1
|
Sun X, Badachhape A, Bhandari P, Chin J, Annapragada A, Tanifum E. A dual target molecular magnetic resonance imaging probe for noninvasive profiling of pathologic alpha-synuclein and microgliosis in a mouse model of Parkinson's disease. Front Neurosci 2024; 18:1428736. [PMID: 39114484 PMCID: PMC11303179 DOI: 10.3389/fnins.2024.1428736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 07/11/2024] [Indexed: 08/10/2024] Open
Abstract
The pathogenesis of Parkinson's disease (PD) is characterized by progressive deposition of alpha-synuclein (α-syn) aggregates in dopaminergic neurons and neuroinflammation. Noninvasive in vivo imaging of α-syn aggregate accumulation and neuroinflammation can elicit the underlying mechanisms involved in disease progression and facilitate the development of effective treatment as well as disease diagnosis and prognosis. Here we present a novel approach to simultaneously profile α-syn aggregation and reactive microgliosis in vivo, by targeting oligomeric α-syn in cerebrospinal fluid with nanoparticle bearing a magnetic resonance imaging (MRI), contrast payload. In this proof-of-concept report we demonstrate, in vitro, that microglia and neuroblastoma cell lines internalize agglomerates formed by cross-linking the nanoparticles with oligomeric α-syn. Delayed in vivo MRI scans following intravenous administration of the nanoparticles in the M83 α-syn transgenic mouse line show statistically significant MR signal enhancement in test mice versus controls. The in vivo data were validated by ex-vivo immunohistochemical analysis which show strong correlation between in vivo MRI signal enhancement, Lewy pathology distribution, and microglia activity in the treated brain tissue. Furthermore, neuronal and microglial cells in brain tissue from treated mice display strong cytosolic signal originating from the nanoparticles, attributed to in vivo cell uptake of nanoparticle/oligomeric α-syn agglomerates.
Collapse
Affiliation(s)
- Xianwei Sun
- Department of Radiology, Baylor College of Medicine, Houston, TX, United States
| | - Andrew Badachhape
- Department of Radiology, Baylor College of Medicine, Houston, TX, United States
| | - Prajwal Bhandari
- Department of Radiology, Baylor College of Medicine, Houston, TX, United States
| | - Jeannie Chin
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States
| | - Ananth Annapragada
- Department of Radiology, Baylor College of Medicine, Houston, TX, United States
- Department of Radiology, Texas Children’s Hospital, Houston, TX, United States
| | - Eric Tanifum
- Department of Radiology, Baylor College of Medicine, Houston, TX, United States
- Department of Radiology, Texas Children’s Hospital, Houston, TX, United States
| |
Collapse
|
2
|
Adler CH, Serrano GE, Shill HA, Driver-Dunckley E, Mehta SH, Zhang N, Glass M, Sue LI, Intorcia A, Beach TG. Symmetry of synuclein density in autopsied Parkinson's disease submandibular glands. Neurosci Lett 2024; 825:137702. [PMID: 38395191 PMCID: PMC10942751 DOI: 10.1016/j.neulet.2024.137702] [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: 01/06/2024] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Peripheral tissue biopsy in Parkinson's disease (PD) may be valuable for clinical care, biomarker validation, and as research enrollment criteria. OBJECTIVE Determine whether submandibular gland pathologic alpha-synuclein (aSyn) density is symmetrical and whether previous needle biopsy caused tissue damage. METHODS Thirty autopsy-confirmed PD cases having fixed submandibular gland tissue from one side and frozen submandibular gland tissue from the contralateral side were studied. Tissue was stained for phosphorylated aSyn and density (0-4 semiquantitative scale) was determined. Three previously biopsied cases were also assessed for tissue damage at subsequent autopsy. RESULTS Mean (SD) age was 80.9 (5.5) years and disease duration 12.5 (9.3). Submandibular gland aSyn staining had a mean score of 2.13 for both the initially fixed and the initially frozen submandibular glands. The correlation between aSyn density of the two sides was r = 0.63. Correlation of aSyn density, in the originally fixed submandibular gland, with disease duration was good (r = 0.49, p =.006). No permanent tissue damage was found in the three previously biopsied cases. CONCLUSIONS This study found good correlation between aSyn density in both submandibular glands of patients with PD and found no evidence of significant tissue damage in previously biopsied subjects.
Collapse
Affiliation(s)
- Charles H Adler
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA.
| | - Geidy E Serrano
- Civin Laboratory of Neuropathology, Banner Sun Health Research Institute, Sun City, AZ, USA
| | | | - Erika Driver-Dunckley
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Shyamal H Mehta
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Nan Zhang
- Department of Biostatistics, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Michael Glass
- Civin Laboratory of Neuropathology, Banner Sun Health Research Institute, Sun City, AZ, USA
| | - Lucia I Sue
- Civin Laboratory of Neuropathology, Banner Sun Health Research Institute, Sun City, AZ, USA
| | - Anthony Intorcia
- Civin Laboratory of Neuropathology, Banner Sun Health Research Institute, Sun City, AZ, USA
| | - Thomas G Beach
- Civin Laboratory of Neuropathology, Banner Sun Health Research Institute, Sun City, AZ, USA
| |
Collapse
|
3
|
Serrano GE, Walker J, Nelson C, Glass M, Arce R, Intorcia A, Cline MP, Nabaty N, Acuña A, Huppert Steed A, Sue LI, Belden C, Choudhury P, Reiman E, Atri A, Beach TG. Correlation of Presynaptic and Postsynaptic Proteins with Pathology in Alzheimer's Disease. Int J Mol Sci 2024; 25:3130. [PMID: 38542104 PMCID: PMC10970005 DOI: 10.3390/ijms25063130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/29/2024] [Accepted: 03/01/2024] [Indexed: 04/28/2024] Open
Abstract
Synaptic transmission is essential for nervous system function and the loss of synapses is a known major contributor to dementia. Alzheimer's disease dementia (ADD) is characterized by synaptic loss in the mesial temporal lobe and cerebral neocortex, both of which are brain areas associated with memory and cognition. The association of synaptic loss and ADD was established in the late 1980s, and it has been estimated that 30-50% of neocortical synaptic protein is lost in ADD, but there has not yet been a quantitative profiling of different synaptic proteins in different brain regions in ADD from the same individuals. Very recently, positron emission tomography (PET) imaging of synapses is being developed, accelerating the focus on the role of synaptic loss in ADD and other conditions. In this study, we quantified the densities of two synaptic proteins, the presynaptic protein Synaptosome Associated Protein 25 (SNAP25) and the postsynaptic protein postsynaptic density protein 95 (PSD95) in the human brain, using enzyme-linked immunosorbent assays (ELISA). Protein was extracted from the cingulate gyrus, hippocampus, frontal, primary visual, and entorhinal cortex from cognitively unimpaired controls, subjects with mild cognitive impairment (MCI), and subjects with dementia that have different levels of Alzheimer's pathology. SNAP25 is significantly reduced in ADD when compared to controls in the frontal cortex, visual cortex, and cingulate, while the hippocampus showed a smaller, non-significant reduction, and entorhinal cortex concentrations were not different. In contrast, all brain areas showed lower PSD95 concentrations in ADD when compared to controls without dementia, although in the hippocampus, this failed to reach significance. Interestingly, cognitively unimpaired cases with high levels of AD pathology had higher levels of both synaptic proteins in all brain regions. SNAP25 and PSD95 concentrations significantly correlated with densities of neurofibrillary tangles, amyloid plaques, and Mini Mental State Examination (MMSE) scores. Our results suggest that synaptic transmission is affected by ADD in multiple brain regions. The differences were less marked in the entorhinal cortex and the hippocampus, most likely due to a ceiling effect imposed by the very early development of neurofibrillary tangles in older people in these brain regions.
Collapse
Affiliation(s)
- Geidy E. Serrano
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA; (J.W.); (R.A.); (A.I.); (M.P.C.); (N.N.); (A.A.); (A.H.S.)
| | - Jessica Walker
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA; (J.W.); (R.A.); (A.I.); (M.P.C.); (N.N.); (A.A.); (A.H.S.)
| | - Courtney Nelson
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA; (J.W.); (R.A.); (A.I.); (M.P.C.); (N.N.); (A.A.); (A.H.S.)
| | - Michael Glass
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA; (J.W.); (R.A.); (A.I.); (M.P.C.); (N.N.); (A.A.); (A.H.S.)
| | - Richard Arce
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA; (J.W.); (R.A.); (A.I.); (M.P.C.); (N.N.); (A.A.); (A.H.S.)
| | - Anthony Intorcia
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA; (J.W.); (R.A.); (A.I.); (M.P.C.); (N.N.); (A.A.); (A.H.S.)
| | - Madison P. Cline
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA; (J.W.); (R.A.); (A.I.); (M.P.C.); (N.N.); (A.A.); (A.H.S.)
| | - Natalie Nabaty
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA; (J.W.); (R.A.); (A.I.); (M.P.C.); (N.N.); (A.A.); (A.H.S.)
| | - Amanda Acuña
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA; (J.W.); (R.A.); (A.I.); (M.P.C.); (N.N.); (A.A.); (A.H.S.)
| | - Ashton Huppert Steed
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA; (J.W.); (R.A.); (A.I.); (M.P.C.); (N.N.); (A.A.); (A.H.S.)
| | - Lucia I. Sue
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA; (J.W.); (R.A.); (A.I.); (M.P.C.); (N.N.); (A.A.); (A.H.S.)
| | - Christine Belden
- Cleo Roberts Center, Banner Sun Health Research Institute, Sun City, AZ 85351, USA (P.C.)
| | - Parichita Choudhury
- Cleo Roberts Center, Banner Sun Health Research Institute, Sun City, AZ 85351, USA (P.C.)
| | - Eric Reiman
- The Banner Alzheimer’s Institute, Phoenix, AZ 85006, USA
| | - Alireza Atri
- Cleo Roberts Center, Banner Sun Health Research Institute, Sun City, AZ 85351, USA (P.C.)
| | - Thomas G. Beach
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA; (J.W.); (R.A.); (A.I.); (M.P.C.); (N.N.); (A.A.); (A.H.S.)
| |
Collapse
|
4
|
Parra-Rivas LA, Madhivanan K, Aulston BD, Wang L, Prakashchand DD, Boyer NP, Saia-Cereda VM, Branes-Guerrero K, Pizzo DP, Bagchi P, Sundar VS, Tang Y, Das U, Scott DA, Rangamani P, Ogawa Y, Subhojit Roy. Serine-129 phosphorylation of α-synuclein is an activity-dependent trigger for physiologic protein-protein interactions and synaptic function. Neuron 2023; 111:4006-4023.e10. [PMID: 38128479 PMCID: PMC10766085 DOI: 10.1016/j.neuron.2023.11.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 10/08/2023] [Accepted: 11/19/2023] [Indexed: 12/23/2023]
Abstract
Phosphorylation of α-synuclein at the serine-129 site (α-syn Ser129P) is an established pathologic hallmark of synucleinopathies and a therapeutic target. In physiologic states, only a fraction of α-syn is phosphorylated at this site, and most studies have focused on the pathologic roles of this post-translational modification. We found that unlike wild-type (WT) α-syn, which is widely expressed throughout the brain, the overall pattern of α-syn Ser129P is restricted, suggesting intrinsic regulation. Surprisingly, preventing Ser129P blocked activity-dependent synaptic attenuation by α-syn-thought to reflect its normal function. Exploring mechanisms, we found that neuronal activity augments Ser129P, which is a trigger for protein-protein interactions that are necessary for mediating α-syn function at the synapse. AlphaFold2-driven modeling and membrane-binding simulations suggest a scenario where Ser129P induces conformational changes that facilitate interactions with binding partners. Our experiments offer a new conceptual platform for investigating the role of Ser129 in synucleinopathies, with implications for drug development.
Collapse
Affiliation(s)
- Leonardo A Parra-Rivas
- Department of Pathology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA; Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD 20815, USA
| | - Kayalvizhi Madhivanan
- Department of Pathology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA
| | - Brent D Aulston
- Department of Pathology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA
| | - Lina Wang
- Department of Pathology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA
| | - Dube Dheeraj Prakashchand
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA, USA
| | - Nicholas P Boyer
- Department of Pathology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA
| | - Veronica M Saia-Cereda
- Department of Pathology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA
| | - Kristen Branes-Guerrero
- Department of Pathology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA
| | - Donald P Pizzo
- Department of Pathology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA
| | - Pritha Bagchi
- Emory Integrated Proteomics Core, Emory University, Atlanta, GA, USA
| | - V S Sundar
- Department of Pathology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA
| | - Yong Tang
- Department of Pathology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA
| | - Utpal Das
- Department of Pathology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA; Department of Neurosciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA
| | - David A Scott
- Department of Pathology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA
| | - Padmini Rangamani
- Department of Mechanical and Aerospace Engineering, University of California, San Diego, La Jolla, CA, USA
| | - Yuki Ogawa
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Subhojit Roy
- Department of Pathology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA; Aligning Science Across Parkinson's (ASAP) Collaborative Research Network, Chevy Chase, MD 20815, USA; Department of Neurosciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA.
| |
Collapse
|
5
|
Coughlin DG, Irwin DJ. Fluid and Biopsy Based Biomarkers in Parkinson's Disease. Neurotherapeutics 2023; 20:932-954. [PMID: 37138160 PMCID: PMC10457253 DOI: 10.1007/s13311-023-01379-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 05/05/2023] Open
Abstract
Several advances in fluid and tissue-based biomarkers for use in Parkinson's disease (PD) and other synucleinopathies have been made in the last several years. While work continues on species of alpha-synuclein (aSyn) and other proteins which can be measured from spinal fluid and plasma samples, immunohistochemistry and immunofluorescence from peripheral tissue biopsies and alpha-synuclein seeding amplification assays (aSyn-SAA: including real-time quaking induced conversion (RT-QuIC) and protein misfolding cyclic amplification (PMCA)) now offer a crucial advancement in their ability to identify aSyn species in PD patients in a categorical fashion (i.e., of aSyn + vs aSyn -); to augment clinical diagnosis however, aSyn-specific assays that have quantitative relevance to pathological burden remain an unmet need. Alzheimer's disease (AD) co-pathology is commonly found postmortem in PD, especially in those who develop dementia, and dementia with Lewy bodies (DLB). Biofluid biomarkers for tau and amyloid beta species can detect AD co-pathology in PD and DLB, which does have relevance for prognosis, but further work is needed to understand the interplay of aSyn tau, amyloid beta, and other pathological changes to generate comprehensive biomarker profiles for patients in a manner translatable to clinical trial design and individualized therapies.
