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Kannappan B, te Nijenhuis J, Choi YY, Lee JJ, Choi KY, Balzekas I, Jung HY, Choe Y, Song MK, Chung JY, Ha JM, Choi SM, Kim H, Kim BC, Jo HJ, Lee KH. Can hippocampal subfield measures supply information that could be used to improve the diagnosis of Alzheimer's disease? PLoS One 2022; 17:e0275233. [PMID: 36327265 PMCID: PMC9632892 DOI: 10.1371/journal.pone.0275233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 09/12/2022] [Indexed: 11/05/2022] Open
Abstract
The diagnosis of Alzheimer's disease (AD) needs to be improved. We investigated if hippocampal subfield volume measured by structural imaging, could supply information, so that the diagnosis of AD could be improved. In this study, subjects were classified based on clinical, neuropsychological, and amyloid positivity or negativity using PET scans. Data from 478 elderly Korean subjects grouped as cognitively unimpaired β-amyloid-negative (NC), cognitively unimpaired β-amyloid-positive (aAD), mild cognitively impaired β-amyloid-positive (pAD), mild cognitively impaired-specific variations not due to dementia β-amyloid-negative (CIND), severe cognitive impairment β-amyloid-positive (ADD+) and severe cognitive impairment β-amyloid-negative (ADD-) were used. NC and aAD groups did not show significant volume differences in any subfields. The CIND did not show significant volume differences when compared with either the NC or the aAD (except L-HATA). However, pAD showed significant volume differences in Sub, PrS, ML, Tail, GCMLDG, CA1, CA4, HATA, and CA3 when compared with the NC and aAD. The pAD group also showed significant differences in the hippocampal tail, CA1, CA4, molecular layer, granule cells/molecular layer/dentate gyrus, and CA3 when compared with the CIND group. The ADD- group had significantly larger volumes than the ADD+ group in the bilateral tail, SUB, PrS, and left ML. The results suggest that early amyloid depositions in cognitive normal stages are not accompanied by significant bilateral subfield volume atrophy. There might be intense and accelerated subfield volume atrophy in the later stages associated with the cognitive impairment in the pAD stage, which subsequently could drive the progression to AD dementia. Early subfield volume atrophy associated with the β-amyloid burden may be characterized by more symmetrical atrophy in CA regions than in other subfields. We conclude that the hippocampal subfield volumetric differences from structural imaging show promise for improving the diagnosis of Alzheimer's disease.
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Affiliation(s)
- Balaji Kannappan
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Biomedical Science, Chosun University, Gwangju, South Korea
| | - Jan te Nijenhuis
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Biomedical Science, Chosun University, Gwangju, South Korea
| | - Yu Yong Choi
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
| | - Jang Jae Lee
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
| | - Kyu Yeong Choi
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
| | - Irena Balzekas
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | - Ho Yub Jung
- Department of Computer Engineering, Chosun University, Gwangju, South Korea
| | | | - Min Kyung Song
- Department of Neurology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
| | - Ji Yeon Chung
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Neurology, Chosun University Hospital, Gwangju, South Korea
| | - Jung-Min Ha
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Nuclear Medicine, Chosun University Hospital, Gwangju, South Korea
| | - Seong-Min Choi
- Department of Neurology, Chonnam National University Medical School, Gwangju, South Korea
| | - Hoowon Kim
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Neurology, Chosun University Hospital, Gwangju, South Korea
| | - Byeong C. Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju, South Korea
| | - Hang Joon Jo
- Department of Physiology, College of Medicine, Hanyang University, Seoul, South Korea
| | - Kun Ho Lee
- Gwangju Alzheimer’s & Related Dementias Cohort Research Center, Chosun University, Gwangju, South Korea
- Department of Biomedical Science, Chosun University, Gwangju, South Korea
- Korea Brain Research Institute, Daegu, South Korea
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Apolipoprotein E ɛ4-related effects on cognition are limited to the Alzheimer's disease spectrum. GeroScience 2021; 44:195-209. [PMID: 34591236 PMCID: PMC8811053 DOI: 10.1007/s11357-021-00450-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 08/23/2021] [Indexed: 11/29/2022] Open
Abstract
Whether the deleterious effects of APOE4 are restricted to the Alzheimer’s disease (AD) spectrum or cause cognitive impairment irrespectively of the development of AD is still a matter of debate, and the focus of this study. Our analyses included APOE4 genotype, neuropsychological variables, amyloid-βeta (Aβ) and Tau markers, FDG-PET values, and hippocampal volumetry data derived from the healthy controls sample of the ADNI database. We formed 4 groups of equal size (n = 30) based on APOE4 carriage and amyloid-PET status. Baseline and follow-up (i.e., 48 months post-baseline) results indicated that Aβ-positivity was the most important factor to explain poorer cognitive performance, while APOE4 only exerted a significant effect in Aβ-positive subjects. Additionally, multiple regression analyses evidenced that, within the Aβ-positive sample, hippocampal volumetry explained most of the variability in cognitive performance for APOE4 carriers. These findings represent a strong support for the so-called preclinical/prodromal hypothesis, which states that the reported differences in cognitive performance between healthy carriers and non-carriers are mainly due to the APOE4’s capability to increase the risk of AD. Moreover, our results reinforce the notion that a synergistic interaction of Aβ and APOE4 elicits a neurodegenerative process in the hippocampus that might be the main cause of impaired cognitive performance.
