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Okechukwu NG, Klein C, Jamann H, Maitre M, Patte-Mensah C, Mensah-Nyagan AG. Monomeric Amyloid Peptide-induced Toxicity in Human Oligodendrocyte Cell Line and Mouse Brain Primary Mixed-glial Cell Cultures: Evidence for a Neuroprotective Effect of Neurosteroid 3α-O-allyl-allopregnanolone. Neurotox Res 2024; 42:37. [PMID: 39102123 DOI: 10.1007/s12640-024-00715-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 04/18/2024] [Accepted: 07/22/2024] [Indexed: 08/06/2024]
Abstract
Amyloid-peptide (Aβ) monomeric forms (ABM) occurring in presymptomatic Alzheimer's disease (AD) brain are thought to be devoid of neurotoxicity while the transition/aggregation of ABM into oligomers is determinant for Aβ-induced toxicity since Aβ is predominantly monomeric up to 3 µM and aggregates over this concentration. However, recent imaging and/or histopathological investigations revealed alterations of myelin in prodromal AD brain in absence of aggregated Aβ oligomers, suggesting that ABM may induce toxicity in myelin-producing cells in early AD-stages. To check this hypothesis, here we studied ABM effects on the viability of the Human oligodendrocyte cell line (HOG), a reliable oligodendrocyte model producing myelin proteins. Furthermore, to mimic closely interactions between oligodendrocytes and other glial cells regulating myelination, we investigated also ABM effects on mouse brain primary mixed-glial cell cultures. Various methods were combined to show that ABM concentrations (600 nM-1 µM), extremely lower than 3 µM, significantly decreased HOG cell and mouse brain primary mixed-glial cell survival. Interestingly, flow-cytometry studies using specific cell-type markers demonstrated that oligodendrocytes represent the most vulnerable glial cell population affected by ABM toxicity. Our work also shows that the neurosteroid 3α-O-allyl-allopregnanolone BR351 (250 and 500 nM) efficiently prevented ABM-induced HOG and brain primary glial cell toxicity. Bicuculline (50-100 nM), the GABA-A-receptor antagonist, was unable to block/reduce BR351 effect against ABM-induced HOG and primary glial cell toxicity, suggesting that BR351-evoked neuroprotection of these cells may not depend on GABA-A-receptor allosterically modulated by neurosteroids. Altogether, our results suggest that further exploration of BR351 therapeutic potential may offer interesting perspectives to develop effective neuroprotective strategies.
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Affiliation(s)
- Nwife Getrude Okechukwu
- Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, INSERM U1119, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Bâtiment CRBS de la Faculté de Médecine, 1 rue Eugène Boeckel, 67 000, Strasbourg, France
| | - Christian Klein
- Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, INSERM U1119, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Bâtiment CRBS de la Faculté de Médecine, 1 rue Eugène Boeckel, 67 000, Strasbourg, France
- Centre d'Investigation Clinique de Strasbourg (CIC), Equipe CIC-Recherche Translationnelle Neuro, INSERM 1434, Université de Strasbourg, Bâtiment CRBS, 1 rue Eugène Boeckel, 67000, Strasbourg, France
| | - Hélène Jamann
- Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, INSERM U1119, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Bâtiment CRBS de la Faculté de Médecine, 1 rue Eugène Boeckel, 67 000, Strasbourg, France
- Centre d'Investigation Clinique de Strasbourg (CIC), Equipe CIC-Recherche Translationnelle Neuro, INSERM 1434, Université de Strasbourg, Bâtiment CRBS, 1 rue Eugène Boeckel, 67000, Strasbourg, France
| | - Michel Maitre
- Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, INSERM U1119, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Bâtiment CRBS de la Faculté de Médecine, 1 rue Eugène Boeckel, 67 000, Strasbourg, France
- Centre d'Investigation Clinique de Strasbourg (CIC), Equipe CIC-Recherche Translationnelle Neuro, INSERM 1434, Université de Strasbourg, Bâtiment CRBS, 1 rue Eugène Boeckel, 67000, Strasbourg, France
| | - Christine Patte-Mensah
- Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, INSERM U1119, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Bâtiment CRBS de la Faculté de Médecine, 1 rue Eugène Boeckel, 67 000, Strasbourg, France
- Centre d'Investigation Clinique de Strasbourg (CIC), Equipe CIC-Recherche Translationnelle Neuro, INSERM 1434, Université de Strasbourg, Bâtiment CRBS, 1 rue Eugène Boeckel, 67000, Strasbourg, France
| | - Ayikoé-Guy Mensah-Nyagan
- Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, INSERM U1119, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Bâtiment CRBS de la Faculté de Médecine, 1 rue Eugène Boeckel, 67 000, Strasbourg, France.