Collapse
Affiliation(s)
- David G Coughlin
- Department of Neurosciences, University of California San Diego, 9444 Medical Center Drive, ECOB 03-021, MCC 0886, La Jolla, CA, 92037, USA.
| | - David J Irwin
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| |
Collapse
|
6
|
Shill HA, Adler CH, Tremblay C, Beach TG. Lack of significant Lewy pathology in 237 essential tremor brains. J Neuropathol Exp Neurol 2023; 82:452-453. [PMID: 36943272 PMCID: PMC10117155 DOI: 10.1093/jnen/nlad022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Affiliation(s)
- Holly A Shill
- Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Charles H Adler
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA
| | | | - Thomas G Beach
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| |
Collapse
|
7
|
Vizcarra JC, Teich AF, Dugger BN, Gutman DA. Survey of Neuroanatomic Sampling and Staining Procedures in Alzheimer Disease Research Center Brain Banks. FREE NEUROPATHOLOGY 2023; 4:4-6. [PMID: 37347036 PMCID: PMC10280272 DOI: 10.17879/freeneuropathology-2023-4696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 03/28/2023] [Indexed: 06/23/2023]
Abstract
The collection of post-mortem brain tissue has been a core function of the Alzheimer Disease Research Center's (ADRCs) network located within the United States since its inception. Individual brain banks and centers follow detailed protocols to record, store, and manage complex datasets that include clinical data, demographics, and when post-mortem tissue is available, a detailed neuropathological assessment. Since each institution often has specific research foci, there can be variability in tissue collection and processing workflows. While published guidelines exist for select diseases, such as those put forth by the National Institute on Aging and Alzheimer Association (NIA-AA), it is of importance to denote the current practices across institutions. To this end a survey was developed and sent to United States based brain bank leaders, collecting data on brain region sampling, including anatomic landmarks used, staining (including antibodies used), as well as whole-slide-image scanning hardware. We distributed this survey to 40 brain banks and obtained a response rate of 95% (38 / 40). Most brain banks followed guidelines defined by the NIA-AA, having H&E staining in all recommended regions and targeted region-based amyloid beta, tau, and alpha-synuclein immunohistochemical staining. However, sampling consistency varied related to key anatomic landmarks/locations in select regions, such as the striatum, periventricular white matter, and parietal cortex. This study highlights the diversity and similarities amongst brain banks and discusses considerations when amalgamating data/samples across multiple centers. This survey aids in establishing benchmarks to enhance dialogues on divergent workflows in a feasible way.
Collapse
Affiliation(s)
- Juan C. Vizcarra
- Department of Biomedical Engineering, Emory University & Georgia Institute of Technology, Atlanta, USA
| | - Andrew F. Teich
- Department of Pathology and Cell Biology, Department of Neurology, The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York, USA
| | - Brittany N. Dugger
- Department of Pathology and Laboratory Medicine, University of California-Davis, Sacramento, California, USA
| | - David A. Gutman
- Department of Neuropathology, Emory University, Atlanta, Georgia, USA
| | | |
Collapse
|
8
|
Mazumder S, Bahar AY, Shepherd CE, Prasad AA. Post-mortem brain histological examination in the substantia nigra and subthalamic nucleus in Parkinson’s disease following deep brain stimulation. Front Neurosci 2022; 16:948523. [PMID: 36188463 PMCID: PMC9516394 DOI: 10.3389/fnins.2022.948523] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022] Open
Abstract
Parkinson’s disease (PD) is a progressive neurodegenerative disorder, pathologically hallmarked by the loss of dopamine neurons in the substantia nigra (SN) and alpha-synuclein aggregation. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a common target to treat the motor symptoms in PD. However, we have less understanding of the cellular changes in the STN during PD, and the impact of DBS on the STN and SN is limited. We examined cellular changes in the SN and STN in PD patients with and without STN-DBS treatment. Post-mortem brain tissues from 6 PD non-STN-DBS patients, 5 PD STN-DBS patients, and 6 age-matched controls were stained with markers for neurodegeneration (tyrosine hydroxylase, alpha-synuclein, and neuronal loss) and astrogliosis (glial fibrillary acidic protein). Changes were assessed using quantitative and semi-quantitative microscopy techniques. As expected, significant neuronal cell loss, alpha-synuclein pathology, and variable astrogliosis were observed in the SN in PD. No neuronal cell loss or astrogliosis was observed in the STN, although alpha-synuclein deposition was present in the STN in all PD cases. DBS did not alter neuronal loss, astrogliosis, or alpha-synuclein pathology in either the SN or STN. This study reports selective pathology in the STN with deposits of alpha-synuclein in the absence of significant neuronal cell loss or inflammation in PD. Despite being effective for the treatment of PD, this small post-mortem study suggests that DBS of the STN does not appear to modulate histological changes in astrogliosis or neuronal survival, suggesting that the therapeutic effects of DBS mechanism may transiently affect STN neural activity.
Collapse
Affiliation(s)
- Srestha Mazumder
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | | | - Claire E. Shepherd
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Asheeta A. Prasad
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Faculty of Medicine and Health, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
- *Correspondence: Asheeta A. Prasad,
| |
Collapse
|
9
|
Koss DJ, Erskine D, Porter A, Palmoski P, Menon H, Todd OGJ, Leite M, Attems J, Outeiro TF. Nuclear alpha-synuclein is present in the human brain and is modified in dementia with Lewy bodies. Acta Neuropathol Commun 2022; 10:98. [PMID: 35794636 PMCID: PMC9258129 DOI: 10.1186/s40478-022-01403-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 11/23/2022] Open
Abstract
Dementia with Lewy bodies (DLB) is pathologically defined by the cytoplasmic accumulation of alpha-synuclein (aSyn) within neurons in the brain. Predominately pre-synaptic, aSyn has been reported in various subcellular compartments in experimental models. Indeed, nuclear alpha-synuclein (aSynNuc) is evident in many models, the dysregulation of which is associated with altered DNA integrity, transcription and nuclear homeostasis. However, the presence of aSynNuc in human brain cells remains controversial, yet the determination of human brain aSynNuc and its pathological modification is essential for understanding synucleinopathies. Here, using a multi-disciplinary approach employing immunohistochemistry, immunoblot, and mass-spectrometry (MS), we confirm aSynNuc in post-mortem brain tissue obtained from DLB and control cases. Highly dependent on antigen retrieval methods, in optimal conditions, intra-nuclear pan and phospho-S129 positive aSyn puncta were observed in cortical neurons and non-neuronal cells in fixed brain sections and in isolated nuclear preparations in all cases examined. Furthermore, an increase in nuclear phospho-S129 positive aSyn immunoreactivity was apparent in DLB cases compared to controls, in both neuronal and non-neuronal cell types. Our initial histological investigations identified that aSynNuc is affected by epitope unmasking methods but present under optimal conditions, and this presence was confirmed by isolation of nuclei and a combined approach of immunoblotting and mass spectrometry, where aSynNuc was approximately tenfold less abundant in the nucleus than cytoplasm. Notably, direct comparison of DLB cases to aged controls identified increased pS129 and higher molecular weight species in the nuclei of DLB cases, suggesting putative pathogenic modifications to aSynNuc in DLB. In summary, using multiple approaches we provide several lines of evidence supporting the presence of aSynNuc in autoptic human brain tissue and, notably, that it is subject to putative pathogenic modifications in DLB that may contribute to the disease phenotype.
Collapse
|
10
|
Jotanovic J, Milin-Lazovic J, Alafuzoff I. Gastrointestinal Biopsy Obtained During Cancer Screening, a Biological Marker for α-Synucleinopathy? J Neuropathol Exp Neurol 2022; 81:356-362. [PMID: 35388426 PMCID: PMC9041339 DOI: 10.1093/jnen/nlac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The hallmark alteration in α-synucleinopathies, α-synuclein, is observed not only in the brain but also in the peripheral tissues, particularly in the intestine. This suggests that endoscopic biopsies performed for colon cancer screening could facilitate the assessment of α-synuclein in the gastrointestinal (GI) tract. Using immunohistochemistry for α-synuclein, we assessed whether GI biopsies could be used to confirm an ongoing α-synucleinopathy. Seventy-four subjects with cerebral α-synucleinopathy in various Braak stages with concomitant GI biopsies were available for study. In 81% of the subjects, α-synuclein was seen in the mucosal/submucosal GI biopsies. Two subjects with severe cerebral α-synucleinopathy and a long delay between biopsy and death displayed no α-synuclein pathology in the gut, and 11 subjects with sparse cerebral α-synucleinopathy displayed GI α-synuclein up to 36 years prior to death. The finding that there was no GI α-synuclein in 19% of the subjects with cerebral α-synucleinopathy, and α-synuclein was observed in the gut of 11 subjects (15%) with sparse cerebral α-synucleinopathy even many years prior to death is unexpected and jeopardizes the use of assessment of α-synuclein in the peripheral tissue for confirmation of an ongoing cerebral α-synucleinopathy.
Collapse
Affiliation(s)
- Jelena Jotanovic
- Department of Pathology, Uppsala University Hospital, Uppsala, Sweden
| | - Jelena Milin-Lazovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Irina Alafuzoff
- Department of Pathology, Uppsala University Hospital, Uppsala, Sweden.,Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| |
Collapse
|
11
|
Neuropathological substrates of cognition in Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2022; 269:177-193. [PMID: 35248194 DOI: 10.1016/bs.pbr.2022.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Autopsy validation is still required for a definitive diagnosis of Parkinson's disease (Postuma et al., 2015), where the presence of Lewy bodies and Lewy neurites, composed primarily of alpha-synuclein, are observed in stereotyped patterns throughout regions of the brainstem, limbic, and neocortical regions of the brain (Braak et al., 2003). In spite of these relatively reliable observed patterns of alpha-synuclein pathology, there is a large degree of heterogeneity in the timing and features of neuropsychiatric and cognitive dysfunction in Parkinson's disease (Fereshtehnejad et al., 2015; Selikhova et al., 2009; Williams-Gray et al., 2013). Detailed studies of their neuropathological substrates of cognitive dysfunction and their associations with a variety of in vivo biomarkers have begun to disentangle this complex relationship, but ongoing multicentered, longitudinal studies of well-characterized and autopsy validated cases are still required.
Collapse
|
12
|
Tremblay C, Serrano GE, Intorcia AJ, Curry J, Sue LI, Nelson CM, Walker JE, Glass MJ, Arce RA, Fleisher AS, Pontecorvo MJ, Atri A, Montine TJ, Chen K, Beach TG. Hemispheric Asymmetry and Atypical Lobar Progression of Alzheimer-Type Tauopathy. J Neuropathol Exp Neurol 2022; 81:158-171. [PMID: 35191506 DOI: 10.1093/jnen/nlac008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The spread of neurofibrillary tau pathology in Alzheimer disease (AD) mostly follows a stereotypical pattern of topographical progression but atypical patterns associated with interhemispheric asymmetry have been described. Because histopathological studies that used bilateral sampling are limited, this study aimed to assess interhemispheric tau pathology differences and the presence of topographically atypical cortical spreading patterns. Immunohistochemical staining for detection of tau pathology was performed in 23 regions of interest in 57 autopsy cases comparing bilateral cortical regions and hemispheres. Frequent mild (82% of cases) and occasional moderate (32%) interhemispheric density discrepancies were observed, whereas marked discrepancies were uncommon (7%) and restricted to occipital regions. Left and right hemispheric tau pathology dominance was observed with similar frequencies, except in Braak Stage VI that favored a left dominance. Interhemispheric Braak stage differences were observed in 16% of cases and were more frequent in advanced (IV-VI) versus early (I-III) stages. One atypical lobar topographical pattern in which occipital tau pathology density exceeded frontal lobe scores was identified in 4 cases favoring a left dominant asymmetry. We speculate that asymmetry and atypical topographical progression patterns may be associated with atypical AD clinical presentations and progression characteristics, which should be tested by comprehensive clinicopathological correlations.
Collapse
Affiliation(s)
- Cécilia Tremblay
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Geidy E Serrano
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Jasmine Curry
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Lucia I Sue
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Courtney M Nelson
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Jessica E Walker
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Michael J Glass
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Richard A Arce
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | - Alireza Atri
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA.,Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas J Montine
- Department of Pathology, Stanford University, Stanford, California, USA
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, Arizona, USA.,School of Mathematics and Statistics, Arizona State University, Tempe, Arizona, USA.,Department of Neurology, College of Medicine Phoenix, University of Arizona, Tucson, Arizona, USA
| | - Thomas G Beach
- From the Banner Sun Health Research Institute, Sun City, Arizona, USA
| |
Collapse
|
13
|
Kantarci K, Nedelska Z, Chen Q, Senjem ML, Schwarz CG, Gunter JL, Przybelski SA, Lesnick TG, Kremers WK, Fields JA, Graff-Radford J, Savica R, Jones D, Botha H, Knopman DS, Lowe V, Graff-Radford NR, Murray MM, Dickson DW, Reichard RR, Jack CR, Petersen RC, Ferman TJ, Boeve BF. OUP accepted manuscript. Brain Commun 2022; 4:fcac013. [PMID: 35415608 PMCID: PMC8994111 DOI: 10.1093/braincomms/fcac013] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 11/10/2021] [Accepted: 02/02/2022] [Indexed: 12/02/2022] Open
Abstract
Mild cognitive impairment with the core clinical features of dementia with Lewy bodies is recognized as a prodromal stage of dementia with Lewy bodies. Although grey matter atrophy has been demonstrated in prodromal dementia with Lewy bodies, longitudinal rates of atrophy during progression to probable dementia with Lewy bodies are unknown. We investigated the regional patterns of cross-sectional and longitudinal rates of grey matter atrophy in prodromal dementia with Lewy bodies, including those who progressed to probable dementia with Lewy bodies. Patients with mild cognitive impairment with at least one core clinical feature of dementia with Lewy bodies (mean age = 70.5; 95% male), who were enrolled in the Mayo Clinic Alzheimer’s Disease Research Center and followed for at least two clinical evaluations and MRI examinations, were included (n = 56). A cognitively unimpaired control group (n = 112) was matched 2:1 to the patients with mild cognitive impairment by age and sex. Patients either remained stable (n = 28) or progressed to probable dementia with Lewy bodies (n = 28) during a similar follow-up period and pathologic confirmation was available in a subset of cases (n = 18). Cross-sectional and longitudinal rates of grey matter atrophy were assessed using voxel-based and atlas-based region of interest analyses. At baseline, prodromal dementia with Lewy bodies was characterized by atrophy in the nucleus basalis of Meynert both in those who remained stable and those who progressed to probable dementia with Lewy bodies (P < 0.05 false discovery rate corrected). Increase in longitudinal grey matter atrophy rates were widespread, with greatest rates of atrophy observed in the enthorhinal and parahippocampal cortices, temporoparietal association cortices, thalamus and the basal ganglia, in mild cognitive impairment patients who progressed to probable dementia with Lewy bodies at follow-up (P < 0.05 false discovery rate corrected). Rates of inferior temporal atrophy were associated with greater rates of worsening on the clinical dementia rating–sum of boxes. Seventeen of the 18 (94%) autopsied cases had Lewy body disease. Results show that atrophy in the nucleus basalis of Meynert is a feature of prodromal dementia with Lewy bodies regardless of proximity to progression to probable dementia with Lewy bodies. Longitudinally, grey matter atrophy progresses in regions with significant cholinergic innervation, in alignment with clinical disease progression, with widespread and accelerated rates of atrophy in patients who progress to probable dementia with Lewy bodies. Given the prominent neurodegeneration in the cholinergic system, patients with prodromal dementia with Lewy bodies may be candidates for cholinesterase inhibitor treatment.