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Guo T, Korman D, Baker SL, Landau SM, Jagust WJ. Longitudinal Cognitive and Biomarker Measurements Support a Unidirectional Pathway in Alzheimer's Disease Pathophysiology. Biol Psychiatry 2021; 89:786-794. [PMID: 32919611 PMCID: PMC9682985 DOI: 10.1016/j.biopsych.2020.06.029] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/29/2020] [Accepted: 06/29/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Amyloid-β (Aβ) likely plays a primary role in Alzheimer's disease pathogenesis, but longitudinal Aβ, tau, and neurodegeneration (A/T/N) measurements in the same individuals have rarely been examined to verify the temporal dynamics of these biomarkers. METHODS In this study, we investigated the temporal ordering of Aβ, tau, and neurodegeneration using longitudinal biomarkers in nondemented elderly individuals. A total of 395 cognitively unimpaired individuals and 204 individuals with mild cognitive impairment (320 [53%] were female) were classified into 8 A±/T±/N± categories according to the abnormal (+)/normal (-) status of Aβ (18F-florbetapir or 18F-florbetaben) positron emission tomography (PET), 18F-flortaucipir PET, and adjusted hippocampal volume (aHCV). Follow-up Aβ PET, tau PET, and aHCV measurements at 0.6 to 4.1 years were available for 35% to 63% of the sample. Baseline Aβ, tau, and aHCV were compared between different A/T/N profiles. We investigated the associations of baseline and longitudinal Aβ, tau, and neurodegeneration in relation to one another continuously. RESULTS Among T- participants, tau was higher for A+/T-/N- individuals compared with the A-/T-/N- group (p = .02). Among N- participants, neurodegeneration was worse among A+/T+/N- individuals compared with the A-/T-/N- group (p = .001). High baseline Aβ was associated (p < .001) with subsequent tau increase and high baseline tau was associated (p = .002) with subsequent aHCV decrease, whereas high tau and low aHCV at baseline were not associated with subsequent Aβ increase. CONCLUSIONS These findings define a sequence of pathological events in Alzheimer's disease that support a current model of Alzheimer's disease pathogenesis in which Aβ appears early, followed by deposition of abnormal tau aggregates and subsequent neurodegeneration.
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Affiliation(s)
- Tengfei Guo
- Helen Wills Neuroscience Institute, University of California, Berkeley, California; Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, California.
| | - Deniz Korman
- Helen Wills Neuroscience Institute, University of California, Berkeley, California
| | - Suzanne L Baker
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, California
| | - Susan M Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley, California; Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, California
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, California; Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, California
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Sleep Quality and Health-Related Quality of Life in Older People With Subjective Cognitive Decline, Mild Cognitive Impairment, and Alzheimer Disease. J Nerv Ment Dis 2020; 208:387-396. [PMID: 31977718 DOI: 10.1097/nmd.0000000000001137] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We aimed to investigate sleep quality and health-related quality of life (HRQOL) in older adults with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and Alzheimer disease (AD). A total of 221 participants were divided into the following five groups: normal controls (NCs), SCD without memory concerns (SCD-0), SCD with memory concerns (SCD-1), MCI, and AD according to their cognitive status. Compared with NC, individuals with SCD-0, SCD-1, MCI, and AD had more sleep problems and reduced HRQOL. Participants with poor sleep quality had an increased risk of cognitive impairment compared with participants with good sleep quality. Within all five subgroups, individuals with poor sleep quality reported more difficulties in HRQOL than individuals with good sleep quality. Future studies employing a longitudinal design, larger samples, and objective evaluation tools are needed.
