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Wang YY, Wang YJ, Zeng F. Case of Autosomal-Dominant Alzheimer Disease With Ribbon-Like Cortical Calcifications. Neurology 2024; 103:e209860. [PMID: 39236272 PMCID: PMC11427219 DOI: 10.1212/wnl.0000000000209860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 07/12/2024] [Indexed: 09/07/2024] Open
Affiliation(s)
- Yuan-Yuan Wang
- From the Clinical Center for Neuroscience and Department of Neurology (Y.-Y.W., Y.-J.W., F.Z.), Daping Hospital, Third Military Medical University, Chongqing, China
| | - Yan-Jiang Wang
- From the Clinical Center for Neuroscience and Department of Neurology (Y.-Y.W., Y.-J.W., F.Z.), Daping Hospital, Third Military Medical University, Chongqing, China
| | - Fan Zeng
- From the Clinical Center for Neuroscience and Department of Neurology (Y.-Y.W., Y.-J.W., F.Z.), Daping Hospital, Third Military Medical University, Chongqing, China
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Banerjee G, Schott JM, Ryan NS. Familial cerebral amyloid disorders with prominent white matter involvement. HANDBOOK OF CLINICAL NEUROLOGY 2024; 204:289-315. [PMID: 39322385 DOI: 10.1016/b978-0-323-99209-1.00010-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/27/2024]
Abstract
Familial cerebral amyloid disorders are characterized by the accumulation of fibrillar protein aggregates, which deposit in the parenchyma as plaques and in the vasculature as cerebral amyloid angiopathy (CAA). Amyloid β (Aβ) is the most common of these amyloid proteins, accumulating in familial and sporadic forms of Alzheimer's disease and CAA. However, there are also a number of rare, hereditary, non-Aβ cerebral amyloidosis. The clinical manifestations of these familial cerebral amyloid disorders are diverse, including cognitive or neuropsychiatric presentations, intracerebral hemorrhage, seizures, myoclonus, headache, ataxia, and spasticity. Some mutations are associated with extensive white matter hyperintensities on imaging, which may or may not be accompanied by hemorrhagic imaging markers of CAA; others are associated with occipital calcification. We describe the clinical, imaging, and pathologic features of these disorders and discuss putative disease mechanisms. Familial disorders of cerebral amyloid accumulation offer unique insights into the contributions of vascular and parenchymal amyloid to pathogenesis and the pathways underlying white matter involvement in neurodegeneration. With Aβ immunotherapies now entering the clinical realm, gaining a deeper understanding of these processes and the relationships between genotype and phenotype has never been more relevant.
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Affiliation(s)
- Gargi Banerjee
- MRC Prion Unit at University College London (UCL), Institute of Prion Diseases, UCL, London, United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom; UK Dementia Research Institute at UCL, London, United Kingdom
| | - Natalie S Ryan
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom; UK Dementia Research Institute at UCL, London, United Kingdom.
