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Zakharova NV, Bugrova AE, Indeykina MI, Fedorova YB, Kolykhalov IV, Gavrilova SI, Nikolaev EN, Kononikhin AS. Proteomic Markers and Early Prediction of Alzheimer's Disease. BIOCHEMISTRY. BIOKHIMIIA 2022; 87:762-776. [PMID: 36171657 DOI: 10.1134/s0006297922080089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 06/16/2023]
Abstract
Alzheimer's disease (AD) is the most common socially significant neurodegenerative pathology, which currently affects more than 30 million elderly people worldwide. Since the number of patients grows every year and may exceed 115 million by 2050, and due to the lack of effective therapies, early prediction of AD remains a global challenge, solution of which can contribute to the timely appointment of a preventive therapy in order to avoid irreversible changes in the brain. To date, clinical assays for the markers of amyloidosis in cerebrospinal fluid (CSF) have been developed, which, in conjunction with the brain MRI and PET studies, are used either to confirm the diagnosis based on obligate clinical criteria or to predict the risk of AD developing at the stage of mild cognitive impairment (MCI). However, the problem of predicting AD at the asymptomatic stage remains unresolved. In this regard, the search for new protein markers and studies of proteomic changes in CSF and blood plasma are of particular interest and may consequentially identify particular pathways involved in the pathogenesis of AD. Studies of specific proteomic changes in blood plasma deserve special attention and are of increasing interest due to the much less invasive method of sample collection as compared to CSF, which is important when choosing the object for large-scale screening. This review briefly summarizes the current knowledge on proteomic markers of AD and considers the prospects of developing reliable methods for early identification of AD risk factors based on the proteomic profile.
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Affiliation(s)
- Natalia V Zakharova
- Emanuel Institute for Biochemical Physics, Russian Academy of Sciences, Moscow, 119334, Russia.
| | - Anna E Bugrova
- Emanuel Institute for Biochemical Physics, Russian Academy of Sciences, Moscow, 119334, Russia
| | - Maria I Indeykina
- Emanuel Institute for Biochemical Physics, Russian Academy of Sciences, Moscow, 119334, Russia
| | | | | | | | - Evgeny N Nikolaev
- Skolkovo Institute of Science and Technology, Moscow, 121205, Russia
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2
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Salimi M, Tabasi F, Abdolsamadi M, Dehghan S, Dehdar K, Nazari M, Javan M, Mirnajafi-Zadeh J, Raoufy MR. Disrupted connectivity in the olfactory bulb-entorhinal cortex-dorsal hippocampus circuit is associated with recognition memory deficit in Alzheimer's disease model. Sci Rep 2022; 12:4394. [PMID: 35292712 PMCID: PMC8924156 DOI: 10.1038/s41598-022-08528-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/02/2022] [Indexed: 12/18/2022] Open
Abstract
Neural synchrony in brain circuits is the mainstay of cognition, including memory processes. Alzheimer's disease (AD) is a progressive neurodegenerative disorder that disrupts neural synchrony in specific circuits, associated with memory dysfunction before a substantial neural loss. Recognition memory impairment is a prominent cognitive symptom in the early stages of AD. The entorhinal–hippocampal circuit is critically engaged in recognition memory and is known as one of the earliest circuits involved due to AD pathology. Notably, the olfactory bulb is closely connected with the entorhinal–hippocampal circuit and is suggested as one of the earliest regions affected by AD. Therefore, we recorded simultaneous local field potential from the olfactory bulb (OB), entorhinal cortex (EC), and dorsal hippocampus (dHPC) to explore the functional connectivity in the OB-EC-dHPC circuit during novel object recognition (NOR) task performance in a rat model of AD. Animals that received amyloid-beta (Aβ) showed a significant impairment in task performance and a marked reduction in OB survived cells. We revealed that Aβ reduced coherence and synchrony in the OB-EC-dHPC circuit at theta and gamma bands during NOR performance. Importantly, our results exhibit that disrupted functional connectivity in the OB-EC-dHPC circuit was correlated with impaired recognition memory induced by Aβ. These findings can elucidate dynamic changes in neural activities underlying AD, helping to find novel diagnostic and therapeutic targets.
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Affiliation(s)
- Morteza Salimi
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, 1411713116, Iran
| | - Farhad Tabasi
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, 1411713116, Iran.,Faculty of Medical Sciences, Institute for Brain Sciences and Cognition, Tarbiat Modares University, Tehran, Iran
| | - Maryam Abdolsamadi
- Department of Mathematics, Faculty of Science, Islamic Azad University, North Tehran Branch, Tehran, Iran
| | - Samaneh Dehghan
- Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran.,Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Kolsoum Dehdar
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, 1411713116, Iran.,Faculty of Medical Sciences, Institute for Brain Sciences and Cognition, Tarbiat Modares University, Tehran, Iran
| | - Milad Nazari
- Department of Molecular Biology and Genetics, Aarhus University, Aarhus, Denmark.,DANDRITE, The Danish Research Institute of Translational Neuroscience, Aarhus University, Aarhus, Denmark
| | - Mohammad Javan
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, 1411713116, Iran.,Faculty of Medical Sciences, Institute for Brain Sciences and Cognition, Tarbiat Modares University, Tehran, Iran
| | - Javad Mirnajafi-Zadeh
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, 1411713116, Iran.,Faculty of Medical Sciences, Institute for Brain Sciences and Cognition, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Reza Raoufy
- Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, 1411713116, Iran. .,Faculty of Medical Sciences, Institute for Brain Sciences and Cognition, Tarbiat Modares University, Tehran, Iran.
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3
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Need for an Update for the Guideline for the Management of Mild Cognitive Impairment. Dement Neurocogn Disord 2022; 21:107-116. [DOI: 10.12779/dnd.2022.21.4.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/09/2022] Open
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4
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Gjerum L, Andersen BB, Bruun M, Simonsen AH, Henriksen OM, Law I, Hasselbalch SG, Frederiksen KS. Comparison of the clinical impact of 2-[18F]FDG-PET and cerebrospinal fluid biomarkers in patients suspected of Alzheimer's disease. PLoS One 2021; 16:e0248413. [PMID: 33711065 PMCID: PMC7954298 DOI: 10.1371/journal.pone.0248413] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/26/2021] [Indexed: 12/14/2022] Open
Abstract
Background The two biomarkers 2-[18F]FDG-PET and cerebrospinal fluid biomarkers are both recommended to support the diagnosis of Alzheimer’s disease. However, there is a lack of knowledge for the comparison of the two biomarkers in a routine clinical setting. Objective The aim was to compare the clinical impact of 2-[18F]FDG-PET and cerebrospinal fluid biomarkers on diagnosis, prognosis, and patient management in patients suspected of Alzheimer’s disease. Methods Eighty-one patients clinically suspected of Alzheimer’s disease were retrospectively included from the Copenhagen Memory Clinic. As part of the clinical work-up all patients had a standard diagnostic program examination including MRI and ancillary investigations with 2-[18F]FDG-PET and cerebrospinal fluid biomarkers. An incremental study design was used to evaluate the clinical impact of the biomarkers. First, the diagnostic evaluation was based on the standard diagnostic program, then the diagnostic evaluation was revised after addition of either cerebrospinal fluid biomarkers or 2-[18F]FDG-PET. At each diagnostic evaluation, two blinded dementia specialists made a consensus decision on diagnosis, prediction of disease course, and change in patient management. Confidence in the decision was measured on a visual analogue scale (0–100). After 6 months, the diagnostic evaluation was performed with addition of the other biomarker. A clinical follow-up after 12 months was used as reference for diagnosis and disease course. Results The two biomarkers had a similar clinical value across all diagnosis when added individually to the standard diagnostic program. However, for the correctly diagnosed patient with Alzheimer’s disease cerebrospinal fluid biomarkers had a significantly higher impact on diagnostic confidence (mean scores±SD: 88±11 vs. 82±11, p = 0.046) and a significant reduction in the need for ancillary investigations (23 vs. 18 patients, p = 0.049) compared to 2-[18F]FDG-PET. Conclusion The two biomarkers had similar clinical impact on diagnosis, but cerebrospinal fluid biomarkers had a more significant value in corroborating the diagnosis of Alzheimer’s disease compared to 2-[18F]FDG-PET.
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Affiliation(s)
- Le Gjerum
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Bo Andersen
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Marie Bruun
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anja Hviid Simonsen
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Otto Mølby Henriksen
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Steen Gregers Hasselbalch
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Kristian Steen Frederiksen
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
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Tabassum S, Misrani A, Tabassum S, Ahmed A, Yang L, Long C. Disrupted prefrontal neuronal oscillations and morphology induced by sleep deprivation in young APP/PS1 transgenic AD mice. Brain Res Bull 2020; 166:12-20. [PMID: 33186630 DOI: 10.1016/j.brainresbull.2020.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 10/31/2020] [Accepted: 11/06/2020] [Indexed: 12/20/2022]
Abstract
Emerging evidence suggests that sleep deprivation (SD) is a public health epidemic and increase the risk of Alzheimer's disease (AD) progression. However, the underlying mechanisms remain to be fully investigated. In this study, we investigate the impact of 72 h SD on the prefrontal cortex (PFC) of 3∼4-months-old APP/PS1 transgenic AD mice - at an age before the onset of plaque formation and memory decline. Our results reveal that SD alters delta, theta and high-gamma oscillations in the PFC, accompanied by increased levels of excitatory postsynaptic signaling (NMDAR, GluR1, and CaMKII) in AD mice. SD also caused alteration in the dendritic length and dendritic branches of PFC pyramidal neurons, accompanied by a reduction in neuroprotective agent CREB. This study suggests that failure to acquire adequate sleep could trigger an early electrophysiological, molecular, and morphological alteration in the PFC of AD mice. Therapeutic interventions that manipulate sleep by targeting these pathways may be a promising approach toward delaying the progression of this incurable disease.
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Affiliation(s)
- Sidra Tabassum
- School of Life Sciences, South China Normal University, Guangzhou 510631, PR China; School of Life Sciences, Guangzhou University, Guangzhou 510006, PR China
| | - Afzal Misrani
- School of Life Sciences, South China Normal University, Guangzhou 510631, PR China; School of Life Sciences, Guangzhou University, Guangzhou 510006, PR China
| | - Sumaiya Tabassum
- School of Life Sciences, South China Normal University, Guangzhou 510631, PR China
| | - Adeel Ahmed
- School of Life Sciences, South China Normal University, Guangzhou 510631, PR China
| | - Li Yang
- School of Life Sciences, Guangzhou University, Guangzhou 510006, PR China.
| | - Cheng Long
- School of Life Sciences, South China Normal University, Guangzhou 510631, PR China; South China Normal University-Panyu Central Hospital Joint Laboratory of Translational Medical Research, Panyu Central Hospital, Guangzhou 511400, PR China.