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Cerebrospinal fluid and plasma neurofilament light relate to abnormal cognition. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2019; 11:700-709. [PMID: 31700989 PMCID: PMC6827361 DOI: 10.1016/j.dadm.2019.08.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Introduction Neuroaxonal damage may contribute to cognitive changes preceding clinical dementia. Accessible biomarkers are critical for detecting such damage. Methods Plasma and cerebrospinal fluid (CSF) neurofilament light (NFL) were related to neuropsychological performance among Vanderbilt Memory & Aging Project participants (plasma n = 333, 73 ± 7 years; CSF n = 149, 72 ± 6 years) ranging from normal cognition (NC) to mild cognitive impairment (MCI). Models adjusted for age, sex, race/ethnicity, education, apolipoprotein E ε4 carriership, and Framingham Stroke Risk Profile. Results Plasma NFL was related to all domains (P values ≤ .008) except processing speed (P values ≥ .09). CSF NFL was related to memory and language (P values ≤ .04). Interactions with cognitive diagnosis revealed widespread plasma associations, particularly in MCI participants, which were further supported in head-to-head comparison models. Discussion Plasma and CSF NFL (reflecting neuroaxonal injury) relate to cognition among non-demented older adults albeit with small to medium effects. Plasma NFL shows particular promise as an accessible biomarker with relevance to cognition in MCI. Plasma and cerebrospinal fluid neurofilament light (NFL) were moderately correlated. Cerebrospinal fluid NFL was related to language and memory functions. Plasma NFL exhibited widespread cognitive associations. Plasma NFL associations were particularly robust in mild cognitive impairment.
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Nosheny RL, Insel PS, Mattsson N, Tosun D, Buckley S, Truran D, Schuff N, Aisen PS, Weiner MW. Associations among amyloid status, age, and longitudinal regional brain atrophy in cognitively unimpaired older adults. Neurobiol Aging 2019; 82:110-119. [PMID: 31437719 PMCID: PMC7198229 DOI: 10.1016/j.neurobiolaging.2019.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/28/2019] [Accepted: 07/07/2019] [Indexed: 01/18/2023]
Abstract
The goal of this study was to compare regional brain atrophy patterns in cognitively unimpaired (CU) older adults with and without brain accumulation of amyloid-β (Aβ) to elucidate contributions of Aβ, age, and other variables to atrophy rates. In 80 CU participants from the Alzheimer's Disease Neuroimaging Initiative, we determined effects of Aβ and age on longitudinal, regional atrophy rates, while accounting for confounding variables including sex, APOE ε4 genotype, white matter lesions, and cerebrospinal fluid total and phosphorylated tau levels. We not only found overlapping patterns of atrophy in Aβ+ versus Aβ- participants but also identified regions where atrophy pattern differed between the 2 groups. Higher Aβ load was associated with increased longitudinal atrophy in the entorhinal cortex, amygdala, and hippocampus, even when accounting for age and other variables. Age was associated with atrophy in insula, fusiform gyrus, and isthmus cingulate, even when accounting for Aβ. We found age by Aβ interactions in the postcentral gyrus and lateral orbitofrontal cortex. These results elucidate the separate and related effects of age, Aβ, and other important variables on longitudinal brain atrophy rates in CU older adults.
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Affiliation(s)
- Rachel L Nosheny
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Psychiatry, University of California, CA, USA.
| | - Philip S Insel
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Niklas Mattsson
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Duygu Tosun
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, CA, USA
| | - Shannon Buckley
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - Diana Truran
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - N Schuff
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - Paul S Aisen
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine of USC, San Diego, CA, USA
| | - Michael W Weiner
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Psychiatry, University of California, CA, USA; Department of Radiology and Biomedical Imaging, University of California, CA, USA
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Ferguson IT, Elbejjani M, Sabayan B, Jacobs DR, Meirelles O, Sanchez OA, Tracy R, Bryan N, Launer LJ. N-Terminal pro-Brain Natriuretic Peptide and Associations With Brain Magnetic Resonance Imaging (MRI) Features in Middle Age: The CARDIA Brain MRI Study. Front Neurol 2018; 9:307. [PMID: 29867721 PMCID: PMC5949318 DOI: 10.3389/fneur.2018.00307] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 04/18/2018] [Indexed: 11/23/2022] Open
Abstract
Objective As part of research on the heart–brain axis, we investigated the association of N-terminal pro-brain natriuretic peptide (NT-proBNP) with brain structure and function in a community-based cohort of middle-aged adults from the Brain Magnetic Resonance Imaging sub-study of the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Approach and results In a cohort of 634 community-dwelling adults with a mean (range) age of 50.4 (46–52) years, we examined the cross-sectional association of NT-proBNP to total, gray (GM) and white matter (WM) volumes, abnormal WM load and WM integrity, and to cognitive function tests [the Digit Symbol Substitution Test (DSST), the Stroop test, and the Rey Auditory–Verbal Learning Test]. These associations were examined using linear regression models adjusted for demographic and cardiovascular risk factors and cardiac output. Higher NT-proBNP concentration was significantly associated with smaller GM volume (β = −3.44; 95% CI = −5.32, −0.53; p = 0.003), even after additionally adjusting for cardiac output (β = −2.93; 95% CI = −5.32, −0.53; p = 0.017). Higher NT-proBNP levels were also associated with lower DSST scores. NT-proBNP was not related to WM volume, WM integrity, or abnormal WM load. Conclusion In this middle-aged cohort, subclinical levels of NT-proBNP were related to brain function and specifically to GM and not WM measures, extending similar findings in older cohorts. Further research is warranted into biomarkers of cardiac dysfunction as a target for early markers of a brain at risk.
