
| | - Ranjan Duara
- Department of Neurology and the Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL, United States
| | - David Vaillancourt
- Department of Applied Physiology and Kinesiology, Gainesville, FL, United States
| | - Steven T. DeKosky
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Glenn Smith
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Efrosyni Sfakianaki
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Monica Rosselli
- Department of Psychology, Florida Atlantic University, Boca Raton, FL, United States
| | - Warren W. Barker
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami, FL, United States
| | - Malek Adjouadi
- Center for Advanced Technology and Education, Florida International University, Miami, FL, United States
| | - Yarlenis Barreto
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Yuleidys Feito
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - David A. Loewenstein
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
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183
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Wolzak K, Vermunt L, Campo MD, Jorge-Oliva M, van Ziel AM, Li KW, Smit AB, Chen-Ploktkin A, Irwin DJ, Lemstra AW, Pijnenburg Y, van der Flier W, Zetterberg H, Gobom J, Blennow K, Visser PJ, Teunissen CE, Tijms BM, Scheper W. Protein disulfide isomerases as CSF biomarkers for the neuronal response to tau pathology. Alzheimers Dement 2023; 19:3563-3574. [PMID: 36825551 DOI: 10.1002/alz.12978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/06/2021] [Accepted: 01/13/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION Cerebrospinal fluid (CSF) biomarkers for specific cellular disease processes are lacking for tauopathies. In this translational study we aimed to identify CSF biomarkers reflecting early tau pathology-associated unfolded protein response (UPR) activation. METHODS We employed mass spectrometry proteomics and targeted immunoanalysis in a combination of biomarker discovery in primary mouse neurons in vitro and validation in patient CSF from two independent large multicentre cohorts (EMIF-AD MBD, n = 310; PRIDE, n = 771). RESULTS First, we identify members of the protein disulfide isomerase (PDI) family in the neuronal UPR-activated secretome and validate secretion upon tau aggregation in vitro. Next, we demonstrate that PDIA1 and PDIA3 levels correlate with total- and phosphorylated-tau levels in CSF. PDIA1 levels are increased in CSF from AD patients compared to controls and patients with tau-unrelated frontotemporal and Lewy body dementia (LBD). HIGHLIGHTS Neuronal unfolded protein response (UPR) activation induces the secretion of protein disulfide isomerases (PDIs) in vitro. PDIA1 is secreted upon tau aggregation in neurons in vitro. PDIA1 and PDIA3 levels correlate with total and phosphorylated tau levels in CSF. PDIA1 levels are increased in CSF from Alzheimer's disease (AD) patients compared to controls. PDIA1 levels are not increased in CSF from tau-unrelated frontotemporal dementia (FTD) and Lewy body dementia (LBD) patients.
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Affiliation(s)
- Kimberly Wolzak
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research (CNCR), Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Functional Genomics Section, Department of Human Genetics, Amsterdam University Medical Centers (UMC) location Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Lisa Vermunt
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam University Medical Centers (UMC) location Vrije Universiteit, Amsterdam, the Netherlands
| | - Marta Del Campo
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam University Medical Centers (UMC) location Vrije Universiteit, Amsterdam, the Netherlands
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo- CEU, CEU Universities, Madrid, Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Marta Jorge-Oliva
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research (CNCR), Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Anna Maria van Ziel
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research (CNCR), Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Functional Genomics Section, Department of Human Genetics, Amsterdam University Medical Centers (UMC) location Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Ka Wan Li
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research (CNCR), Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - August B Smit
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research (CNCR), Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Alice Chen-Ploktkin
- Department of Neurology, Perelman school of medicine, University of Pennsylvania, Philadelphia, USA
| | - David J Irwin
- Department of Neurology, Perelman school of medicine, University of Pennsylvania, Philadelphia, USA
- Penn Frontotemporal Degeneration Center, Perelman school of medicine, University of Pennsylvania, Philadelphia, USA
| | - Afina W Lemstra
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam University Medical Centers (UMC) location Vrije Universiteit, Amsterdam, the Netherlands
| | - Yolande Pijnenburg
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam University Medical Centers (UMC) location Vrije Universiteit, Amsterdam, the Netherlands
| | - Wiesje van der Flier
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam University Medical Centers (UMC) location Vrije Universiteit, Amsterdam, the Netherlands
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers (UMC) location Vrije Universiteit, Amsterdam, the Netherlands
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Johan Gobom
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Pieter Jelle Visser
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam University Medical Centers (UMC) location Vrije Universiteit, Amsterdam, the Netherlands
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte E Teunissen
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam University Medical Centers (UMC) location Vrije Universiteit, Amsterdam, the Netherlands
| | - Betty M Tijms
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam University Medical Centers (UMC) location Vrije Universiteit, Amsterdam, the Netherlands
| | - Wiep Scheper
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research (CNCR), Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Functional Genomics Section, Department of Human Genetics, Amsterdam University Medical Centers (UMC) location Vrije Universiteit, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
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184
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Terracciano A, Walker K, An Y, Luchetti M, Stephan Y, Moghekar AR, Sutin AR, Ferrucci L, Resnick SM. The association between personality and plasma biomarkers of astrogliosis and neuronal injury. Neurobiol Aging 2023; 128:65-73. [PMID: 37210782 PMCID: PMC10247521 DOI: 10.1016/j.neurobiolaging.2023.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/31/2023] [Accepted: 04/22/2023] [Indexed: 05/23/2023]
Abstract
Personality traits have been associated with the risk of dementia and Alzheimer's disease neuropathology, including amyloid and tau. This study examines whether personality traits are concurrently related to plasma glial fibrillary acidic protein (GFAP), a marker of astrogliosis, and neurofilament light (NfL), a marker of neuronal injury. Cognitively unimpaired participants from the Baltimore Longitudinal Study on Aging (N = 786; age: 22-95) were assayed for plasma GFAP and NfL and completed the Revised NEO Personality Inventory, which measures 5 domains and 30 facets of personality. Neuroticism (particularly vulnerability to stress, anxiety, and depression) was associated with higher GFAP and NfL. Conscientiousness was associated with lower GFAP. Extraversion (particularly positive emotions, assertiveness, and activity) was related to lower GFAP and NfL. These associations were independent of demographic, behavioral, and health covariates and not moderated by age, sex, or apolipoprotein E genotype. The personality correlates of astrogliosis and neuronal injury tend to be similar, are found in individuals without cognitive impairment, and point to potential neurobiological underpinnings of the association between personality traits and neurodegenerative diseases.