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Cecchini MA, Foss MP, Tumas V, Patrocinio FAP, Chiari-Correia RD, Novaretti N, Brozinga TR, Bahia VS, de Souza LC, Cerqueira Guimarães H, Caramelli P, Lima-Silva TB, Cassimiro L, Brucki SMD, Nitrini R, Della Sala S, Parra MA, Yassuda MS. Profiles of cognitive impairment in the continuum from normal cognition to Alzheimer's clinical syndrome: Contributions of the short-term memory binding tests. Int J Geriatr Psychiatry 2020; 35:1331-1340. [PMID: 32584463 DOI: 10.1002/gps.5370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/21/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND Short-term memory binding (STMB) tests assess conjunctive binding, in which participants should remember the integration of features, such as shapes (or objects) and colors, forming a unique representation in memory. In this study, we investigated two STMB paradigms: change detection (CD) and free recall (FR). OBJECTIVE To investigate the cognitive profile in the CD and FR tasks of three diagnostic groups: cognitively unimpaired (CU), mild cognitive impairment (MCI), and Alzheimer's clinical syndrome (ACS). In addition, we aimed to calculate and compare the accuracy of the CD and FR tasks to identify MCI and ACS. METHODS Participants were 24 CU, 24 MCI, and 37 ACS. The cognitive scores of the clinical groups were compared using analysis of variance (ANOVA) and receiver-operating characteristic (ROC) analyses were carried out to verify the accuracy of the STMB tasks. RESULTS In the CD task, CU was different from MCI and ACS (CU > MCI = ACS), while in the FR task all groups were different (CU > MCI > ACS). The ROC analyses showed an area under the curve (AUC) of 0.855 comparing CU with MCI for the CD task and 0.975 for the FR. The AUC comparing CU and ACS was 0.924 for the CD and 0.973 for the FR task. The FR task showed better accuracy to identify MCI patients, and the same accuracy to detect ACS. CONCLUSION The present findings indicate that impairments in CD and FR of bound representations are features of the cognitive profiles of MCI and ACS patients.
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Affiliation(s)
- Mario Amore Cecchini
- Neurology, School of Medicine, University of São Paulo, Sao Paulo, Brazil.,Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, UK
| | - Maria Paula Foss
- Neurology, School of Medicine, University of São Paulo Ribeirão Preto, Sao Paulo, Brazil
| | - Vitor Tumas
- Neurology, School of Medicine, University of São Paulo Ribeirão Preto, Sao Paulo, Brazil
| | - Flávia A P Patrocinio
- Neurology, School of Medicine, University of São Paulo Ribeirão Preto, Sao Paulo, Brazil
| | - Rodolfo D Chiari-Correia
- Center of Image Sciences and Medical Physics, University of Sao Paulo Ribeirão Preto, Sao Paulo, Brazil
| | - Nathalia Novaretti
- Neurology, School of Medicine, University of São Paulo Ribeirão Preto, Sao Paulo, Brazil
| | - Tamara R Brozinga
- Neurology, School of Medicine, University of São Paulo Ribeirão Preto, Sao Paulo, Brazil
| | | | - Leonardo Cruz de Souza
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Henrique Cerqueira Guimarães
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Paulo Caramelli
- Grupo de Pesquisa em Neurologia Cognitiva e do Comportamento, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Luciana Cassimiro
- Neurology, School of Medicine, University of São Paulo, Sao Paulo, Brazil
| | | | - Ricardo Nitrini
- Neurology, School of Medicine, University of São Paulo, Sao Paulo, Brazil
| | - Sergio Della Sala
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, UK
| | - Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.,Department of Psychology, Universidad Autónoma del Caribe, Barranquilla, Colombia
| | - Mônica Sanches Yassuda
- Neurology, School of Medicine, University of São Paulo, Sao Paulo, Brazil.,Gerontology, School of Arts, Sciences and Humanities, University of São Paulo, Sao Paulo, Brazil
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7
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Souza VC, Morais GS, Henriques AD, Machado-Silva W, Perez DIV, Brito CJ, Camargos EF, Moraes CF, Nóbrega OT. Whole-Blood Levels of MicroRNA-9 Are Decreased in Patients With Late-Onset Alzheimer Disease. Am J Alzheimers Dis Other Demen 2020; 35:1533317520911573. [PMID: 32301334 PMCID: PMC10623914 DOI: 10.1177/1533317520911573] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Recent evidence suggests changes in circulating microRNA levels may be promising biomarkers for the clinical diagnosis of Alzheimer disease (AD). We hypothesized that whole-blood microRNAs may be useful to identify individuals with established AD. For this purpose, a sample of community-dwelling women (≥55 years old) carrying the ApoE ∊4 allele were clinically evaluated using the American Psychiatric Association/Diagnostic and Statistical Manual of Mental Disorders, Fourth edition and the Alzheimer Disease Assessment Scale-Cognitive Subscale criteria to diagnose probable AD, and the Clinical Dementia Rating scale to stage the dementia. A set of 25 mature microRNAs was rationally selected for evaluation based on experimental evidence of interaction with genes linked to the late-onset AD neuropathology. Whole-blood concentrations were determined by quantitative real-time polymerase chain reaction. Compared to patients without dementia, a median 3-fold decrease in miR-9 levels was found among patients with AD (P = .001). Our findings support blood-borne miR-9 as a candidate biomarker for probable AD, embodied by evidence from the literature of its implication in amyloidogenesis.
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Affiliation(s)
| | | | | | | | | | - Ciro José Brito
- Physical Education Department, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | | | - Clayton Franco Moraes
- Medical Faculty, University of Brasília, Brasília, Federal District, Brazil
- Gerontology Program, Catholic University of Brasília, Brasília, Federal District, Brazil
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Cho BG, Veillon L, Mechref Y. N-Glycan Profile of Cerebrospinal Fluids from Alzheimer's Disease Patients Using Liquid Chromatography with Mass Spectrometry. J Proteome Res 2019; 18:3770-3779. [PMID: 31437391 PMCID: PMC7027932 DOI: 10.1021/acs.jproteome.9b00504] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Glycosylation, an essential post-translational protein modification, is known to be altered in a variety of diseases, including neurodegenerative diseases such as Alzheimer's disease (AD), which is one of the most common neurodegenerative disorders that results in cognitive and memory impairments. To investigate the progression of such a condition, cerebrospinal fluid (CSF), a unique biofluid that may possess significant biochemical and neurochemical changes due to the disease, is utilized. However, due to the low concentration of proteins in CSF, a large volume of the biofluid is often required to comprehensively characterize the glycome in CSF. In this work, a glycomic study of CSF was performed using as little as 10 μL of CSF. This approach was executed with permethylation of released N-glycans with minimal sample cleanup, in conjunction with an online purification system attached to liquid chromatography and a high-resolution mass spectrometer. This technique was then applied to clinical samples. Preliminary data suggest that fucosylated and bisecting GlcNAc structures were higher in abundances in females with AD, while both females and males exhibited lower abundances of high-mannose structures. Although there seems to be statistically significant differences between disease state and disease-free CSF, due to the lack of number of samples, further validation study should be conducted.
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Affiliation(s)
- Byeong Gwan Cho
- Department of Chemistry and Biochemistry, Texas Tech University, Lubbock, TX 79409-1061
| | - Lucas Veillon
- Department of Chemistry and Biochemistry, Texas Tech University, Lubbock, TX 79409-1061
| | - Yehia Mechref
- Department of Chemistry and Biochemistry, Texas Tech University, Lubbock, TX 79409-1061
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Lipidomic alterations in lipoproteins of patients with mild cognitive impairment and Alzheimer’s disease by asymmetrical flow field-flow fractionation and nanoflow ultrahigh performance liquid chromatography-tandem mass spectrometry. J Chromatogr A 2018; 1568:91-100. [DOI: 10.1016/j.chroma.2018.07.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/22/2018] [Accepted: 07/04/2018] [Indexed: 12/29/2022]
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10
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Eliassen CF, Reinvang I, Selnes P, Fladby T, Hessen E. Convergent Results from Neuropsychology and from Neuroimaging in Patients with Mild Cognitive Impairment. Dement Geriatr Cogn Disord 2018; 43:144-154. [PMID: 28152536 DOI: 10.1159/000455832] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS To investigate the correspondence between neuropsychological single measures and variation in fludeoxyglucose positron emission tomography (FDG PET) glucose metabolism and magnetic resonance imaging (MRI) cortical thickness in mild cognitive impairment (MCI) patients. METHODS Forty-two elderly controls and 73 MCI subjects underwent FDG PET and MRI scanning. Backward regression analyses with PET and MRI regions were used as dependent variables, while Rey Auditory Verbal Memory Test (RAVLT) recall, Trail Making Test B (TMT B), and a composite test score (RAVLT learning and immediate recall, TMT A, COWAT, and letter-number sequencing) were used as predictor variables. RESULTS The composite score predicted variation in cortical metabolism; supplementary analyses showed that TMT B was significantly correlated with PET metabolism as well. RAVLT and TMT B were significant predictors of variation in MRI cortical thickness. CONCLUSION Our results indicate that RAVLT and TMT B are sensitive to variation in Alzheimer disease neuroimaging markers.
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Goodman MS, Kumar S, Zomorrodi R, Ghazala Z, Cheam ASM, Barr MS, Daskalakis ZJ, Blumberger DM, Fischer C, Flint A, Mah L, Herrmann N, Bowie CR, Mulsant BH, Rajji TK. Theta-Gamma Coupling and Working Memory in Alzheimer's Dementia and Mild Cognitive Impairment. Front Aging Neurosci 2018; 10:101. [PMID: 29713274 PMCID: PMC5911490 DOI: 10.3389/fnagi.2018.00101] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 03/26/2018] [Indexed: 01/09/2023] Open
Abstract
Working memory deficits are common among individuals with Alzheimer's dementia (AD) or mild cognitive impairment (MCI). Yet, little is known about the mechanisms underlying these deficits. Theta-gamma coupling-the modulation of high-frequency gamma oscillations by low-frequency theta oscillations-is a neurophysiologic process underlying working memory. We assessed the relationship between theta-gamma coupling and working memory deficits in AD and MCI. We hypothesized that: (1) individuals with AD would display the most significant working memory impairments followed by MCI and finally healthy control (HC) participants; and (2) there would be a significant association between working memory performance and theta-gamma coupling across all participants. Ninety-eight participants completed the N-back working memory task during an electroencephalography (EEG) recording: 33 with AD (mean ± SD age: 76.5 ± 6.2), 34 with MCI (mean ± SD age: 74.8 ± 5.9) and 31 HCs (mean ± SD age: 73.5 ± 5.2). AD participants performed significantly worse than control and MCI participants on the 1- and 2-back conditions. Regarding theta-gamma coupling, AD participants demonstrated the lowest level of coupling followed by the MCI and finally control participants on the 2-back condition. Finally, a linear regression analysis demonstrated that theta-gamma coupling (β = 0.69, p < 0.001) was the most significant predictor of 2-back performance. Our results provide evidence for a relationship between altered theta-gamma coupling and working memory deficits in individuals with AD and MCI. They also provide insight into a potential mechanism underlying working memory impairments in these individuals.