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Affiliation(s)
- Ian T Ferguson
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
| | - Martine Elbejjani
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
| | - Behnam Sabayan
- Department of Neurology, Northwestern University, Chicago, IL, United States
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Osorio Meirelles
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
| | - Otto A Sanchez
- Division of Renal Diseases and Hypertension, Department of Internal Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Russell Tracy
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, United States.,Department of Biochemistry, University of Vermont College of Medicine, Burlington, VT, United States
| | - Nick Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Lenore J Launer
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MD, United States
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Wisse LEM, Das SR, Davatzikos C, Dickerson BC, Xie SX, Yushkevich PA, Wolk DA. Defining SNAP by cross-sectional and longitudinal definitions of neurodegeneration. NEUROIMAGE-CLINICAL 2018; 18:407-412. [PMID: 29487798 PMCID: PMC5816023 DOI: 10.1016/j.nicl.2018.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 12/20/2017] [Accepted: 02/06/2018] [Indexed: 12/23/2022]
Abstract
Introduction Suspected non-Alzheimer's pathophysiology (SNAP) is a biomarker driven designation that represents a heterogeneous group in terms of etiology and prognosis. SNAP has only been identified by cross-sectional neurodegeneration measures, whereas longitudinal measures might better reflect “active” neurodegeneration and might be more tightly linked to prognosis. We compare neurodegeneration defined by cross-sectional ‘hippocampal volume’ only (SNAP/L−) versus both cross-sectional and longitudinal ‘hippocampal atrophy rate’ (SNAP/L+) and investigate how these definitions impact prevalence and the clinical and biomarker profile of SNAP in Mild Cognitive Impairment (MCI). Methods 276 MCI patients from ADNI-GO/2 were designated amyloid “positive” (A+) or “negative” (A−) based on their florbetapir scan and neurodegeneration ‘positive’ or ‘negative’ based on cross-sectional hippocampal volume and longitudinal hippocampal atrophy rate. Results 74.1% of all SNAP participants defined by the cross-sectional definition of neurodegeneration also met the longitudinal definition of neurodegeneration, whereas 25.9% did not. SNAP/L+ displayed larger white matter hyperintensity volume, a higher conversion rate to dementia over 5 years and a steeper decline on cognitive tasks compared to SNAP/L− and the A- CN group. SNAP/L− had more abnormal values on neuroimaging markers and worse performance on cognitive tasks than the A- CN group, but did not show a difference in dementia conversion rate or longitudinal cognition. Discussion Using a longitudinal definition of neurodegeneration in addition to a cross-sectional one identifies SNAP participants with significant cognitive decline and a worse clinical prognosis for which cerebrovascular disease may be an important driver. 74.1% of SNAP subjects also met the criteria for longitudinal neurodegeneration (L+). SNAP/L+ had a larger WMH volume compared to the SNAP/L− group and the A- CN group. SNAP/L+ showed a higher conversion rate and steeper cognitive decline than A- CN. SNAP/L− showed similar conversion rate and cognitive decline as A- CN.
