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Ji J, Hou Z, He Y, Liu L, Xue F, Chen H, Yuan Z. Differential network knockoff filter with application to brain connectivity analysis. Stat Med 2024; 43:3830-3861. [PMID: 38922944 DOI: 10.1002/sim.10155] [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: 05/14/2023] [Revised: 04/30/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
The brain functional connectivity can typically be represented as a brain functional network, where nodes represent regions of interest (ROIs) and edges symbolize their connections. Studying group differences in brain functional connectivity can help identify brain regions and recover the brain functional network linked to neurodegenerative diseases. This process, known as differential network analysis focuses on the differences between estimated precision matrices for two groups. Current methods struggle with individual heterogeneity in measuring the brain connectivity, false discovery rate (FDR) control, and accounting for confounding factors, resulting in biased estimates and diminished power. To address these issues, we present a two-stage FDR-controlled feature selection method for differential network analysis using functional magnetic resonance imaging (fMRI) data. First, we create individual brain connectivity measures using a high-dimensional precision matrix estimation technique. Next, we devise a penalized logistic regression model that employs individual brain connectivity data and integrates a new knockoff filter for FDR control when detecting significant differential edges. Through extensive simulations, we showcase the superiority of our approach compared to other methods. Additionally, we apply our technique to fMRI data to identify differential edges between Alzheimer's disease and control groups. Our results are consistent with prior experimental studies, emphasizing the practical applicability of our method.
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Affiliation(s)
- Jiadong Ji
- Institute for Financial Studies, Shandong University, Jinan, Shandong, China
| | - Zhendong Hou
- Institute for Financial Studies, Shandong University, Jinan, Shandong, China
| | - Yong He
- Institute for Financial Studies, Shandong University, Jinan, Shandong, China
| | - Lei Liu
- Division of Biostatistics, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Hao Chen
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Zhongshang Yuan
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Rajendran K, Krishnan UM. Biomarkers in Alzheimer's disease. Clin Chim Acta 2024; 562:119857. [PMID: 38986861 DOI: 10.1016/j.cca.2024.119857] [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: 05/13/2024] [Revised: 07/05/2024] [Accepted: 07/06/2024] [Indexed: 07/12/2024]
Abstract
Alzheimer's disease (AD) is among the most common neurodegenerative disorders. AD is characterized by deposition of neurofibrillary tangles and amyloid plaques, leading to associated secondary pathologies, progressive neurodegeneration, and eventually death. Currently used diagnostics are largely image-based, lack accuracy and do not detect early disease, ie, prior to onset of symptoms, thus limiting treatment options and outcomes. Although biomarkers such as amyloid-β and tau protein in cerebrospinal fluid have gained much attention, these are generally limited to disease progression. Unfortunately, identification of biomarkers for early and accurate diagnosis remains a challenge. As such, body fluids such as sweat, serum, saliva, mucosa, tears, and urine are under investigation as alternative sources for biomarkers that can aid in early disease detection. This review focuses on biomarkers identified through proteomics in various biofluids and their potential for early and accurate diagnosis of AD.
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Affiliation(s)
- Kayalvizhi Rajendran
- Centre for Nanotechnology & Advanced Biomaterials, SASTRA Deemed University, Thanjavur, India; School of Chemical & Biotechnology, SASTRA Deemed University, Thanjavur, India
| | - Uma Maheswari Krishnan
- Centre for Nanotechnology & Advanced Biomaterials, SASTRA Deemed University, Thanjavur, India; School of Arts, Sciences, Humanities, & Education, SASTRA Deemed University, Thanjavur, India.