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Affiliation(s)
- Michelle S Goodman
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sanjeev Kumar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Reza Zomorrodi
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Zaid Ghazala
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Amay S M Cheam
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Mera S Barr
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Zafiris J Daskalakis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Daniel M Blumberger
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Corinne Fischer
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
| | - Alastair Flint
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Mental Health, University Health Network, Toronto, ON, Canada
| | - Linda Mah
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, ON, Canada
| | - Nathan Herrmann
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Christopher R Bowie
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Benoit H Mulsant
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Tarek K Rajji
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Caminiti SP, Ballarini T, Sala A, Cerami C, Presotto L, Santangelo R, Fallanca F, Vanoli EG, Gianolli L, Iannaccone S, Magnani G, Perani D. FDG-PET and CSF biomarker accuracy in prediction of conversion to different dementias in a large multicentre MCI cohort. Neuroimage Clin 2018; 18:167-177. [PMID: 29387532 PMCID: PMC5790816 DOI: 10.1016/j.nicl.2018.01.019] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/15/2017] [Accepted: 01/18/2018] [Indexed: 01/29/2023]
Abstract
Background/aims In this multicentre study in clinical settings, we assessed the accuracy of optimized procedures for FDG-PET brain metabolism and CSF classifications in predicting or excluding the conversion to Alzheimer's disease (AD) dementia and non-AD dementias. Methods We included 80 MCI subjects with neurological and neuropsychological assessments, FDG-PET scan and CSF measures at entry, all with clinical follow-up. FDG-PET data were analysed with a validated voxel-based SPM method. Resulting single-subject SPM maps were classified by five imaging experts according to the disease-specific patterns, as "typical-AD", "atypical-AD" (i.e. posterior cortical atrophy, asymmetric logopenic AD variant, frontal-AD variant), "non-AD" (i.e. behavioural variant FTD, corticobasal degeneration, semantic variant FTD; dementia with Lewy bodies) or "negative" patterns. To perform the statistical analyses, the individual patterns were grouped either as "AD dementia vs. non-AD dementia (all diseases)" or as "FTD vs. non-FTD (all diseases)". Aβ42, total and phosphorylated Tau CSF-levels were classified dichotomously, and using the Erlangen Score algorithm. Multivariate logistic models tested the prognostic accuracy of FDG-PET-SPM and CSF dichotomous classifications. Accuracy of Erlangen score and Erlangen Score aided by FDG-PET SPM classification was evaluated. Results The multivariate logistic model identified FDG-PET "AD" SPM classification (Expβ = 19.35, 95% C.I. 4.8-77.8, p < 0.001) and CSF Aβ42 (Expβ = 6.5, 95% C.I. 1.64-25.43, p < 0.05) as the best predictors of conversion from MCI to AD dementia. The "FTD" SPM pattern significantly predicted conversion to FTD dementias at follow-up (Expβ = 14, 95% C.I. 3.1-63, p < 0.001). Overall, FDG-PET-SPM classification was the most accurate biomarker, able to correctly differentiate either the MCI subjects who converted to AD or FTD dementias, and those who remained stable or reverted to normal cognition (Expβ = 17.9, 95% C.I. 4.55-70.46, p < 0.001). Conclusions Our results support the relevant role of FDG-PET-SPM classification in predicting progression to different dementia conditions in prodromal MCI phase, and in the exclusion of progression, outperforming CSF biomarkers.
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Key Words
- AD, Alzheimer's disease
- AUC, area under curve
- Alzheimer's disease dementia
- CBD, corticobasal degeneration
- CDR, Clinical Dementia Rating
- CSF, cerebrospinal fluid
- Clinical setting
- DLB, dementia with Lewy bodies
- EANM, European Association of Nuclear Medicine
- Erlangen Score
- FDG, fluorodeoxyglucose
- FTD, frontotemporal dementia
- Frontotemporal dementia
- LR+, positive likelihood ratio
- LR-, negative likelihood ratio
- MCI, mild cognitive impairment
- PET, positron emission tomography
- PSP, progressive supranuclear palsy
- Prognosis
- aMCI, single-domain amnestic mild cognitive impairment
- bvFTD, behavioral variant of frontotemporal dementia
- md aMCI, multi-domain amnestic mild cognitive impairment
- md naMCI, multi-domain non-amnestic mild cognitive impairment
- naMCI, single-domain non-amnestic mild cognitive impairment
- p-tau, phosphorylated tau
- t-tau, total tau
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Affiliation(s)
- Silvia Paola Caminiti
- Vita-Salute San Raffaele University, Milan, Italy; Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Tommaso Ballarini
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Arianna Sala
- Vita-Salute San Raffaele University, Milan, Italy; Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Cerami
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Clinical Neuroscience Department, San Raffaele Turro Hospital, Milan, Italy
| | - Luca Presotto
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Santangelo
- Department of Neurology and INSPE, San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Luigi Gianolli
- Nuclear Medicine Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Sandro Iannaccone
- Clinical Neuroscience Department, San Raffaele Turro Hospital, Milan, Italy
| | - Giuseppe Magnani
- Department of Neurology and INSPE, San Raffaele Scientific Institute, Milan, Italy
| | - Daniela Perani
- Vita-Salute San Raffaele University, Milan, Italy; Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Nuclear Medicine Unit, IRCCS San Raffaele Hospital, Milan, Italy.
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Serpente M, Fenoglio C, Cioffi SMG, Oldoni E, Arcaro M, Arighi A, Fumagalli GG, Ghezzi L, Scarpini E, Galimberti D. Profiling of Specific Gene Expression Pathways in Peripheral Cells from Prodromal Alzheimer’s Disease Patients. J Alzheimers Dis 2018; 61:1289-1294. [DOI: 10.3233/jad-170861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Maria Serpente
- Department of Pathophysiology and Transplantation, Neurodegenerative Disease Unit, “Dino Ferrari” Center, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Fenoglio
- Department of Pathophysiology and Transplantation, Neurodegenerative Disease Unit, “Dino Ferrari” Center, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara Maria Giulia Cioffi
- Department of Pathophysiology and Transplantation, Neurodegenerative Disease Unit, “Dino Ferrari” Center, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Emanuela Oldoni
- Department of Pathophysiology and Transplantation, Neurodegenerative Disease Unit, “Dino Ferrari” Center, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Marina Arcaro
- Department of Pathophysiology and Transplantation, Neurodegenerative Disease Unit, “Dino Ferrari” Center, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Arighi
- Department of Pathophysiology and Transplantation, Neurodegenerative Disease Unit, “Dino Ferrari” Center, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Giorgio Giulio Fumagalli
- Department of Pathophysiology and Transplantation, Neurodegenerative Disease Unit, “Dino Ferrari” Center, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Laura Ghezzi
- Department of Pathophysiology and Transplantation, Neurodegenerative Disease Unit, “Dino Ferrari” Center, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Elio Scarpini
- Department of Pathophysiology and Transplantation, Neurodegenerative Disease Unit, “Dino Ferrari” Center, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniela Galimberti
- Department of Pathophysiology and Transplantation, Neurodegenerative Disease Unit, “Dino Ferrari” Center, University of Milan, Fondazione Cà Granda, IRCCS Ospedale Maggiore Policlinico, Milan, Italy
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14
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Frisoni GB, Boccardi M, Barkhof F, Blennow K, Cappa S, Chiotis K, Démonet JF, Garibotto V, Giannakopoulos P, Gietl A, Hansson O, Herholz K, Jack CR, Nobili F, Nordberg A, Snyder HM, Ten Kate M, Varrone A, Albanese E, Becker S, Bossuyt P, Carrillo MC, Cerami C, Dubois B, Gallo V, Giacobini E, Gold G, Hurst S, Lönneborg A, Lovblad KO, Mattsson N, Molinuevo JL, Monsch AU, Mosimann U, Padovani A, Picco A, Porteri C, Ratib O, Saint-Aubert L, Scerri C, Scheltens P, Schott JM, Sonni I, Teipel S, Vineis P, Visser PJ, Yasui Y, Winblad B. Strategic roadmap for an early diagnosis of Alzheimer's disease based on biomarkers. Lancet Neurol 2017; 16:661-676. [PMID: 28721928 DOI: 10.1016/s1474-4422(17)30159-x] [Citation(s) in RCA: 394] [Impact Index Per Article: 56.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 04/27/2017] [Accepted: 04/28/2017] [Indexed: 12/15/2022]
Abstract
The diagnosis of Alzheimer's disease can be improved by the use of biological measures. Biomarkers of functional impairment, neuronal loss, and protein deposition that can be assessed by neuroimaging (ie, MRI and PET) or CSF analysis are increasingly being used to diagnose Alzheimer's disease in research studies and specialist clinical settings. However, the validation of the clinical usefulness of these biomarkers is incomplete, and that is hampering reimbursement for these tests by health insurance providers, their widespread clinical implementation, and improvements in quality of health care. We have developed a strategic five-phase roadmap to foster the clinical validation of biomarkers in Alzheimer's disease, adapted from the approach for cancer biomarkers. Sufficient evidence of analytical validity (phase 1 of a structured framework adapted from oncology) is available for all biomarkers, but their clinical validity (phases 2 and 3) and clinical utility (phases 4 and 5) are incomplete. To complete these phases, research priorities include the standardisation of the readout of these assays and thresholds for normality, the evaluation of their performance in detecting early disease, the development of diagnostic algorithms comprising combinations of biomarkers, and the development of clinical guidelines for the use of biomarkers in qualified memory clinics.