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Affiliation(s)
- Antonio Terracciano
- Department of Geriatrics, Florida State University College of Medicine, Tallahassee, FL, USA; Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA.
| | - Keenan Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Yang An
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA
| | | | - Abhay R Moghekar
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Luigi Ferrucci
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
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185
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Gagliardi G, Rodriguez-Vieitez E, Montal V, Sepulcre J, Diez I, Lois C, Hanseeuw B, Schultz AP, Properzi MJ, Papp KV, Marshall GA, Fortea J, Johnson KA, Sperling RA, Vannini P. Cortical microstructural changes predict tau accumulation and episodic memory decline in older adults harboring amyloid. COMMUNICATIONS MEDICINE 2023; 3:106. [PMID: 37528163 PMCID: PMC10394044 DOI: 10.1038/s43856-023-00324-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/19/2023] [Indexed: 08/03/2023] Open
Abstract
INTRODUCTION Non-invasive diffusion-weighted imaging (DWI) to assess brain microstructural changes via cortical mean diffusivity (cMD) has been shown to be cross-sectionally associated with tau in cognitively normal older adults, suggesting that it might be an early marker of neuronal injury. Here, we investigated how regional cortical microstructural changes measured by cMD are related to the longitudinal accumulation of regional tau as well as to episodic memory decline in cognitively normal individuals harboring amyloid pathology. METHODS 122 cognitively normal participants from the Harvard Aging Brain Study underwent DWI, T1w-MRI, amyloid and tau PET imaging, and Logical Memory Delayed Recall (LMDR) assessments. We assessed whether the interaction of baseline amyloid status and cMD (in entorhinal and inferior-temporal cortices) was associated with longitudinal regional tau accumulation and with longitudinal LMDR using separate linear mixed-effects models. RESULTS We find a significant interaction effect of the amyloid status and baseline cMD in predicting longitudinal tau in the entorhinal cortex (p = 0.044) but not the inferior temporal lobe, such that greater baseline cMD values predicts the accumulation of entorhinal tau in amyloid-positive participants. Moreover, we find a significant interaction effect of the amyloid status and baseline cMD in the entorhinal cortex (but not inferior temporal cMD) in predicting longitudinal LMDR (p < 0.001), such that baseline entorhinal cMD predicts the episodic memory decline in amyloid-positive participants. CONCLUSIONS The combination of amyloidosis and elevated cMD in the entorhinal cortex may help identify individuals at short-term risk of tau accumulation and Alzheimer's Disease-related episodic memory decline, suggesting utility in clinical trials.
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Affiliation(s)
- Geoffroy Gagliardi
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Elena Rodriguez-Vieitez
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, 14152, Sweden
| | - Victor Montal
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, 08041, Spain
- Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, 28031, Spain
| | - Jorge Sepulcre
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Gordon Center for Medical Imaging, Boston, MA, 02114, USA
| | - Ibai Diez
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Gordon Center for Medical Imaging, Boston, MA, 02114, USA
| | - Cristina Lois
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Gordon Center for Medical Imaging, Boston, MA, 02114, USA
| | - Bernard Hanseeuw
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Gordon Center for Medical Imaging, Boston, MA, 02114, USA
- Saint Luc University Hospital, Université Catholique de Louvain, Brussels, 1200, Belgium
| | - Aaron P Schultz
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA
| | - Michael J Properzi
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Kathryn V Papp
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Gad A Marshall
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Juan Fortea
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, 08041, Spain
- Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, 28031, Spain
| | - Keith A Johnson
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Gordon Center for Medical Imaging, Boston, MA, 02114, USA
| | - Reisa A Sperling
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Patrizia Vannini
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, 02129, USA.
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.
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186
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Horie K, Salvadó G, Barthélemy NR, Janelidze S, Li Y, He Y, Saef B, Chen CD, Jiang H, Strandberg O, Pichet Binette A, Palmqvist S, Sato C, Sachdev P, Koyama A, Gordon BA, Benzinger TLS, Holtzman DM, Morris JC, Mattsson-Carlgren N, Stomrud E, Ossenkoppele R, Schindler SE, Hansson O, Bateman RJ. CSF MTBR-tau243 is a specific biomarker of tau tangle pathology in Alzheimer's disease. Nat Med 2023; 29:1954-1963. [PMID: 37443334 PMCID: PMC10427417 DOI: 10.1038/s41591-023-02443-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 06/05/2023] [Indexed: 07/15/2023]
Abstract
Aggregated insoluble tau is one of two defining features of Alzheimer's disease. Because clinical symptoms are strongly correlated with tau aggregates, drug development and clinical diagnosis need cost-effective and accessible specific fluid biomarkers of tau aggregates; however, recent studies suggest that the fluid biomarkers currently available cannot specifically track tau aggregates. We show that the microtubule-binding region (MTBR) of tau containing the residue 243 (MTBR-tau243) is a new cerebrospinal fluid (CSF) biomarker specific for insoluble tau aggregates and compared it to multiple other phosphorylated tau measures (p-tau181, p-tau205, p-tau217 and p-tau231) in two independent cohorts (BioFINDER-2, n = 448; and Knight Alzheimer Disease Research Center, n = 219). MTBR-tau243 was most strongly associated with tau-positron emission tomography (PET) and cognition, whereas showing the lowest association with amyloid-PET. In combination with p-tau205, MTBR-tau243 explained most of the total variance in tau-PET burden (0.58 ≤ R2 ≤ 0.75) and the performance in predicting cognitive measures (0.34 ≤ R2 ≤ 0.48) approached that of tau-PET (0.44 ≤ R2 ≤ 0.52). MTBR-tau243 levels longitudinally increased with insoluble tau aggregates, unlike CSF p-tau species. CSF MTBR-tau243 is a specific biomarker of tau aggregate pathology, which may be utilized in interventional trials and in the diagnosis of patients. Based on these findings, we propose to revise the A/T/(N) criteria to include MTBR-tau243 as representing insoluble tau aggregates ('T').