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Affiliation(s)
- L E M Wisse
- Penn Image Computing and Science Laboratory, Department of Radiology, University of Pennsylvania, 3700 Hamilton Walk, Philadelphia, PA 19104, USA.
| | - S R Das
- Penn Memory Center, Department of Neurology, 3700 Hamilton Walk, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - C Davatzikos
- Center for Biomedical Image Computing and Analytics, 3700 Hamilton Walk, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - B C Dickerson
- Department of Psychiatry and Neurology Services, Massachusetts General Hospital, Harvard Medical School, Building 149 13th Street, Charlestown, MA 02129, USA
| | - S X Xie
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - P A Yushkevich
- Penn Image Computing and Science Laboratory, Department of Radiology, University of Pennsylvania, 3700 Hamilton Walk, Philadelphia, PA 19104, USA
| | - D A Wolk
- Penn Memory Center, Department of Neurology, 3700 Hamilton Walk, University of Pennsylvania, Philadelphia, PA 19104, USA
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Jacquemont T, De Vico Fallani F, Bertrand A, Epelbaum S, Routier A, Dubois B, Hampel H, Durrleman S, Colliot O. Amyloidosis and neurodegeneration result in distinct structural connectivity patterns in mild cognitive impairment. Neurobiol Aging 2017; 55:177-189. [DOI: 10.1016/j.neurobiolaging.2017.03.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 03/17/2017] [Accepted: 03/19/2017] [Indexed: 01/01/2023]
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Dani M, Brooks D, Edison P. Suspected non-Alzheimer's pathology - Is it non-Alzheimer's or non-amyloid? Ageing Res Rev 2017; 36:20-31. [PMID: 28235659 DOI: 10.1016/j.arr.2017.02.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/04/2017] [Accepted: 02/16/2017] [Indexed: 01/10/2023]
Abstract
Neurodegeneration, the progressive loss of neurons, is a major process involved in dementia and age-related cognitive impairment. It can be detected clinically using currently available biomarker tests. Suspected Non-Alzheimer Pathology (SNAP) is a biomarker-based concept that encompasses a group of individuals with neurodegeneration, but no evidence of amyloid deposition (thereby distinguishing it from Alzheimer's disease (AD)). These individuals may often have a clinical diagnosis of AD, but their clinical features, genetic susceptibility and progression can differ significantly, carrying crucial implications for precise diagnostics, clinical management, and efficacy of clinical drug trials. SNAP has caused wide interest in the dementia research community, because it is still unclear whether it represents distinct pathology separate from AD, or whether in some individuals, it could represent the earliest stage of AD. This debate has raised pertinent questions about the pathways to AD, the need for biomarkers, and the sensitivity of current biomarker tests. In this review, we discuss the biomarker and imaging trials that first recognized SNAP. We describe the pathological correlates of SNAP and comment on the different causes of neurodegeneration. Finally, we discuss the debate around the concept of SNAP, and further unanswered questions that are emerging.
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Akhtar RS, Xie SX, Chen YJ, Rick J, Gross RG, Nasrallah IM, Van Deerlin VM, Trojanowski JQ, Chen-Plotkin AS, Hurtig HI, Siderowf AD, Dubroff JG, Weintraub D. Regional brain amyloid-β accumulation associates with domain-specific cognitive performance in Parkinson disease without dementia. PLoS One 2017; 12:e0177924. [PMID: 28542444 PMCID: PMC5444629 DOI: 10.1371/journal.pone.0177924] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 05/05/2017] [Indexed: 01/31/2023] Open
Abstract
Parkinson disease patients develop clinically significant cognitive impairment at variable times over their disease course, which is often preceded by milder deficits in memory, visuo-spatial, and executive domains. The significance of amyloid-β accumulation to these problems is unclear. We hypothesized that amyloid-β PET imaging by 18F-florbetapir, a radiotracer that detects fibrillar amyloid-β plaque deposits, would identify subjects with global cognitive impairment or poor performance in individual cognitive domains in non-demented Parkinson disease patients. We assessed 61 non-demented Parkinson disease patients with detailed cognitive assessments and 18F-florbetapir PET brain imaging. Scans were interpreted qualitatively (positive or negative) by two independent nuclear medicine physicians blinded to clinical data, and quantitatively by a novel volume-weighted method. The presence of mild cognitive impairment was determined through an expert consensus process using Level 1 criteria from the Movement Disorder Society. Nineteen participants (31.2%) were diagnosed with mild cognitive impairment and the remainder had normal cognition. Qualitative 18F-florbetapir PET imaging was positive in 15 participants (24.6%). Increasing age and presence of an APOE ε4 allele were associated with higher composite 18F-florbetapir binding. In multivariable models, an abnormal 18F-florbetapir scan by expert rating was not associated with a diagnosis of mild cognitive impairment. However, 18F-florbetapir retention values in the posterior cingulate gyrus inversely correlated with verbal memory performance. Retention values in the frontal cortex, precuneus, and anterior cingulate gyrus retention values inversely correlated with naming performance. Regional cortical amyloid-β amyloid, as measured by 18F-florbetapir PET, may be a biomarker of specific cognitive deficits in non-demented Parkinson disease patients.