Collapse
Affiliation(s)
- Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Correspondence to: Kejal Kantarci, MD, MS Department of Radiology Mayo Clinic 200 First Street SW Rochester, MN 55905, USA E-mail:
| | - Zuzana Nedelska
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Charles University, Prague, Czech Republic
| | - Qin Chen
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | | | | | | | | | | | - Walter K. Kremers
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Julie A. Fields
- Department of Psychology and Psychiatry, Mayo Clinic, Rochester, MN, USA
| | | | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - David Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Val Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Melissa M. Murray
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Dennis W. Dickson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - R. Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA
| | | | | | - Tanis J. Ferman
- Department of Psychology and Psychiatry, Mayo Clinic, Jacksonville, FL, USA
| | | |
Collapse
|
14
|
Dent SE, King DP, Osterberg VR, Adams EK, Mackiewicz MR, Weissman TA, Unni VK. Phosphorylation of the aggregate-forming protein alpha-synuclein on serine-129 inhibits its DNA-bending properties. J Biol Chem 2021; 298:101552. [PMID: 34973339 PMCID: PMC8800120 DOI: 10.1016/j.jbc.2021.101552] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/18/2021] [Accepted: 12/21/2021] [Indexed: 01/08/2023] Open
Abstract
Alpha-synuclein (aSyn) is a vertebrate protein, normally found within the presynaptic nerve terminal and nucleus, which is known to form somatic and neuritic aggregates in certain neurodegenerative diseases. Disease-associated aggregates of aSyn are heavily phosphorylated at serine-129 (pSyn), while normal aSyn protein is not. Within the nucleus, aSyn can directly bind DNA, but the mechanism of binding and the potential modulatory roles of phosphorylation are poorly understood. Here we demonstrate using a combination of electrophoretic mobility shift assay and atomic force microscopy approaches that both aSyn and pSyn can bind DNA within the major groove, in a DNA length-dependent manner and with little specificity for DNA sequence. Our data are consistent with a model in which multiple aSyn molecules bind a single 300 base pair (bp) DNA molecule in such a way that stabilizes the DNA in a bent conformation. We propose that serine-129 phosphorylation decreases the ability of aSyn to both bind and bend DNA, as aSyn binds 304 bp circular DNA forced into a bent shape, but pSyn does not. Two aSyn paralogs, beta- and gamma-synuclein, also interact with DNA differently than aSyn, and do not stabilize similar DNA conformations. Our work suggests that reductions in aSyn's ability to bind and bend DNA induced by serine-129 phosphorylation may be important for modulating aSyn's known roles in DNA metabolism, including the regulation of transcription and DNA repair.
Collapse
Affiliation(s)
- Sydney E Dent
- Jungers Center for Neurosciences Research, Department of Neurology, Oregon Health & Science University, Portland, Oregon, 97239, USA
| | - Dennisha P King
- Jungers Center for Neurosciences Research, Department of Neurology, Oregon Health & Science University, Portland, Oregon, 97239, USA
| | - Valerie R Osterberg
- Jungers Center for Neurosciences Research, Department of Neurology, Oregon Health & Science University, Portland, Oregon, 97239, USA
| | - Eleanor K Adams
- Department of Chemistry, Portland State University, Portland, Oregon, 97239, USA
| | - Marilyn R Mackiewicz
- Department of Chemistry, Portland State University, Portland, Oregon, 97239, USA
| | - Tamily A Weissman
- Department of Biology, Lewis & Clark College, Portland, Oregon, 97219, USA
| | - Vivek K Unni
- Jungers Center for Neurosciences Research, Department of Neurology, Oregon Health & Science University, Portland, Oregon, 97239, USA; OHSU Parkinson Center, Oregon Health & Science University, Portland, Oregon, 97239, USA.
| |
Collapse
|
15
|
Adler CH, Beach TG, Zhang N, Shill HA, Driver-Dunckley E, Mehta SH, Atri A, Caviness JN, Serrano G, Shprecher DR, Sue LI, Belden CM. Clinical Diagnostic Accuracy of Early/Advanced Parkinson Disease: An Updated Clinicopathologic Study. Neurol Clin Pract 2021; 11:e414-e421. [PMID: 34484939 DOI: 10.1212/cpj.0000000000001016] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/01/2020] [Indexed: 11/15/2022]
Abstract
Objective To update data for diagnostic accuracy of a clinical diagnosis of Parkinson disease (PD) using neuropathologic diagnosis as the gold standard. Methods Data from the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND) were used to determine the predictive value of a clinical PD diagnosis. Two clinical diagnostic confidence levels were used, possible PD (PossPD, never treated or not responsive) and probable PD (ProbPD, 2/3 cardinal clinical signs and responsive to dopaminergic medications). Neuropathologic diagnosis was the gold standard. Results Based on the first visit to AZSAND, 15/54 (27.8%) PossPD participants and 138/163 (84.7%) ProbPD participants had confirmed PD. PD was confirmed in 24/34 (70.6%) ProbPD with <5 years and 114/128 (89.1%) with ≥5 years disease duration. Using the consensus final clinical diagnosis following death, 161/187 (86.1%) ProbPD had neuropathologically confirmed PD. Diagnostic accuracy for ProbPD improved if included motor fluctuations, dyskinesias, and hyposmia, and hyposmia for PossPD. Conclusions This updated study confirmed lower clinical diagnostic accuracy for elderly, untreated or poorly responsive PossPD participants and for ProbPD with <5 years of disease duration, even when medication responsive. Caution continues to be needed when interpreting clinical studies of PD, especially studies of early disease, that do not have autopsy confirmation. Classification of Evidence This study provides Class II evidence that a clinical diagnosis of ProbPD at the first visit identifies participants who will have pathologically confirmed PD with a sensitivity of 82.6% and a specificity of 86.0%.
Collapse
Affiliation(s)
- Charles H Adler
- Parkinson's Disease and Movement Disorders Center (CHA, EDD, SHM), Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Civin Laboratory for Neuropathology (TGB, GS, LIS), Banner Sun Health Research Institute, Sun City, AZ; Department of Biostatistics (NZ), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Barrow Neurologic Institute (HAS), Phoenix, AZ; Cleo Roberts Center (AA, DRS, CMB), Banner Sun Health Research Institute, Sun City, AZ; and Center for Brain/Mind Medicine (AA), Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Thomas G Beach
- Parkinson's Disease and Movement Disorders Center (CHA, EDD, SHM), Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Civin Laboratory for Neuropathology (TGB, GS, LIS), Banner Sun Health Research Institute, Sun City, AZ; Department of Biostatistics (NZ), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Barrow Neurologic Institute (HAS), Phoenix, AZ; Cleo Roberts Center (AA, DRS, CMB), Banner Sun Health Research Institute, Sun City, AZ; and Center for Brain/Mind Medicine (AA), Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Nan Zhang
- Parkinson's Disease and Movement Disorders Center (CHA, EDD, SHM), Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Civin Laboratory for Neuropathology (TGB, GS, LIS), Banner Sun Health Research Institute, Sun City, AZ; Department of Biostatistics (NZ), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Barrow Neurologic Institute (HAS), Phoenix, AZ; Cleo Roberts Center (AA, DRS, CMB), Banner Sun Health Research Institute, Sun City, AZ; and Center for Brain/Mind Medicine (AA), Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Holly A Shill
- Parkinson's Disease and Movement Disorders Center (CHA, EDD, SHM), Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Civin Laboratory for Neuropathology (TGB, GS, LIS), Banner Sun Health Research Institute, Sun City, AZ; Department of Biostatistics (NZ), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Barrow Neurologic Institute (HAS), Phoenix, AZ; Cleo Roberts Center (AA, DRS, CMB), Banner Sun Health Research Institute, Sun City, AZ; and Center for Brain/Mind Medicine (AA), Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Erika Driver-Dunckley
- Parkinson's Disease and Movement Disorders Center (CHA, EDD, SHM), Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Civin Laboratory for Neuropathology (TGB, GS, LIS), Banner Sun Health Research Institute, Sun City, AZ; Department of Biostatistics (NZ), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Barrow Neurologic Institute (HAS), Phoenix, AZ; Cleo Roberts Center (AA, DRS, CMB), Banner Sun Health Research Institute, Sun City, AZ; and Center for Brain/Mind Medicine (AA), Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Shyamal H Mehta
- Parkinson's Disease and Movement Disorders Center (CHA, EDD, SHM), Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Civin Laboratory for Neuropathology (TGB, GS, LIS), Banner Sun Health Research Institute, Sun City, AZ; Department of Biostatistics (NZ), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Barrow Neurologic Institute (HAS), Phoenix, AZ; Cleo Roberts Center (AA, DRS, CMB), Banner Sun Health Research Institute, Sun City, AZ; and Center for Brain/Mind Medicine (AA), Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Alireza Atri
- Parkinson's Disease and Movement Disorders Center (CHA, EDD, SHM), Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Civin Laboratory for Neuropathology (TGB, GS, LIS), Banner Sun Health Research Institute, Sun City, AZ; Department of Biostatistics (NZ), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Barrow Neurologic Institute (HAS), Phoenix, AZ; Cleo Roberts Center (AA, DRS, CMB), Banner Sun Health Research Institute, Sun City, AZ; and Center for Brain/Mind Medicine (AA), Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - John N Caviness
- Parkinson's Disease and Movement Disorders Center (CHA, EDD, SHM), Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Civin Laboratory for Neuropathology (TGB, GS, LIS), Banner Sun Health Research Institute, Sun City, AZ; Department of Biostatistics (NZ), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Barrow Neurologic Institute (HAS), Phoenix, AZ; Cleo Roberts Center (AA, DRS, CMB), Banner Sun Health Research Institute, Sun City, AZ; and Center for Brain/Mind Medicine (AA), Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Geidy Serrano
- Parkinson's Disease and Movement Disorders Center (CHA, EDD, SHM), Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Civin Laboratory for Neuropathology (TGB, GS, LIS), Banner Sun Health Research Institute, Sun City, AZ; Department of Biostatistics (NZ), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Barrow Neurologic Institute (HAS), Phoenix, AZ; Cleo Roberts Center (AA, DRS, CMB), Banner Sun Health Research Institute, Sun City, AZ; and Center for Brain/Mind Medicine (AA), Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - David R Shprecher
- Parkinson's Disease and Movement Disorders Center (CHA, EDD, SHM), Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Civin Laboratory for Neuropathology (TGB, GS, LIS), Banner Sun Health Research Institute, Sun City, AZ; Department of Biostatistics (NZ), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Barrow Neurologic Institute (HAS), Phoenix, AZ; Cleo Roberts Center (AA, DRS, CMB), Banner Sun Health Research Institute, Sun City, AZ; and Center for Brain/Mind Medicine (AA), Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Lucia I Sue
- Parkinson's Disease and Movement Disorders Center (CHA, EDD, SHM), Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Civin Laboratory for Neuropathology (TGB, GS, LIS), Banner Sun Health Research Institute, Sun City, AZ; Department of Biostatistics (NZ), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Barrow Neurologic Institute (HAS), Phoenix, AZ; Cleo Roberts Center (AA, DRS, CMB), Banner Sun Health Research Institute, Sun City, AZ; and Center for Brain/Mind Medicine (AA), Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Christine M Belden
- Parkinson's Disease and Movement Disorders Center (CHA, EDD, SHM), Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Civin Laboratory for Neuropathology (TGB, GS, LIS), Banner Sun Health Research Institute, Sun City, AZ; Department of Biostatistics (NZ), Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale; Barrow Neurologic Institute (HAS), Phoenix, AZ; Cleo Roberts Center (AA, DRS, CMB), Banner Sun Health Research Institute, Sun City, AZ; and Center for Brain/Mind Medicine (AA), Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| |
Collapse
|
16
|
Beach TG, Adler CH, Sue LI, Shill HA, Driver-Dunckley E, Mehta SH, Intorcia AJ, Glass MJ, Walker JE, Arce R, Nelson CM, Serrano GE. Vagus Nerve and Stomach Synucleinopathy in Parkinson's Disease, Incidental Lewy Body Disease, and Normal Elderly Subjects: Evidence Against the "Body-First" Hypothesis. JOURNAL OF PARKINSONS DISEASE 2021; 11:1833-1843. [PMID: 34151862 PMCID: PMC10082635 DOI: 10.3233/jpd-212733] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Braak and others have proposed that Lewy-type α-synucleinopathy in Parkinson's disease (PD) may arise from an exogenous pathogen that passes across the gastric mucosa and then is retrogradely transported up the vagus nerve to the medulla. OBJECTIVE We tested this hypothesis by immunohistochemically staining, with a method specific for p-serine 129 α-synuclein (pSyn), stomach and vagus nerve tissue from an autopsy series of 111 normal elderly subjects, 33 with incidental Lewy body disease (ILBD) and 53 with PD. METHODS Vagus nerve samples were taken adjacent to the carotid artery in the neck. Stomach samples were taken from the gastric body, midway along the greater curvature. Formalin-fixed paraffin-embedded sections were immunohistochemically stained for pSyn, shown to be highly specific and sensitive for α-synuclein pathology. RESULTS Median disease duration for the PD group was 13 years. In the vagus nerve none of the 111 normal subjects had pSyn in the vagus, while 12/26 ILBD (46%) and 32/36 PD (89%) subjects were pSyn-positive. In the stomach none of the 102 normal subjects had pSyn while 5/30 (17%) ILBD and 42/52 (81%) of PD subjects were pSyn-positive. CONCLUSION As there was no pSyn in the vagus nerve or stomach of subjects without brain pSyn, these results support initiation of pSyn in the brain. The presence of pSyn in the vagus nerve and stomach of a subset of ILBD cases indicates that synucleinopathy within the peripheral nervous system may occur, within a subset of individuals, at preclinical stages of Lewy body disease.
Collapse
Affiliation(s)
| | - Charles H Adler
- Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Lucia I Sue
- Banner Sun Health Research Institute, Sun City, AZ, USA
| | | | | | - Shyamal H Mehta
- Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | | | | | | | - Richard Arce
- Banner Sun Health Research Institute, Sun City, AZ, USA
| | | | | |
Collapse
|
17
|
Alpha-synuclein increases in rodent and human spinal cord injury and promotes inflammation and tissue loss. Sci Rep 2021; 11:11720. [PMID: 34083630 PMCID: PMC8175699 DOI: 10.1038/s41598-021-91116-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/17/2021] [Indexed: 12/27/2022] Open
Abstract
Synucleinopathies are neurodegenerative diseases in which α-synuclein protein accumulates in neurons and glia. In these diseases, α-synuclein forms dense intracellular aggregates that are disease hallmarks and actively contribute to tissue pathology. Interestingly, many pathological mechanisms, including iron accumulation and lipid peroxidation, are shared between classical synucleinopathies such as Alzheimer’s disease, Parkinson’s disease and traumatic spinal cord injury (SCI). However, to date, no studies have determined if α-synuclein accumulation occurs after human SCI. To examine this, cross-sections from injured and non-injured human spinal cords were immunolabeled for α-synuclein. This showed robust α-synuclein accumulation in profiles resembling axons and astrocytes in tissue surrounding the injury, revealing that α-synuclein markedly aggregates in traumatically injured human spinal cords. We also detected significant iron deposition in the injury site, a known catalyst for α-synuclein aggregation. Next a rodent SCI model mimicking the histological features of human SCI revealed aggregates and structurally altered monomers of α-synuclein are present after SCI. To determine if α-synuclein exacerbates SCI pathology, α-synuclein knockout mice were tested. Compared to wild type mice, α-synuclein knockout mice had significantly more spared axons and neurons and lower pro-inflammatory mediators, macrophage accumulation, and iron deposition in the injured spinal cord. Interestingly, locomotor analysis revealed that α-synuclein may be essential for dopamine-mediated hindlimb function after SCI. Collectively, the marked upregulation and long-lasting accumulation of α-synuclein and iron suggests that SCI may fit within the family of synucleinopathies and offer new therapeutic targets for promoting neuron preservation and improving function after spinal trauma.