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Liang Z, Wu Y, Li C, Liu Z. Clinical and genetic characteristics in a central-southern Chinese cohort of early-onset Alzheimer's disease. Front Neurol 2023; 14:1119326. [PMID: 37051054 PMCID: PMC10084792 DOI: 10.3389/fneur.2023.1119326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/21/2023] [Indexed: 03/29/2023] Open
Abstract
BackgroundMutations in the presenilin-1 (PSEN1), presenilin-2 (PSEN2), and amyloid precursor protein (APP) genes have been commonly identified in early-onset Alzheimer's disease (EOAD). Some of the mutations in the three causative genes, especially the PSEN1 gene, result in variable phenotypes and exhibit clinical heterogeneity among EOAD families.MethodsUsing next-generation sequencing (NGS), we performed genetic screening in a Chinese cohort of 18 patients with EOAD, consisting of five familial EOAD and 13 sporadic cases.ResultsWe identified two likely pathogenic PSEN1 mutations (one novel) and a novel APP mutation in three cases of EOAD, where two are familial and one is sporadic, respectively. In addition, we detected a few variants of uncertain significance (VUS) in several genes, including not only the two known variants in PSEN2 (p.H169N and p.V214L) but also genes causal of other types of dementia or previously identified as risk factors for AD, suggesting the possible involvement of multiple genes in the etiopathology of AD. The patients carrying PSEN1 mutations had an earlier mean age at the onset than those with PSEN2 or APP variants. The initial symptoms varied greatly among patients in the EOAD cohort, from progressive memory impairment and epilepsy to uncommon motor symptoms such as involuntary tremors in the upper extremities.ConclusionsIn conclusion, our study provides further evidence of the genetic profile of patients with EOAD from China and expands the mutation spectrum of both PSEN1 and APP. In addition, our results highlight the clinical heterogeneity in patients with EOAD and mutations in PSEN1, PSEN2, and APP and suggest strong effects of genetic variants on clinical phenotypes. Future functional studies are needed to clarify the interaction between AD-causative gene mutations and phenotypic heterogeneity.
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Affiliation(s)
- Zhihou Liang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Wu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chuanzhou Li
- Department of Medical Genetics, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Chuanzhou Li
| | - Zhijun Liu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Zhijun Liu
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McAleese KE, Miah M, Graham S, Hadfield GM, Walker L, Johnson M, Colloby SJ, Thomas AJ, DeCarli C, Koss D, Attems J. Frontal white matter lesions in Alzheimer's disease are associated with both small vessel disease and AD-associated cortical pathology. Acta Neuropathol 2021; 142:937-950. [PMID: 34608542 PMCID: PMC8568857 DOI: 10.1007/s00401-021-02376-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 12/22/2022]
Abstract
Cerebral white matter lesions (WML) encompass axonal loss and demyelination and are assumed to be associated with small vessel disease (SVD)-related ischaemia. However, our previous study in the parietal lobe white matter revealed that WML in Alzheimer's disease (AD) are linked with degenerative axonal loss secondary to the deposition of cortical AD pathology. Furthermore, neuroimaging data suggest that pathomechanisms for the development of WML differ between anterior and posterior lobes with AD-associated degenerative mechanism driving posterior white matter disruption, and both AD-associated degenerative and vascular mechanisms contributed to anterior matter disruption. In this pilot study, we used human post-mortem brain tissue to investigate the composition and aetiology of frontal WML from AD and non-demented controls to determine if frontal WML are SVD-associated and to reveal any regional differences in the pathogenesis of WML. Frontal WML tissue sections from 40 human post-mortem brains (AD, n = 19; controls, n = 21) were quantitatively assessed for demyelination, axonal loss, cortical hyperphosphorylated tau (HPτ) and amyloid-beta (Aβ) burden, and arteriolosclerosis as a measure of SVD. Biochemical assessment included Wallerian degeneration-associated protease calpain and the myelin-associated glycoprotein to proteolipid protein ratio as a measure of ante-mortem ischaemia. Arteriolosclerosis severity was found to be associated with and a significant predictor of frontal WML severity in both AD and non-demented controls. Interesting, frontal axonal loss was also associated with HPτ and calpain levels were associated with increasing Aβ burden in the AD group, suggestive of an additional degenerative influence. To conclude, this pilot data suggest that frontal WML in AD may result from both increased arteriolosclerosis and AD-associated degenerative changes. These preliminary findings in combination with previously published data tentatively indicate regional differences in the aetiology of WML in AD, which should be considered in the clinical diagnosis of dementia subtypes: posterior WML maybe associated with degenerative mechanisms secondary to AD pathology, while anterior WML could be associated with both SVD-associated and degenerative mechanisms.