- Centre d'Investigation Clinique de Strasbourg (CIC), Equipe CIC-Recherche Translationnelle Neuro, INSERM 1434, Université de Strasbourg, Bâtiment CRBS, 1 rue Eugène Boeckel, 67000, Strasbourg, France.
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2
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Zhang Z, Luo X, Jiang L, Wu H, Tan Z. How do HCN channels play a part in Alzheimer's and Parkinson's disease? Ageing Res Rev 2024; 100:102436. [PMID: 39047878 DOI: 10.1016/j.arr.2024.102436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 07/08/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024]
Abstract
Neurodegenerative diseases like Alzheimer's and Parkinson's disease (AD and PD) are well-known, yet their underlying causes remain unclear. Recent studies have suggested that disruption of ion channels contribute to their pathogenesis. Among these channels, the hyperpolarization-activated cyclic nucleotide-gated (HCN) channels, encoded by HCN1-4 genes, are of particular interest due to their role in generating hyperpolarization-activated current (Ih), which is crucial in various neural activities impacting memory and motor functions. A growing body of evidence underscores the pivotal role of HCN in Aβ generation, glial cell function, and ischemia-induced dementia; while HCN is expressed in various regions of the basal ganglia, modulating their functions and influencing motor disorders in PD; neuroinflammation triggered by microglial activation represents a shared pathological mechanism in both AD and PD, in which HCN also plays a significant part. This review delves into the neuronal functions governed by HCN, its roles in the aforementioned pathogenesis, its expression patterns in AD and PD, and discusses potential therapeutic drugs targeting HCN for the treatment of these diseases, aiming to offer a novel perspective and inspire future research endeavors.
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Affiliation(s)
- Zhuo Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, PR China; Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha 410078, PR China; Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha 410078, PR China; National Clinical Research Center for Geriatric Disorders, Changsha 410008, PR China; Changsha Taihe Hospital, Changsha 410000, PR China; Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha 410205, PR China
| | - Xin Luo
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, PR China; Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha 410078, PR China; Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha 410078, PR China; National Clinical Research Center for Geriatric Disorders, Changsha 410008, PR China; Changsha Taihe Hospital, Changsha 410000, PR China; Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha 410205, PR China
| | - Liping Jiang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, PR China; Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha 410078, PR China; Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha 410078, PR China; National Clinical Research Center for Geriatric Disorders, Changsha 410008, PR China; Department of Physiology, Basic Medical School, Hengyang Medical College, The Neuroscience Institute, University of South China, Hengyang 421001, PR China; Changsha Taihe Hospital, Changsha 410000, PR China; Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha 410205, PR China
| | - Huilan Wu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, PR China; Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha 410078, PR China; Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha 410078, PR China; National Clinical Research Center for Geriatric Disorders, Changsha 410008, PR China; Changsha Taihe Hospital, Changsha 410000, PR China; Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha 410205, PR China
| | - Zhirong Tan
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, PR China; Hunan Key Laboratory of Pharmacogenetics, Institute of Clinical Pharmacology, Central South University, Changsha 410078, PR China; Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha 410078, PR China; National Clinical Research Center for Geriatric Disorders, Changsha 410008, PR China; Changsha Taihe Hospital, Changsha 410000, PR China; Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha 410205, PR China.