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Grants
- P30 AG066444 NIA NIH HHS
- R01 AG070941 NIA NIH HHS
- P01 AG003991 NIA NIH HHS
- P01 AG026276 NIA NIH HHS
- P30 NS048056 NINDS NIH HHS
- S10 OD025214 NIH HHS
- The Tracy Family SILQ Center established by the Tracy Family, Richard Frimel and Gary Werths, GHR Foundation, David Payne, and the Willman Family brought together by The Foundation for Barnes-Jewish Hospital.
- Eisai industry grant
- The European Union’s Horizon 2020 research and innovation program under the Marie Sklodowska-Curie action grant agreement No 101061836, from Greta och Johan Kocks research grants and, travel grants from the Strategic Research Area MultiPark (Multidisciplinary Research in Parkinson’s disease) at Lund University
- U.S. Department of Health & Human Services | National Institutes of Health (NIH)
- The Swedish Research Council (2016-00906), the Knut and Alice Wallenberg foundation (2017-0383), the Marianne and Marcus Wallenberg foundation (2015.0125), the Strategic Research Area MultiPark (Multidisciplinary Research in Parkinson’s disease) at Lund University, the Swedish Alzheimer Foundation (AF-939932), the Swedish Brain Foundation (FO2021-0293), The Parkinson foundation of Sweden (1280/20), the Cure Alzheimer’s fund, the Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, the Skåne University Hospital Foundation (2020-O000028), Regionalt Forskningsstöd (2020-0314) and the Swedish federal government under the ALF agreement (2018-Projekt0279)
- The Knight ADRC developmental project
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Affiliation(s)
- Kanta Horie
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Eisai Inc., Nutley, NJ, USA
| | - Gemma Salvadó
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Nicolas R Barthélemy
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Yan Li
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Yingxin He
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Benjamin Saef
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Charles D Chen
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Hong Jiang
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Chihiro Sato
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | | | | | - Brian A Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - David M Holtzman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Suzanne E Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
- Memory Clinic, Skåne University Hospital, Malmö, Sweden.
| | - Randall J Bateman
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, USA.
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA.
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA.
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187
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Geerts H, Bergeler S, Lytton WW, van der Graaf PH. Computational neurosciences and quantitative systems pharmacology: a powerful combination for supporting drug development in neurodegenerative diseases. J Pharmacokinet Pharmacodyn 2023:10.1007/s10928-023-09876-6. [PMID: 37505397 DOI: 10.1007/s10928-023-09876-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023]
Abstract
Successful clinical development of new therapeutic interventions is notoriously difficult, especially in neurodegenerative diseases, where predictive biomarkers are scarce and functional improvement is often based on patient's perception, captured by structured interviews. As a consequence, mechanistic modeling of the processes relevant to therapeutic interventions in CNS disorders has been lagging behind other disease indications, probably because of the perceived complexity of the brain. However in this report, we develop the argument that a combination of Computational Neurosciences and Quantitative Systems Pharmacology (QSP) modeling of molecular pathways is a powerful simulation tool to enhance the probability of successful drug development for neurodegenerative diseases. Computational Neurosciences aims to predict action potential dynamics and neuronal circuit activation that are ultimately linked to behavioral changes and clinically relevant functional outcomes. These processes can not only be affected by the disease state, but also by common genotype variants on neurotransmitter-related proteins and the psycho-active medications often prescribed in these patient populations. Quantitative Systems Pharmacology (QSP) modeling of molecular pathways allows to simulate key pathological drivers of dementia, such as protein aggregation and neuroinflammatory responses. They often impact neurotransmitter homeostasis and voltage-gated ion-channels or lead to mitochondrial dysfunction, ultimately leading to changes in action potential dynamics and clinical readouts. Combining these two modeling approaches can lead to better actionable understanding of the many non-linear pharmacodynamic processes active in the human diseased brain. Practical applications include a rational selection of the optimal doses in combination therapies, identification of subjects more likely to respond to treatment, a more balanced stratification of treatment arms in terms of comedications, disease status and common genotype variants and re-analysis of small clinical trials to uncover a possible clinical signal. Ultimately this will lead to a higher success rate of bringing new therapeutics to the right patient populations.
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Affiliation(s)
| | | | - William W Lytton
- Downstate Health Science University, State University of New York, Brooklyn, USA
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188
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Peretti DE, Ribaldi F, Scheffler M, Mu L, Treyer V, Gietl AF, Hock C, Frisoni GB, Garibotto V. ATN profile classification across two independent prospective cohorts. Front Med (Lausanne) 2023; 10:1168470. [PMID: 37559930 PMCID: PMC10407659 DOI: 10.3389/fmed.2023.1168470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND The ATN model represents a research framework used to describe in subjects the presence or absence of Alzheimer's disease (AD) pathology through biomarkers. The aim of this study was to describe the prevalence of different ATN profiles using quantitative imaging biomarkers in two independent cohorts, and to evaluate the pertinence of ATN biomarkers to identify comparable populations across independent cohorts. METHODS A total of 172 subjects from the Geneva Memory Clinic and 113 volunteers from a study on healthy aging at the University Hospital of Zurich underwent amyloid (A) and tau (T) PET, as well as T1-weigthed MRI scans using site-specific protocols. Subjects were classified by cognition (cognitively unimpaired, CU, or impaired, CI) based on clinical assessment by experts. Amyloid data converted into the standardized centiloid scale, tau PET data normalized to cerebellar uptake, and hippocampal volume expressed as a ratio over total intracranial volume ratio were considered as biomarkers for A, T, and neurodegeneration (N), respectively. Positivity for each biomarker was defined based on previously published thresholds. Subjects were then classified according to the ATN model. Differences among profiles were tested using Kruskal-Wallis ANOVA, and between cohorts using Wilcoxon tests. RESULTS Twenty-nine percent of subjects from the Geneva cohorts were classified with a normal (A-T-N-) profile, while the Zurich cohort included 64% of subjects in the same category. Meanwhile, 63% of the Geneva and 16% of the Zurich cohort were classified within the AD continuum (being A+ regardless of other biomarkers' statuses). Within cohorts, ATN profiles were significantly different for age and mini-mental state examination scores, but not for years of education. Age was not significantly different between cohorts. In general, imaging A and T biomarkers were significantly different between cohorts, but they were no longer significantly different when stratifying the cohorts by ATN profile. N was not significantly different between cohorts. CONCLUSION Stratifying subjects into ATN profiles provides comparable groups of subjects even when individual recruitment followed different criteria.