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Affiliation(s)
- Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University Hospitals and University of Geneva, Geneva, Switzerland; Department of Internal Medicine, University Hospitals and University of Geneva, Geneva, Switzerland.
| | - Marina Boccardi
- Laboratory of Neuroimaging of Aging (LANVIE), University Hospitals and University of Geneva, Geneva, Switzerland; Laboratory of Alzheimer Neuroimaging and Epidemiology (LANE), IRCCS S Giovanni di Dio-Fatebenefratelli, Brescia, Italy
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, Netherlands; Institute of Neurology, University College London, London, UK; Institute of Healthcare Engineering, University College London, London, UK; European Society of Neuroradiology, Zurich, Switzerland
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; International Federation of Clinical Chemistry and Laboratory Medicine Working Group for CSF proteins (IFCC WG-CSF), Gothenburg, Sweden
| | - Stefano Cappa
- Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, Netherlands; Istituto Universitario di Studi Superiori di Pavia, Pavia, Italy, on behalf of Federation of European Neuropsychological Societies
| | - Konstantinos Chiotis
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Translational Alzheimer Neurobiology, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Jean-Francois Démonet
- Leenards Memory Centre, Department of Clinical Neuroscience, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Valentina Garibotto
- Nuclear Medicine and Molecular Imaging Division, University Hospitals and University of Geneva, Geneva, Switzerland
| | | | - Anton Gietl
- Institute for Regenerative Medicine-IREM, University of Zurich Campus Schlieren, Zurich, Switzerland
| | - Oskar Hansson
- Memory Clinic, Skåne University Hospital, Lund, Sweden; Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Karl Herholz
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | | | - Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy; IRCCS AOU San Martino-IST, Genoa, Italy, on behalf of the European Association of Nuclear Medicine
| | - Agneta Nordberg
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Translational Alzheimer Neurobiology, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | | | - Mara Ten Kate
- Department of Neurology, Alzheimer Centre, VU University Medical Centre, Amsterdam, Netherlands
| | - Andrea Varrone
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Emiliano Albanese
- Department of Psychiatry, University Hospitals and University of Geneva, Geneva, Switzerland
| | | | - Patrick Bossuyt
- Clinical Epidemiology, University of Amsterdam, Amsterdam, Netherlands, on behalf of the European Federation of Laboratory Medicine
| | | | - Chiara Cerami
- Clinical Neuroscience Department, Vita-Salute San Raffaele University, Milan, Italy; Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Bruno Dubois
- Institut de la Mémoire et de la Maladie d'Alzheimer, Hôpital Pitié Salpêtrière, UPMC University Paris 6, Paris, France
| | - Valentina Gallo
- Centre for Primary Care and Public Health, Barts and The London School of Medicine, Blizard Institute, Queen Mary University of London, London, UK
| | - Ezio Giacobini
- Department of Internal Medicine, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Gabriel Gold
- Service of Geriatrics, Department of Internal Medicine Rehabilitation and Geriatrics, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Samia Hurst
- Institute for Ethics, History, and the Humanities, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Anders Lönneborg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Karl-Olof Lovblad
- Diagnostic and Interventional Neuroradiology, University Hospital of Geneva, Geneva, Switzerland
| | - Niklas Mattsson
- Memory Clinic, Skåne University Hospital, Lund, Sweden; Department of Neurology, Skåne University Hospital, Lund, Sweden; Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - José-Luis Molinuevo
- Barcelona Beta Brain Research Centre, Pasqual Maragall Foundation, Barcelona, Spain
| | - Andreas U Monsch
- Memory Clinic, University Centre for Medicine of Ageing, Felix Platter Hospital, Basel, Switzerland
| | - Urs Mosimann
- Department of Old Age Psychiatry, University of Bern, Bern, Switzerland
| | - Alessandro Padovani
- Department of Clinical Neurosciences, Faculty of Medicine, University of Brescia, Brescia, Italy
| | - Agnese Picco
- Laboratory of Neuroimaging of Aging (LANVIE), University Hospitals and University of Geneva, Geneva, Switzerland; Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Corinna Porteri
- Bioethics Unit, IRCCS S Giovanni di Dio-Fatebenefratelli, Brescia, Italy
| | - Osman Ratib
- Department of Radiology, University Hospital of Geneva, Geneva, Switzerland; Division of Nuclear Medicine, University Hospital of Geneva, Geneva, Switzerland
| | - Laure Saint-Aubert
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Translational Alzheimer Neurobiology, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Charles Scerri
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta; Alzheimer Europe, Luxembourg, Luxembourg
| | - Philip Scheltens
- Department of Neurology, Alzheimer Centre, VU University Medical Centre, Amsterdam, Netherlands
| | | | - Ida Sonni
- PET Centre, Department of Clinical Neurosciences, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden; Division of Nuclear Medicine and Molecular Imaging, Stanford University, Standford, CA, USA
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE)-Rostock/Greifswald, Rostock, Germany; Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| | - Paolo Vineis
- Faculty of Medicine, Imperial College London, London, UK
| | - Pieter Jelle Visser
- Department of Neurology, Alzheimer Centre, VU University Medical Centre, Amsterdam, Netherlands; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Yutaka Yasui
- St Jude Children's Research Hospital, Memphis, TN, USA
| | - Bengt Winblad
- Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden; Department of Neurobiology, Care Siences and Society, Centre for Alzheimer Research, Division of Neurogeriatrics, Karolinska Institutet, Huddinge, Sweden; European Alzheimer's Disease Consortium
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15
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Lauer J, Moreno-López L, Manktelow A, Carroll EL, Outtrim JG, Coles JP, Newcombe VF, Sahakian BJ, Menon DK, Stamatakis EA. Neural correlates of visual memory in patients with diffuse axonal injury. Brain Inj 2017; 31:1513-1520. [PMID: 28707953 DOI: 10.1080/02699052.2017.1341998] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PRIMARY OBJECTIVE To investigate the neural substrates of visual memory in a sample of patients with traumatic brain injury (TBI). We hypothesized that patients with decreased grey and white matter volume in frontal and parietal cortices as well as medial temporal and occipital lobes would perform poorly on the tests of visual memory analysed. METHODS AND PROCEDURES 39 patients and 53 controls were assessed on tests of visual memory and learning from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Patients with TBI were scanned with magnetic resonance imaging (MRI). Partial correlations and multiple regression analyses were used to examine relationships between cognitive variables and MRI volumetric findings. This study complements and extends previous studies by performing volumetric comparisons on a variety of resolution levels, from whole brain to voxel-based level analysis. MAIN OUTCOMES AND RESULTS Patients with TBI performed significantly worse than controls in all the tasks assessed. Performance was associated with wide-spread reductions in grey and white matter volume of several cortical and subcortical structures as well as with cerebrospinal fluid space enlargement in accordance with previous studies of memory in patients with TBI and cognitive models suggesting that memory problems involve the alteration of multiple systems. CONCLUSIONS Our results propose that compromised visual memory in patients with TBI is related to a distributed pattern of volume loss in regions mediating memory and attentional processing.
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Affiliation(s)
- Juliane Lauer
- a Division of Anaesthesia , University of Cambridge , Cambridge , UK
| | | | - Anne Manktelow
- a Division of Anaesthesia , University of Cambridge , Cambridge , UK
| | - Ellen L Carroll
- a Division of Anaesthesia , University of Cambridge , Cambridge , UK
| | - Joanne G Outtrim
- a Division of Anaesthesia , University of Cambridge , Cambridge , UK
| | - Jonathan P Coles
- a Division of Anaesthesia , University of Cambridge , Cambridge , UK
| | - Virginia F Newcombe
- a Division of Anaesthesia , University of Cambridge , Cambridge , UK.,c Department of Clinical Neurosciences, Wolfson Brain Imaging Centre , University of Cambridge , Cambridge Biomedical Campus, Cambridge , UK
| | - Barbara J Sahakian
- b Department of Psychiatry and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute , University of Cambridge , Cambridge , UK.,c Department of Clinical Neurosciences, Wolfson Brain Imaging Centre , University of Cambridge , Cambridge Biomedical Campus, Cambridge , UK
| | - David K Menon
- a Division of Anaesthesia , University of Cambridge , Cambridge , UK.,c Department of Clinical Neurosciences, Wolfson Brain Imaging Centre , University of Cambridge , Cambridge Biomedical Campus, Cambridge , UK
| | - Emmanuel A Stamatakis
- a Division of Anaesthesia , University of Cambridge , Cambridge , UK.,c Department of Clinical Neurosciences, Wolfson Brain Imaging Centre , University of Cambridge , Cambridge Biomedical Campus, Cambridge , UK
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16
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Huynh RA, Mohan C. Alzheimer's Disease: Biomarkers in the Genome, Blood, and Cerebrospinal Fluid. Front Neurol 2017; 8:102. [PMID: 28373857 PMCID: PMC5357660 DOI: 10.3389/fneur.2017.00102] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 03/01/2017] [Indexed: 01/20/2023] Open
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disorder that slowly destroys memory and thinking skills, resulting in behavioral changes. It is estimated that nearly 36 million are affected globally with numbers reaching 115 million by 2050. AD can only be definitively diagnosed at autopsy since its manifestations of senile plaques and neurofibrillary tangles throughout the brain cannot yet be fully captured with current imaging technologies. Current AD therapeutics have also been suboptimal. Besides identifying markers that distinguish AD from controls, there has been a recent drive to identify better biomarkers that can predict the rates of cognitive decline and neocortical amyloid burden in those who exhibit preclinical, prodromal, or clinical AD. This review covers biomarkers of three main types: genes, cerebrospinal fluid-derived, and blood-derived biomarkers. Looking ahead, cutting-edge OMICs technologies, including proteomics and metabolomics, ought to be fully tapped in order to mine even better biomarkers for AD that are more predictive.
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Affiliation(s)
- Rose Ann Huynh
- Department of Biomedical Engineering, University of Houston , Houston, TX , USA
| | - Chandra Mohan
- Department of Biomedical Engineering, University of Houston , Houston, TX , USA
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17
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Schütz L, Lobsien D, Fritzsch D, Tiepolt S, Werner P, Schroeter ML, Berrouschot J, Saur D, Hesse S, Jochimsen T, Rullmann M, Sattler B, Patt M, Gertz HJ, Villringer A, Claßen J, Hoffmann KT, Sabri O, Barthel H. Feasibility and acceptance of simultaneous amyloid PET/MRI. Eur J Nucl Med Mol Imaging 2016; 43:2236-2243. [PMID: 27435367 DOI: 10.1007/s00259-016-3462-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 07/06/2016] [Indexed: 12/22/2022]
Abstract
PURPOSE Established Alzheimer's disease (AD) biomarker concepts classify into amyloid pathology and neuronal injury biomarkers, while recent alternative concepts classify into diagnostic and progression AD biomarkers. However, combined amyloid positron emission tomography/magnetic resonance imaging (PET/MRI) offers the chance to obtain both biomarker category read-outs within one imaging session, with increased patient as well as referrer convenience. The aim of this pilot study was to investigate this matter for the first time. METHODS 100 subjects (age 70 ± 10 yrs, 46 female), n = 51 with clinically defined mild cognitive impairment (MCI), n = 44 with possible/probable AD dementia, and n = 5 with frontotemporal lobe degeneration, underwent simultaneous [18F]florbetaben or [11C]PIB PET/MRI (3 Tesla Siemens mMR). Brain amyloid load, mesial temporal lobe atrophy (MTLA) by means of the Scheltens scale, and other morphological brain pathologies were scored by respective experts. The patients/caregivers as well as the referrers were asked to assess on a five-point scale the convenience related to the one-stop-shop PET and MRI approach. RESULTS In three subjects, MRI revealed temporal lobe abnormalities other than MTLA. According to the National Institute on Aging-Alzheimer's Association classification, the combined amyloid-beta PET/MRI evaluation resulted in 31 %, 45 %, and 24 % of the MCI subjects being categorized as "MCI-unlikely due to AD", "MCI due to AD-intermediate likelihood", and "MCI due to AD-high likelihood", respectively. 50 % of the probable AD dementia patients were categorized as "High level of evidence of AD pathophysiological process", and 56 % of the possible AD dementia patients as "Possible AD dementia - with evidence of AD pathophysiological process". With regard to the International Working Group 2 classification, 36 subjects had both positive diagnostic and progression biomarkers. The patient/caregiver survey revealed a gain of convenience in 88 % of responders as compared to a theoretically separate PET and MR imaging. In the referrer survey, an influence of the combined amyloid-beta PET/MRI on the final diagnosis was reported by 82 % of responders, with a referrer acceptance score of 3.7 ± 1.0 on a 5-point scale. CONCLUSION Simultaneous amyloid PET/MRI is feasible and provides imaging biomarkers of all categories which are able to supplement the clinical diagnosis of MCI due to AD and that of AD dementia. Further, patient and referrer convenience is improved by this one-stop-shop imaging approach.