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Kapoor A, Dutt S, Alitin JPM, Sible IJ, Marshall A, Shenasa F, Engstrom AC, Gaubert A, Shao X, Bradford DR, Rodgers K, Mather M, Wang DJJ, Nation DA. Older adults with reduced cerebrovascular reactivity exhibit high white matter hyperintensity burden. Neurobiol Aging 2024; 139:5-10. [PMID: 38579393 DOI: 10.1016/j.neurobiolaging.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/17/2024] [Accepted: 03/22/2024] [Indexed: 04/07/2024]
Abstract
Cerebrovascular reactivity (CVR) deficits may contribute to small vessel disease, such as white matter hyperintensities (WMH). Moreover, apolipoprotein-e4 (APOE4) carriers at genetic risk for Alzheimer's disease exhibit cerebrovascular dysfunction relative to non-carriers. We examined whether older adults, and APOE4 carriers specifically, with diminished CVR would exhibit higher WMH burden. Independently living older adults (N = 125, mean age = 69.2 years; SD = 7.6; 31.2% male) free of dementia or clinical stroke underwent brain MRI to quantify cerebral perfusion during CVR to hypercapnia and hypocapnia and determine WMH volume. Adjusting for age, sex and intracranial volume, hierarchical regression analysis revealed a significant association between whole brain CVR to hypercapnia and WMH overall [B = -.02, 95% CI (-.04, -.008), p =.003] and in APOE4 carriers [B = -.03, 95% CI (-.06, -.009), p =.009]. Findings suggest deficits in cerebral vasodilatory capacity are associated with WMH burden in older adults and future studies are warranted to further delineate the effect of APOE4 on precipitating WMH.
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Affiliation(s)
- Arunima Kapoor
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - John Paul M Alitin
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Anisa Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Fatemah Shenasa
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Allison C Engstrom
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Aimée Gaubert
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Xingfeng Shao
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - David Robert Bradford
- Center for Innovations in Brain Science, Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - Kathleen Rodgers
- Center for Innovations in Brain Science, Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - Mara Mather
- University of Southern California Leonard Davis School of Gerontology, USA
| | - Danny J J Wang
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Daniel A Nation
- University of Southern California Leonard Davis School of Gerontology, USA; Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, University of Southern California Keck School of Medicine, USA.
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Chatterjee A, Lee S, Diaz V, Saloner R, Sanderson-Cimino M, deCarli C, Maillard P, Hinman J, Vossel K, Casaletto KB, Staffaroni AM, Paolillo EW, Kramer JH. Associations of cerebrovascular disease and Alzheimer's disease pathology with cognitive decline: Analysis of the National Alzheimer's Coordinating Center Uniform Data Set. Neurobiol Aging 2024; 142:1-7. [PMID: 39024720 DOI: 10.1016/j.neurobiolaging.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 07/20/2024]
Abstract
Cerebrovascular disease (CVD) and Alzheimer's disease (AD) often co-occur and may impact specific cognitive domains. This study's goal was to determine effects of CVD and AD burden on cross-sectional and longitudinal executive function (EF) and memory in older adults. Longitudinally followed participants from the National Alzheimer Coordinating Center database (n = 3342) were included. Cognitive outcomes were EF and memory composite scores. Baseline CVD presence was defined by moderate-to-severe white matter hyperintensities or lacunar infarct on MRI. Baseline AD pathology was defined by amyloid positivity via PET or CSF. Linear mixed models examined effects of CVD, AD, and time on cognitive outcomes, controlling for sex, education, baseline age, MoCA score, and total number of study visits. At baseline, CVD associated with lower EF (p < 0.001), while AD associated with lower EF and memory (ps < 0.001). Longitudinally only AD associated with faster declines in memory and EF (ps < 0.001). These results extend our understanding of CVD and AD pathology, highlighting that CVD does not necessarily indicate accelerated decline.