Collapse
|
18
|
Beach T, Chahine LM, Adler CH, Mollenhauer B. Author Response: In Vivo Distribution of α-Synuclein in Multiple Tissues and Biofluids in Parkinson Disease. Neurology 2021; 96:965-967. [PMID: 34001544 DOI: 10.1212/wnl.0000000000011938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
19
|
George S, Tyson T, Rey NL, Sheridan R, Peelaerts W, Becker K, Schulz E, Meyerdirk L, Burmeister AR, von Linstow CU, Steiner JA, Galvis MLE, Ma J, Pospisilik JA, Labrie V, Brundin L, Brundin P. T Cells Limit Accumulation of Aggregate Pathology Following Intrastriatal Injection of α-Synuclein Fibrils. JOURNAL OF PARKINSONS DISEASE 2021; 11:585-603. [PMID: 33579871 PMCID: PMC8150548 DOI: 10.3233/jpd-202351] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND α-Synuclein (α-syn) is the predominant protein in Lewy-body inclusions, which are pathological hallmarks of α-synucleinopathies, such as Parkinson's disease (PD) and multiple system atrophy (MSA). Other hallmarks include activation of microglia, elevation of pro-inflammatory cytokines, as well as the activation of T and B cells. These immune changes point towards a dysregulation of both the innate and the adaptive immune system. T cells have been shown to recognize epitopes derived from α-syn and altered populations of T cells have been found in PD and MSA patients, providing evidence that these cells can be key to the pathogenesis of the disease.ObjectiveTo study the role of the adaptive immune system with respect to α-syn pathology. METHODS We injected human α-syn preformed fibrils (PFFs) into the striatum of immunocompromised mice (NSG) and assessed accumulation of phosphorylated α-syn pathology, proteinase K-resistant α-syn pathology and microgliosis in the striatum, substantia nigra and frontal cortex. We also assessed the impact of adoptive transfer of naïve T and B cells into PFF-injected immunocompromised mice. RESULTS Compared to wildtype mice, NSG mice had an 8-fold increase in phosphorylated α-syn pathology in the substantia nigra. Reconstituting the T cell population decreased the accumulation of phosphorylated α-syn pathology and resulted in persistent microgliosis in the striatum when compared to non-transplanted mice. CONCLUSION Our work provides evidence that T cells play a role in the pathogenesis of experimental α-synucleinopathy.
Collapse
Affiliation(s)
- Sonia George
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Trevor Tyson
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Nolwen L Rey
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA.,Laboratory of Neurodegenerative Diseases, Institut François Jacob, MIRCen, CEA, CNRS, Fontenay-aux-Roses, France
| | - Rachael Sheridan
- Flow Cytometry Core Facility, Van Andel Institute, Grand Rapids, MI, USA
| | - Wouter Peelaerts
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Katelyn Becker
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Emily Schulz
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Lindsay Meyerdirk
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | - Amanda R Burmeister
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | | | - Jennifer A Steiner
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | | | - Jiyan Ma
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA
| | | | - Viviane Labrie
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA.,Michigan State University - College of Human Medicine, Department of Psychiatry, Grand Rapids, MI, USA
| | - Lena Brundin
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA.,Michigan State University - College of Human Medicine, Department of Psychiatry, Grand Rapids, MI, USA
| | - Patrik Brundin
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI, USA.,Michigan State University - College of Human Medicine, Department of Psychiatry, Grand Rapids, MI, USA
| |
Collapse
|
20
|
Vitic Z, Safory H, Jovanovic VM, Sarusi Y, Stavsky A, Kahn J, Kuzmina A, Toker L, Gitler D, Taube R, Friedel RH, Engelender S, Brodski C. BMP5/7 protect dopaminergic neurons in an α-synuclein mouse model of Parkinson's disease. Brain 2021; 144:e15. [PMID: 33253359 PMCID: PMC7940172 DOI: 10.1093/brain/awaa368] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Zagorka Vitic
- Department of Physiology and Cell Biology, Zlotowski Center for Neuroscience, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Be'er Sheva, Israel
| | - Hazem Safory
- Department of Biochemistry, The B. Rappaport Faculty of Medicine and Institute of Medical Research, Technion-Israel Institute of Technology, Haifa 31096, Israel
| | - Vukasin M Jovanovic
- National Center for Advancing Translational Sciences (NCATS), Stem Cell Translation Laboratory (SCTL), National Institutes of Health (NIH), Rockville, MD 20850, USA
| | - Yael Sarusi
- Department of Physiology and Cell Biology, Zlotowski Center for Neuroscience, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Be'er Sheva, Israel
| | - Alexandra Stavsky
- Department of Physiology and Cell Biology, Zlotowski Center for Neuroscience, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Be'er Sheva, Israel
| | - Joy Kahn
- Department of Physiology and Cell Biology, Zlotowski Center for Neuroscience, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Be'er Sheva, Israel
| | - Alona Kuzmina
- Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Be'er Sheva, Israel
| | - Lilah Toker
- Neuro-SysMed Center of Excellence for Clinical Research in Neurological Diseases, Department of Neurology, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Clinical Medicine, University of Bergen, 5007 Bergen, Norway
| | - Daniel Gitler
- Department of Physiology and Cell Biology, Zlotowski Center for Neuroscience, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Be'er Sheva, Israel
| | - Ran Taube
- Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Be'er Sheva, Israel
| | - Roland H Friedel
- Departments of Neuroscience and Neurosurgery, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Simone Engelender
- Department of Biochemistry, The B. Rappaport Faculty of Medicine and Institute of Medical Research, Technion-Israel Institute of Technology, Haifa 31096, Israel
| | - Claude Brodski
- Department of Physiology and Cell Biology, Zlotowski Center for Neuroscience, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Be'er Sheva, Israel
| |
Collapse
|
21
|
Weston LJ, Stackhouse TL, Spinelli KJ, Boutros SW, Rose EP, Osterberg VR, Luk KC, Raber J, Weissman TA, Unni VK. Genetic deletion of Polo-like kinase 2 reduces alpha-synuclein serine-129 phosphorylation in presynaptic terminals but not Lewy bodies. J Biol Chem 2021; 296:100273. [PMID: 33428941 PMCID: PMC7948797 DOI: 10.1016/j.jbc.2021.100273] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 12/29/2022] Open
Abstract
Phosphorylation of alpha-synuclein at serine-129 is an important marker of pathologically relevant, aggregated forms of the protein in several important human diseases, including Parkinson's disease, Dementia with Lewy bodies, and Multiple system atrophy. Although several kinases have been shown to be capable of phosphorylating alpha-synuclein in various model systems, the identity of the kinase that phosphorylates alpha-synuclein in the Lewy body remains unknown. One member of the Polo-like kinase family, PLK2, is a strong candidate for being the Lewy body kinase. To examine this possibility, we have used a combination of approaches, including biochemical, immunohistochemical, and in vivo multiphoton imaging techniques to study the consequences of PLK2 genetic deletion on alpha-synuclein phosphorylation in both the presynaptic terminal and preformed fibril-induced Lewy body pathology in mouse cortex. We find that PLK2 deletion reduces presynaptic terminal alpha-synuclein serine-129 phosphorylation, but has no effect on Lewy body phosphorylation levels. Serine-129 mutation to the phosphomimetic alanine or the unphosphorylatable analog aspartate does not change the rate of cell death of Lewy inclusion-bearing neurons in our in vivo multiphoton imaging paradigm, but PLK2 deletion does slow the rate of neuronal death. Our data indicate that inhibition of PLK2 represents a promising avenue for developing new therapeutics, but that the mechanism of neuroprotection by PLK2 inhibition is not likely due to reducing alpha-synuclein serine-129 phosphorylation and that the true Lewy body kinase still awaits discovery.
Collapse
Affiliation(s)
- Leah J Weston
- Department of Neurology & Jungers Center for Neurosciences Research, Oregon Health & Science University, Portland, Oregon, USA
| | - Teresa L Stackhouse
- Department of Neurology & Jungers Center for Neurosciences Research, Oregon Health & Science University, Portland, Oregon, USA
| | - Kateri J Spinelli
- Department of Neurology & Jungers Center for Neurosciences Research, Oregon Health & Science University, Portland, Oregon, USA
| | - Sydney W Boutros
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, USA
| | - Elizabeth P Rose
- Department of Neurology & Jungers Center for Neurosciences Research, Oregon Health & Science University, Portland, Oregon, USA; Neuroscience Graduate Program, Vollum Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Valerie R Osterberg
- Department of Neurology & Jungers Center for Neurosciences Research, Oregon Health & Science University, Portland, Oregon, USA
| | - Kelvin C Luk
- Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jacob Raber
- Departments of Behavioral Neuroscience, Neurology, and Radiation Medicine and Division of Neuroscience, ONPRC, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Vivek K Unni
- Department of Neurology & Jungers Center for Neurosciences Research, Oregon Health & Science University, Portland, Oregon, USA; OHSU Parkinson Center, Oregon Health & Science University, Portland, Oregon, USA.
| |
Collapse
|
22
|
Trejo-Lopez JA, Sorrentino ZA, Riffe CJ, Prokop S, Dickson DW, Yachnis AT, Giasson BI. Generation and Characterization of Novel Monoclonal Antibodies Targeting p62/sequestosome-1 Across Human Neurodegenerative Diseases. J Neuropathol Exp Neurol 2020; 79:407-418. [PMID: 32106300 DOI: 10.1093/jnen/nlaa007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 01/25/2020] [Indexed: 12/17/2022] Open
Abstract
Human neurodegenerative diseases can be characterized as disorders of protein aggregation. As a key player in cellular autophagy and the ubiquitin proteasome system, p62 may represent an effective immunohistochemical target, as well as mechanistic operator, across neurodegenerative proteinopathies. In this study, 2 novel mouse-derived monoclonal antibodies 5G3 and 2A5 raised against residues 360-380 of human p62/sequestosome-1 were characterized via immunohistochemical application upon human tissues derived from cases of C9orf72-expansion spectrum diseases, Alzheimer disease, progressive supranuclear palsy, Lewy body disease, and multiple system atrophy. 5G3 and 2A5 reliably highlighted neuronal dipeptide repeat, tau, and α-synuclein inclusions in a distribution similar to a polyclonal antibody to p62, phospho-tau antibodies 7F2 and AT8, and phospho-α-synuclein antibody 81A. However, antibodies 5G3 and 2A5 consistently stained less neuropil structures, such as tau neuropil threads and Lewy neurites, while 2A5 marked fewer glial inclusions in progressive supranuclear palsy. Both 5G3 and 2A5 revealed incidental astrocytic tau immunoreactivity in cases of Alzheimer disease and Lewy body disease with resolution superior to 7F2. Through their unique ability to highlight specific types of pathological deposits in neurodegenerative brain tissue, these novel monoclonal p62 antibodies may provide utility in both research and diagnostic efforts.
Collapse
Affiliation(s)
- Jorge A Trejo-Lopez
- Department of Pathology, Immunology, and Laboratory Medicine.,Center for Translational Research in Neurodegenerative Disease
| | - Zachary A Sorrentino
- Center for Translational Research in Neurodegenerative Disease.,Department of Neuroscience
| | - Cara J Riffe
- Center for Translational Research in Neurodegenerative Disease.,Department of Neuroscience
| | - Stefan Prokop
- Department of Pathology, Immunology, and Laboratory Medicine.,Center for Translational Research in Neurodegenerative Disease.,McKnight Brain Institute.,Fixel Institute for Neurological Diseases, University of Florida, Gainesville, Florida
| | | | | | - Benoit I Giasson
- Center for Translational Research in Neurodegenerative Disease.,Department of Neuroscience.,McKnight Brain Institute
| |
Collapse
|
23
|
Hanna Al-Shaikh FS, Duara R, Crook JE, Lesser ER, Schaeverbeke J, Hinkle KM, Ross OA, Ertekin-Taner N, Pedraza O, Dickson DW, Graff-Radford NR, Murray ME. Selective Vulnerability of the Nucleus Basalis of Meynert Among Neuropathologic Subtypes of Alzheimer Disease. JAMA Neurol 2020; 77:225-233. [PMID: 31657834 PMCID: PMC6820048 DOI: 10.1001/jamaneurol.2019.3606] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Importance Corticolimbic patterns of neurofibrillary tangle (NFT) accumulation define neuropathologic subtypes of Alzheimer disease (AD), which underlie the clinical heterogeneity observed antemortem. The cholinergic system, which is the target of acetylcholinesterase inhibitor therapy, is selectively vulnerable in AD. Objective To investigate the major source of cholinergic innervation, the nucleus basalis of Meynert (nbM), in order to determine whether there is differential involvement of NFT accumulation or neuronal loss among AD subtypes. Design, Setting, and Participants In this cross-sectional study, retrospective abstraction of clinical records and quantitative assessment of NFTs and neuron counts in the nbM was completed in January 2019 at the Mayo Clinic using the Florida Autopsied Multi-Ethnic (FLAME) cohort, which had been accessioned from 1991 until 2015. The FLAME cohort is derived from the deeded autopsy program funded throughout the State of Florida's memory disorder clinic referral services. Of the 2809 consecutively accessioned FLAME cohort, 1464 were identified as neuropathologically diagnosed AD cases and nondemented normal controls available for clinicopathologic assessment. Quantification of NFTs and neuronal density in the anterior nbM was performed blinded to neuropathologic groupings. Main Outcomes and Measures Demographic and clinical characteristics, including cognitive decline measured using the Mini-Mental State Examination score (range, 0-30), were evaluated. The anterior nbM was investigated quantitatively for neuronal loss and NFT accumulation. Results In total, 1361 AD subtypes and 103 nondemented controls were assessed. The median (interquartile range) age at death was 72 (66-80) years in hippocampal sparing (HpSp) AD, 81 (76-86) years in typical AD, and 86 (82-90) years in limbic predominant AD. The median (interquartile range) count per 0.125 mm2 of thioflavin S-positive NFTs was highest in the nbM of HpSp AD (14 [9-20]; n = 163), lower in typical AD (10 [5-16]; n = 937), and lowest in limbic predominant AD (8 [5-11], n = 163) (P < .001). The median (interquartile range) neuronal density per millimeters squared was lowest in HpSp AD cases (22 [17-28]; n = 148), higher in typical AD (25 [19-30]; n = 727), and highest in limbic predominant AD (26 [19-32]; n = 127) (P = .002). Multivariable regression modeling of clinical and demographic variables was performed to assess overlap in NFT accumulation and neuronal density differences among AD subtypes. Higher NFT accumulation in the nbM was associated with younger age at onset for HpSp AD (β, -1.5; 95% CI, -2.9 to -0.15; P = .03) and typical AD (β, -3.2; 95% CI, -3.9 to -2.4; P < .001). In addition, higher NFT accumulation in the nbM of typical AD cases was associated with female sex (β, 2.5; 95% CI, 1.4-3.5; P < .001), apolipoprotein E ε4 allele (β, 1.3; 95% CI, 0.15-2.5; P = .03), and lower Mini-Mental State Examination scores (β, -1.8; 95% CI, -3.2 to -0.31; P = .02). Demographic and clinical progression variables were not associated with NFT accumulation in the nbM of limbic predominant AD cases. Conclusions and Relevance These data provide supportive evidence that NFT accumulation in the nbM may underlie more widespread and severe cholinergic deficits in young-onset AD, in particular in patients with HpSp AD. Moreover, these findings underscore the importance of considering age at onset, sex, and apolipoprotein E genotype when assessing outcomes in AD.