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Affiliation(s)
- Lisa Schütz
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, 04103, Leipzig, Germany
| | - Donald Lobsien
- Department of Neuroradiology, Leipzig University Hospital, 04103, Leipzig, Germany
| | - Dominik Fritzsch
- Department of Neuroradiology, Leipzig University Hospital, 04103, Leipzig, Germany
| | - Solveig Tiepolt
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, 04103, Leipzig, Germany
| | - Peter Werner
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, 04103, Leipzig, Germany
| | - Matthias L Schroeter
- Day Clinic for Cognitive Neurology, Leipzig University Hospital & Max Planck Institute for Human Cognitive and Brain Sciences, 04103, Leipzig, Germany.,IFB Adiposity Diseases, Leipzig University Hospital, 04103, Leipzig, Germany
| | | | - Dorothee Saur
- Department of Neurology, Leipzig University Hospital, 04103, Leipzig, Germany
| | - Swen Hesse
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, 04103, Leipzig, Germany.,IFB Adiposity Diseases, Leipzig University Hospital, 04103, Leipzig, Germany
| | - Thies Jochimsen
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, 04103, Leipzig, Germany
| | - Michael Rullmann
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, 04103, Leipzig, Germany
| | - Bernhard Sattler
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, 04103, Leipzig, Germany
| | - Marianne Patt
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, 04103, Leipzig, Germany
| | - Hermann-Josef Gertz
- Department of Psychiatry, Leipzig University Hospital, 04103, Leipzig, Germany
| | - Arno Villringer
- Day Clinic for Cognitive Neurology, Leipzig University Hospital & Max Planck Institute for Human Cognitive and Brain Sciences, 04103, Leipzig, Germany.,IFB Adiposity Diseases, Leipzig University Hospital, 04103, Leipzig, Germany
| | - Joseph Claßen
- Department of Neurology, Leipzig University Hospital, 04103, Leipzig, Germany
| | - Karl-Titus Hoffmann
- Department of Neuroradiology, Leipzig University Hospital, 04103, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, 04103, Leipzig, Germany.,IFB Adiposity Diseases, Leipzig University Hospital, 04103, Leipzig, Germany
| | - Henryk Barthel
- Department of Nuclear Medicine, Leipzig University Hospital, Liebigstr. 18, 04103, Leipzig, Germany.
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18
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Banik A, Brown RE, Bamburg J, Lahiri DK, Khurana D, Friedland RP, Chen W, Ding Y, Mudher A, Padjen AL, Mukaetova-Ladinska E, Ihara M, Srivastava S, Padma Srivastava MV, Masters CL, Kalaria RN, Anand A. Translation of Pre-Clinical Studies into Successful Clinical Trials for Alzheimer's Disease: What are the Roadblocks and How Can They Be Overcome? J Alzheimers Dis 2016; 47:815-43. [PMID: 26401762 DOI: 10.3233/jad-150136] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Preclinical studies are essential for translation to disease treatments and effective use in clinical practice. An undue emphasis on single approaches to Alzheimer's disease (AD) appears to have retarded the pace of translation in the field, and there is much frustration in the public about the lack of an effective treatment. We critically reviewed past literature (1990-2014), analyzed numerous data, and discussed key issues at a consensus conference on Brain Ageing and Dementia to identify and overcome roadblocks in studies intended for translation. We highlight various factors that influence the translation of preclinical research and highlight specific preclinical strategies that have failed to demonstrate efficacy in clinical trials. The field has been hindered by the domination of the amyloid hypothesis in AD pathogenesis while the causative pathways in disease pathology are widely considered to be multifactorial. Understanding the causative events and mechanisms in the pathogenesis are equally important for translation. Greater efforts are necessary to fill in the gaps and overcome a variety of confounds in the generation, study design, testing, and evaluation of animal models and the application to future novel anti-dementia drug trials. A greater variety of potential disease mechanisms must be entertained to enhance progress.
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Affiliation(s)
- Avijit Banik
- Neuroscience Research Lab, Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Richard E Brown
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - James Bamburg
- Department of Biochemistry and Molecular Biology, Colorado State University, Fort Collins, CO, USA
| | - Debomoy K Lahiri
- Departments of Psychiatry and of Medical & Molecular Genetics, Indiana University School of Medicine, Neuroscience Research Center, Indianapolis, IN, USA
| | - Dheeraj Khurana
- Neuroscience Research Lab, Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Robert P Friedland
- Department of Neurology, University of Louisville, School of Medicine, Louisville, KY, USA
| | - Wei Chen
- Division of Pulmonary Medicine, Allergy and Immunology, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ying Ding
- Department of Biostatistics, University of Pittsburgh, 318C Parran Hall, Pittsburgh, PA, USA
| | - Amritpal Mudher
- Southampton Neurosciences Group, University of Southampton, Southampton, UK
| | - Ante L Padjen
- Department of Pharmacology & Therapeutics, McGill University, Montreal, QC, Canada
| | - Elizabeta Mukaetova-Ladinska
- Institute of Neuroscience, Newcastle University, NIHR Biomedical Research Building, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - Masafumi Ihara
- Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Sudhir Srivastava
- Division of Toxicology, Central Drug Research Institute, Lucknow, India
| | - M V Padma Srivastava
- Department of Neurology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Colin L Masters
- Mental Health Research Institute, University of Melbourne, Royal Parade, The VIC, Australia
| | - Raj N Kalaria
- Institute of Neuroscience, Newcastle University, NIHR Biomedical Research Building, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Moretti DV. Electroencephalography-driven approach to prodromal Alzheimer's disease diagnosis: from biomarker integration to network-level comprehension. Clin Interv Aging 2016; 11:897-912. [PMID: 27462146 PMCID: PMC4939982 DOI: 10.2147/cia.s103313] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Decay of the temporoparietal cortex is associated with prodromal Alzheimer's disease (AD). Additionally, shrinkage of the temporoparietal cerebral area has been connected with an increase in α3/α2 electroencephalogram (EEG) power ratio in prodromal AD. Furthermore, a lower regional blood perfusion has been exhibited in patients with a higher α3/α2 proportion when contrasted with low α3/α2 proportion. Furthermore, a lower regional blood perfusion and reduced hippocampal volume has been exhibited in patients with higher α3/α2 when contrasted with lower α3/α2 EEG power ratio. Neuropsychological evaluation, EEG recording, and magnetic resonance imaging were conducted in 74 patients with mild cognitive impairment (MCI). Estimation of cortical thickness and α3/α2 frequency power ratio was conducted for each patient. A subgroup of 27 patients also underwent single-photon emission computed tomography evaluation. In view of α3/α2 power ratio, the patients were divided into three groups. The connections among cortical decay, cerebral perfusion, and memory loss were evaluated by Pearson's r coefficient. Results demonstrated that higher α3/α2 frequency power ratio group was identified with brain shrinkage and cutdown perfusion inside the temporoparietal projections. In addition, decay and cutdown perfusion rate were connected with memory shortfalls in patients with MCI. MCI subgroup with higher α3/α2 EEG power ratio are at a greater risk to develop AD dementia.
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Affiliation(s)
- Davide Vito Moretti
- Rehabilitation in Alzheimer’s Disease Operative Unit, IRCCS San Giovanni di Dio, Fatebenefratelli, Brescia, Italy
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Moretti DV. Conversion of mild cognitive impairment patients in Alzheimer's disease: prognostic value of Alpha3/Alpha2 electroencephalographic rhythms power ratio. Alzheimers Res Ther 2015; 7:80. [PMID: 26715588 PMCID: PMC4696332 DOI: 10.1186/s13195-015-0162-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 11/04/2015] [Indexed: 11/10/2022]
Abstract
INTRODUCTION The increase in electroencephalogram (EEG) alpha3/alpha2 frequency power ratio has been demonstrated as a biomarker characteristic of subjects with mild cognitive impairment (MCI) who will develop Alzheimer's disease (AD). METHODS Seventy-four adult subjects with MCI underwent clinical and neuropsychological evaluation, EEG recording, and high-resolution 3D magnetic resonance imaging (MRI). This group has been evaluated after a three years follow-up. Twenty-seven of these subjects underwent perfusion single-photon emission computed tomography (SPECT) evaluation also. Increasing alpha3/alpha2 power ratio, was computed for each subject. Differences in EEG markers, cortical thickness, brain perfusion among the groups were estimated. RESULTS In the higher alpha3/alpha2 frequency power ratio group, greater memory impairment was correlated with greater cortical atrophy and lower perfusional rate in the temporo-parietal cortex. After a follow-up of three years, these patients converted in AD. CONCLUSION High EEG upper/low alpha power ratio was associated with cortical thinning and lower perfusion in the temporo-parietal lobe. Moreover, atrophy and lower perfusion rate were both significantly correlated with memory impairment in MCI subjects. The increase of EEG upper/low alpha frequency power ratio could be useful for identifying individuals at risk for progression to AD dementia and may be of value in the clinical context.