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Rabl M, Zullo L, Lewczuk P, Kornhuber J, Karikari TK, Blennow K, Zetterberg H, Bavato F, Quednow BB, Seifritz E, von Gunten A, Clark C, Popp J. Plasma neurofilament light, glial fibrillary acid protein, and phosphorylated tau 181 as biomarkers for neuropsychiatric symptoms and related clinical disease progression. Alzheimers Res Ther 2024; 16:165. [PMID: 39054505 PMCID: PMC11270946 DOI: 10.1186/s13195-024-01526-4] [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: 03/17/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) are common in older people, may occur early in the development of dementia disorders, and have been associated with faster cognitive decline. Here, our objectives were to investigate whether plasma levels of neurofilament light chain (NfL), glial fibrillary acid protein (GFAP), and tau phosphorylated at threonine 181 (pTau181) are associated with current NPS and predict future NPS in non-demented older people. Furthermore, we tested whether the presence of NPS combined with plasma biomarkers are useful to predict Alzheimer's disease (AD) pathology and cognitive decline. METHODS One hundred and fifty-one participants with normal cognition (n = 76) or mild cognitive impairment (n = 75) were examined in a longitudinal brain aging study at the Memory Centers, University Hospital of Lausanne, Switzerland. Plasma levels of NfL, GFAP, and pTau181 along with CSF biomarkers of AD pathology were measured at baseline. NPS were assessed through the Neuropsychiatric Inventory Questionnaire (NPI-Q), along with the cognitive and functional performance at baseline and follow-up (mean: 20 months). Different regression and ROC analyses were used to address the associations of interest. RESULTS None of the three plasma biomarker was associated with NPS at baseline. Higher GFAP levels were associated with the presence of NPS at follow-up (OR = 2.8, p = .002) and both, higher NfL and higher GFAP with an increase in the NPI-Q severity score over time (β = 0.25, p = .034 and β = 0.30, p = .013, respectively). Adding NPS and the plasma biomarkers to a reference model improved the prediction of future NPS (AUC 0.72 to 0.88, p = .002) and AD pathology (AUC 0.78 to 0.87, p = .010), but not of cognitive decline (AUC 0.79 to 0.85, p = .081). CONCLUSION Plasma NfL and GFAP are both associated with future NPS and NPS severity change. Considering the presence of NPS along with blood-based AD-biomarkers may improve the prediction of clinical progression of NPS over time and inform clinical decision-making in non-demented older people.
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Affiliation(s)
- Miriam Rabl
- Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Lenggstrasse 31, Zurich, 8032, Switzerland.
| | - Leonardo Zullo
- Old-Age Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, 1005, Switzerland
- Leenaards Memory Clinic, Lausanne University Hospital, Lausanne, 1005, Switzerland
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg, 91054, Erlangen, Germany
- Department of Neurodegeneration Diagnostics, Medical University of Białystok, Białystok, 15-269, Poland
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg, 91054, Erlangen, Germany
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, 431 41, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, 431 41, Sweden
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15219, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, 431 41, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, 431 41, Sweden
- Paris Brain Institute, ICM, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
- Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, Department of Neurology, Institute on Aging and Brain Disorders, University of Science and Technology of China and First Affiliated Hospital of USTC, Hefei, P.R. China
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, 431 41, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, 431 41, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, WC1E 6BT, UK
- UK Dementia Research Institute at University College London, London, W1T 7NF, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, 999077, China
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Francesco Bavato
- Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Lenggstrasse 31, Zurich, 8032, Switzerland
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, 8032, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, 8032, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, 8057, Switzerland
| | - Erich Seifritz
- Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Lenggstrasse 31, Zurich, 8032, Switzerland
| | - Armin von Gunten
- Old-Age Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, 1005, Switzerland
| | - Christopher Clark
- Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Lenggstrasse 31, Zurich, 8032, Switzerland
| | - Julius Popp
- Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Lenggstrasse 31, Zurich, 8032, Switzerland
- Old-Age Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, 1005, Switzerland
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Angelopoulou E, Bougea A, Hatzimanolis A, Scarmeas N, Papageorgiou SG. Unraveling the Potential Underlying Mechanisms of Mild Behavioral Impairment: Focusing on Amyloid and Tau Pathology. Cells 2024; 13:1164. [PMID: 38995015 PMCID: PMC11240615 DOI: 10.3390/cells13131164] [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: 05/27/2024] [Revised: 06/21/2024] [Accepted: 06/27/2024] [Indexed: 07/13/2024] Open
Abstract
The emergence of sustained neuropsychiatric symptoms (NPS) among non-demented individuals in later life, defined as mild behavioral impairment (MBI), is linked to a higher risk of cognitive decline. However, the underlying pathophysiological mechanisms remain largely unexplored. A growing body of evidence has shown that MBI is associated with alterations in structural and functional neuroimaging studies, higher genetic predisposition to clinical diagnosis of Alzheimer's disease (AD), as well as amyloid and tau pathology assessed in the blood, cerebrospinal fluid, positron-emission tomography (PET) imaging and neuropathological examination. These findings shed more light on the MBI-related potential neurobiological mechanisms, paving the way for the development of targeted pharmacological approaches. In this review, we aim to discuss the available clinical evidence on the role of amyloid and tau pathology in MBI and the potential underlying pathophysiological mechanisms. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, disruption of neurotrophic factors, such as the brain-derived neurotrophic factor (BDNF), abnormal neuroinflammatory responses including the kynurenine pathway, dysregulation of transforming growth factor beta (TGF-β1), epigenetic alterations including micro-RNA (miR)-451a and miR-455-3p, synaptic dysfunction, imbalance in neurotransmitters including acetylcholine, dopamine, serotonin, gamma-aminobutyric acid (GABA) and norepinephrine, as well as altered locus coeruleus (LC) integrity are some of the potential mechanisms connecting MBI with amyloid and tau pathology. The elucidation of the underlying neurobiology of MBI would facilitate the design and efficacy of relative clinical trials, especially towards amyloid- or tau-related pathways. In addition, we provide insights for future research into our deeper understanding of its underlying pathophysiology of MBI, and discuss relative therapeutic implications.