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Affiliation(s)
- Ankita Chatterjee
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, USA.
| | - Shannon Lee
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, USA
| | - Valentina Diaz
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, USA
| | - Rowan Saloner
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, USA
| | - Mark Sanderson-Cimino
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, USA
| | - Charles deCarli
- Department of Neurology, University of California, Davis, USA
| | | | - Jason Hinman
- Mary S. Easton Center for Alzheimer's Research and Care, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Keith Vossel
- Mary S. Easton Center for Alzheimer's Research and Care, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Kaitlin B Casaletto
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, USA
| | - Adam M Staffaroni
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, USA
| | - Emily W Paolillo
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, USA
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Anderson ME, Wind EJ, Robison LS. Exploring the neuroprotective role of physical activity in cerebral small vessel disease. Brain Res 2024; 1833:148884. [PMID: 38527712 DOI: 10.1016/j.brainres.2024.148884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 03/27/2024]
Abstract
Cerebral small vessel disease (cSVD) is a common neurological finding characterized by abnormalities of the small blood vessels in the brain. Previous research has established a strong connection between cSVD and stroke, as well as neurodegenerative disorders, notably Alzheimer's disease (AD) and other dementias. As the search for effective interventions continues, physical activity (PA) has emerged as a potential preventative and therapeutic avenue. This review synthesizes the human and animal literature on the influence of PA on cSVD, highlighting the importance of determining optimal exercise protocols, considering aspects such as intensity, duration, timing, and exercise type. Furthermore, the necessity of widening the age bracket in research samples is discussed, ensuring a holistic understanding of the interventions across varying pathological stages of the disease. The review also suggests the potential of exploring diverse biomarkers and risk profiles associated with clinically significant outcomes. Moreover, we review findings demonstrating the beneficial effects of PA in various rodent models of cSVD, which have uncovered numerous mechanisms of neuroprotection, including increases in neuroplasticity and integrity of the vasculature and white matter; decreases in inflammation, oxidative stress, and mitochondrial dysfunction; and alterations in amyloid processing and neurotransmitter signaling. In conclusion, this review highlights the potential of physical activity as a preventive strategy for addressing cSVD, offering insights into the need for refining exercise parameters, diversifying research populations, and exploring novel biomarkers, while shedding light on the intricate mechanisms through which exercise confers neuroprotection in both humans and animal models.
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Affiliation(s)
- Maria E Anderson
- Department of Psychology, Family, and Justice Studies, University of Saint Joseph, 1678 Asylum Ave, West Hartford, CT 06117, USA
| | - Eleanor J Wind
- Department of Psychology and Neuroscience, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL 33328, USA
| | - Lisa S Robison
- Department of Psychology and Neuroscience, Nova Southeastern University, 3300 S. University Drive, Fort Lauderdale, FL 33328, USA.
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Biesbroek JM, Coenen M, DeCarli C, Fletcher EM, Maillard PM, Barkhof F, Barnes J, Benke T, Chen CPLH, Dal‐Bianco P, Dewenter A, Duering M, Enzinger C, Ewers M, Exalto LG, Franzmeier N, Hilal S, Hofer E, Koek HL, Maier AB, McCreary CR, Papma JM, Paterson RW, Pijnenburg YAL, Rubinski A, Schmidt R, Schott JM, Slattery CF, Smith EE, Sudre CH, Steketee RME, Teunissen CE, van den Berg E, van der Flier WM, Venketasubramanian N, Venkatraghavan V, Vernooij MW, Wolters FJ, Xin X, Kuijf HJ, Biessels GJ. Amyloid pathology and vascular risk are associated with distinct patterns of cerebral white matter hyperintensities: A multicenter study in 3132 memory clinic patients. Alzheimers Dement 2024; 20:2980-2989. [PMID: 38477469 PMCID: PMC11032573 DOI: 10.1002/alz.13765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION White matter hyperintensities (WMH) are associated with key dementia etiologies, in particular arteriolosclerosis and amyloid pathology. We aimed to identify WMH locations associated with vascular risk or cerebral amyloid-β1-42 (Aβ42)-positive status. METHODS Individual patient data (n = 3,132; mean age 71.5 ± 9 years; 49.3% female) from 11 memory clinic cohorts were harmonized. WMH volumes in 28 regions were related to a vascular risk compound score (VRCS) and Aß42 status (based on cerebrospinal fluid or amyloid positron emission tomography), correcting for age, sex, study site, and total WMH volume. RESULTS VRCS was associated with WMH in anterior/superior corona radiata (B = 0.034/0.038, p < 0.001), external capsule (B = 0.052, p < 0.001), and middle cerebellar peduncle (B = 0.067, p < 0.001), and Aß42-positive status with WMH in posterior thalamic radiation (B = 0.097, p < 0.001) and splenium (B = 0.103, p < 0.001). DISCUSSION Vascular risk factors and Aß42 pathology have distinct signature WMH patterns. This regional vulnerability may incite future studies into how arteriolosclerosis and Aß42 pathology affect the brain's white matter. HIGHLIGHTS Key dementia etiologies may be associated with specific patterns of white matter hyperintensities (WMH). We related WMH locations to vascular risk and cerebral Aβ42 status in 11 memory clinic cohorts. Aβ42 positive status was associated with posterior WMH in splenium and posterior thalamic radiation. Vascular risk was associated with anterior and infratentorial WMH. Amyloid pathology and vascular risk have distinct signature WMH patterns.