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Affiliation(s)
- D V Moretti
- Alzheimer' Disease Rehabilitation Unit, IRCCS S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
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Abstract
This report discusses the public health impact of Alzheimer’s disease (AD), including incidence and prevalence, mortality rates, costs of care and the overall effect on caregivers and society. It also examines the challenges encountered by health care providers when disclosing an AD diagnosis to patients and caregivers. An estimated 5.3 million Americans have AD; 5.1 million are age 65 years, and approximately 200,000 are age <65 years and have younger onset AD. By mid-century, the number of people living with AD in the United States is projected to grow by nearly 10 million, fueled in large part by the aging baby boom generation. Today, someone in the country develops AD every 67 seconds. By 2050, one new case of AD is expected to develop every 33 seconds, resulting in nearly 1 million new cases per year, and the estimated prevalence is expected to range from 11 million to 16 million. In 2013, official death certificates recorded 84,767 deaths from AD, making AD the sixth leading cause of death in the United States and the fifth leading cause of death in Americans age 65 years. Between 2000 and 2013, deaths resulting from heart disease, stroke and prostate cancer decreased 14%, 23% and 11%, respectively, whereas deaths from AD increased 71%. The actual number of deaths to which AD contributes (or deaths with AD) is likely much larger than the number of deaths from AD recorded on death certificates. In 2015, an estimated 700,000 Americans age 65 years will die with AD, and many of them will die from complications caused by AD. In 2014, more than 15 million family members and other unpaid caregivers provided an estimated 17.9 billion hours of care to people with AD and other dementias, a contribution valued at more than $217 billion. Average per-person Medicare payments for services to beneficiaries age 65 years with AD and other dementias are more than two and a half times as great as payments for all beneficiaries without these conditions, and Medicaid payments are 19 times as great. Total payments in 2015 for health care, long-term care and hospice services for people age 65 years with dementia are expected to be $226 billion. Among people with a diagnosis of AD or another dementia, fewer than half report having been told of the diagnosis by their health care provider. Though the benefits of a prompt, clear and accurate disclosure of an AD diagnosis are recognized by the medical profession, improvements to the disclosure process are needed. These improvements may require stronger support systems for health care providers and their patients.
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Moretti DV. Association of EEG, MRI, and regional blood flow biomarkers is predictive of prodromal Alzheimer's disease. Neuropsychiatr Dis Treat 2015; 11:2779-91. [PMID: 26604762 PMCID: PMC4629965 DOI: 10.2147/ndt.s93253] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Thinning in the temporoparietal cortex, hippocampal atrophy, and a lower regional blood perfusion is connected with prodromal stage of Alzheimer's disease (AD). Of note, an increase of electroencephalography (EEG) upper/low alpha frequency power ratio has also been associated with these major landmarks of prodromal AD. METHODS Clinical and neuropsychological assessment, EEG recording, and high-resolution three-dimensional magnetic resonance imaging were done in 74 grown up subjects with mild cognitive impairment. This information was gathered and has been assessed 3 years postliminary. EEG recording and perfusion single-photon emission computed tomography assessment was done in 27 subjects. Alpha3/alpha2 frequency power ratio, including cortical thickness, was figured for every subject. Contrasts in cortical thickness among the groups were assessed. Pearson's r relationship coefficient was utilized to evaluate the quality of the relationship between cortical thinning, brain perfusion, and EEG markers. RESULTS The higher alpha3/alpha2 frequency power ratio group corresponded with more prominent cortical decay and a lower perfusional rate in the temporoparietal cortex. In a subsequent meetup after 3 years, these patients had AD. CONCLUSION High EEG upper/low alpha power ratio was connected with cortical diminishing and lower perfusion in the temporoparietal brain area. The increase in EEG upper/low alpha frequency power ratio could be helpful in recognizing people in danger of conversion to AD dementia and this may be quality information in connection with clinical assessment.
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Moretti DV. Mild Cognitive Impairment: Structural, Metabolical, and Neurophysiological Evidence of a Novel EEG Biomarker. Front Neurol 2015. [PMID: 26217299 PMCID: PMC4491619 DOI: 10.3389/fneur.2015.00152] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Recent studies demonstrate that the alpha3/alpha2 power ratio correlates with cortical atrophy, regional hypoperfusion, and memory impairment in subjects with mild cognitive impairment (MCI). METHODS Evidences were reviewed in subjects with MCI, who underwent EEG recording, magnetic resonance imaging (MRI) scans, and memory evaluation. Alpha3/alpha2 power ratio (alpha2 8.9-10.9 Hz range; alpha3 10.9-12.9 Hz range), cortical thickness, linear EEG coherence, and memory impairment have been evaluated in a large group of 74 patients. A subset of 27 subjects within the same group also underwent single photon emission computed tomography (SPECT) evaluation. RESULTS In MCI subjects with higher EEG upper/low alpha power ratio, a greater temporo-parietal and hippocampal atrophy was found as well as a decrease in regional blood perfusion and memory impairment. In this group, an increase of theta oscillations is associated with a greater interhemispheric coupling between temporal areas. CONCLUSION The increase of alpha3/alpha2 power ratio is a promising novel biomarker in identifying MCI subjects at risk for Alzheimer's disease.
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A Cochrane review on brain [18F]FDG PET in dementia: limitations and future perspectives. Eur J Nucl Med Mol Imaging 2015; 42:1487-91. [DOI: 10.1007/s00259-015-3098-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Moretti DV. Theta and alpha EEG frequency interplay in subjects with mild cognitive impairment: evidence from EEG, MRI, and SPECT brain modifications. Front Aging Neurosci 2015; 7:31. [PMID: 25926789 PMCID: PMC4396516 DOI: 10.3389/fnagi.2015.00031] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 02/27/2015] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Temporo-parietal and medial temporal cortex atrophy are associated with mild cognitive impairment (MCI) due to Alzheimer disease (AD) as well as the reduction of regional cerebral blood perfusion in hippocampus. Moreover, the increase of EEG alpha3/alpha2 power ratio has been associated with MCI due to AD and with an increase in theta frequency power in a group of subjects with impaired cerebral perfusion in hippocampus. METHODS Seventy four adult subjects with MCI underwent clinical and neuropsychological evaluation, electroencephalogram (EEG) recording and high resolution 3D magnetic resonance imaging (MRI). Among the patients, a subset of 27 subjects underwent also perfusion single-photon emission computed tomography and hippocampal atrophy evaluation. Alpha3/alpha2 power ratio as well as cortical thickness was computed for each subject. Three MCI groups were detected according to increasing tertile values of alpha3/alpha2 power ratio and difference of cortical thickness among the groups estimated. RESULTS Higher alpha3/alpha2 power ratio group had wider cortical thinning than other groups, mapped to the Supramarginal and Precuneus bilaterally. Subjects with higher alpha3/alpha2 frequency power ratio showed a constant trend to a lower perfusion than lower alpha3/alpha2 group. Moreover, this group correlates with both a bigger hippocampal atrophy and an increase of theta frequency power. CONCLUSION Higher EEG alpha3/alpha2 power ratio was associated with temporo-parietal cortical thinning, hippocampal atrophy and reduction of regional cerebral perfusion in medial temporal cortex. In this group an increase of theta frequency power was detected inMCI subjects. The combination of higher EEG alpha3/alpha2 power ratio, cortical thickness measure and regional cerebral perfusion reveals a complex interplay between EEG cerebral rhythms, structural and functional brain modifications.
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Affiliation(s)
- Davide V. Moretti
- Istituto di Ricovero e Cura a Carattere Scientifico San Giovanni di Dio – Fatebenefratelli, Brescia, Italy
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Moretti DV. Understanding early dementia: EEG, MRI, SPECT and memory evaluation. Transl Neurosci 2015; 6:32-46. [PMID: 28123789 PMCID: PMC4936613 DOI: 10.1515/tnsci-2015-0005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 12/01/2014] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND An increase in the EEG upper/low α power ratio has been associated with mild cognitive impairment (MCI) due to Alzheimer's disease (AD) and to the atrophy of temporoparietal brain areas. Subjects with a higher α3/α2 frequency power ratio showed lower brain perfusion than in the low α3/α2 group. The two groups show significantly different hippocampal volumes and correlation with θ frequency activity. METHODS Seventy-four adult subjects with MCI underwent clinical and neuropsychological evaluation, electroencephalogram (EEG) recording, and high resolution 3D magnetic resonance imaging (MRI). Twenty-seven of them underwent EEG recording and perfusion single-photon emission computed tomography (SPECT) evaluation. The α3/α2 power ratio and cortical thickness were computed for each subject. The difference in cortical thickness between the groups was estimated. RESULTS In the higher upper/low α group, memory impairment was more pronounced in both the MRI group and the SPECT MCI groups. An increase in the production of θ oscillations was associated with greater interhemisperic coupling between temporal areas. It also correlated with greater cortical atrophy and lower perfusional rate in the temporoparietal cortex. CONCLUSION High EEG upper/low α power ratio was associated with cortical thinning and lower perfusion in temporoparietal areas. Moreover, both atrophy and lower perfusion rate significantly correlated with memory impairment in MCI subjects. Therefore, the increase in the EEG upper/low α frequency power ratio could be useful in identifying individuals at risk for progression to AD dementia in a clinical context.
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Affiliation(s)
- Davide Vito Moretti
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Brain metabolic maps in Mild Cognitive Impairment predict heterogeneity of progression to dementia. NEUROIMAGE-CLINICAL 2014; 7:187-94. [PMID: 25610780 PMCID: PMC4300010 DOI: 10.1016/j.nicl.2014.12.004] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 07/27/2014] [Accepted: 12/01/2014] [Indexed: 12/04/2022]
Abstract
[18F]FDG-PET imaging has been recognized as a crucial diagnostic marker in Mild Cognitive Impairment (MCI), supporting the presence or the exclusion of Alzheimer's Disease (AD) pathology. A clinical heterogeneity, however, underlies MCI definition. In this study, we aimed to evaluate the predictive role of single-subject voxel-based maps of [18F]FDG distribution generated through statistical parametric mapping (SPM) in the progression to different dementia subtypes in a sample of 45 MCI. Their scans were compared to a large normal reference dataset developed and validated for comparison at single-subject level. Additionally, Aβ42 and Tau CSF values were available in 34 MCI subjects. Clinical follow-up (mean 28.5 ± 7.8 months) assessed subsequent progression to AD or non-AD dementias. The SPM analysis showed: 1) normal brain metabolism in 14 MCI cases, none of them progressing to dementia; 2) the typical temporo-parietal pattern suggestive for prodromal AD in 15 cases, 11 of them progressing to AD; 3) brain hypometabolism suggestive of frontotemporal lobar degeneration (FTLD) subtypes in 7 and dementia with Lewy bodies (DLB) in 2 subjects (all fulfilled FTLD or DLB clinical criteria at follow-up); and 4) 7 MCI cases showed a selective unilateral or bilateral temporo-medial hypometabolism without the typical AD pattern, and they all remained stable. In our sample, objective voxel-based analysis of [18F]FDG-PET scans showed high predictive prognostic value, by identifying either normal brain metabolism or hypometabolic patterns suggestive of different underlying pathologies, as confirmed by progression at follow-up. These data support the potential usefulness of this SPM [18F]FDG PET analysis in the early dementia diagnosis and for improving subject selection in clinical trials based on MCI definition. We used an optimized voxel-based single-subject [18F]FDG-PET analysis We showed different hypometabolic patterns (AD and non-AD) underlying MCI condition Heterogeneous PET profiles predicted progression into specific dementia subtypes. Statistical analyses showed high positive and negative post-test probability values. CSF findings agreed with [18F]FDG-PET imaging in single cases.