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Affiliation(s)
- Efthalia Angelopoulou
- 1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Anastasia Bougea
- 1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Alexandros Hatzimanolis
- 1st Department of Psychiatry, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Sokratis G Papageorgiou
- 1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
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Ferreira DA, Macedo LBC, Foss MP. Neuropsychiatric symptoms as a prodromal factor in Alzheimer's type neurodegenerative disease: A scoping review. Clin Neuropsychol 2024; 38:1031-1059. [PMID: 37881945 DOI: 10.1080/13854046.2023.2273574] [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: 05/21/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023]
Abstract
Objective: Identifying neuropsychiatric symptoms (NPS) can aid in the early detection of Alzheimer's disease (AD); however, there is still a need for a greater consensus. This review aims to delineate the predominant NPS, compile a comprehensive list of the most commonly employed NPS assessment tools, and corroborate the principal findings regarding the link between NPS and neuropsychological assessment and neurobiological substrates. Methods: To conduct this scoping review, we followed the Preferred Reporting Items for Systematic Reviews guidelines and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We searched for relevant articles published between 2017 and 2023 in MEDLINE, PsycINFO, PubMed, Web of Science, and Cochrane Library. Results: Of the 61 eligible articles, depression, anxiety, and apathy were the main NPSs. The Neuropsychiatric Inventory Questionnaire and Neuropsychiatric Inventory were the primary assessment tools used to evaluate NPS. Correlations between NPS severity and neurobiological markers were considered clinically significant. Furthermore, clinical procedures prioritized the use of global cognitive screening tools, assessments of executive functions, and functionality evaluations. Conclusion: Standardization of procedures is necessary because of the diversity of methods. The data show that NPS can predict the etiology, severity, form, and type of disease progression, serving as a precursor sign of AD. The results of the most common cognitive screening tools and NPS instruments provided an interesting overview of future clinical approaches.
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Affiliation(s)
- Diego Alves Ferreira
- Department of Neuroscience and Behavior Science, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Lorena Barbosa Cunha Macedo
- Faculty of Philosophy, Sciences, and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Maria Paula Foss
- Department of Neuroscience and Behavior Science, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
- Faculty of Philosophy, Sciences, and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Ronat L, Hanganu A, Chylinski D, Van Egroo M, Narbutas J, Besson G, Muto V, Schmidt C, Bahri MA, Phillips C, Salmon E, Maquet P, Vandewalle G, Collette F, Bastin C. Prediction of cognitive decline in healthy aging based on neuropsychiatric symptoms and PET-biomarkers of Alzheimer's disease. J Neurol 2024; 271:2067-2077. [PMID: 38114820 DOI: 10.1007/s00415-023-12131-0] [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: 10/17/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023]
Abstract
Neuropsychiatric symptoms (NPS) have been associated with a risk of accelerated cognitive decline or conversion to dementia of the Alzheimer's Disease (AD) type. Moreover, the NPS were also associated with higher AD biomarkers (brain tau and amyloid burden) even in non-demented patients. But the effect of the relationship between NPS and biomarkers on cognitive decline has not yet been studied. This work aims to assess the relationship between longitudinal cognitive changes and NPS, specifically depression and anxiety, in association with AD biomarkers in healthy middle-aged to older participants. The cohort consisted of 101 healthy participants aged 50-70 years, 66 of whom had neuropsychological assessments of memory, executive functions, and global cognition at a 2-year follow-up. At baseline, NPS were assessed using the Beck Depression and Anxiety Inventories while brain tau and amyloid loads were measured using positron emission topography. For tau burden, THK5351 uptake is used as a proxy of tau and neuroinflammation. Participants, declining or remaining stable at follow-up, were categorized into groups for each cognitive domain. Group classification was investigated using binary logistic regressions based on combined AD biomarkers and the two NPS. The results showed that an association between anxiety and prefrontal amyloid burden significantly classified episodic memory decline, while the classification of global cognitive decline involved temporal and occipital amyloid burden but not NPS. Moreover, depression together with prefrontal and hippocampal tau burden were associated with a decline in memory. The classification of participants based on executive decline was related to depression and mainly prefrontal tau burden. These findings suggest that the combination of NPS and brain biomarkers of AD predicts the occurrence of cognitive decline in aging.