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Affiliation(s)
- Débora E. Peretti
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Faculty of Medicine, Geneva University Neurocenter, University of Geneva, Geneva, Switzerland
| | - Federica Ribaldi
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
| | - Max Scheffler
- Division of Radiology, Geneva University Hospitals, Geneva, Switzerland
| | - Linjing Mu
- Department of Nuclear Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
- Institute of Pharmaceutical Sciences, Zurich, Switzerland
| | - Valerie Treyer
- Department of Nuclear Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Anton F. Gietl
- Department of Nuclear Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Christoph Hock
- Department of Nuclear Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Giovanni B. Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Valentina Garibotto
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Faculty of Medicine, Geneva University Neurocenter, University of Geneva, Geneva, Switzerland
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland
- Center for Biomedical Imaging, University of Geneva, Geneva, Switzerland
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189
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Lim AC, Barnes LL, Weissberger GH, Lamar M, Nguyen AL, Fenton L, Herrera J, Han SD. Quantification of race/ethnicity representation in Alzheimer's disease neuroimaging research in the USA: a systematic review. COMMUNICATIONS MEDICINE 2023; 3:101. [PMID: 37491471 PMCID: PMC10368705 DOI: 10.1038/s43856-023-00333-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Racial and ethnic minoritized groups are disproportionately at risk for Alzheimer's Disease (AD), but are not sufficiently recruited in AD neuroimaging research in the United States. This is important as sample composition impacts generalizability of findings, biomarker cutoffs, and treatment effects. No studies have quantified the breadth of race/ethnicity representation in the AD literature. METHODS This review identified median race/ethnicity composition of AD neuroimaging US-based research samples available as free full-text articles on PubMed. Two types of published studies were analyzed: studies that directly report race/ethnicity data (i.e., direct studies), and studies that do not report race/ethnicity but used data from a cohort study/database that does report this information (i.e., indirect studies). RESULTS Direct studies (n = 719) have median representation of 88.9% white or 87.4% Non-Hispanic white, 7.3% Black/African American, and 3.4% Hispanic/Latino ethnicity, with 0% Asian American, Native Hawaiian/Pacific Islander, and American Indian/Alaska Native, Multiracial, and Other Race participants. Cohort studies/databases (n = 44) from which indirect studies (n = 1745) derived are more diverse, with median representation of 84.2% white, 83.7% Non-Hispanic white, 11.6% Black/African American, 4.7% Hispanic/Latino, and 1.75% Asian American participants. Notably, 94% of indirect studies derive from just 10 cohort studies/databases. Comparisons of two time periods using a median split for publication year, 1994-2017 and 2018-2022, indicate that sample diversity has improved recently, particularly for Black/African American participants (3.39% from 1994-2017 and 8.29% from 2018-2022). CONCLUSIONS There is still underrepresentation of all minoritized groups relative to Census data, especially for Hispanic/Latino and Asian American individuals. The AD neuroimaging literature will benefit from increased representative recruitment of ethnic/racial minorities. More transparent reporting of race/ethnicity data is needed.
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Affiliation(s)
- Aaron C Lim
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Gali H Weissberger
- The Interdisciplinary Department of Social Sciences, Bar-Ilan University, Raman Gat, Israel
| | - Melissa Lamar
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Annie L Nguyen
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - Laura Fenton
- Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA
| | - Jennifer Herrera
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA
| | - S Duke Han
- Department of Family Medicine, Keck School of Medicine of USC, Alhambra, CA, USA.
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
- Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA.
- USC School of Gerontology, Los Angeles, CA, USA.
- Department of Neurology, Keck School of Medicine of USC, Los Angeles, CA, USA.
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190
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Valverde-Salazar V, Ruiz-Gabarre D, García-Escudero V. Alzheimer's Disease and Green Tea: Epigallocatechin-3-Gallate as a Modulator of Inflammation and Oxidative Stress. Antioxidants (Basel) 2023; 12:1460. [PMID: 37507998 PMCID: PMC10376369 DOI: 10.3390/antiox12071460] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/05/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Alzheimer's disease (AD) is the most common cause of dementia, characterised by a marked decline of both memory and cognition, along with pathophysiological hallmarks including amyloid beta peptide (Aβ) accumulation, tau protein hyperphosphorylation, neuronal loss and inflammation in the brain. Additionally, oxidative stress caused by an imbalance between free radicals and antioxidants is considered one of the main risk factors for AD, since it can result in protein, lipid and nucleic acid damage and exacerbate Aβ and tau pathology. To date, there is a lack of successful pharmacological approaches to cure or even ameliorate the terrible impact of this disease. Due to this, dietary compounds with antioxidative and anti-inflammatory properties acquire special relevance as potential therapeutic agents. In this context, green tea, and its main bioactive compound, epigallocatechin-3-gallate (EGCG), have been targeted as a plausible option for the modulation of AD. Specifically, EGCG acts as an antioxidant by regulating inflammatory processes involved in neurodegeneration such as ferroptosis and microglia-induced cytotoxicity and by inducing signalling pathways related to neuronal survival. Furthermore, it reduces tau hyperphosphorylation and aggregation and promotes the non-amyloidogenic route of APP processing, thus preventing the formation of Aβ and its subsequent accumulation. Taken together, these results suggest that EGCG may be a suitable candidate in the search for potential therapeutic compounds for neurodegenerative disorders involving inflammation and oxidative stress, including Alzheimer's disease.