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Affiliation(s)
- Rizwan S. Akhtar
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Center for Neurodegenerative Disease Research and Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| | - Sharon X. Xie
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Yin J. Chen
- Department of Radiology, Division of Nuclear Medicine and Clinical Molecular Imaging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Jacqueline Rick
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Rachel G. Gross
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Ilya M. Nasrallah
- Department of Radiology, Division of Nuclear Medicine and Clinical Molecular Imaging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Vivianna M. Van Deerlin
- Center for Neurodegenerative Disease Research and Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - John Q. Trojanowski
- Center for Neurodegenerative Disease Research and Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Alice S. Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Howard I. Hurtig
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Andrew D. Siderowf
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- AVID Radiopharmaceuticals, Philadelphia, Pennsylvania, United States of America
| | - Jacob G. Dubroff
- Department of Radiology, Division of Nuclear Medicine and Clinical Molecular Imaging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Daniel Weintraub
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Psychiatry, Perelman School of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Parkinson’s Disease and Mental Health Research, Education, and Clinical Centers (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, United States of America
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12
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Sun Y, Wang Y, Lu J, Liu R, Schwarz CG, Zhao H, Zhang Y, Xu L, Zhu B, Zhang B, Liu B, Wan S, Xu Y. Disrupted functional connectivity between perirhinal and parahippocampal cortices with hippocampal subfields in patients with mild cognitive impairment and Alzheimer's disease. Oncotarget 2017; 8:99112-99124. [PMID: 29228757 PMCID: PMC5716797 DOI: 10.18632/oncotarget.17944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 03/06/2017] [Indexed: 11/25/2022] Open
Abstract
Most patients with mild cognitive impairment and Alzheimer's disease can initially present memory loss. The medial temporal lobes are the brain regions most associated with declarative memory function. As sub-components of the MTL, the perirhinal cortex, parahippocampal cortex and hippocampus have also been identified as playing important roles in memory. The functional connectivity between hippocampus subfields and perirhnial cortices as well as parahippocampal cortices among normal cognition controls (NC group, n=33), mild cognitive impairment (MCI group, n=31) and Alzheimer's disease (AD group, n=27) was investigated in this study. The result shows significant differences of functional connectivity in 3 pairs of regions among NC group, MCI group and AD group: right perirhinal cortex with right hippocampus tail, left perirhinal cortex with right hippocampus tail, and right parahippocampal cortex with right hippocampus head. Clustering methods were used to classify NC group, MCI group and AD group (accuracy=100%) as well as different subtypes of mild cognitive impairment patients based on functional alterations. Functional connectivity disrupted between perirhinal and parahippocampal cortex with hippocampal subfields, which may provide a better understanding of the neurodegenerative progress of MCI and AD.
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Affiliation(s)
- Yu Sun
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China.,The Institute of Cancer and Genomics Sciences, University of Birmingham, Birmingham, U.K
| | - Yafei Wang
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
| | - Jiaming Lu
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Rengyuan Liu
- Department of Neurology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | | | - Hui Zhao
- Department of Neurology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yue Zhang
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
| | - Lingyi Xu
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
| | - Bin Zhu
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Bing Zhang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Bing Liu
- Brainnetome Center, Institute of Automation, Chinese Academy of Science, Beijing, China
| | - Suiren Wan
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
| | - Yun Xu
- Department of Neurology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
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13
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Pascoal TA, Mathotaarachchi S, Shin M, Benedet AL, Mohades S, Wang S, Beaudry T, Kang MS, Soucy JP, Labbe A, Gauthier S, Rosa-Neto P. Synergistic interaction between amyloid and tau predicts the progression to dementia. Alzheimers Dement 2016; 13:644-653. [PMID: 28024995 DOI: 10.1016/j.jalz.2016.11.005] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 09/07/2016] [Accepted: 11/07/2016] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Recent literature proposes that amyloid β (Aβ) and phosphorylated tau (p-tau) synergism accelerates biomarker abnormalities in controls. Yet, it remains to be answered whether this synergism is the driving force behind Alzheimer disease (AD) dementia. METHODS We stratified 314 mild cognitive impairment individuals using [18F]florbetapir positron emission tomography Aβ imaging and cerebrospinal fluid p-tau. Regression and voxel-based logistic regression models with interaction terms evaluated 2-year changes in cognition and clinical status as a function of baseline biomarkers. RESULTS We found that the synergism between [18F]florbetapir and p-tau, rather than their additive effects, was associated with the cognitive decline and progression to AD. Furthermore, voxel-based analysis revealed that temporal and inferior parietal were the regions where the synergism determined an increased likelihood of developing AD. DISCUSSION Together, the present results support that progression to AD dementia is driven by the synergistic rather than a mere additive effect between Aβ and p-tau proteins.