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Affiliation(s)
- Lucas Ronat
- Faculty of Medicine, Department of Medicine, University of Montreal, Montreal, QC, Canada
- Research Centre, University Institute of Geriatrics of Montreal, CIUSSS du Centre-Sud-de-l'Ile-de-Montréal, Montreal, QC, Canada
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium
| | - Alexandru Hanganu
- Research Centre, University Institute of Geriatrics of Montreal, CIUSSS du Centre-Sud-de-l'Ile-de-Montréal, Montreal, QC, Canada
- Faculty of Arts and Sciences, Department of Psychology, University of Montreal, Montreal, QC, Canada
| | - Daphné Chylinski
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium
| | - Maxime Van Egroo
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium
| | - Justinas Narbutas
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liege, 4000, Liege, Belgium
| | - Gabriel Besson
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium
| | - Vincenzo Muto
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium
| | - Christina Schmidt
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liege, 4000, Liege, Belgium
| | - Mohamed Ali Bahri
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium
| | - Christophe Phillips
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium
| | - Eric Salmon
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liege, 4000, Liege, Belgium
- Department of Neurology, CHU Liege, 4000, Liege, Belgium
| | - Pierre Maquet
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium
- Department of Neurology, CHU Liege, 4000, Liege, Belgium
| | - Gilles Vandewalle
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium
- F.R.S.-Fonds National de la Recherche Scientifique, Brussels, Belgium
| | - Fabienne Collette
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liege, 4000, Liege, Belgium
- F.R.S.-Fonds National de la Recherche Scientifique, Brussels, Belgium
| | - Christine Bastin
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, 4000, Liège, Belgium.
- Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liege, 4000, Liege, Belgium.
- F.R.S.-Fonds National de la Recherche Scientifique, Brussels, Belgium.
- Bât. B30 GIGA CRC In Vivo Imaging - Aging and Memory, Quartier Agora, Allée du 6 Août 8, 4000, Liege, Belgium.
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Rabl M, Zullo L, Lewczuk P, Kornhuber J, Karikari TK, Blennow K, Zetterberg H, Bavato F, Quednow BB, Seifritz E, von Gunten A, Clark C, Popp J. Plasma neurofilament light, glial fibrillary acid protein, and phosphorylated tau 181 as biomarkers for neuropsychiatric symptoms and related clinical disease progression. RESEARCH SQUARE 2024:rs.3.rs-4116836. [PMID: 38562890 PMCID: PMC10984087 DOI: 10.21203/rs.3.rs-4116836/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) are common in older people, may occur early in the development of dementia disorders, and have been associated with faster cognitive decline. Here, our objectives were to investigate whether plasma levels of neurofilament light chain (NfL), glial fibrillary acid protein (GFAP), and tau phosphorylated at threonine 181 (pTau181) are associated with current NPS and predict future NPS in non-demented older people. Furthermore, we tested whether the presence of NPS combined with plasma biomarkers are useful to predict Alzheimer's disease (AD) pathology and cognitive decline. METHODS One hundred and fifty-one participants with normal cognition (n=76) or mild cognitive impairment (n=75) were examined in a longitudinal brain aging study at the Memory Centers, University Hospital of Lausanne, Switzerland. Plasma levels of NfL, GFAP, and pTau181 along with CSF biomarkers of AD pathology were measured at baseline. NPS were assessed through the Neuropsychiatric Inventory Questionnaire (NPI-Q), along with the cognitive and functional performance at baseline and follow-up (mean: 20 months). Linear regression and ROC analyses were used to address the associations of interest. RESULTS Higher GFAP levels were associated with NPS at baseline (β=0.23, p=.008). Higher NfL and GFAP levels were associated with the presence of NPS at follow-up (β=0.29, p=.007 and β=0.28, p=.007, respectively) and with an increase in the NPI-Q severity score over time (β=0.23, p=.035 and β=0.27, p=.011, respectively). Adding NPS and the plasma biomarkers to a reference model improved the prediction of future NPS (AUC 0.73 to 0.84, p=.007) and AD pathology (AUC 0.79 to 0.86, p=.006), but not of cognitive decline (AUC 0.79 to 0.84, p=.068). CONCLUSION Plasma GFAP is associated with NPS while NfL and GFAP are both associated with future NPS and NPS severity. Considering the presence of NPS along with blood-based AD-biomarkers may improve diagnosis and prediction of clinical progression of NPS and inform clinical decision-making in non-demented older people.