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Affiliation(s)
- Víctor Valverde-Salazar
- Department of Anatomy, Histology and Neuroscience, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
| | - Daniel Ruiz-Gabarre
- Department of Anatomy, Histology and Neuroscience, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
| | - Vega García-Escudero
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, 28031 Madrid, Spain
- Institute for Molecular Biology-IUBM, Universidad Autónoma de Madrid, 28049 Madrid, Spain
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191
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Salvadó G, Horie K, Barthélemy NR, Vogel JW, Binette AP, Chen CD, Aschenbrenner AJ, Gordon BA, Benzinger TL, Holtzman DM, Morris JC, Palmqvist S, Stomrud E, Janelidze S, Ossenkoppele R, Schindler SE, Bateman RJ, Hansson O. Novel CSF tau biomarkers can be used for disease staging of sporadic Alzheimer's disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.14.23292650. [PMID: 37503281 PMCID: PMC10370223 DOI: 10.1101/2023.07.14.23292650] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Biological staging of individuals with Alzheimer's disease (AD) may improve diagnostic and prognostic work-up of dementia in clinical practice and the design of clinical trials. Here, we created a staging model using the Subtype and Stage Inference (SuStaIn) algorithm by evaluating cerebrospinal fluid (CSF) amyloid-β (Aβ) and tau biomarkers in 426 participants from BioFINDER-2, that represent the entire spectrum of AD. The model composition and main analyses were replicated in 222 participants from the Knight ADRC cohort. SuStaIn revealed in the two cohorts that the data was best explained by a single biomarker sequence (one subtype), and that five CSF biomarkers (ordered: Aβ42/40, tau phosphorylation occupancies at the residues 217 and 205 [pT217/T217 and pT205/T205], microtubule-binding region of tau containing the residue 243 [MTBR-tau243], and total tau) were sufficient to create an accurate disease staging model. Increasing CSF stages (0-5) were associated with increased abnormality in other AD-related biomarkers, such as Aβ- and tau-PET, and aligned with different phases of longitudinal biomarker changes consistent with current models of AD progression. Higher CSF stages at baseline were associated with higher hazard ratio of clinical decline. Our findings indicate that a common pathophysiologic molecular pathway develops across all AD patients, and that a single CSF collection is sufficient to reliably indicate the presence of both AD pathologies and the degree and stage of disease progression.
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Affiliation(s)
- Gemma Salvadó
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Kanta Horie
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, United States
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
- Eisai Inc., Nutley, NJ, United States
| | - Nicolas R. Barthélemy
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, United States
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
| | - Jacob W. Vogel
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Department of Clinical Science, Malmö, SciLifeLab, Lund University, Lund, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Charles D. Chen
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrew J Aschenbrenner
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian A. Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L.S. Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - David M. Holtzman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - John C. Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Suzanne E. Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Randall J. Bateman
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, United States
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
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192
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Paciotti S, Wojdała AL, Bellomo G, Toja A, Chipi E, Piersma SR, Pham TV, Gaetani L, Jimenez CR, Parnetti L, Chiasserini D. Potential diagnostic value of CSF metabolism-related proteins across the Alzheimer's disease continuum. Alzheimers Res Ther 2023; 15:124. [PMID: 37454217 DOI: 10.1186/s13195-023-01269-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) cerebrospinal fluid (CSF) core biomarkers (Aβ42/40 ratio, p-tau, and t-tau) provide high diagnostic accuracy, even at the earliest stage of disease. However, these markers do not fully reflect the complex AD pathophysiology. Recent large scale CSF proteomic studies revealed several new AD candidate biomarkers related to metabolic pathways. In this study we measured the CSF levels of four metabolism-related proteins not directly linked to amyloid- and tau-pathways (i.e., pyruvate kinase, PKM; aldolase, ALDO; ubiquitin C-terminal hydrolase L1, UCHL1, and fatty acid-binding protein 3, FABP3) across the AD continuum. We aimed at validating the potential value of these proteins as new CSF biomarkers for AD and their possible involvement in AD pathogenesis, with specific interest on the preclinical phase of the disease. METHODS CSF PKM and ALDO activities were measured with specific enzyme assays while UCHL1 and FABP3 levels were measured with immunoassays in a cohort of patients composed as follows: preclinical AD (pre-AD, n = 19, cognitively unimpaired), mild cognitive impairment due to AD (MCI-AD, n = 50), dementia due to AD (ADdem, n = 45), and patients with frontotemporal dementia (FTD, n = 37). Individuals with MCI not due to AD (MCI, n = 30) and subjective cognitive decline (SCD, n = 52) with negative CSF AD-profile, were enrolled as control groups. RESULTS CSF UCHL1 and FABP3 levels, and PKM activity were significantly increased in AD patients, already at the pre-clinical stage. CSF PKM activity was also increased in FTD patients compared with control groups, being similar between AD and FTD patients. No difference was found in ALDO activity among the groups. UCHL1 showed good performance in discriminating early AD patients (pre-AD and MCI-AD) from controls (AUC ~ 0.83), as assessed by ROC analysis. Similar results were obtained for FABP3. Conversely, PKM provided the best performance when comparing FTD vs. MCI (AUC = 0.80). Combination of PKM, FABP3, and UCHL1 improved the diagnostic accuracy for the detection of patients within the AD continuum when compared with single biomarkers. CONCLUSIONS Our study confirmed the potential role of UCHL1 and FABP3 as neurodegenerative biomarkers for AD. Furthermore, our results validated the increase of PKM activity in CSF of AD patients, already at the preclinical phase of the disease. Increased PKM activity was observed also in FTD patients, possibly underlining similar alterations in energy metabolism in AD and FTD.
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Affiliation(s)
- Silvia Paciotti
- Section of Physiology and Biochemistry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Anna Lidia Wojdała
- Laboratory of Clinical Neurochemistry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giovanni Bellomo
- Laboratory of Clinical Neurochemistry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Andrea Toja
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elena Chipi
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Sander R Piersma
- OncoProteomics Laboratory, Laboratory Medical Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Thang V Pham
- OncoProteomics Laboratory, Laboratory Medical Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Lorenzo Gaetani
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Connie R Jimenez
- OncoProteomics Laboratory, Laboratory Medical Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Lucilla Parnetti
- Section of Neurology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
| | - Davide Chiasserini
- Section of Physiology and Biochemistry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
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193
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Keleman AA, Nicosia J, Bollinger RM, Wisch JK, Hassenstab J, Morris JC, Ances BM, Balota DA, Stark SL. Precipitating Mechanisms of Falls in Preclinical Alzheimer's Disease. J Alzheimers Dis Rep 2023; 7:739-750. [PMID: 37483329 PMCID: PMC10357117 DOI: 10.3233/adr-230002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 06/21/2023] [Indexed: 07/25/2023] Open
Abstract
Background Individuals with Alzheimer's disease (AD) are more than twice as likely to incur a serious fall as the general population of older adults. Although AD is commonly associated with cognitive changes, impairments in other clinical measures such as strength or functional mobility (i.e., gait and balance) may precede symptomatic cognitive impairment in preclinical AD and lead to increased fall risk. Objective To examine mechanisms (i.e., functional mobility, cognition, AD biomarkers) associated with increased falls in cognitively normal older adults. Methods This 1-year study was part of an ongoing longitudinal cohort study. We examined the relationships among falls, clinical measures of functional mobility and cognition, and neuroimaging AD biomarkers in cognitively normal older adults. We also investigated which domain(s) best predicted fall propensity and severity through multiple regression models. Results A total of 182 older adults were included (mean age 75 years, 53% female). A total of 227 falls were reported over the year; falls per person ranged from 0-16 with a median of 1. Measures of functional mobility were the best predictors of fall propensity and severity. Cognition and AD biomarkers were associated with each other but not with the fall outcome measures. Conclusion These results suggest that, although subtle changes in cognition may be more closely associated with AD neuropathology, functional mobility indicators better predict falls in cognitively normal older adults. This study adds to our understanding of the mechanisms underlying falls in older adults and could lead to the development of targeted fall prevention strategies.