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Van Etten EJ, Bharadwaj PK, Grilli MD, Raichlen DA, Hishaw GA, Huentelman MJ, Trouard TP, Alexander GE. Impact of age and apolipoprotein E ε4 status on regional white matter hyperintensity volume and cognition in healthy aging. J Int Neuropsychol Soc 2024:1-11. [PMID: 38515367 DOI: 10.1017/s1355617724000122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
OBJECTIVE White matter hyperintensity (WMH) volume is a neuroimaging marker of lesion load related to small vessel disease that has been associated with cognitive aging and Alzheimer's disease (AD) risk. METHOD The present study sought to examine whether regional WMH volume mediates the relationship between APOE ε4 status, a strong genetic risk factor for AD, and cognition and if this association is moderated by age group differences within a sample of 187 healthy older adults (APOE ε4 status [carrier/non-carrier] = 56/131). RESULTS After we controlled for sex, education, and vascular risk factors, ANCOVA analyses revealed significant age group by APOE ε4 status interactions for right parietal and left temporal WMH volumes. Within the young-old group (50-69 years), ε4 carriers had greater right parietal and left temporal WMH volumes than non-carriers. However, in the old-old group (70-89 years), right parietal and left temporal WMH volumes were comparable across APOE ε4 groups. Further, within ε4 non-carriers, old-old adults had greater right parietal and left temporal WMH volumes than young-old adults, but there were no significant differences across age groups in ε4 carriers. Follow-up moderated mediation analyses revealed that, in the young-old, but not the old-old group, there were significant indirect effects of ε4 status on memory and executive functions through left temporal WMH volume. CONCLUSIONS These findings suggest that, among healthy young-old adults, increased left temporal WMH volume, in the context of the ε4 allele, may represent an early marker of cognitive aging with the potential to lead to greater risk for AD.
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Affiliation(s)
- Emily J Van Etten
- Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Pradyumna K Bharadwaj
- Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Matthew D Grilli
- Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Neurology, University of Arizona, Tucson, AZ, USA
| | - David A Raichlen
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles, CA, USA
| | - Georg A Hishaw
- Department of Neurology, University of Arizona, Tucson, AZ, USA
| | - Matthew J Huentelman
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Theodore P Trouard
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Arizona Alzheimer's Consortium, Phoenix, AZ, USA
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
| | - Gene E Alexander
- Department of Psychology, University of Arizona, Tucson, AZ, USA
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Arizona Alzheimer's Consortium, Phoenix, AZ, USA
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA
- Neuroscience Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA
- Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA
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Kawade N, Yamanaka K. Novel insights into brain lipid metabolism in Alzheimer's disease: Oligodendrocytes and white matter abnormalities. FEBS Open Bio 2024; 14:194-216. [PMID: 37330425 PMCID: PMC10839347 DOI: 10.1002/2211-5463.13661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/07/2023] [Accepted: 06/14/2023] [Indexed: 06/19/2023] Open
Abstract
Alzheimer's disease (AD) is the most common cause of dementia. A genome-wide association study has shown that several AD risk genes are involved in lipid metabolism. Additionally, epidemiological studies have indicated that the levels of several lipid species are altered in the AD brain. Therefore, lipid metabolism is likely changed in the AD brain, and these alterations might be associated with an exacerbation of AD pathology. Oligodendrocytes are glial cells that produce the myelin sheath, which is a lipid-rich insulator. Dysfunctions of the myelin sheath have been linked to white matter abnormalities observed in the AD brain. Here, we review the lipid composition and metabolism in the brain and myelin and the association between lipidic alterations and AD pathology. We also present the abnormalities in oligodendrocyte lineage cells and white matter observed in AD. Additionally, we discuss metabolic disorders, including obesity, as AD risk factors and the effects of obesity and dietary intake of lipids on the brain.