Collapse
Affiliation(s)
| | - Ranjan Duara
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, Florida
| | - Julia E Crook
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, Florida
| | - Elizabeth R Lesser
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, Florida
| | | | - Kelly M Hinkle
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
| | - Owen A Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
| | - Nilufer Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida.,Department of Neurology, Mayo Clinic, Jacksonville, Florida
| | - Otto Pedraza
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida
| | | | | | | |
Collapse
|
24
|
Rouaud T, Corbillé AG, Leclair-Visonneau L, de Guilhem de Lataillade A, Lionnet A, Preterre C, Damier P, Derkinderen P. Pathophysiology of Parkinson's disease: Mitochondria, alpha-synuclein and much more…. Rev Neurol (Paris) 2020; 177:260-271. [PMID: 33032797 DOI: 10.1016/j.neurol.2020.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 12/21/2022]
Abstract
Parkinson's disease (PD) is a complex, age-related, neurodegenerative disease whose pathogenesis remains incompletely understood. Here, we give an overview of the progress that has been made over the past four decades in our understanding of this disorder. We review the role of mitochondria, environmental toxicants, alpha-synuclein and neuroinflammation in the development of PD. We also discuss more recent data from genetics, which strongly support the endosomal-lysosomal pathways and mitophagy as being central to PD. Finally, we discuss the emerging role of the gut-brain axis as a modulator of PD progression. This article is intended to provide a comprehensive, general and practical review of PD pathogenesis for the general neurologist.
Collapse
Affiliation(s)
- T Rouaud
- CHU de Nantes, Centre expert Parkinson, Department of Neurology, 44093 Nantes, France.
| | - A-G Corbillé
- CHU de Nantes, Centre expert Parkinson, Department of Neurology, 44093 Nantes, France.
| | | | | | - A Lionnet
- CHU de Nantes, Centre expert Parkinson, Department of Neurology, 44093 Nantes, France.
| | - C Preterre
- CHU de Nantes, Centre expert Parkinson, Department of Neurology, 44093 Nantes, France.
| | - P Damier
- CHU de Nantes, Centre expert Parkinson, Department of Neurology, 44093 Nantes, France.
| | - P Derkinderen
- CHU de Nantes, Centre expert Parkinson, Department of Neurology, 44093 Nantes, France.
| |
Collapse
|
25
|
Wang N, Garcia J, Freeman R, Gibbons CH. Phosphorylated Alpha-Synuclein Within Cutaneous Autonomic Nerves of Patients With Parkinson's Disease: The Implications of Sample Thickness on Results. J Histochem Cytochem 2020; 68:669-678. [PMID: 32921251 DOI: 10.1369/0022155420960250] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The detection of cutaneous phosphorylated alpha-synuclein (P-syn) in patients with Parkinson's disease (PD) has ranged from 30% to 100% across different studies. We hypothesize that part of the variability in P-syn detection is due to methodological differences using sections of different tissue thickness. Three skin biopsies were obtained from 29 individuals with PD and 21 controls. Tissues were cut into 10-, 20-, and 50-µm-thick sections and double-stained with protein gene product (PGP) 9.5 and P-syn. We quantified the deposition of P-syn with and without PGP 9.5 in sweat glands, pilomotor muscle, and blood vessels using confocal digital images of autonomic structures. Overall, the P-syn-positive rates with PGP 9.5 colocalization in subjects with PD were 100% using 50 µm sections, 90% using 20 µm sections, and 73% using 10 µm sections with 100% specificity. (No P-syn was detected within control subjects.) Without PGP 9.5, colocalization of the P-syn-positive rates was 100% for all samples, but specificity dropped below 70%. In this study, double-immunostained 50 µm skin biopsy tissue sections are superior to 20 and 10 µm tissue sections at detecting P-syn in subjects with PD. The increased sensitivity is likely secondary to a combination of greater volume of tissue analyzed and improved visualization of nerve fiber architecture.
Collapse
Affiliation(s)
- Ningshan Wang
- Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Jennifer Garcia
- Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Roy Freeman
- Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Christopher H Gibbons
- Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| |
Collapse
|
26
|
Abstract
BACKGROUND Gastrointestinal (GI) symptoms are common in Parkinson disease (PD), often preceding neurological manifestations; however, early diagnostic utility of GI biopsies remains controversial. Studies suggest aberrant deposition of alpha-synuclein (α-syn) follows step-wise progression in central nervous system though histologic interpretation of normal and aberrant staining patterns have shown variable results. This study examines whether GI α-syn mRNA expression combined with standard α-syn immunohistochemical staining enhance the role of GI biopsy in PD. MATERIALS AND METHODS Four groups were examined, including pediatric (21) and adult control patients (18), PD clinic patients (17), and pathologically confirmed PD cases from hospital archives (16). Enteric nervous system α-syn staining was evaluated by immunohistochemistry in 33 PD and 39 controls. α-Syn mRNA levels were compared between patient groups using quantitative polymerase chain reaction and stomach and colon levels in PD. RESULTS PD patients had Lewy bodies (LB) and diffuse neuronal α-syn staining. GI tissues from elderly controls, children, and young adults exhibited diffuse positivity. LB were limited to PD. Myenteric plexus immunoreactivity varied in different regions. Widespread staining was noted within stomach and colon. Immunoreactivity was present within esophagus, appendix, and small bowel. α-Syn mRNA expression was highest in PD; however, levels varied between proximal and distal GI tract. CONCLUSIONS α-Syn is normally present within young and elderly enteric nervous system; furthermore, while α-syn mRNA is always detectable, levels are highest and most variable in PD. This suggests that enteric α-syn may be altered in neurodegenerative disease. The presence of LB in the GI tract, not solely α-syn expression, may prove useful, distinguishing neurodegenerative disease patients from normal controls.
Collapse
|
27
|
Soto-Rojas LO, Martínez-Dávila IA, Luna-Herrera C, Gutierrez-Castillo ME, Lopez-Salas FE, Gatica-Garcia B, Soto-Rodriguez G, Bringas Tobon ME, Flores G, Padilla-Viveros A, Bañuelos C, Blanco-Alvarez VM, Dávila-Ayala J, Reyes-Corona D, Garcés-Ramírez L, Hidalgo-Alegria O, De La Cruz-lópez F, Martinez-Fong D. Unilateral intranigral administration of β-sitosterol β-D-glucoside triggers pathological α-synuclein spreading and bilateral nigrostriatal dopaminergic neurodegeneration in the rat. Acta Neuropathol Commun 2020; 8:56. [PMID: 32321590 PMCID: PMC7178762 DOI: 10.1186/s40478-020-00933-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/14/2020] [Indexed: 02/05/2023] Open
Abstract
The spreading and accumulation of α-synuclein and dopaminergic neurodegeneration, two hallmarks of Parkinson’s disease (PD), have been faithfully reproduced in rodent brains by chronic, oral administration of β-sitosterol β-D-glucoside (BSSG). We investigated whether a single injection of BSSG (6 μg BSSG/μL DMSO) in the left substantia nigra of Wistar rats causes the same effects. Mock DMSO injections and untreated rats formed control groups. We performed immunostainings against the pathological α-synuclein, the dopaminergic marker tyrosine hydroxylase (TH), the neuroskeleton marker β-III tubulin, the neurotensin receptor type 1 (NTSR1) as non-dopaminergic phenotype marker and Fluro-Jade C (F-J C) label for neurodegeneration. Using β-galactosidase (β-Gal) assay and active caspase-3 immunostaining, we assessed cell death mechanisms. Golgi-Cox staining was used to measure the density and types of dendritic spines of striatal medium spiny neurons. Motor and non-motor alterations were also evaluated. The study period comprised 15 to 120 days after the lesion. In the injured substantia nigra, BSSG caused a progressive α-synuclein aggregation and dopaminergic neurodegeneration caused by senescence and apoptosis. The α-synuclein immunoreactivity was also present within microglia cells. Decreased density of dopaminergic fibers and dendritic spines also occurred in the striatum. Remarkably, all the histopathological changes also appeared on the contralateral nigrostriatal system, and α-synuclein aggregates were present in other brain regions. Motor and non-motor behavioral alterations were progressive. Our data show that the stereotaxic BSSG administration reproduces PD α-synucleinopathy phenotype in the rat. This approach will aid in identifying the spread mechanism of α-synuclein pathology and validate anti-synucleinopathy therapies.
Collapse
|
28
|
Zitser J, Gibbons C, Miglis MG. The role of tissue biopsy as a biomarker in REM sleep behavior disorder. Sleep Med Rev 2020; 51:101283. [PMID: 32187564 DOI: 10.1016/j.smrv.2020.101283] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/15/2020] [Accepted: 01/27/2020] [Indexed: 02/03/2023]
Abstract
Patients with idiopathic REM-sleep behavior disorder (iRBD) are at substantial risk of progressive neurodegenerative disease of α-synuclein pathology. Longitudinal studies have demonstrated that abnormal α-synuclein deposition occurs early in the course of disease and may precede the appearance of motor symptoms by several decades. This provides rationale for the use of a reliable biomarker to both follow disease progression and to assess treatment response, once disease-modifying treatments become available. Tissue α-synuclein has emerged as a promising candidate, however the utility of α-synuclein detection in tissues accessible to biopsy in iRBD remains unclear. This article summarizes the current literature on the role of tissue biopsy in iRBD, with specific focus on its potential role as a biomarker of disease progression and its role in future clinical trials.
Collapse
Affiliation(s)
- Jennifer Zitser
- Department of Neurology & Neurological Sciences, University of California, San Francisco, CA, USA; Movement Disorders Unit, Department of Neurology, Tel Aviv Sourazky Medical Center, Affiliate of Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Christopher Gibbons
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Mitchell G Miglis
- Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, CA, USA.
| |
Collapse
|
29
|
Serrano GE, Shprecher D, Callan M, Cutler B, Glass M, Zhang N, Walker J, Intorcia A, Adler CH, Shill HA, Driver-Dunckley E, Mehta SH, Belden CM, Zamrini E, Sue LI, Vargas D, Beach TG. Cardiac sympathetic denervation and synucleinopathy in Alzheimer's disease with brain Lewy body disease. Brain Commun 2020; 2:fcaa004. [PMID: 32064463 PMCID: PMC7008146 DOI: 10.1093/braincomms/fcaa004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/11/2019] [Accepted: 11/25/2019] [Indexed: 12/18/2022] Open
Abstract
Comorbid Lewy body pathology is very common in Alzheimer’s disease and may confound clinical trial design, yet there is no in vivo test to identify patients with this. Tissue (and/or radioligand imaging) studies have shown cardiac sympathetic denervation in Parkinson’s disease and dementia with Lewy bodies, but this has not been explored in Alzheimer’s subjects with Lewy bodies not meeting dementia with Lewy bodies clinicopathological criteria. To determine if Alzheimer’s disease with Lewy bodies subjects show sympathetic cardiac denervation, we analysed epicardial and myocardial tissue from autopsy-confirmed cases using tyrosine hydroxylase and neurofilament immunostaining. Comparison of tyrosine hydroxylase fibre density in 19 subjects with Alzheimer’s disease/dementia with Lewy bodies, 20 Alzheimer’s disease with Lewy bodies, 12 Alzheimer’s disease subjects without Lewy body disease, 19 Parkinson’s disease, 30 incidental Lewy body disease and 22 cognitively normal without Alzheimer’s disease or Lewy body disease indicated a significant group difference (P < 0.01; Kruskal–Wallis analysis of variance) and subsequent pair-wise Mann–Whitney U tests showed that Parkinson’s disease (P < 0.05) and Alzheimer’s disease/dementia with Lewy bodies (P < 0.01) subjects, but not Alzheimer’s disease with Lewy bodies subjects, had significantly reduced tyrosine hydroxylase fibre density as compared with cognitively normal. Both Parkinson’s disease and Alzheimer’s disease/dementia with Lewy bodies subjects also showed significant epicardial losses of neurofilament protein-immunoreactive nerve fibre densities within the fibre bundles as compared with cognitively normal subjects (P < 0.01) and both groups showed high pathologic alpha-synuclein densities (P < 0.0001). Cardiac alpha-synuclein densities correlated significantly with brain alpha-synuclein (P < 0.001), while cardiac tyrosine hydroxylase and neurofilament immunoreactive nerve fibre densities were negatively correlated with the densities of both brain and cardiac alpha-synuclein, as well as Unified Parkinson’s Disease Rating Scale scores (P < 0.05). The clear separation of Alzheimer’s disease/dementia with Lewy bodies subjects from Alzheimer’s disease and cognitively normal, based on cardiac tyrosine hydroxylase fibre density, is the first report of a statistically significant difference between these groups. Our data do not show significant sympathetic cardiac denervation in Alzheimer’s disease with Lewy bodies, but strongly confirm that cardiac nuclear imaging with a noradrenergic radioligand is worthy of further study as a potential means to separate Alzheimer’s disease from Alzheimer’s disease/dementia with Lewy bodies during life.
Collapse
Affiliation(s)
- Geidy E Serrano
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - David Shprecher
- Cleo Roberts Center, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Michael Callan
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Brett Cutler
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Michael Glass
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Nan Zhang
- Section of Biostatistics, Department of Health Science Research, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA
| | - Jessica Walker
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Anthony Intorcia
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Charles H Adler
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA
| | - Holly A Shill
- Muhammad Ali Parkinson Center, Barrow Neurological Institute, Phoenix, AZ 85013, USA
| | - Erika Driver-Dunckley
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA
| | - Shyamal H Mehta
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ 85259, USA
| | - Christine M Belden
- Cleo Roberts Center, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Edward Zamrini
- Cleo Roberts Center, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Lucia I Sue
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Daisy Vargas
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Thomas G Beach
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| |
Collapse
|
30
|
Kantarci K, Lowe VJ, Chen Q, Przybelski SA, Lesnick TG, Schwarz CG, Senjem ML, Gunter JL, Jack CR, Graff-Radford J, Jones DT, Knopman DS, Graff-Radford N, Ferman TJ, Parisi JE, Dickson DW, Petersen RC, Boeve BF, Murray ME. β-Amyloid PET and neuropathology in dementia with Lewy bodies. Neurology 2020; 94:e282-e291. [PMID: 31862783 PMCID: PMC7108811 DOI: 10.1212/wnl.0000000000008818] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/07/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE β-Amyloid (Aβ) pathology is common in patients with probable dementia with Lewy bodies (DLB). However, the pathologic basis and the differential diagnostic performance of Aβ PET are not established in DLB. Our objective was to investigate the pathologic correlates of 11C-Pittsburgh compound B(PiB) uptake on PET in cases with antemortem diagnosis of probable DLB or Lewy body disease (LBD) at autopsy. METHODS Autopsied cases who underwent antemortem PiB-PET and were assigned a clinical diagnosis of probable DLB or LBD at autopsy were included (n = 39). The primary endpoint was pathologic diagnosis of LBD, Alzheimer disease (AD), or mixed (LBD and AD) pathology; the secondary endpoints included Thal Aβ phase and diffuse and neuritic Aβ plaques. RESULTS Lower global cortical PiB standardized uptake value ratio (SUVr) distinguished cases with LBD from cases with AD or mixed pathology with an accuracy of 93%. Greater global cortical PiB SUVr correlated with higher Thal Aβ phase (r = 0.75, p ≤ 0.001). Voxel-based analysis demonstrated that Aβ pathology relatively spared the occipital lobes in cases with mixed pathology and LBD compared to cases with AD without LBD, in whom the entire cerebral cortex was involved. Global cortical PiB SUVr was associated primarily with the abundance of diffuse Aβ plaques in cases with LBD in a multivariable regression model. CONCLUSION Lower PiB uptake accurately distinguishes cases with LBD from cases with AD or mixed pathology, correlating with the Thal Aβ phase. The severity of diffuse Aβ pathology is the primary contributor to elevated PiB uptake in LBD. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that lower PiB uptake accurately distinguishes patients with LBD from those with AD or mixed pathology.