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Affiliation(s)
- Audrey A. Keleman
- Program in Occupational Therapy, Washington University in St. Louis, St. Louis, MO, USA
| | - Jessica Nicosia
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Rebecca M. Bollinger
- Program in Occupational Therapy, Washington University in St. Louis, St. Louis, MO, USA
| | - Julie K. Wisch
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- Department of Psychology, Washington University in St. Louis, St. Louis, MO, USA
| | - John C. Morris
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO, USA
| | - Beau M. Ances
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO, USA
| | - David A. Balota
- Department of Psychology, Washington University in St. Louis, St. Louis, MO, USA
| | - Susan L. Stark
- Program in Occupational Therapy, Washington University in St. Louis, St. Louis, MO, USA
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
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194
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Sung YJ, Yang C, Norton J, Johnson M, Fagan A, Bateman RJ, Perrin RJ, Morris JC, Farlow MR, Chhatwal JP, Schofield PR, Chui H, Wang F, Novotny B, Eteleeb A, Karch C, Schindler SE, Rhinn H, Johnson EC, Se-Hwee Oh H, Rutledge JE, Dammer EB, Seyfried NT, Wyss-Coray T, Harari O, Cruchaga C. Proteomics of brain, CSF, and plasma identifies molecular signatures for distinguishing sporadic and genetic Alzheimer's disease. Sci Transl Med 2023; 15:eabq5923. [PMID: 37406134 PMCID: PMC10803068 DOI: 10.1126/scitranslmed.abq5923] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/13/2023] [Indexed: 07/07/2023]
Abstract
Proteomic studies for Alzheimer's disease (AD) are instrumental in identifying AD pathways but often focus on single tissues and sporadic AD cases. Here, we present a proteomic study analyzing 1305 proteins in brain tissue, cerebrospinal fluid (CSF), and plasma from patients with sporadic AD, TREM2 risk variant carriers, patients with autosomal dominant AD (ADAD), and healthy individuals. We identified 8 brain, 40 CSF, and 9 plasma proteins that were altered in individuals with sporadic AD, and we replicated these findings in several external datasets. We identified a proteomic signature that differentiated TREM2 variant carriers from both individuals with sporadic AD and healthy individuals. The proteins associated with sporadic AD were also altered in patients with ADAD, but with a greater effect size. Brain-derived proteins associated with ADAD were also replicated in additional CSF samples. Enrichment analyses highlighted several pathways, including those implicated in AD (calcineurin and Apo E), Parkinson's disease (α-synuclein and LRRK2), and innate immune responses (SHC1, ERK-1, and SPP1). Our findings suggest that combined proteomics across brain tissue, CSF, and plasma can be used to identify markers for sporadic and genetically defined AD.
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Affiliation(s)
- Yun Ju Sung
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63108, USA
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Chengran Yang
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Joanne Norton
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Matt Johnson
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Anne Fagan
- The Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO 63108, USA
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63108, USA
| | - Randall J. Bateman
- The Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO 63108, USA
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63108, USA
| | - Richard J. Perrin
- The Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO 63108, USA
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63108, USA
- Department of Pathology & Immunology, Washington University School of Medicine, St Louis, MO 63108, USA
| | - John C. Morris
- The Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO 63108, USA
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63108, USA
- Department of Pathology & Immunology, Washington University School of Medicine, St Louis, MO 63108, USA
| | - Martin R. Farlow
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Jasmeer P. Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Peter R. Schofield
- Neuroscience Research Australia, Randwick, NSW, 2031, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Helena Chui
- Department of Neurology, University of Southern California, Los Angeles, CA 90089, USA
| | - Fengxian Wang
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Brenna Novotny
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108, USA
| | - Abdallah Eteleeb
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108, USA
| | - Celeste Karch
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Suzanne E. Schindler
- The Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO 63108, USA
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63108, USA
| | - Herve Rhinn
- Department of Bioinformatics. Alector, Inc. 151 Oyster Point Blvd. #300 South San Francisco CA 94080, USA
| | - Erik C.B. Johnson
- Goizueta Alzheimer’s Disease Research Center, Emory University School of Medicine, Atlanta, GA 30329, USA
| | - Hamilton Se-Hwee Oh
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Jarod Evert Rutledge
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Eric B Dammer
- Goizueta Alzheimer’s Disease Research Center, Emory University School of Medicine, Atlanta, GA 30329, USA
| | - Nicholas T. Seyfried
- Goizueta Alzheimer’s Disease Research Center, Emory University School of Medicine, Atlanta, GA 30329, USA
- Department of Biochemistry, Emory School of Medicine, Atlanta, GA 30329, USA
| | - Tony Wyss-Coray
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Oscar Harari
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63108, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63108, USA
- The Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO 63108, USA
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195
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Høilund-Carlsen PF, Revheim ME, Costa T, Kepp KP, Castellani RJ, Perry G, Alavi A, Barrio JR. FDG-PET versus Amyloid-PET Imaging for Diagnosis and Response Evaluation in Alzheimer's Disease: Benefits and Pitfalls. Diagnostics (Basel) 2023; 13:2254. [PMID: 37443645 DOI: 10.3390/diagnostics13132254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
In June 2021, the US Federal Drug and Food Administration (FDA) granted accelerated approval for the antibody aducanumab and, in January 2023, also for the antibody lecanemab, based on a perceived drug-induced removal of cerebral amyloid-beta as assessed by amyloid-PET and, in the case of lecanemab, also a presumption of limited clinical efficacy. Approval of the antibody donanemab is awaiting further data. However, published trial data indicate few, small and uncertain clinical benefits, below what is considered "clinically meaningful" and similar to the effect of conventional medication. Furthermore, a therapy-related decrease in the amyloid-PET signal may also reflect increased cell damage rather than simply "amyloid removal". This interpretation is more consistent with increased rates of amyloid-related imaging abnormalities and brain volume loss in treated patients, relative to placebo. We also challenge the current diagnostic criteria for AD based on amyloid-PET imaging biomarkers and recommend that future anti-AD therapy trials apply: (1) diagnosis of AD based on the co-occurrence of cognitive decline and decreased cerebral metabolism assessed by FDA-approved FDG-PET, (2) therapy efficacy determined by favorable effect on cognitive ability, cerebral metabolism by FDG-PET, and brain volumes by MRI, and (3) neuropathologic examination of all deaths occurring in these trials.