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Affiliation(s)
- Miriam Rabl
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich
| | - Leonardo Zullo
- Department of Psychiatry, Old Age Psychiatry Service, Lausanne University Hospital
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg
| | - Francesco Bavato
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich
| | - Erich Seifritz
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich
| | - Armin von Gunten
- Department of Psychiatry, Old Age Psychiatry Service, Lausanne University Hospital
| | - Christopher Clark
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich
| | - Julius Popp
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich
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8
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Congdon EE, Ji C, Tetlow AM, Jiang Y, Sigurdsson EM. Tau-targeting therapies for Alzheimer disease: current status and future directions. Nat Rev Neurol 2023; 19:715-736. [PMID: 37875627 PMCID: PMC10965012 DOI: 10.1038/s41582-023-00883-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/26/2023]
Abstract
Alzheimer disease (AD) is the most common cause of dementia in older individuals. AD is characterized pathologically by amyloid-β (Aβ) plaques and tau neurofibrillary tangles in the brain, with associated loss of synapses and neurons, which eventually results in dementia. Many of the early attempts to develop treatments for AD focused on Aβ, but a lack of efficacy of these treatments in terms of slowing disease progression led to a change of strategy towards targeting of tau pathology. Given that tau shows a stronger correlation with symptom severity than does Aβ, targeting of tau is more likely to be efficacious once cognitive decline begins. Anti-tau therapies initially focused on post-translational modifications, inhibition of tau aggregation and stabilization of microtubules. However, trials of many potential drugs were discontinued because of toxicity and/or lack of efficacy. Currently, the majority of tau-targeting agents in clinical trials are immunotherapies. In this Review, we provide an update on the results from the initial immunotherapy trials and an overview of new therapeutic candidates that are in clinical development, as well as considering future directions for tau-targeting therapies.
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Affiliation(s)
- Erin E Congdon
- Department of Neuroscience and Physiology, New York University Grossman School of Medicine, New York, NY, USA
- Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, USA
| | - Changyi Ji
- Department of Neuroscience and Physiology, New York University Grossman School of Medicine, New York, NY, USA
- Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, USA
| | - Amber M Tetlow
- Department of Neuroscience and Physiology, New York University Grossman School of Medicine, New York, NY, USA
- Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, USA
| | - Yixiang Jiang
- Department of Neuroscience and Physiology, New York University Grossman School of Medicine, New York, NY, USA
- Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, USA
| | - Einar M Sigurdsson
- Department of Neuroscience and Physiology, New York University Grossman School of Medicine, New York, NY, USA.
- Neuroscience Institute, New York University Grossman School of Medicine, New York, NY, USA.
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.
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Krell-Roesch J, Rakusa M, Syrjanen JA, van Harten AC, Lowe VJ, Jack CR, Kremers WK, Knopman DS, Stokin GB, Petersen RC, Vassilaki M, Geda YE. Association between CSF biomarkers of Alzheimer's disease and neuropsychiatric symptoms: Mayo Clinic Study of Aging. Alzheimers Dement 2023; 19:4498-4506. [PMID: 35142047 PMCID: PMC10433790 DOI: 10.1002/alz.12557] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/17/2021] [Accepted: 11/02/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION We examined the association between cerebrospinal fluid (CSF)-derived biomarkers of Alzheimer's disease and neuropsychiatric symptoms (NPS) in older non-demented adults. METHODS We included 784 persons (699 cognitively unimpaired, 85 with mild cognitive impairment) aged ≥ 50 years who underwent CSF amyloid beta (Aβ42), hyperphosphorylated tau 181 (p-tau), and total tau (t-tau) as well as NPS assessment using Beck Depression and Anxiety Inventories (BDI-II, BAI), and Neuropsychiatric Inventory Questionnaire (NPI-Q). RESULTS Lower CSF Aβ42, and higher t-tau/Aβ42 and p-tau/Aβ42 ratios were associated with BDI-II and BAI total scores, clinical depression (BDI-II ≥ 13), and clinical anxiety (BAI ≥ 10), as well as NPI-Q-assessed anxiety, apathy, and nighttime behavior. DISCUSSION CSF Aβ42, t-tau/Aβ42, and p-tau/Aβ42 ratios were associated with NPS in community-dwelling individuals free of dementia. If confirmed by a longitudinal cohort study, the findings have clinical relevance of taking into account the NPS status of individuals with abnormal CSF biomarkers.