Collapse
Affiliation(s)
- Kejal Kantarci
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL.
| | - Val J Lowe
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Qin Chen
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Scott A Przybelski
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Timothy G Lesnick
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Christopher G Schwarz
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Matthew L Senjem
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Jeffrey L Gunter
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Clifford R Jack
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Jonathan Graff-Radford
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - David T Jones
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - David S Knopman
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Neill Graff-Radford
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Tanis J Ferman
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Joseph E Parisi
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Dennis W Dickson
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Ronald C Petersen
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Bradley F Boeve
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Melissa E Murray
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| |
Collapse
|
31
|
A single intranigral administration of β-sitosterol β-d-glucoside elicits bilateral sensorimotor and non-motor alterations in the rat. Behav Brain Res 2020; 378:112279. [DOI: 10.1016/j.bbr.2019.112279] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/27/2019] [Accepted: 10/04/2019] [Indexed: 12/14/2022]
|
32
|
Coughlin DG, Hurtig H, Irwin DJ. Pathological Influences on Clinical Heterogeneity in Lewy Body Diseases. Mov Disord 2020; 35:5-19. [PMID: 31660655 PMCID: PMC7233798 DOI: 10.1002/mds.27867] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 08/06/2019] [Accepted: 09/03/2019] [Indexed: 12/11/2022] Open
Abstract
PD, PD with dementia, and dementia with Lewy bodies are clinical syndromes characterized by the neuropathological accumulation of alpha-synuclein in the CNS that represent a clinicopathological spectrum known as Lewy body disorders. These clinical entities have marked heterogeneity of motor and nonmotor symptoms with highly variable disease progression. The biological basis for this clinical heterogeneity remains poorly understood. Previous attempts to subtype patients within the spectrum of Lewy body disorders have centered on clinical features, but converging evidence from studies of neuropathology and ante mortem biomarkers, including CSF, neuroimaging, and genetic studies, suggest that Alzheimer's disease beta-amyloid and tau copathology strongly influence clinical heterogeneity and prognosis in Lewy body disorders. Here, we review previous clinical biomarker and autopsy studies of Lewy body disorders and propose that Alzheimer's disease copathology is one of several likely pathological contributors to clinical heterogeneity of Lewy body disorders, and that such pathology can be assessed in vivo. Future work integrating harmonized assessments and genetics in PD, PD with dementia, and dementia with Lewy bodies patients followed to autopsy will be critical to further refine the classification of Lewy body disorders into biologically distinct endophenotypes. This approach will help facilitate clinical trial design for both symptomatic and disease-modifying therapies to target more homogenous subsets of Lewy body disorders patients with similar prognosis and underlying biology. © 2019 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- David G Coughlin
- University of Pennsylvania Health System, Department of Neurology
- Digital Neuropathology Laboratory
- Lewy Body Disease Research Center of Excellence
| | - Howard Hurtig
- University of Pennsylvania Health System, Department of Neurology
| | - David J Irwin
- University of Pennsylvania Health System, Department of Neurology
- Digital Neuropathology Laboratory
- Lewy Body Disease Research Center of Excellence
- Frontotemporal Degeneration Center, Philadelphia PA, USA 19104
| |
Collapse
|
33
|
Adler CH, Serrano GE, Zhang N, Hinni ML, Lott DG, Mehta SH, Sue LI, Intorcia A, Beach TG. Feasibility of repeat and bilateral submandibular gland needle biopsies in Parkinson's disease. Parkinsonism Relat Disord 2019; 68:69-72. [PMID: 31621624 PMCID: PMC9979781 DOI: 10.1016/j.parkreldis.2019.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/01/2019] [Accepted: 10/06/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Submandibular gland (SMG) biopsies detect pathological alpha-synuclein (aSyn) in patients with Parkinson's disease (PD). The objectives of this study were to determine 1) the feasibility of performing a second SMG biopsy in previously biopsied patients, 2) the feasibility of doing bilateral SMG biopsies, 3) laterality of aSyn density, 4) whether aSyn density changes over time. METHODS Seven PD patients (6 males) previously having positive unilateral SMG biopsies underwent bilateral needle biopsies. Staining with a validated antibody to pathologic p-serine 129 aSyn was performed. RESULTS Mean age at time of second biopsy was 76 years and mean time between biopsies was 4.1 years. Five subjects had sufficient SMG tissue bilaterally and two only unilaterally for a total of 12/14 glands biopsied having sufficient tissue, all 7 subjects having sufficient tissue on at least one side, and all 12 glands being aSyn positive. There was a 4x increase in aSyn density on average in the repeat biopsy, with 5 subjects having an increase, one no change, and one a decrease in density. Side effects were similar to previous reports; mainly bruising, swelling, slight bleeding. CONCLUSIONS This is the first published study of bilateral transcutaneous needle biopsies of the SMG in living patients with PD which showed better tissue acquisition and a change in aSyn density over time. While further study is needed, there is potential for SMG biopsies to serve as a tissue biomarker for PD disease progression and potentially as a peripheral outcome measure for anti-aSyn treatment.
Collapse
Affiliation(s)
- Charles H. Adler
- Parkinson’s Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic, Scottsdale, AZ, USA,Corresponding author. Department of Neurology, Mayo Clinic Arizona, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA. (C.H. Adler)
| | | | - Nan Zhang
- Department of Biostatistics, Mayo Clinic College of Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | | | - David G. Lott
- Department of Otolaryngology, Mayo Clinic, Phoenix, AZ, USA
| | - Shyamal H. Mehta
- Parkinson’s Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Lucia I. Sue
- Banner Sun Health Research Institute, Sun City, AZ, USA
| | | | | |
Collapse
|
34
|
Beach TG, Serrano GE, Kremer T, Canamero M, Dziadek S, Sade H, Derkinderen P, Corbillé AG, Letournel F, Munoz DG, White CL, Schneider J, Crary JF, Sue LI, Adler CH, Glass MJ, Intorcia AJ, Walker JE, Foroud T, Coffey CS, Ecklund D, Riss H, Goßmann J, König F, Kopil CM, Arnedo V, Riley L, Linder C, Dave KD, Jennings D, Seibyl J, Mollenhauer B, Chahine L. Immunohistochemical Method and Histopathology Judging for the Systemic Synuclein Sampling Study (S4). J Neuropathol Exp Neurol 2019; 77:793-802. [PMID: 30107604 DOI: 10.1093/jnen/nly056] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Immunohistochemical (IHC) α-synuclein (Asyn) pathology in peripheral biopsies may be a biomarker of Parkinson disease (PD). The multi-center Systemic Synuclein Sampling Study (S4) is evaluating IHC Asyn pathology within skin, colon and submandibular gland biopsies from 60 PD and 20 control subjects. Asyn pathology is being evaluated by a blinded panel of specially trained neuropathologists. Preliminary work assessed 2 candidate immunoperoxidase methods using a set of PD and control autopsy-derived sections from formalin-fixed, paraffin-embedded blocks of the 3 tissues. Both methods had 100% specificity; one, utilizing the 5C12 monoclonal antibody, was more sensitive in skin (67% vs 33%), and was chosen for further use in S4. Four trainee neuropathologists were trained to perform S4 histopathology readings; in subsequent testing, their scoring was compared to that of the trainer neuropathologist on both glass slides and digital images. Specificity and sensitivity were both close to 100% with all readers in all tissue types on both glass slides and digital images except for skin, where sensitivity averaged 75% with digital images and 83.5% with glass slides. Semiquantitative (0-3) density score agreement between trainees and trainer averaged 67% for glass slides and 62% for digital images.
Collapse
Affiliation(s)
- Thomas G Beach
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona
| | - Geidy E Serrano
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona
| | - Thomas Kremer
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F Hoffman-La Roche, Ltd, Basel, Switzerland.,Roche Pharma Research and Early Development, Roche Innovation Center, Munich, Penzberg, Germany
| | - Marta Canamero
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F Hoffman-La Roche, Ltd, Basel, Switzerland.,Roche Pharma Research and Early Development, Roche Innovation Center, Munich, Penzberg, Germany
| | - Sebastian Dziadek
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F Hoffman-La Roche, Ltd, Basel, Switzerland.,Roche Pharma Research and Early Development, Roche Innovation Center, Munich, Penzberg, Germany
| | - Hadassah Sade
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F Hoffman-La Roche, Ltd, Basel, Switzerland.,Roche Pharma Research and Early Development, Roche Innovation Center, Munich, Penzberg, Germany
| | - Pascal Derkinderen
- Department of Neurology, CHU Nantes, Inserm, U1235, Nantes University, Nantes F-44035, France.,CHU Angers, Neurobiology and Neuropathology Laboratory, Angers F-49033, France
| | - Anne-Gaëlle Corbillé
- Department of Neurology, CHU Nantes, Inserm, U1235, Nantes University, Nantes F-44035, France.,CHU Angers, Neurobiology and Neuropathology Laboratory, Angers F-49033, France
| | - Franck Letournel
- Department of Neurology, CHU Nantes, Inserm, U1235, Nantes University, Nantes F-44035, France.,CHU Angers, Neurobiology and Neuropathology Laboratory, Angers F-49033, France
| | - David G Munoz
- Laboratory Medicine and Keenan Research Centre for Biomedical Research of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Charles L White
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - John F Crary
- Department of Pathology, Fishberg Department of Neuroscience, Friedman Brain Institute, Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lucia I Sue
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona
| | - Charles H Adler
- Department of Neurology, Mayo Clinic Arizona, Scottsdale, Arizona
| | - Michael J Glass
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona
| | - Anthony J Intorcia
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona
| | - Jessica E Walker
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona
| | - Tatiana Foroud
- Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Dixie Ecklund
- Department of Biostatistics, University of Iowa, Iowa City, Iowa
| | - Holly Riss
- Department of Biostatistics, University of Iowa, Iowa City, Iowa
| | | | - Fatima König
- Targos Molecular Pathology GmbH, Kassel, Germany
| | - Catherine M Kopil
- The Michael J. Fox Foundation for Parkinson's Research, New York, New York
| | - Vanessa Arnedo
- The Michael J. Fox Foundation for Parkinson's Research, New York, New York
| | - Lindsey Riley
- The Michael J. Fox Foundation for Parkinson's Research, New York, New York
| | - Carly Linder
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Kuldip D Dave
- The Michael J. Fox Foundation for Parkinson's Research, New York, New York
| | | | - John Seibyl
- Institute for Neurodegenerative Disorders, New Haven, Connecticut
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel and University Medical Center Goettingen, Goettingen, Germany
| | - Lana Chahine
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | |
Collapse
|
35
|
Sorrentino ZA, Goodwin MS, Riffe CJ, Dhillon JKS, Xia Y, Gorion KM, Vijayaraghavan N, McFarland KN, Golbe LI, Yachnis AT, Giasson BI. Unique α-synuclein pathology within the amygdala in Lewy body dementia: implications for disease initiation and progression. Acta Neuropathol Commun 2019; 7:142. [PMID: 31477175 PMCID: PMC6718048 DOI: 10.1186/s40478-019-0787-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 08/09/2019] [Indexed: 01/01/2023] Open
Abstract
The protein α-synuclein (αsyn) forms pathologic aggregates in a number of neurodegenerative diseases including Lewy body dementia (LBD) and Parkinson's disease (PD). It is unclear why diseases such as LBD may develop widespread αsyn pathology, while in Alzheimer's disease with amygdala restricted Lewy bodies (AD/ALB) the αsyn aggregates remain localized. The amygdala contains αsyn aggregates in both LBD and in AD/ALB; to understand why αsyn pathology continues to progress in LBD but not in AD/ALB, tissue from the amygdala and other regions were obtained from 14 cases of LBD, 9 cases of AD/ALB, and 4 controls for immunohistochemical and biochemical characterization. Utilizing a panel of previously characterized αsyn antibodies, numerous unique pathologies differentiating LBD and AD/ALB were revealed; particularly the presence of dense neuropil αsyn aggregates, astrocytic αsyn, and αsyn-containing dystrophic neurites within senile plaques. Within LBD, these unique pathologies were predominantly present within the amygdala. Biochemically, the amygdala in LBD prominently contained specific carboxy-truncated forms of αsyn which are highly prone to aggregate, suggesting that the amygdala may be prone to initiate development of αsyn pathology. Similar to carboxy-truncated αsyn, it was demonstrated herein that the presence of aggregation prone A53T αsyn is sufficient to drive misfolding of wild-type αsyn in human disease. Overall, this study identifies within the amygdala in LBD the presence of unique strain-like variation in αsyn pathology that may be a determinant of disease progression.
Collapse
Affiliation(s)
- Zachary A Sorrentino
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
- Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Marshall S Goodwin
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
- Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Cara J Riffe
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
- Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Jess-Karan S Dhillon
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
- Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Yuxing Xia
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
- Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Kimberly-Marie Gorion
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
- Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Niran Vijayaraghavan
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
- Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Karen N McFarland
- Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
- McKnight Brain Institute, College of Medicine University of Florida, Gainesville, FL, 32610, USA
| | - Lawrence I Golbe
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08901, USA
| | - Anthony T Yachnis
- Department of Pathology, College of Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Benoit I Giasson
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, 32610, USA.
- Center for Translational Research in Neurodegenerative Disease, College of Medicine, University of Florida, Gainesville, FL, 32610, USA.
- McKnight Brain Institute, College of Medicine University of Florida, Gainesville, FL, 32610, USA.
| |
Collapse
|
36
|
Seeding of protein aggregation causes cognitive impairment in rat model of cortical synucleinopathy. Mov Disord 2019; 34:1699-1710. [DOI: 10.1002/mds.27810] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 07/09/2019] [Accepted: 07/11/2019] [Indexed: 12/15/2022] Open
|
37
|
Cardiac sympathetic innervation in the MPTP non-human primate model of Parkinson disease. Clin Auton Res 2019; 29:415-425. [PMID: 31338635 DOI: 10.1007/s10286-019-00620-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/13/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE Systemic administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) induces degeneration of dopaminergic neurons and reproduces the motor features of Parkinson disease (PD); however, the effect of MPTP on extranigral structures has been poorly studied. The aim of this research was to study the cardiac sympathetic innervation of control and MPTP-treated monkeys in order to describe the influence of MPTP toxicity on cardiac tissue. METHODS Eight monkeys were included in the study and divided into two groups, four monkeys serving as controls and four forming the MPTP group. Sections from the anterior left ventricle were immunohistochemically examined to characterize the sympathetic fibers of cardiac tissue. The intensity of immunoreactivity in the nerve fibers was quantitatively analyzed using ImageJ software. RESULTS As occurs in PD, the sympathetic peripheral nervous system is affected in MPTP-treated monkeys. The percentage of tyrosine hydroxylase immunoreactive fibers in the entire fascicle area was markedly lower in the MPTP group (24.23%) than the control group (35.27%) (p < 0.05), with preservation of neurofilament immunoreactive fibers in the epicardium of MPTP-treated monkeys. Alpha-synuclein deposits were observed in sections of the anterior left ventricle of MPTP-treated monkeys but not in control animals, whereas phosphorylated synuclein aggregates were not observed in either controls or MPTP-treated monkeys. CONCLUSION The peripheral autonomic system can also be affected by neurotoxins that specifically inhibit mitochondrial complex I.