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Affiliation(s)
- Poul F Høilund-Carlsen
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense C, Denmark
- Research Unit of Clinical Physiology and Nuclear Medicine, Department of Clinical Research, University of Southern Denmark, 5230 Odense M, Denmark
| | - Mona-Elisabeth Revheim
- The Intervention Centre, Division of Technology and Innovation, Oslo University Hospital, 0372 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, 0313 Oslo, Norway
| | - Tommaso Costa
- GDS, Department of Psychology, Koelliker Hospital, University of Turin, 10124 Turin, Italy
- FOCUS Lab, Department of Psychology, University of Turin, 10124 Turin, Italy
| | - Kasper P Kepp
- Section of Biophysical and Biomedicinal Chemistry, DTU Chemistry, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - Rudolph J Castellani
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - George Perry
- Department of Neuroscience, Developmental and Regenerative Biology and Genetics of Neurodegeneration, Departments of Psychiatry and Neuroscience, University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - Abass Alavi
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jorge R Barrio
- Department of Molecular and Medical Pharmacology, David Geffen UCLA School of Medicine, Los Angeles, CA 90095, USA
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Kodosaki E, Zetterberg H, Heslegrave A. Validating blood tests as a possible routine diagnostic assay of Alzheimer's disease. Expert Rev Mol Diagn 2023; 23:1153-1165. [PMID: 38018372 DOI: 10.1080/14737159.2023.2289553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023]
Abstract
INTRODUCTION In recent years, exciting developments in disease modifying treatments for Alzheimer's disease (AD) have made accurate and timely diagnosis of this disease a priority. Blood biomarkers (BBMs) for amyloid pathology using improved immunoassay and mass spectrometry techniques have been an area of intense research for the last 10 years and are coming to the fore, as a real prospect to be used in the clinical diagnostics of the disease. AREAS COVERED The following review will update and discuss blood biomarkers that will be most useful in diagnosing AD and the context necessary for their implementation. EXPERT OPINION It is clear we now have BBMs, and technology to measure them, that are capable of detecting amyloid pathology in AD. The challenge is to validate them across platforms and populations to incorporate them into clinical practice. It is important that implementation comes with education, we need to give clinicians the tools for appropriate use and interpretation. It is feasible that BBMs will be used to screen populations, initially for clinical trial entry but also therapeutic intervention in the foreseeable future. We now need to focus BBM research on other pathologies to ensure we accelerate the development of therapeutics for all neurodegenerative diseases.
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Affiliation(s)
- Eleftheria Kodosaki
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Dementia Research Institute at UCL, London, UK
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Dementia Research Institute at UCL, London, UK
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Wisconsin Alzheimer's Disease Research Centre, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology,Dementia Research Institute at UCL, London, UK
- Hong Kong Centre for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
| | - Amanda Heslegrave
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Dementia Research Institute at UCL, London, UK
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He R, Tward D. Applying Joint Graph Embedding to Study Alzheimer's Neurodegeneration Patterns in Volumetric Data. Neuroinformatics 2023; 21:601-614. [PMID: 37314682 PMCID: PMC10406695 DOI: 10.1007/s12021-023-09634-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2023] [Indexed: 06/15/2023]
Abstract
Neurodegeneration measured through volumetry in MRI is recognized as a potential Alzheimer's Disease (AD) biomarker, but its utility is limited by lack of specificity. Quantifying spatial patterns of neurodegeneration on a whole brain scale rather than locally may help address this. In this work, we turn to network based analyses and extend a graph embedding algorithm to study morphometric connectivity from volume-change correlations measured with structural MRI on the timescale of years. We model our data with the multiple random eigengraphs framework, as well as modify and implement a multigraph embedding algorithm proposed earlier to estimate a low dimensional embedding of the networks. Our version of the algorithm guarantees meaningful finite-sample results and estimates maximum likelihood edge probabilities from population-specific network modes and subject-specific loadings. Furthermore, we propose and implement a novel statistical testing procedure to analyze group differences after accounting for confounders and locate significant structures during AD neurodegeneration. Family-wise error rate is controlled at 5% using permutation testing on the maximum statistic. We show that results from our analysis reveal networks dominated by known structures associated to AD neurodegeneration, indicating the framework has promise for studying AD. Furthermore, we find network-structure tuples that are not found with traditional methods in the field.
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Affiliation(s)
- Rosemary He
- Departments of Computer Science and Computational Medicine, University of California, Los Angeles, USA
| | - Daniel Tward
- Departments of Computational Medicine and Neurology, University of California, Los Angeles, USA.
- , Neuroscience Research Building (NRB) 635 Charles E Young Drive South, Rm 225J, Los Angeles, CA, 90095, USA.
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198
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Tombini M, Boscarino M, Di Lazzaro V. Tackling seizures in patients with Alzheimer's disease. Expert Rev Neurother 2023; 23:1131-1145. [PMID: 37946507 DOI: 10.1080/14737175.2023.2278487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION In past years, a possible bidirectional link between epilepsy and Alzheimer's disease (AD) has been proposed: if AD patients are more likely to develop epilepsy, people with late-onset epilepsy evidence an increased risk of dementia. Furthermore, current research suggested that subclinical epileptiform discharges may be more frequent in patients with AD and network hyperexcitability may hasten cognitive impairment. AREAS COVERED In this narrative review, the authors discuss the recent evidence linking AD and epilepsy as well as seizures semeiology and epileptiform activity observed in patients with AD. Finally, anti-seizure medications (ASMs) and therapeutic trials to tackle seizures and network hyperexcitability in this clinical scenario have been summarized. EXPERT OPINION There is growing experimental evidence demonstrating a strong connection between seizures, neuronal hyperexcitability, and AD. Epilepsy in AD has shown a good response to ASMs both at the late and prodromal stages. The new generation ASMs with fewer cognitive adverse effects seem to be a preferable option. Data on the possible effects of network hyperexcitability and ASMs on AD progression are still inconclusive. Further clinical trials are mandatory to identify clear guidelines about treatment of subclinical epileptiform discharges in patients with AD without seizures.