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Affiliation(s)
- Kirsty E McAleese
- Translation and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
| | - Mohi Miah
- Translation and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Sophie Graham
- Translation and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Georgina M Hadfield
- Translation and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Lauren Walker
- Translation and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Mary Johnson
- Translation and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Sean J Colloby
- Translation and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Alan J Thomas
- Translation and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Charles DeCarli
- Department of Neurology, University of California, Davis, CA, USA
| | - David Koss
- Translation and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
| | - Johannes Attems
- Translation and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK
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5
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Rasing I, Voigt S, Koemans EA, van Zwet E, de Kruijff PC, van Harten TW, van Etten ES, van Rooden S, van der Weerd L, van Buchem MA, van Osch MJP, Greenberg SM, van Walderveen MAA, Terwindt GM, Wermer MJH. Occipital Cortical Calcifications in Cerebral Amyloid Angiopathy. Stroke 2021; 52:1851-1855. [PMID: 33813865 DOI: 10.1161/strokeaha.120.033286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Ingeborg Rasing
- Departments of Neurology (I.R., S.V., E.A.K., P.C.d.K., E.S.v.E., G.M.T., M.J.H.W.), Leiden University Medical Center, the Netherlands
| | - Sabine Voigt
- Departments of Neurology (I.R., S.V., E.A.K., P.C.d.K., E.S.v.E., G.M.T., M.J.H.W.), Leiden University Medical Center, the Netherlands
| | - Emma A Koemans
- Departments of Neurology (I.R., S.V., E.A.K., P.C.d.K., E.S.v.E., G.M.T., M.J.H.W.), Leiden University Medical Center, the Netherlands
| | - Erik van Zwet
- Biomedical Data Sciences (E.v.Z.), Leiden University Medical Center, the Netherlands
| | - Paul C de Kruijff
- Departments of Neurology (I.R., S.V., E.A.K., P.C.d.K., E.S.v.E., G.M.T., M.J.H.W.), Leiden University Medical Center, the Netherlands
| | - Thijs W van Harten
- Radiology (T.W.v.H., S.v.R., L.v.d.W., M.A.v.B., M.J.P.v.O., M.A.A.v.M.), Leiden University Medical Center, the Netherlands
| | - Ellis S van Etten
- Departments of Neurology (I.R., S.V., E.A.K., P.C.d.K., E.S.v.E., G.M.T., M.J.H.W.), Leiden University Medical Center, the Netherlands
| | - Sanneke van Rooden
- Radiology (T.W.v.H., S.v.R., L.v.d.W., M.A.v.B., M.J.P.v.O., M.A.A.v.M.), Leiden University Medical Center, the Netherlands
| | - Louise van der Weerd
- Radiology (T.W.v.H., S.v.R., L.v.d.W., M.A.v.B., M.J.P.v.O., M.A.A.v.M.), Leiden University Medical Center, the Netherlands.,Human Genetics (L.v.d.W.), Leiden University Medical Center, the Netherlands
| | - Mark A van Buchem
- Radiology (T.W.v.H., S.v.R., L.v.d.W., M.A.v.B., M.J.P.v.O., M.A.A.v.M.), Leiden University Medical Center, the Netherlands
| | - Matthias J P van Osch
- Radiology (T.W.v.H., S.v.R., L.v.d.W., M.A.v.B., M.J.P.v.O., M.A.A.v.M.), Leiden University Medical Center, the Netherlands
| | - Steven M Greenberg
- Department of Neurology, Massachusetts General Hospital, Boston (S.M.G.)
| | - Marianne A A van Walderveen
- Radiology (T.W.v.H., S.v.R., L.v.d.W., M.A.v.B., M.J.P.v.O., M.A.A.v.M.), Leiden University Medical Center, the Netherlands
| | - Gisela M Terwindt
- Departments of Neurology (I.R., S.V., E.A.K., P.C.d.K., E.S.v.E., G.M.T., M.J.H.W.), Leiden University Medical Center, the Netherlands
| | - Marieke J H Wermer
- Departments of Neurology (I.R., S.V., E.A.K., P.C.d.K., E.S.v.E., G.M.T., M.J.H.W.), Leiden University Medical Center, the Netherlands
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