Collapse
|
38
|
Kuzkina A, Schulmeyer L, Monoranu CM, Volkmann J, Sommer C, Doppler K. The aggregation state of α-synuclein deposits in dermal nerve fibers of patients with Parkinson's disease resembles that in the brain. Parkinsonism Relat Disord 2019; 64:66-72. [DOI: 10.1016/j.parkreldis.2019.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/01/2019] [Accepted: 03/05/2019] [Indexed: 11/16/2022]
|
39
|
Dhillon JKS, Trejo-Lopez JA, Riffe C, McFarland NR, Hiser WM, Giasson BI, Yachnis AT. Dissecting α-synuclein inclusion pathology diversity in multiple system atrophy: implications for the prion-like transmission hypothesis. J Transl Med 2019; 99:982-992. [PMID: 30737468 PMCID: PMC7209695 DOI: 10.1038/s41374-019-0198-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/28/2018] [Accepted: 12/05/2018] [Indexed: 02/06/2023] Open
Abstract
Synucleinopathies are a group of neurodegenerative diseases characterized by the accumulation of insoluble, aggregated α-synuclein (αS) pathological inclusions. Multiple system atrophy (MSA) presents with extensive oligodendroglial αS pathology and additional more limited neuronal inclusions while most of the other synucleinopathies, such as Parkinson's disease and dementia with Lewy bodies (DLB), develop αS pathology primarily in neuronal cell populations. αS biochemical alterations specific to MSA have been described but thorough examination of these unique and disease-specific protein deposits is further warranted especially given recent findings implicating the prion-like nature of synucleinopathies perhaps with distinct strain-like properties. Taking advantage of an extensive panel of antibodies that target a wide range of epitopes within αS, we investigated the distinct properties of the various types of αS inclusion present in MSA brains with comparison to DLB. Brain biochemical fractionation followed by immunoblotting revealed that the immunoreactive profiles were significantly more consistent for DLB than for MSA. Furthermore, epitope-specific immunohistochemistry varied greatly between different types of MSA αS inclusions and even within different brain regions of individual MSA brains. These studies highlight the importance of using a battery of antibodies for adequate appreciation of the various pathology in this distinct synucleinopathy. In addition, it can be posited that if the spread of pathology in MSA undergoes prion-like mechanisms, "strains" of αS aggregated conformers must be inherently unstable and readily mutable, perhaps resulting in a more stochastic progression process.
Collapse
Affiliation(s)
- Jess-Karan S. Dhillon
- Department of Neuroscience, University of Florida, Gainesville, FL 32610, USA.,Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL 32610, USA
| | - Jorge A. Trejo-Lopez
- Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL 32610, USA.,Department of Pathology, University of Florida, Gainesville, FL 32610, USA
| | - Cara Riffe
- Department of Neuroscience, University of Florida, Gainesville, FL 32610, USA.,Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL 32610, USA
| | - Nikolaus R. McFarland
- Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL 32610, USA.,Department of Neurology, University of Florida, Gainesville, FL 32610, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA
| | - Wesley M. Hiser
- Department of Pathology, University of Florida, Gainesville, FL 32610, USA
| | - Benoit I. Giasson
- Department of Neuroscience, University of Florida, Gainesville, FL 32610, USA.,Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL 32610, USA.,McKnight Brain Institute, University of Florida, Gainesville, FL 32610, USA.,Corresponding author: Benoit I. Giasson () or Anthony Yachnis ()
| | - Anthony T. Yachnis
- Department of Pathology, University of Florida, Gainesville, FL 32610, USA.,Corresponding author: Benoit I. Giasson () or Anthony Yachnis ()
| |
Collapse
|
40
|
Coughlin DG, Petrovitch H, White LR, Noorigian J, Masaki KH, Ross GW, Duda JE. Most cases with Lewy pathology in a population-based cohort adhere to the Braak progression pattern but 'failure to fit' is highly dependent on staging system applied. Parkinsonism Relat Disord 2019; 64:124-131. [PMID: 30948243 PMCID: PMC6739131 DOI: 10.1016/j.parkreldis.2019.03.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 02/13/2019] [Accepted: 03/25/2019] [Indexed: 01/23/2023]
Abstract
Braak et al.'s 2003 paper detailing the caudo-rostral progression of Lewy body pathology (LP) formed the foundation of current understanding of disease spread in Parkinson's disease (PD); however, its methods are difficult to recreate and consequently multiple new staging systems emerged to recapitulate Braak's staging system using standard neuropathological methods and to account for other patterns of LP. Studies using these systems have documented widely variable rates of cases that 'fail to fit' expected patterns of LP spread. This could be due to population differences, features of individual systems, or may constitute under-recognized patterns of disease. We examined 324 neuropathological cases from the Honolulu Asia Aging Study and applied four different LP staging systems to determine the proportion of cases adhering to different staging methodologies and those that 'fail to fit' expected patterns of LP. Of 141 cases with LP (24: PD, 8: Dementia with Lewy bodies (DLB), 109: Incidental Lewy body disease (ILBD)), our application of Braak et al., 2003 classified 83.7%, Müller et al., 2005 classified 87.9%, Beach et al., 2009 classified 100%, and Leverenz et al., 2008 classified 98.6%. There were significant differences in the cases classifiable by the Leverenz and Beach systems versus the Braak and Müller systems (p < 0.001 for each). In this population-based autopsy cohort with a high prevalence of ILBD, the majority of cases were consistent with the progression characterized by the Braak et al. however, the determination of cases as atypical is highly dependent on the staging system applied.
Collapse
Affiliation(s)
- David G Coughlin
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Helen Petrovitch
- Veterans Affairs Pacific Islands Health Care System, Honolulu, HI, USA; Departments of Medicine and John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA; The John A Hartford Foundation Center of Excellence in Geriatrics, Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Lon R White
- Veterans Affairs Pacific Islands Health Care System, Honolulu, HI, USA; Departments of Medicine and John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA; The John A Hartford Foundation Center of Excellence in Geriatrics, Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Joseph Noorigian
- Parkinson's Disease Research, Education and Clinical Center, Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Kamal H Masaki
- The John A Hartford Foundation Center of Excellence in Geriatrics, Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA; Kuakini Medical Center, Honolulu, HI, USA
| | - G Webster Ross
- Veterans Affairs Pacific Islands Health Care System, Honolulu, HI, USA; Departments of Medicine and John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA; The John A Hartford Foundation Center of Excellence in Geriatrics, Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - John E Duda
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA; Parkinson's Disease Research, Education and Clinical Center, Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
| |
Collapse
|
41
|
Nitrated alpha-synuclein in minor salivary gland biopsies in Parkinson's disease. Neurosci Lett 2019; 704:45-49. [PMID: 30946930 DOI: 10.1016/j.neulet.2019.03.054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 03/24/2019] [Accepted: 03/31/2019] [Indexed: 12/11/2022]
Abstract
Alpha-synuclein (α-SYN) is found in peripheral autonomic neuronal network apart from brain in Parkinson's disease (PD). Nitrated α-SYN is an undesirable modification associated with oxidative and nitrative damage and has been found extensively in brain, gastrointestinal(GI) tract and blood cells in PD. We aim to investigate the presence of nitrated α-SYN in minor salivary gland biopsy in PD. Patients with PD and age-matched controls underwent minor salivary gland biopsy. Motor impairment was assessed by Hoehn-Yahr (H-Y) stage and Unified Parkinson's Disease Rating Scale (UPDRS) Part III in off-state. 11C-methyl-N-2b-carbomethoxy-3b-(4-fluorophenyl) tropane (11C-CFT) DAT-PET scan was performed in all subjects. Immunohistochemical staining for nitrated α-SYN was performed in the minor salivary gland tissues. The minor salivary gland tissues of 8 PD cases and 7 controls with early stage (H-Y stage 1-2) were detected. All PD patients showed asymmetrical and reduction of 11C-CFT uptake in the caudate, anterior and posterior putamen, while all control subjects showed normal DAT-PET scan. Positive nitrated α-SYN immunostaining was observed in all PD patients (8/8,100%) but not in control subjects (0/7). The results were consistent well with that of DAT-PET. These nitrated alpha-synuclein positive structures were mainly located in the periacinar stroma in PD patients. Our result suggests that nitrated α-SYN exists in the early stage and is probably a promising biomarker for PD. Minor salivary gland is an ideal site for α-SYN nitration detection. Despite of the small number of subjects, attention should be given to α-SYN nitration in PD and more investigations on nitrated α-SYN in different sites and large sample using should be explored in future.
Collapse
|
42
|
Ma LY, Liu GL, Wang DX, Zhang MM, Kou WY, Feng T. Alpha-Synuclein in Peripheral Tissues in Parkinson's Disease. ACS Chem Neurosci 2019; 10:812-823. [PMID: 30714719 DOI: 10.1021/acschemneuro.8b00383] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder. To date, the diagnosis of PD relies mainly on clinical manifestations whereas neuropathological confirmation of the brain is only possible with postmortem studies. Neuronal loss in the substantia nigra pars compacta (SNc) associated with Lewy bodies/neurites is the pathological hallmark feature of PD. The major component of Lewy pathology (LP) is misfolded alpha-synuclein (α-SYN). There is evidence that the distribution of LP is not only limited to the brain but extends to peripheral tissues, including gastrointestinal tract, salivary glands, olfactory mucosa, skin, retina, adrenal gland, and heart. Sensitivity and specificity of α-SYN detection in PD vary greatly among studies due to methodological heterogeneity, such as sampling sites and size, tissue preparation, staining techniques, and antibodies used. Of note, α-SYN has also been found in preclinical and prodromal PD. Further in vivo studies focusing on favorable biopsy sites and standard techniques are needed to get better understanding of α-SYN deposits in preclinical, prodromal, and clinical PD.
Collapse
Affiliation(s)
- Ling-Yan Ma
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Gen-Liang Liu
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Dong-Xu Wang
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Mei-Mei Zhang
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Wen-Yi Kou
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Tao Feng
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- Parkinson’s Disease Center, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China
| |
Collapse
|
43
|
Santos OA, Pedraza O, Lucas JA, Duara R, Greig-Custo MT, Hanna Al-Shaikh FS, Liesinger AM, Bieniek KF, Hinkle KM, Lesser ER, Crook JE, Carrasquillo MM, Ross OA, Ertekin-Taner N, Graff-Radford NR, Dickson DW, Murray ME. Ethnoracial differences in Alzheimer's disease from the FLorida Autopsied Multi-Ethnic (FLAME) cohort. Alzheimers Dement 2019; 15:635-643. [PMID: 30792090 PMCID: PMC6511501 DOI: 10.1016/j.jalz.2018.12.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 11/13/2018] [Accepted: 12/02/2018] [Indexed: 12/28/2022]
Abstract
Introduction: Our primary goal was to examine demographic and clinicopathologic differences across an ethnoracially diverse autopsy-confirmed cohort of Alzheimer’s disease cases. Methods: A retrospective study was conducted in the Florida Autopsied Multi-Ethnic cohort on 1625 Alzheimer’s disease cases, including decedents who self-reported as Hispanic/Latino (n = 67), black/African American (n = 19), and white/European American (n = 1539). Results: Hispanic decedents had a higher frequency of family history of cognitive impairment (58%), an earlier age at onset (median age of 70 years), longer disease duration (median of 12 years), and lower MMSE proximal to death (median of 4 points) compared with the other ethnoracial groups. Black decedents had a lower Braak tangle stage (stage V) and higher frequency of coexisting hippocampal sclerosis (21%); however, only hippocampal sclerosis differences survived adjustment for sex, age at onset, and disease duration. Neither Thal amyloid phase nor coexisting Lewy body disease differed across ethnoracial groups. Discussion: Despite a smaller sample size, Hispanics demonstrated longer disease duration with Alzheimer’s disease, but not greater lifespan. Neuropathologic differences across ethnoracial groups supported differences in tau pathology distribution and coexisting hippocampal sclerosis, which may impact biomarker studies.
Collapse
Affiliation(s)
- Octavio A Santos
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | - Otto Pedraza
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | - John A Lucas
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | - Ranjan Duara
- Department of Neurology, Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA; University of Florida College of Medicine, Gainesville, FL, USA
| | - Maria T Greig-Custo
- Department of Neurology, Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | | | | | - Kevin F Bieniek
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Kelly M Hinkle
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | | | - Julia E Crook
- Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA
| | | | - Owen A Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Nilüfer Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA; Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | | | | | | |
Collapse
|
44
|
Creed RB, Goldberg MS. Analysis of α-Synuclein Pathology in PINK1 Knockout Rat Brains. Front Neurosci 2019; 12:1034. [PMID: 30686993 PMCID: PMC6333903 DOI: 10.3389/fnins.2018.01034] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 12/20/2018] [Indexed: 12/28/2022] Open
Abstract
Mutations in PTEN induced kinase 1 (PINK1) cause autosomal recessive Parkinson’s disease (PD). The main pathological hallmarks of PD are loss of dopaminergic neurons in the substantia nigra pars compacta and the formation of protein aggregates containing α-synuclein. Previous studies of PINK1 knockout (PINK1-/-) rats have reported mitochondrial dysfunction, locomotor behavioral deficits, loss of neurons in the substantia nigra and α-synuclein aggregates in various brain regions. We sought to characterize PINK1-/- rats in more detail specifically with respect to α-synuclein pathology because abnormal α-synuclein has been implicated genetically, biophysically and neuropathologically as a mechanism of PD pathogenesis. Moreover, the spontaneous formation of α-synuclein aggregates without α-synuclein overexpression, injection or toxin administration is a rare and important characteristic for an animal model of PD or other synucleinopathies, such as dementia with Lewy bodies and multiple system atrophy. We observed α-synuclein-immunoreactive aggregates in various brain regions of PINK1-/- rats including cortex, thalamus, striatum and ventral midbrain, but nowhere in wild-type (WT) rats. Co-immunofluorescence showed that the α-synuclein-immunoreactive aggregates are both thioflavin S and ubiquitin positive. Many cells in the brains of PINK1-/- rats but not WT rats contained protease-resistant α-synuclein. Total synuclein protein levels were unchanged; however, biochemical fractionation showed a significant shift of α-synuclein from the cytosolic fraction to the synaptic vesicle-enriched fraction of PINK1-/- brain homogenates compared to WT. This data indicates that PINK1 deficiency results in abnormal α-synuclein localization, protease resistance and aggregation in vivo. The PINK1-/- rat could be a useful animal model to study the role of abnormal α-synuclein in PD-related neurodegeneration.