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Abstract
This report discusses the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality rates, costs of care, and overall effect on caregivers and society. It also examines the impact of AD on women compared with men. An estimated 5.2 million Americans have AD. Approximately 200,000 people younger than 65 years with AD comprise the younger onset AD population; 5 million are age 65 years or older. By mid-century, fueled in large part by the baby boom generation, the number of people living with AD in the United States is projected to grow by about 9 million. Today, someone in the country develops AD every 67 seconds. By 2050, one new case of AD is expected to develop every 33 seconds, or nearly a million new cases per year, and the total estimated prevalence is expected to be 13.8 million. In 2010, official death certificates recorded 83,494 deaths from AD, making AD the sixth leading cause of death in the United States and the fifth leading cause of death in Americans aged 65 years or older. Between 2000 and 2010, the proportion of deaths resulting from heart disease, stroke, and prostate cancer decreased 16%, 23%, and 8%, respectively, whereas the proportion resulting from AD increased 68%. The actual number of deaths to which AD contributes (or deaths with AD) is likely much larger than the number of deaths from AD recorded on death certificates. In 2014, an estimated 700,000 older Americans will die with AD, and many of them will die from complications caused by AD. In 2013, more than 15 million family members and other unpaid caregivers provided an estimated 17.7 billion hours of care to people with AD and other dementias, a contribution valued at more than $220 billion. Average per-person Medicare payments for services to beneficiaries aged 65 years and older with AD and other dementias are more than two and a half times as great as payments for all beneficiaries without these conditions, and Medicaid payments are 19 times as great. Total payments in 2014 for health care, long-term care, and hospice services for people aged 65 years and older with dementia are expected to be $214 billion. AD takes a stronger toll on women than men. More women than men develop the disease, and women are more likely than men to be informal caregivers for someone with AD or another dementia. As caregiving responsibilities become more time consuming and burdensome or extend for prolonged durations, women assume an even greater share of the caregiving burden. For every man who spends 21 to more than 60 hours per week as a caregiver, there are 2.1 women. For every man who lives with the care recipient and provides around-the-clock care, there are 2.5 women. In addition, for every man who has provided caregiving assistance for more than 5 years, there are 2.3 women.
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Perani D, Della Rosa PA, Cerami C, Gallivanone F, Fallanca F, Vanoli EG, Panzacchi A, Nobili F, Pappatà S, Marcone A, Garibotto V, Castiglioni I, Magnani G, Cappa SF, Gianolli L. Validation of an optimized SPM procedure for FDG-PET in dementia diagnosis in a clinical setting. NEUROIMAGE-CLINICAL 2014; 6:445-54. [PMID: 25389519 PMCID: PMC4225527 DOI: 10.1016/j.nicl.2014.10.009] [Citation(s) in RCA: 148] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/25/2014] [Accepted: 10/18/2014] [Indexed: 01/11/2023]
Abstract
Diagnostic accuracy in FDG-PET imaging highly depends on the operating procedures. In this clinical study on dementia, we compared the diagnostic accuracy at a single-subject level of a) Clinical Scenarios, b) Standard FDG Images and c) Statistical Parametrical (SPM) Maps generated via a new optimized SPM procedure. We evaluated the added value of FDG-PET, either Standard FDG Images or SPM Maps, to Clinical Scenarios. In 88 patients with neurodegenerative diseases (Alzheimer's Disease—AD, Frontotemporal Lobar Degeneration—FTLD, Dementia with Lewy bodies—DLB and Mild Cognitive Impairment—MCI), 9 neuroimaging experts made a forced diagnostic decision on the basis of the evaluation of the three types of information. There was also the possibility of a decision of normality on the FDG-PET images. The clinical diagnosis confirmed at a long-term follow-up was used as the gold standard. SPM Maps showed higher sensitivity and specificity (96% and 84%), and better diagnostic positive (6.8) and negative (0.05) likelihood ratios compared to Clinical Scenarios and Standard FDG Images. SPM Maps increased diagnostic accuracy for differential diagnosis (AD vs. FTD; beta 1.414, p = 0.019). The AUC of the ROC curve was 0.67 for SPM Maps, 0.57 for Clinical Scenarios and 0.50 for Standard FDG Images. In the MCI group, SPM Maps showed the highest predictive prognostic value (mean LOC = 2.46), by identifying either normal brain metabolism (exclusionary role) or hypometabolic patterns typical of different neurodegenerative conditions. Brain FDG-PET was evaluated with a new optimized SPM procedure in dementias. We compared the diagnostic accuracy of clinical information, visual and SPM FDG-PET. SPM had the best sensitivity (96%), specificity (84%) and positive and negative LR. In an MCI subgroup, SPM had the highest predictive prognostic value.
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Affiliation(s)
- Daniela Perani
- Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
- Nuclear Medicine Unit, San Raffaele Hospital, Milan, Italy
- Istituto di Bioimmagini e Fisiologia Molecolare, CNR, Segrate, Italy
- Corresponding author: Vita-Salute San Raffaele University, Nuclear Medicine Department, San Raffaele Hospital, Division of Neuroscience, San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy. Tel: +39 02 26432224 or 26432223; fax: +39 02 26415202.
| | | | - Chiara Cerami
- Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
- Clinical Neurosciences Department, San Raffaele Hospital, Milan, Italy
| | | | | | | | | | - Flavio Nobili
- Dept of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Sabina Pappatà
- Institute of Biostructure and Bioimaging, CNR, Naples, Italy
| | | | | | | | | | - Stefano F. Cappa
- Clinical Neurosciences Department, San Raffaele Hospital, Milan, Italy
- Istituto Universitario degli Studi Superiori, Pavia, Italy
| | - Luigi Gianolli
- Nuclear Medicine Unit, San Raffaele Hospital, Milan, Italy
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Ferreira D, Rivero-Santana A, Perestelo-Pérez L, Westman E, Wahlund LO, Sarría A, Serrano-Aguilar P. Improving CSF Biomarkers' Performance for Predicting Progression from Mild Cognitive Impairment to Alzheimer's Disease by Considering Different Confounding Factors: A Meta-Analysis. Front Aging Neurosci 2014; 6:287. [PMID: 25360114 PMCID: PMC4199277 DOI: 10.3389/fnagi.2014.00287] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 09/29/2014] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cerebrospinal fluid (CSF) biomarkers' performance for predicting conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) is still suboptimal. OBJECTIVE By considering several confounding factors we aimed to identify in which situations these CSF biomarkers can be useful. DATA SOURCES A systematic review was conducted on MEDLINE, PreMedline, EMBASE, PsycInfo, CINAHL, Cochrane, and CRD (1990-2013). ELIGIBILITY CRITERIA (1) Prospective studies of CSF biomarkers' performance for predicting conversion from MCI to AD/dementia; (2) inclusion of Aβ42 and T-tau and/or p-tau. Several meta-analyses were performed. RESULTS Aβ42/p-tau ratio had high capacity to predict conversion to AD in MCI patients younger than 70 years. The p-tau had high capacity to identify MCI cases converting to AD in ≤24 months. CONCLUSIONS Explaining how different confounding factors influence CSF biomarkers' predictive performance is mandatory to elaborate a definitive map of situations, where these CSF biomarkers are useful both in clinics and research.
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Affiliation(s)
- Daniel Ferreira
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden
| | - Amado Rivero-Santana
- Canarian Foundation of Health and Research (FUNCIS) , Las Palmas de Gran Canaria , Spain ; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) , Santa Cruz de Tenerife , Spain
| | - Lilisbeth Perestelo-Pérez
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) , Santa Cruz de Tenerife , Spain ; Evaluation Unit of the Canary Islands Health Service (SESCS) , Santa Cruz de Tenerife , Spain ; Center for Biomedical Research of the Canary Islands (CIBICAN), University of La Laguna , Tenerife , Spain
| | - Eric Westman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden
| | - Lars-Olof Wahlund
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden
| | - Antonio Sarría
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) , Santa Cruz de Tenerife , Spain ; Agency for Health Technology Assessment (AETS), Institute of Health Carlos III , Madrid , Spain
| | - Pedro Serrano-Aguilar
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC) , Santa Cruz de Tenerife , Spain ; Evaluation Unit of the Canary Islands Health Service (SESCS) , Santa Cruz de Tenerife , Spain ; Center for Biomedical Research of the Canary Islands (CIBICAN), University of La Laguna , Tenerife , Spain
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Menéndez-González M. Routine lumbar puncture for the early diagnosis of Alzheimer's disease. Is it safe? Front Aging Neurosci 2014; 6:65. [PMID: 24782762 PMCID: PMC3988385 DOI: 10.3389/fnagi.2014.00065] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 03/24/2014] [Indexed: 11/15/2022] Open
Affiliation(s)
- Manuel Menéndez-González
- Sección de Neurología, Hospital Álvarez-Buylla Mieres, Spain ; Morfología y Biología Celular, Universidad de Oviedo Oviedo, Spain
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Ferreira D, Perestelo-Pérez L, Westman E, Wahlund LO, Sarría A, Serrano-Aguilar P. Meta-Review of CSF Core Biomarkers in Alzheimer's Disease: The State-of-the-Art after the New Revised Diagnostic Criteria. Front Aging Neurosci 2014; 6:47. [PMID: 24715863 PMCID: PMC3970033 DOI: 10.3389/fnagi.2014.00047] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 03/02/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Current research criteria for Alzheimer's disease (AD) include cerebrospinal fluid (CSF) biomarkers into the diagnostic algorithm. However, spreading their use to the clinical routine is still questionable. OBJECTIVE To provide an updated, systematic and critical review on the diagnostic utility of the CSF core biomarkers for AD. DATA SOURCES MEDLINE, PreMedline, EMBASE, PsycInfo, CINAHL, Cochrane Library, and CRD. ELIGIBILITY CRITERIA (1a) Systematic reviews with meta-analysis; (1b) Primary studies published after the new revised diagnostic criteria; (2) Evaluation of the diagnostic performance of at least one CSF core biomarker. RESULTS The diagnostic performance of CSF biomarkers is generally satisfactory. They are optimal for discriminating AD patients from healthy controls. Their combination may also be suitable for mild cognitive impairment (MCI) prognosis. However, CSF biomarkers fail to distinguish AD from other forms of dementia. LIMITATIONS (1) Use of clinical diagnosis as standard instead of pathological postmortem confirmation; (2) variability of methodological aspects; (3) insufficiently long follow-up periods in MCI studies; and (4) lower diagnostic accuracy in primary care compared with memory clinics. CONCLUSION Additional work needs to be done to validate the application of CSF core biomarkers as they are proposed in the new revised diagnostic criteria. The use of CSF core biomarkers in clinical routine is more likely if these limitations are overcome. Early diagnosis is going to be of utmost importance when effective pharmacological treatment will be available and the CSF core biomarkers can also be implemented in clinical trials for drug development.