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Affiliation(s)
- Tharick A Pascoal
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Sulantha Mathotaarachchi
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Monica Shin
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Andrea L Benedet
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada; CAPES Foundation, Ministry of Education of Brazil, Brasília, Brazil
| | - Sara Mohades
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Seqian Wang
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Tom Beaudry
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | - Min Su Kang
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada
| | | | - Aurelie Labbe
- Douglas Hospital Research Centre, McGill University, Montreal, Canada; Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada
| | - Serge Gauthier
- AD Research Unit, The McGill University Research Centre for Studies in Aging, Montreal, Canada; McGill University, Montreal, Canada
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, Canada; Montreal Neurological Institute, Montreal, Canada; AD Research Unit, The McGill University Research Centre for Studies in Aging, Montreal, Canada; McGill University, Montreal, Canada; Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
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14
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Knopman DS, Jack CR, Lundt ES, Weigand SD, Vemuri P, Lowe VJ, Kantarci K, Gunter JL, Senjem ML, Mielke MM, Machulda MM, Roberts RO, Boeve BF, Jones DT, Petersen RC. Evolution of neurodegeneration-imaging biomarkers from clinically normal to dementia in the Alzheimer disease spectrum. Neurobiol Aging 2016; 46:32-42. [PMID: 27460147 PMCID: PMC5018437 DOI: 10.1016/j.neurobiolaging.2016.06.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/20/2016] [Accepted: 06/08/2016] [Indexed: 12/11/2022]
Abstract
The availability of antemortem biomarkers for Alzheimer's disease (AD) enables monitoring the evolution of neurodegenerative processes in real time. Pittsburgh compound B (PIB) positron emission tomography (PET) was used to select participants in the Mayo Clinic Study of Aging and the Mayo Alzheimer's Disease Research Center with elevated β-amyloid, designated as "A+," and hippocampal volume and (18)fluorodeoxyglucose (FDG) positron emission tomography were used to characterize participants as having evidence of neurodegeneration ("N+") at the baseline evaluation. There were 145 clinically normal (CN) A+ individuals, 62 persons with mild cognitive impairment (MCI) who were A+ and 20 with A+ AD dementia. Over a period of 1-6 years, MCI A+N+ individuals showed declines in medial temporal, lateral temporal, lateral parietal, and to a lesser extent, medial parietal regions for both FDG standardized uptake value ratio and gray matter volume that exceeded declines seen in the CN A+N+ group. The AD dementia group showed declines in the same regions on FDG standardized uptake value ratio and gray matter volume with rates that exceeded that in MCI A+N+. Expansion of regional involvement and faster rate of neurodegeneration characterizes progression in the AD pathway.
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Affiliation(s)
- David S Knopman
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA.