Collapse
Affiliation(s)
- Rose B Creed
- Center for Neurodegeneration and Experimental Therapeutics, Department of Neurology, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Matthew S Goldberg
- Center for Neurodegeneration and Experimental Therapeutics, Department of Neurology, The University of Alabama at Birmingham, Birmingham, AL, United States.,Department of Neurobiology, The University of Alabama at Birmingham, Birmingham, AL, United States
| |
Collapse
|
45
|
Savica R, Beach TG, Hentz JG, Sabbagh MN, Serrano GE, Sue LI, Dugger BN, Shill HA, Driver-Dunckley E, Caviness JN, Mehta SH, Jacobson SA, Belden CM, Davis KJ, Zamrini E, Shprecher DR, Adler CH. Lewy body pathology in Alzheimer's disease: A clinicopathological prospective study. Acta Neurol Scand 2019; 139:76-81. [PMID: 30229861 DOI: 10.1111/ane.13028] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 09/04/2018] [Accepted: 09/13/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Identify clinical features predictive of Lewy body pathology in Alzheimer's disease (AD) patients in an ongoing longitudinal clinicopathologic study. MATERIAL AND METHODS We queried the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND) database for dementia cases with AD pathology (1997-2015). Subjects received longitudinal comprehensive clinical evaluations including motor/neuropsychological assessment and Apo-E4 genotyping. All cases were autopsied and had standard neuropathological assessments for AD and Lewy-type synucleinopathy (LTS). Subjects were categorized based on standardized pathological criteria with AD cases that had LTS but did not meet DLB pathologic criteria being categorized as ADLB. We performed pairwise comparison between the different diagnoses and multivariable modelling to identify clinical symptoms that predict the pathological diagnosis. RESULTS We identified 32 DLB/AD, 54 ADLB, 70 AD only and 41 PDD/AD cases. AD subjects with LTS pathology had higher UPDRS II and III total scores as well as generally higher individual scores compared to AD alone. While depression scales and Trail-making Test A correlated significantly with LTS, other neuropsychological variables were not significantly different. Apo E4 occurrence was similar in all groups (40%-49%). CONCLUSIONS Our study suggests that the presence (or absence) of LTS influences motor and non-motor clinical findings in AD patients. These findings may lead to biomarkers that allow for more targeted treatment of AD.
Collapse
Affiliation(s)
- Rodolfo Savica
- Department of Neurology; Mayo Clinic; Rochester Minnesota
- Department of Health Science Research; Mayo Clinic; Rochester Minnesota
| | - Thomas G. Beach
- Civin Laboratory for Neuropathology; Banner Sun Health Research Institute; Sun City Arizona
| | - Joseph G. Hentz
- Section of Biostatistics; Mayo Clinic Arizona; Scottsdale Arizona
| | - Marwan N. Sabbagh
- Department of Neurology; University of Arizona College of Medicine; Phoenix Arizona
- Barrow Neurological Institute; Phoenix Arizona
- Cleveland Clinic Foundation; Cleveland Ohio
| | - Geidy E. Serrano
- Civin Laboratory for Neuropathology; Banner Sun Health Research Institute; Sun City Arizona
| | - Lucia I. Sue
- Civin Laboratory for Neuropathology; Banner Sun Health Research Institute; Sun City Arizona
| | - Brittany N. Dugger
- Department of Neurology; University of California Davis; Davis California
| | | | | | - John N. Caviness
- Department of Neurology; Mayo Clinic College of Medicine; Scottsdale Arizona
| | - Shyamal H. Mehta
- Department of Neurology; Mayo Clinic College of Medicine; Scottsdale Arizona
| | - Sandra A. Jacobson
- Department of Psychiatry; University of Arizona College of Medicine; Phoenix Arizona
| | | | - Kathryn J. Davis
- Civin Laboratory for Neuropathology; Banner Sun Health Research Institute; Sun City Arizona
| | - Edward Zamrini
- Cleo Roberts Center; Banner Sun Health Research Institute; Sun City Arizona
| | - David R. Shprecher
- Department of Neurology; University of Arizona College of Medicine; Phoenix Arizona
- Cleo Roberts Center; Banner Sun Health Research Institute; Sun City Arizona
| | - Charles H. Adler
- Department of Neurology; Mayo Clinic College of Medicine; Scottsdale Arizona
| |
Collapse
|
46
|
Liesinger AM, Graff-Radford NR, Duara R, Carter RE, Hanna Al-Shaikh FS, Koga S, Hinkle KM, DiLello SK, Johnson MF, Aziz A, Ertekin-Taner N, Ross OA, Dickson DW, Murray ME. Sex and age interact to determine clinicopathologic differences in Alzheimer's disease. Acta Neuropathol 2018; 136:873-885. [PMID: 30219939 PMCID: PMC6280837 DOI: 10.1007/s00401-018-1908-x] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 09/08/2018] [Accepted: 09/09/2018] [Indexed: 01/09/2023]
Abstract
Women reportedly make up two-thirds of Alzheimer’s disease (AD) dementia sufferers. Many estimates regarding AD, however, are based on clinical series lacking autopsy confirmation. The Florida Autopsied Multi-Ethnic (FLAME) cohort was queried for AD cases with a total of 1625 identified ranging in age from 53 to 102 years at death. Standard neuropathologic procedures were employed and clinical information was retrospectively collected. Clinicopathologic and genetic data (MAPT and APOE) were stratified by sex. Within the neuropathologically diagnosed AD cohort, the overall number of women and men did not differ. Men were younger at onset of cognitive symptoms, had a shorter disease duration, and more often had atypical (non-amnestic) clinical presentations. The frequency of autopsy-confirmed AD among women and men stratified by age at death revealed an inverse U-shaped curve in men and a U-shaped curve in women, with both curves having inflections at approximately 70 years of age. Regional counts of neurofibrillary tangles differed in women and men, especially when examined by age intervals. Women had overall greater severity of neurofibrillary tangle counts compared to men, especially in the hippocampus. Men were more often classified as hippocampal sparing AD, whereas limbic predominant AD was more common in women. Men and women did not differ in frequency of MAPT haplotype or APOE genotype. Atypical clinical presentations, younger age at onset and shorter disease duration were more frequent in men, suggesting that the lower reported frequency of AD in men may be due to more frequent atypical clinical presentations not recognized as AD. Our data suggest that neuropathologically diagnosed AD cases have the same frequency of women and men, but their clinical presentations and ages at onset tend to differ.
Collapse
Affiliation(s)
| | | | - Ranjan Duara
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Rickey E Carter
- Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA
| | | | - Shunsuke Koga
- Departments of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Kelly M Hinkle
- Departments of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Sarah K DiLello
- Departments of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - McKenna F Johnson
- Departments of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Adel Aziz
- Departments of and Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Nilufer Ertekin-Taner
- Departments of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
- Departments of and Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Owen A Ross
- Departments of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Dennis W Dickson
- Departments of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Melissa E Murray
- Departments of Neuroscience, Mayo Clinic, Jacksonville, FL, 32224, USA.
| |
Collapse
|
47
|
Donadio V. Skin nerve α-synuclein deposits in Parkinson's disease and other synucleinopathies: a review. Clin Auton Res 2018; 29:577-585. [PMID: 30506233 DOI: 10.1007/s10286-018-0581-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 11/19/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE The in vivo diagnosis of synucleinopathies is an important research aim since clinical diagnostic criteria show low accuracy. The skin innervation, especially the autonomic subdivision, is a useful region to search for abnormal α-syn aggregates in synucleinopathies since the peripheral sympathetic nerves can be the earliest-affected neural region and autonomic symptoms may precede the classical symptoms of these disorders. METHODS The major advantages of skin biopsy as an in vivo diagnostic tool for synucleinopathies are that it is an inexpensive and easy-to-perform technique requiring only limited facilities, and that it is repeatable in long-term studies as it causes only minor discomfort to the patient. RESULTS This review analyzes current progress in this area of research that may facilitate the standardization of this method, potentially eliminating differences among laboratories in the implementation of the method. CONCLUSIONS The most suitable and commonly used technique for identifying in vivo α-syn aggregates in skin nerves is indirect immunofluorescence, although several aspects of this approach need to be standardized, particularly when synucleinopathies without autonomic failure present a patchy distribution of abnormal α-syn aggregates in skin nerves. By contrast, synucleinopathies with autonomic failure may present widespread diffusion of abnormal aggregates in autonomic skin nerves.
Collapse
Affiliation(s)
- Vincenzo Donadio
- IRCCS Istituto Delle Scienze Neurologiche di Bologna (Italy), UOC Clinica Neurologica, Via Altura 3, 40139, Bologna, Italy.
| |
Collapse
|
48
|
Zhang H, Zhu L, Sun L, Zhi Y, Ding J, Yuan YS, Shen FF, Li X, Ji P, Wang Z, Niu Q, Zhang KZ. Phosphorylated α-synuclein deposits in sural nerve deriving from Schwann cells: A biomarker for Parkinson's disease. Parkinsonism Relat Disord 2018; 60:57-63. [PMID: 30297212 DOI: 10.1016/j.parkreldis.2018.10.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/06/2018] [Accepted: 10/01/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Paresthesia is common in Parkinson's disease (PD) patients. We assumed that peripheral nerve might be implicated. This study aimed to investigate whether phosphorylated α-synuclein (pSNCA) pathology occurred in sural nerve fibers and to explore the underlying pathogenesis of paresthesia of lower limbs associated with PD. METHODS Clinical assessments and sural nerve biopsy were performed to evaluate clinical characteristics and the deposition of total α-synuclein (tSNCA) and pSNCA in biopsy pieces using immunochemistry methods on 16 PD patients and 15 controls. In addition, immunofluorescence staining was performed using certain antibodies to characterize the component of sural nerve and to localize the expression of pSNCA. RESULTS Deposition of pSNCA was found in 16/16 PD patients with a high positive percentage of 100% but in 0/15 controls, however, all biopsy pieces showed positive response to tSNCA immunohistological staining in nerve fibers. pSNCA was expressed mainly in Schwann cells but scarcely in axons, demonstrating a novel pattern of pSNCA expression in peripheral nervous system. CONCLUSION Our findings suggest that peripheral somatic sensory nerve is also involved in SNCA pathology in PD. The search for pSNCA in sural nerve might serve as a novel biomarker for early diagnosis of PD and pSNCA in sural nerve may derive from Schwann cells rather than propagate retrograde along the primary sensory neurons from the central nervous system.
Collapse
Affiliation(s)
- Hui Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Lin Zhu
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Li Sun
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Yan Zhi
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Jian Ding
- Department of Neurology, The First People's Hospital of Changzhou, No. 185 Juqian Road, Changzhou, 213003, China
| | - Yong-Sheng Yuan
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Fei-Fei Shen
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiao Li
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Pan Ji
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Zhen Wang
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Qi Niu
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Ke-Zhong Zhang
- Department of Neurology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China.
| |
Collapse
|
49
|
Maarouf CL, Walker JE, Sue LI, Dugger BN, Beach TG, Serrano GE. Impaired hepatic amyloid-beta degradation in Alzheimer's disease. PLoS One 2018; 13:e0203659. [PMID: 30192871 PMCID: PMC6128628 DOI: 10.1371/journal.pone.0203659] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 08/26/2018] [Indexed: 12/26/2022] Open
Abstract
Extensive research strongly suggests that amyloid beta (Aβ) aggregates in the brain have a central role in Alzheimer's disease (AD) pathogenesis. Pathological Aβ deposition is likely due to an altered balance between overproduction and elimination. Rodent studies have suggested that the liver has a major role in Aβ degradation. It is possible alterations of liver function could affect brain Aβ levels through changes in blood Aβ concentration. In this study, we hypothesized hepatic Aβ degradation to be impaired in AD subjects. To test our hypothesis, an Aβ degradation assay was developed using synthetic fluorescein-labeled Aβ40 and Aβ42 spiked into human liver homogenates. Aβ degradation rates were lower in AD-derived homogenates as compared with those from non-demented (ND) control subjects, even after accounting for such covariates as age, sex, and APOE genotype. The protein expression of potential Aβ-degrading enzymes were also examined. Neprilysin levels were not different in AD liver samples, while cathepsin D and insulin-degrading enzyme were significantly altered in AD subjects. The results support the possibility that impaired hepatic Aβ degradation could be a factor contributing to increased brain Aβ accumulation and AD.
Collapse
Affiliation(s)
- Chera L. Maarouf
- Banner Sun Health Research Institute, Sun City, AZ, United States of America
| | - Jessica E. Walker
- Banner Sun Health Research Institute, Sun City, AZ, United States of America
| | - Lucia I. Sue
- Banner Sun Health Research Institute, Sun City, AZ, United States of America
| | - Brittany N. Dugger
- Department of Pathology and Laboratory Medicine, University of California Davis School of Medicine, Sacramento, CA, United States of America
| | - Thomas G. Beach
- Banner Sun Health Research Institute, Sun City, AZ, United States of America
| | - Geidy E. Serrano
- Banner Sun Health Research Institute, Sun City, AZ, United States of America
| |
Collapse
|
50
|
Dickson DW, Heckman MG, Murray ME, Soto AI, Walton RL, Diehl NN, van Gerpen JA, Uitti RJ, Wszolek ZK, Ertekin-Taner N, Knopman DS, Petersen RC, Graff-Radford NR, Boeve BF, Bu G, Ferman TJ, Ross OA. APOE ε4 is associated with severity of Lewy body pathology independent of Alzheimer pathology. Neurology 2018; 91:e1182-e1195. [PMID: 30143564 DOI: 10.1212/wnl.0000000000006212] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 06/25/2018] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To evaluate whether APOE ε4 is associated with severity of Lewy body (LB) pathology, independently of Alzheimer disease (AD) pathology. METHODS Six hundred fifty-two autopsy-confirmed LB disease (LBD) cases and 660 clinical controls were genotyped for APOE. In case-control analysis, LBD cases were classified into 9 different groups according to severity of both LB pathology (brainstem, transitional, diffuse) and AD pathology (low, moderate, high) to assess associations between APOE ε4 and risk of different neuropathologically defined LBD subgroups in comparison to controls. In LBD cases only, we also measured LB counts from 5 cortical regions and evaluated associations with ε4 according to severity of AD pathology. RESULTS As expected, APOE ε4 was associated with an increased risk of transitional and diffuse LBD in cases with moderate or high AD pathology (all odds ratios ≥3.42, all p ≤ 0.004). Of note, ε4 was also associated with an increased risk of diffuse LBD with low AD pathology (odds ratio = 3.46, p = 0.001). In the low AD pathology LBD subgroup, ε4 was associated with significantly more LB counts in the 5 cortical regions, independently of Braak stage and Thal phase (all p ≤ 0.002). CONCLUSIONS Our results indicate that APOE ε4 is independently associated with a greater severity of LB pathology. These findings increase our understanding of the mechanism behind reported associations of ε4 with risk of dementia with Lewy bodies and Parkinson disease with dementia, and suggest that ε4 may function as a modifier of processes that favor LB spread rather than acting directly to initiate LB pathology.
Collapse
Affiliation(s)
- Dennis W Dickson
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Michael G Heckman
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Melissa E Murray
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Alexandra I Soto
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Ronald L Walton
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Nancy N Diehl
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Jay A van Gerpen
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Ryan J Uitti
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Zbigniew K Wszolek
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Nilüfer Ertekin-Taner
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - David S Knopman
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Ronald C Petersen
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Neill R Graff-Radford
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Bradley F Boeve
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Guojun Bu
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Tanis J Ferman
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN
| | - Owen A Ross
- From the Department of Neuroscience (D.W.D., M.E.M., A.I.S., R.W., N.E.-T., G.B., O.A.R.), Division of Biomedical Statistics and Informatics (M.G.H., N.N.D.), and Departments of Neurology (J.A.v.G., R.J.U., Z.K.W., N.E.-T., N.R.G.-R.) and Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL; and Department of Neurology (D.S.K., R.C.P., B.F.B.), Mayo Clinic, Rochester, MN.
| |
Collapse
|