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Affiliation(s)
- Daniel Ferreira
- Section of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden
| | - Lilisbeth Perestelo-Pérez
- Evaluation Unit of the Canary Islands Health Service , Santa Cruz de Tenerife , Spain ; Red de Investigación en Servicios de Salud en Enfermedades Crónicas , Santa Cruz de Tenerife , Spain
| | - Eric Westman
- Section of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden
| | - Lars-Olof Wahlund
- Section of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet , Stockholm , Sweden
| | - Antonio Sarría
- Evaluation Unit of the Canary Islands Health Service , Santa Cruz de Tenerife , Spain ; Agency for Health Technology Assessment, Institute of Health Carlos III , Madrid , Spain
| | - Pedro Serrano-Aguilar
- Evaluation Unit of the Canary Islands Health Service , Santa Cruz de Tenerife , Spain ; Red de Investigación en Servicios de Salud en Enfermedades Crónicas , Santa Cruz de Tenerife , Spain
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Menéndez-González M. The many questions on the use of biomarkers for neurodegenerative diseases in clinical practice. Front Aging Neurosci 2014; 6:45. [PMID: 24672480 PMCID: PMC3957090 DOI: 10.3389/fnagi.2014.00045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 03/01/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Manuel Menéndez-González
- Neurología, Hospital Álvarez-Buylla Mieres, Spain ; Morfología y Biología Celular, Universidad de Oviedo Oviedo, Spain ; Instituto de Neurociencias Oviedo, Spain
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Moretti DV, Paternicò D, Binetti G, Zanetti O, Frisoni GB. Electroencephalographic upper/low alpha frequency power ratio relates to cortex thinning in mild cognitive impairment. NEURODEGENER DIS 2014; 14:18-30. [PMID: 24434624 DOI: 10.1159/000354863] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 08/06/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Temporoparietal cortex thinning is associated with mild cognitive impairment (MCI) due to Alzheimer disease (AD). The increase in EEG upper/low α frequency power ratio has been associated with AD converter MCI subjects. We investigated the association of the EEG upper/low α frequency power ratio with patterns of cortical thickness in MCI. METHODS 74 adult subjects with MCI underwent clinical and neuropsychological evaluation, electroencephalography (EEG) recording and high-resolution 3-dimensional magnetic resonance imaging (MRI). The EEG upper/low α frequency power ratio as well as cortical thickness were computed for each subject. Three MCI groups were detected according to increasing tertile values of EEG upper/low α frequency power ratios, and the difference of cortical thickness among the groups was estimated. RESULTS The EEG high upper/low α frequency power ratio group had a total cortical grey matter volume reduction of 471 mm(2), greater than that of the EEG low upper/low α frequency power ratio group (p < 0.001). The EEG high upper/low α frequency power ratio group showed a similar but less marked pattern (160 mm(2)) of cortical thinning when compared to the EEG middle upper/low α frequency power ratio group (p < 0.001). Moreover, the EEG high upper/low α frequency power ratio group had wider cortical thinning than other groups, mapped to the supramarginal gyrus and precuneus bilaterally. No significant regional cortical thickness differences were found between middle and low EEG upper/low α frequency power ratio groups. CONCLUSION A high EEG upper/low α frequency power ratio was associated with temporoparietal cortical thinning in MCI subjects. The combination of upper/low α frequency power ratio and cortical thickness measurement could be useful for identifying individuals at risk for progression to AD dementia and may be of value in the clinical context.
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Affiliation(s)
- D V Moretti
- IRCCS, S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Moretti DV, Prestia A, Binetti G, Zanetti O, Frisoni GB. Increase of theta frequency is associated with reduction in regional cerebral blood flow only in subjects with mild cognitive impairment with higher upper alpha/low alpha EEG frequency power ratio. Front Behav Neurosci 2013; 7:188. [PMID: 24367305 PMCID: PMC3851738 DOI: 10.3389/fnbeh.2013.00188] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 11/17/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Several biomarkers have been proposed for detecting Alzheimer's disease (AD) in its earliest stages, that is, in the predementia stage. In an attempt to find noninvasive biomarkers, researchers have investigated the feasibility of neuroimaging tools, such as MRI, SPECT as well as neurophysiological measurements using EEG. Moreover, the increase of EEG alpha3/alpha2 frequency power ratio has been associated with AD-converters subjects with mild cognitive impairment (MCI). OBJECTIVE To study the association of alpha3/alpha2 frequency power ratio with regional cerebral blood flow (rCBF) changes in subjects with MCI. METHODS Twenty-seven adult subjects with MCI underwent EEG recording and perfusion single-photon emission computed tomography (SPECT) evaluation. The alpha3/alpha2 frequency power ratio was computed for each subject. Two groups were obtained according to the median values of alpha3/alpha2, at a cut-off of 1.17. Correlation between brain perfusion and EEG markers were detected. RESULTS Subjects with higher alpha3/alpha2 frequency power ratio showed a constant trend to a lower perfusion than low alpha3/alpha2 group. The two groups were significantly different as about the hippocampal volume and correlation with the theta frequency activity. CONCLUSION There is a complex interplay between cerebral blood flow, theta frequency activity, and hippocampal volume in MCI patients with prodromal Alzheimer's disease, characterized by higher EEG alpha3/alpha2 frequency power ratio.
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Affiliation(s)
- Davide V. Moretti
- Alzheimer Unit, IRCCS San Giovanni di Dio FatebenefratelliBrescia, Italy
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Moretti DV, Paternicò D, Binetti G, Zanetti O, Frisoni GB. EEG upper/low alpha frequency power ratio relates to temporo-parietal brain atrophy and memory performances in mild cognitive impairment. Front Aging Neurosci 2013; 5:63. [PMID: 24187540 PMCID: PMC3807715 DOI: 10.3389/fnagi.2013.00063] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 10/02/2013] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE Temporo-parietal cortex thinning is associated to mild cognitive impairment (MCI) due to Alzheimer disease (AD). The increase of EEG upper/low alpha power ratio has been associated with AD-converter MCI subjects. We investigated the association of alpha3/alpha2 ratio with patterns of cortical thickness in MCI. MATERIALS AND METHODS Seventy-four adult subjects with MCI underwent clinical and neuropsychological evaluation, electroencephalogram (EEG) recording and high resolution 3D magnetic resonance imaging. Alpha3/alpha2 power ratio as well as cortical thickness was computed for each subject. Three MCI groups were detected according to increasing tertile values of upper/low alpha power ratio. Difference of cortical thickness among the groups was estimated. Pearson's r was used to assess the topography of the correlation between cortical thinning and memory impairment. RESULTS High upper/low alpha power ratio group had total cortical gray matter volume reduction of 471 mm(2) than low upper/low alpha power ratio group (p < 0.001). Upper/low alpha group showed a similar but less marked pattern (160 mm(2)) of cortical thinning when compared to middle upper/low alpha power ratio group (p < 0.001). Moreover, high upper/low alpha group had wider cortical thinning than other groups, mapped to the Supramarginal and Precuneus bilaterally. Finally, in high upper/low alpha group temporo-parietal cortical thickness was correlated to memory performance. No significant cortical thickness differences was found between middle and low alpha3/alpha2 power ratio groups. CONCLUSION High EEG upper/low alpha power ratio was associated with temporo-parietal cortical thinning and memory impairment in MCI subjects. The combination of EEG upper/low alpha ratio and cortical thickness measure could be useful for identifying individuals at risk for progression to AD dementia and may be of value in clinical context.
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Affiliation(s)
- Davide V. Moretti
- Istituto di Ricovero e Cura a Carattere Scientifico Centro San Giovanni di Dio FatebenefratelliBrescia, Italy
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Sagare AP, Bell RD, Srivastava A, Sengillo JD, Singh I, Nishida Y, Chow N, Zlokovic BV. A lipoprotein receptor cluster IV mutant preferentially binds amyloid-β and regulates its clearance from the mouse brain. J Biol Chem 2013; 288:15154-66. [PMID: 23580652 DOI: 10.1074/jbc.m112.439570] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Soluble low density lipoprotein receptor-related protein-1 (sLRP1) binds ~70% of amyloid β-peptide (Aβ) in human plasma. In Alzheimer disease (AD) and individuals with mild cognitive impairment converting to AD, plasma sLRP1 levels are reduced and sLRP1 is oxidized, which results in diminished Aβ peripheral binding and higher levels of free Aβ in plasma. Experimental studies have shown that free circulating Aβ re-enters the brain and that sLRP1 and/or its recombinant wild type cluster IV (WT-LRPIV) prevent Aβ from entering the brain. Treatment of Alzheimer APPsw(+/0) mice with WT-LRPIV has been shown to reduce brain Aβ pathology. In addition to Aβ, LRPIV binds multiple ligands. To enhance LRPIV binding for Aβ relative to other LRP1 ligands, we generated a library of LRPIV-derived fragments and full-length LRPIV variants with glycine replacing aspartic acid residues 3394, 3556, and 3674 in the calcium binding sites. Compared with WT-LRPIV, a lead LRPIV-D3674G mutant had 1.6- and 2.7-fold higher binding affinity for Aβ40 and Aβ42 in vitro, respectively, and a lower binding affinity for other LRP1 ligands (e.g. apolipoprotein E2, E3, and E4 (1.3-1.8-fold), tissue plasminogen activator (2.7-fold), matrix metalloproteinase-9 (4.1-fold), and Factor Xa (3.8-fold)). LRPIV-D3674G cleared mouse endogenous brain Aβ40 and Aβ42 25-27% better than WT-LRPIV. A 3-month subcutaneous treatment of APPsw(+/0) mice with LRPIV-D3674G (40 μg/kg/day) reduced Aβ40 and Αβ42 levels in the hippocampus, cortex, and cerebrospinal fluid by 60-80% and improved cerebral blood flow responses and hippocampal function at 9 months of age. Thus, LRPIV-D3674G is an efficient new Aβ clearance therapy.
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Affiliation(s)
- Abhay P Sagare
- Zilkha Neurogenetic Institute and Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA
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