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Affiliation(s)
- Mario Tombini
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico, Rome, Italy
| | - Marilisa Boscarino
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico, Rome, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Department, Milan, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico, Rome, Italy
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Ketchum FB, Chin NA, Erickson C, Lambrou NH, Basche K, Gleason CE, Clark L. The importance of the dyad: Participant perspectives on sharing biomarker results in Alzheimer's disease research. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2023; 9:e12416. [PMID: 37583545 PMCID: PMC10423755 DOI: 10.1002/trc2.12416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND In the asymptomatic "preclinical" phase of Alzheimer's disease (AD), abnormal biomarkers indicate risk for developing cognitive impairment. Biomarker information is increasingly being disclosed to participants in research settings, and biomarker testing and results disclosure will be implemented in clinical settings in the future. Biomarker disclosure has potential psychosocial benefits and harms, impacting affected individuals and their support person(s). Limited data are available about with whom research participants share their results, information that will be necessary to develop disclosure protocols and post-disclosure resources. Additionally, existing research has been conducted in largely White cohorts, limiting applicability to future clinical populations. METHODS We enrolled a diverse cohort of 329 adults (184 non-Hispanic White and 145 Black/African American individuals) who previously participated in AD research. After reviewing a vignette describing a hypothetical biomarker research study, participants indicated their anticipated willingness to share biomarker results with loved ones, and what reactions they anticipated from others. Using mixed-methods analysis, we identified responses related to willingness to share results. RESULTS A majority (78.7%) were willing to share their results with support persons. Many (59.6%) felt it would not be difficult to share, and most (90.6%) believed their loved ones would be supportive. The most common reasons for sharing were to prepare for possible future AD (41.0% of respondents), while the most common reason for not sharing was to avoid worrying loved ones (4.8% of respondents). A total of 7.3% of respondents related reasons regarding being unsure about sharing. DISCUSSION Participants' interest in sharing results supports integrating support persons into AD biomarker research, and may help maximize potential benefits for participants. Communicating with this "dyad" of research participant and support person(s) may improve involvement in research, and help prepare for implementation of clinical biomarker testing by clarifying communication preferences and the influence of support persons on psychosocial outcomes.
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Affiliation(s)
- Fred B. Ketchum
- Department of NeurologySchool of Medicine and Public HealthUniversity of WisconsinMadisonWisconsinUSA
| | - Nathaniel A. Chin
- Division of GeriatricsDepartment of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterMadisonWisconsinUSA
| | - Claire Erickson
- Department of Medical Ethics and Health PolicyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Nickolas H. Lambrou
- Division of GeriatricsDepartment of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Kristin Basche
- Division of GeriatricsDepartment of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Carey E. Gleason
- Division of GeriatricsDepartment of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterMadisonWisconsinUSA
- Geriatric ResearchEducation and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Lindsay Clark
- Division of GeriatricsDepartment of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterMadisonWisconsinUSA
- Geriatric ResearchEducation and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
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Bermudez C, Graff-Radford J, Syrjanen JA, Stricker NH, Algeciras-Schimnich A, Kouri N, Kremers WK, Petersen RC, Jack CR, Knopman DS, Dickson DW, Nguyen AT, Reichard RR, Murray ME, Mielke MM, Vemuri P. Plasma biomarkers for prediction of Alzheimer's disease neuropathologic change. Acta Neuropathol 2023; 146:13-29. [PMID: 37269398 PMCID: PMC10478071 DOI: 10.1007/s00401-023-02594-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 05/14/2023] [Accepted: 05/24/2023] [Indexed: 06/05/2023]
Abstract
While plasma biomarkers for Alzheimer's disease (AD) are increasingly being evaluated for clinical diagnosis and prognosis, few population-based autopsy studies have evaluated their utility in the context of predicting neuropathological changes. Our goal was to investigate the utility of clinically available plasma markers in predicting Braak staging, neuritic plaque score, Thal phase, and overall AD neuropathological change (ADNC).We utilized a population-based prospective study of 350 participants with autopsy and antemortem plasma biomarker testing using clinically available antibody assay (Quanterix) consisting of Aβ42/40 ratio, p-tau181, GFAP, and NfL. We utilized a variable selection procedure in cross-validated (CV) logistic regression models to identify the best set of plasma predictors along with demographic variables, and a subset of neuropsychological tests comprising the Mayo Clinic Preclinical Alzheimer Cognitive Composite (Mayo-PACC). ADNC was best predicted with plasma GFAP, NfL, p-tau181 biomarkers along with APOE ε4 carrier status and Mayo-PACC cognitive score (CV AUC = 0.798). Braak staging was best predicted using plasma GFAP, p-tau181, and cognitive scores (CV AUC = 0.774). Neuritic plaque score was best predicted using plasma Aβ42/40 ratio, p-tau181, GFAP, and NfL biomarkers (CV AUC = 0.770). Thal phase was best predicted using GFAP, NfL, p-tau181, APOE ε4 carrier status and Mayo-PACC cognitive score (CV AUC = 0.754). We found that GFAP and p-tau provided non-overlapping information on both neuritic plaque and Braak stage scores whereas Aβ42/40 and NfL were mainly useful for prediction of neuritic plaque scores. Separating participants by cognitive status improved predictive performance, particularly when plasma biomarkers were included. Plasma biomarkers can differentially inform about overall ADNC pathology, Braak staging, and neuritic plaque score when combined with demographics and cognitive variables and have significant utility for earlier detection of AD.
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Affiliation(s)
- Camilo Bermudez
- Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA.
| | | | - Jeremy A Syrjanen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Nikki H Stricker
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Naomi Kouri
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Walter K Kremers
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Ronald C Petersen
- Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA
| | | | - David S Knopman
- Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA
| | | | - Aivi T Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - R Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Michelle M Mielke
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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