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Affiliation(s)
- Janina Krell-Roesch
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Martin Rakusa
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, University Medical Centre Maribor, Maribor, Slovenia
| | - Jeremy A. Syrjanen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Argonde C. van Harten
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Walter K. Kremers
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Gorazd B. Stokin
- International Clinical Research Center, St. Anne’s Hospital, Brno, Czech Republic
| | - Ronald C. Petersen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Maria Vassilaki
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Yonas E. Geda
- Department of Neurology, Barrow Neurological Institute, Phoenix, AZ, USA
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Celis K, Zaman A, Adams LD, Gardner O, Farid R, Starks TD, Lacroix FC, Hamilton-Nelson K, Mena P, Tejada S, Laux R, Song YE, Caban-Holt A, Feliciano-Astacio B, Vance JM, Haines JL, Byrd GS, Beecham GW, Pericak-Vance MA, Cuccaro ML. Neuropsychiatric features in a multi-ethnic population with Alzheimer disease and mild cognitive impairment. Int J Geriatr Psychiatry 2023; 38:e5992. [PMID: 37655494 PMCID: PMC10518518 DOI: 10.1002/gps.5992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 08/12/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Alzheimer disease (AD) is more prevalent in African American (AA) and Hispanic White (HIW) compared to Non-Hispanic White (NHW) individuals. Similarly, neuropsychiatric symptoms (NPS) vary by population in AD. This is likely the result of both sociocultural and genetic ancestral differences. However, the impact of these NPS on AD in different groups is not well understood. METHODS Self-declared AA, HIW, and NHW individuals were ascertained as part of ongoing AD genetics studies. Participants who scored higher than 0.5 on the Clinical Dementia Rating (CDR) Scale (CDR) were included. Group similarities and differences on Neuropsychiatric Inventory Questionnaire (NPI-Q) outcomes (NPI-Q total score, NPI-Q items) were evaluated using univariate ANOVAs and post hoc comparisons after controlling for sex and CDR stage. RESULTS Our sample consisted of 498 participants (26% AA; 30% HIW; 44% NHW). Overall, NPI-Q total scores differed significantly between our groups, with HIW having the highest NPI-Q total scores, and by AD stage as measured by CDR. We found no significant difference in NPI-Q total score by sex. There were six NPI-Q items with comparable prevalence in all groups and six items that significantly differed between the groups (Anxiety, Apathy, Depression, Disinhibition, Elation, and Irritability). Further, within the HIW group, differences were found between Puerto Rican and Cuban American Hispanics across several NPI-Q items. Finally, Six NPI-Q items were more prevalent in the later stages of AD including Agitation, Appetite, Hallucinations, Irritability, Motor Disturbance, and Nighttime Behavior. CONCLUSIONS We identified differences in NPS among HIW, AA, and NHW individuals. Most striking was the high burden of NPS in HIW, particularly for mood and anxiety symptoms. We suggest that NPS differences may represent the impact of sociocultural influences on symptom presentation as well as potential genetic factors rooted in ancestral background. Given the complex relationship between AD and NPS it is crucial to discern the presence of NPS to ensure appropriate interventions.
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Affiliation(s)
- Katrina Celis
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Andrew Zaman
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Larry Deon Adams
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Olivia Gardner
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Rajabli Farid
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Takiyah D Starks
- Maya Angelou Center for Health Equity, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Faina C Lacroix
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Kara Hamilton-Nelson
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Pedro Mena
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Sergio Tejada
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Renee Laux
- Department of Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Yeunjoo E Song
- Department of Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Allison Caban-Holt
- Maya Angelou Center for Health Equity, Wake Forest University, Winston-Salem, North Carolina, USA
| | | | - Jeffery M Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
- Dr. John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jonathan L Haines
- Department of Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- Cleveland Institute for Computational Biology, Cleveland, Ohio, USA
| | - Goldie S Byrd
- Maya Angelou Center for Health Equity, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Gary W Beecham
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
- Dr. John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
- Dr. John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Michael L Cuccaro
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
- Dr. John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, Florida, USA
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11