| | - Clifford R Jack
- Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Emily S Lundt
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Stephen D Weigand
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Prashanthi Vemuri
- Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Val J Lowe
- Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Kejal Kantarci
- Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Jeffrey L Gunter
- Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Information Technology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Matthew L Senjem
- Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Information Technology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Michelle M Mielke
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Mary M Machulda
- Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Psychiatry, Division of Psychology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Rosebud O Roberts
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA
| | - David T Jones
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Ronald C Petersen
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN, USA
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15
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Daulatzai MA. Cerebral hypoperfusion and glucose hypometabolism: Key pathophysiological modulators promote neurodegeneration, cognitive impairment, and Alzheimer's disease. J Neurosci Res 2016; 95:943-972. [PMID: 27350397 DOI: 10.1002/jnr.23777] [Citation(s) in RCA: 274] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 05/06/2016] [Accepted: 05/07/2016] [Indexed: 02/06/2023]
Abstract
Aging, hypertension, diabetes, hypoxia/obstructive sleep apnea (OSA), obesity, vitamin B12/folate deficiency, depression, and traumatic brain injury synergistically promote diverse pathological mechanisms including cerebral hypoperfusion and glucose hypometabolism. These risk factors trigger neuroinflammation and oxidative-nitrosative stress that in turn decrease nitric oxide and enhance endothelin, Amyloid-β deposition, cerebral amyloid angiopathy, and blood-brain barrier disruption. Proinflammatory cytokines, endothelin-1, and oxidative-nitrosative stress trigger several pathological feedforward and feedback loops. These upstream factors persist in the brain for decades, upregulating amyloid and tau, before the cognitive decline. These cascades lead to neuronal Ca2+ increase, neurodegeneration, cognitive/memory decline, and Alzheimer's disease (AD). However, strategies are available to attenuate cerebral hypoperfusion and glucose hypometabolism and ameliorate cognitive decline. AD is the leading cause of dementia among the elderly. There is significant evidence that pathways involving inflammation and oxidative-nitrosative stress (ONS) play a key pathophysiological role in promoting cognitive dysfunction. Aging and several comorbid conditions mentioned above promote diverse pathologies. These include inflammation, ONS, hypoperfusion, and hypometabolism in the brain. In AD, chronic cerebral hypoperfusion and glucose hypometabolism precede decades before the cognitive decline. These comorbid disease conditions may share and synergistically activate these pathophysiological pathways. Inflammation upregulates cerebrovascular pathology through proinflammatory cytokines, endothelin-1, and nitric oxide (NO). Inflammation-triggered ONS promotes long-term damage involving fatty acids, proteins, DNA, and mitochondria; these amplify and perpetuate several feedforward and feedback pathological loops. The latter includes dysfunctional energy metabolism (compromised mitochondrial ATP production), amyloid-β generation, endothelial dysfunction, and blood-brain-barrier disruption. These lead to decreased cerebral blood flow and chronic cerebral hypoperfusion- that would modulate metabolic dysfunction and neurodegeneration. In essence, hypoperfusion deprives the brain from its two paramount trophic substances, viz., oxygen and nutrients. Consequently, the brain suffers from synaptic dysfunction and neuronal degeneration/loss, leading to both gray and white matter atrophy, cognitive dysfunction, and AD. This Review underscores the importance of treating the above-mentioned comorbid disease conditions to attenuate inflammation and ONS and ameliorate decreased cerebral blood flow and hypometabolism. Additionally, several strategies are described here to control chronic hypoperfusion of the brain and enhance cognition. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Mak Adam Daulatzai
- Sleep Disorders Group, EEE Dept/MSE, The University of Melbourne, Parkville, Victoria, Australia
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16
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Raman MR, Schwarz CG, Murray ME, Lowe VJ, Dickson DW, Jack CR, Kantarci K. An MRI-Based Atlas for Correlation of Imaging and Pathologic Findings in Alzheimer's Disease. J Neuroimaging 2016; 26:264-8. [PMID: 27017996 PMCID: PMC4848115 DOI: 10.1111/jon.12341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 02/01/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Pathologic diagnosis is the gold standard in evaluating imaging measures developed as biomarkers for pathologically defined disorders. A brain MRI atlas representing autopsy-sampled tissue can be used to directly compare imaging and pathology findings. Our objective was to develop a brain MRI atlas representing the cortical regions that are routinely sampled at autopsy for the diagnosis of Alzheimer's disease (AD). METHODS Subjects (n = 22; ages at death = 70-95) with a range of pathologies and antemortem 3T MRI were included. Histology slides from 8 cortical regions sampled from the left hemisphere at autopsy guided the localization of the atlas regions of interest (ROIs) on each subject's antemortem 3D T1 -weighted MRI. These ROIs were then registered to a common template and combined to form one ROI representing the volume of tissue that was sampled by the pathologists. A subset of the subjects (n = 4; ages at death = 79-95) had amyloid PET imaging. Density of β-amyloid immunostain was quantified from the autopsy-sampled regions in the 4 subjects using a custom-designed ImageScope algorithm. Median uptake values were calculated in each ROI on the amyloid-PET images. RESULTS We found an association between β-amyloid plaque density in 8 ROIs of the 4 subjects (total ROI n = 32) and median PiB SUVR (r(2) = .64; P < .0001). CONCLUSIONS In an atlas developed for imaging and pathologic correlation studies, we demonstrated that antemortem amyloid burden measured in the atlas ROIs on amyloid PET is strongly correlated with β-amyloid density measured on histology. This atlas can be used in imaging and pathologic correlation studies.
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Affiliation(s)
- Mekala R Raman
- Neurobiology of Disease Graduate Program, Mayo Graduate School, Rochester, MN.,Department of Neurology, Mayo Clinic, Rochester, MN
| | | | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN
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