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Krell‐Roesch J, Zaniletti I, Syrjanen JA, Kremers WK, Algeciras‐Schimnich A, Dage JL, van Harten AC, Fields JA, Knopman DS, Jack CR, Petersen RC, Vassilaki M, Geda YE. Plasma-derived biomarkers of Alzheimer's disease and neuropsychiatric symptoms: A community-based study. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12461. [PMID: 37529120 PMCID: PMC10387518 DOI: 10.1002/dad2.12461] [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: 10/31/2022] [Revised: 05/31/2023] [Accepted: 06/21/2023] [Indexed: 08/03/2023]
Abstract
INTRODUCTION We examined associations between plasma-derived biomarkers of Alzheimer's disease (AD) and neuropsychiatric symptoms (NPS) in community-dwelling older adults. METHODS Cross-sectional study involving 1005 persons ≥50 years of age (mean 74 years, 564 male, 118 cognitively impaired), who completed plasma-derived biomarker (amyloid beta 42 [Aβ42]/Aβ40, phosphorylated tau 181 [p-tau181], p-tau217, total tau [t-tau], neurofilament light [NfL]), and NPS assessment. RESULTS P-tau181 (odds ratio [OR] 2.06, 95% confidence interval [CI] 1.41-3.00, p < 0.001), p-tau217 (OR 1.70, 95% CI 1.10-2.61, p = 0.016), and t-tau (OR 1.44, 95% CI 1.08-1.92, p = 0.012) were associated with appetite change. We also found that p-tau181 and p-tau217 were associated with increased symptoms of agitation (OR 1.93, 95% CI 1.20-3.11, p = 0.007 and OR 2.04, 95% CI 1.21-3.42, p = 0.007, respectively), and disinhibition (OR 2.39, 95% CI 1.45-3.93, p = 0.001 and OR 2.30, 95% CI 1.33-3.98, p = 0.003, respectively). Aβ42/Aβ40 and NfL were not associated with NPS. CONCLUSION Higher plasma-derived p-tau181 and p-tau217 levels are associated with increased symptoms of appetite change, agitation, and disinhibition. These findings may support the validity of plasma tau biomarkers for predicting behavioral symptoms that often accompany cognitive impairment. HIGHLIGHTS We studied 1005 community-dwelling persons aged ≥ 50 yearsHigher plasma tau levels are associated with increased neuropsychiatric symptomsAβ42/Aβ40 and NfL are not associated with neuropsychiatric symptomsClinicians should treat neuropsychiatric symptoms in persons with high plasma-derived tau.
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Affiliation(s)
- Janina Krell‐Roesch
- Institute of Sports and Sports ScienceKarlsruhe Institute of TechnologyKarlsruheGermany
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Isabella Zaniletti
- Department of Quantitative Health SciencesMayo ClinicScottsdaleArizonaUSA
| | - Jeremy A. Syrjanen
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Walter K. Kremers
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | | | - Jeffrey L. Dage
- Department of Neurology and Stark Neurosciences Research InstituteIndiana University School of MedicineIndianapolisIndianaUSA
| | - Argonde C. van Harten
- Alzheimer Center, Department of NeurologyVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Julie A. Fields
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | | | | | - Ronald C. Petersen
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Maria Vassilaki
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Yonas E. Geda
- Department of Neurology and the Franke Barrow Global Neuroscience Education CenterBarrow Neurological InstitutePhoenixArizonaUSA
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12
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Spampinato MV, Ulber JL, Fayyaz H, Sullivan A, Collins HR. Neuropsychiatric Symptoms and In Vivo Alzheimer's Biomarkers in Mild Cognitive Impairment. J Alzheimers Dis 2023; 96:1827-1836. [PMID: 38007644 DOI: 10.3233/jad-220835] [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: 11/27/2023]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) carry an increased risk of progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD). There is a need to understand how to integrate NPS into the paradigm outlined in the 2018 NIA-AA Research Framework. OBJECTIVE To evaluate a prediction model of MCI-AD progression using a collection of variables, including NPS, cognitive testing, apolipoprotein E4 status (APOE4), imaging and laboratory AD biomarkers. METHODS Of 300 elderly subjects, 219 had stable MCI and 81 MCI-AD progression over a 5-year follow-up. NPS were measured using the Neuropsychiatric Inventory (NPI). A multivariate Cox Proportional Hazards Regression Analysis assessed the effects of APOE4, baseline NPI, baseline CSF amyloid-β, phosphorylated and total tau, baseline AD-signature MRI biomarker, baseline memory and executive function on MCI-AD progression. RESULTS 27% progressed to dementia (median follow-up = 43 months). NPS were found in stable MCI (62.6%) and MCI-AD converters (70.3%). The Cox model exhibited a good fit (p < 0.001), and NPS (HR = 1.033, p = 0.027), phosphorylated tau (HR = 1.011, p = 0.025), total tau (HR = 1.005, p = 0.024), AD-signature MRI biomarker (HR = 0.111, p = 0.002), executive function (HR = 0.727, p = 0.045), and memory performance (HR = 0.387, p < 0.001) were significantly associated with dementia. CONCLUSIONS NPS may inform dementia risk assessment in conjunction with cognitive testing and imaging and laboratory AD biomarkers. NPS is independently associated with the risk of MCI-dementia progression, over and beyond the contributions of CSF biomarkers.
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Affiliation(s)
- Maria Vittoria Spampinato
- Radiology and Radiological Science Department, Medical University of South Carolina, Charleston, SC, USA
| | - Jenny L Ulber
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Habiba Fayyaz
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Allison Sullivan
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Heather R Collins
- Radiology and Radiological Science Department, Medical University of South Carolina, Charleston, SC, USA
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Manca R, Jones SA, Venneri A. Macrostructural and Microstructural White Matter Alterations Are Associated with Apathy across the Clinical Alzheimer's Disease Spectrum. Brain Sci 2022; 12:1383. [PMID: 36291317 PMCID: PMC9599811 DOI: 10.3390/brainsci12101383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/04/2022] [Accepted: 10/09/2022] [Indexed: 11/30/2022] Open
Abstract
Apathy is the commonest neuropsychiatric symptom in Alzheimer's disease (AD). Previous findings suggest that apathy is caused by a communication breakdown between functional neural networks involved in motivational-affective processing. This study investigated the relationship between white matter (WM) damage and apathy in AD. Sixty-one patients with apathy (AP-PT) and 61 without apathy (NA-PT) were identified from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database and matched for cognitive status, age and education. Sixty-one cognitively unimpaired (CU) participants were also included as controls. Data on cognitive performance, cerebrospinal fluid biomarkers, brain/WM hyperintensity volumes and diffusion tensor imaging indices were compared across groups. No neurocognitive differences were found between patient groups, but the AP-PT group had more severe neuropsychiatric symptoms. Compared with CU participants, only apathetic patients had deficits on the Clock Drawing Test. AP-PT had increased WM damage, both macrostructurally, i.e., larger WM hyperintensity volume, and microstructurally, i.e., increased radial/axial diffusivity and reduced fractional anisotropy in the fornix, cingulum, anterior thalamic radiations and superior longitudinal and uncinate fasciculi. AP-PT showed signs of extensive WM damage, especially in associative tracts in the frontal lobes, fornix and cingulum. Disruption in structural connectivity might affect crucial functional inter-network communication, resulting in motivational deficits and worse cognitive decline.
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Affiliation(s)
- Riccardo Manca
- Department of Life Sciences, Brunel University London, Uxbridge UB8 3BH, UK
| | - Sarah A. Jones
- Rotherham Doncaster and South Humber NHS Foundation Trust, Rotherham DN4 8QN, UK
| | - Annalena Venneri
- Department of Life Sciences, Brunel University London, Uxbridge UB8 3BH, UK
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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14
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Pradhan LK, Sahoo PK, Chauhan S, Das SK. Recent Advances Towards Diagnosis and Therapeutic Fingerprinting for Alzheimer's Disease. J Mol Neurosci 2022; 72:1143-1165. [PMID: 35553375 DOI: 10.1007/s12031-022-02009-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/02/2022] [Indexed: 12/12/2022]
Abstract
Since the report of "a peculiar severe disease process of the cerebral cortex" by Alois Alzheimer in 1906, it was considered to be a rare condition characterized by loss of cognition, memory impairment, and pathological markers such as senile plaques or neurofibrillary tangles (NFTs). Later on, the report was published in the textbook "Psychiatrie" and the disease was named as Alzheimer's disease (AD) and was known to be the consequences of aging; however, owing to its complex etiology, there is no cure for the progressive neurodegenerative disorder. Our current understanding of the mechanisms involved in the pathogenesis of AD is still at the mechanistic level. The treatment strategies applied currently only alleviate the symptoms and co-morbidities. For instance, the available treatments such as the usage of acetylcholinesterase inhibitors and N-methyl D-aspartate antagonists have minimal impact on the disease progression and target the later aspects of the disease. The recent advancements in the last two decades have made us more clearly understand the pathophysiology of the disease which has led to the development of novel therapeutic strategies. This review gives a brief idea about the various facets of AD pathophysiology and its management through modern investigational therapies to give a new direction for development of targeted therapeutic measures.
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Affiliation(s)
- Lilesh Kumar Pradhan
- Neurobiology Laboratory, Centre for Biotechnology, Siksha 'O' Anusandhan (Deemed to Be University), Kalinga Nagar, Bhubaneswar-751003, India
| | - Pradyumna Kumar Sahoo
- Neurobiology Laboratory, Centre for Biotechnology, Siksha 'O' Anusandhan (Deemed to Be University), Kalinga Nagar, Bhubaneswar-751003, India
| | - Santosh Chauhan
- Autophagy Laboratory, Infectious Disease Biology Division, Institute of Life Sciences, Bhubaneswar-751023, India.
| | - Saroj Kumar Das
- Neurobiology Laboratory, Centre for Biotechnology, Siksha 'O' Anusandhan (Deemed to Be University), Kalinga Nagar, Bhubaneswar-751003, India.
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