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Affiliation(s)
- Noe Kawade
- Department of Neuroscience and Pathobiology, Research Institute of Environmental MedicineNagoya UniversityJapan
- Department of Neuroscience and Pathobiology, Nagoya University Graduate School of MedicineNagoya UniversityJapan
| | - Koji Yamanaka
- Department of Neuroscience and Pathobiology, Research Institute of Environmental MedicineNagoya UniversityJapan
- Department of Neuroscience and Pathobiology, Nagoya University Graduate School of MedicineNagoya UniversityJapan
- Institute for Glyco‐core Research (iGCORE)Nagoya UniversityJapan
- Center for One Medicine Innovative Translational Research (COMIT)Nagoya UniversityJapan
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9
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Hotz I, Deschwanden PF, Mérillat S, Jäncke L. Associations between white matter hyperintensities, lacunes, entorhinal cortex thickness, declarative memory and leisure activity in cognitively healthy older adults: A 7-year study. Neuroimage 2023; 284:120461. [PMID: 37981203 DOI: 10.1016/j.neuroimage.2023.120461] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 11/02/2023] [Accepted: 11/16/2023] [Indexed: 11/21/2023] Open
Abstract
INTRODUCTION Cerebral small vessel disease (cSVD) is a growing epidemic that affects brain health and cognition. Therefore, a more profound understanding of the interplay between cSVD, brain atrophy, and cognition in healthy aging is of great importance. In this study, we examined the association between white matter hyperintensities (WMH) volume, number of lacunes, entorhinal cortex (EC) thickness, and declarative memory in cognitively healthy older adults over a seven-year period, controlling for possible confounding factors. Because there is no cure for cSVD to date, the neuroprotective potential of an active lifestyle has been suggested. Supporting evidence, however, is scarce. Therefore, a second objective of this study is to examine the relationship between leisure activities, cSVD, EC thickness, and declarative memory. METHODS We used a longitudinal dataset, which consisted of five measurement time points of structural MRI and psychometric cognitive ability and survey data, collected from a sample of healthy older adults (baseline N = 231, age range: 64-87 years, age M = 70.8 years), to investigate associations between cSVD MRI markers, EC thickness and verbal and figural memory performance. Further, we computed physical, social, and cognitive leisure activity scores from survey-based assessments and examined their associations with brain structure and declarative memory. To provide more accurate estimates of the trajectories and cross-domain correlations, we applied latent growth curve models controlling for potential confounders. RESULTS Less age-related thinning of the right (β = 0.92, p<.05) and left EC (β = 0.82, p<.05) was related to less declarative memory decline; and a thicker EC at baseline predicted less declarative memory loss (β = 0.54, p<.05). Higher baseline levels of physical (β = 0.24, p<.05), and social leisure activity (β = 0.27, p<.01) predicted less thinning of right EC. No relation was found between WMH or lacunes and declarative memory or between leisure activity and declarative memory. Higher education was initially related to more physical activity (β = 0.16, p<.05) and better declarative memory (β = 0.23, p<.001), which, however, declined steeper in participants with higher education (β = -.35, p<.05). Obese participants were less physically (β = -.18, p<.01) and socially active (β = -.13, p<.05) and had thinner left EC (β = -.14, p<.05) at baseline. Antihypertensive medication use (β = -.26, p<.05), and light-to-moderate alcohol consumption (β = -.40, p<.001) were associated with a smaller increase in the number of lacunes whereas a larger increase in the number of lacunes was observed in current smokers (β = 0.30, p<.05). CONCLUSIONS Our results suggest complex relationships between cSVD MRI markers (total WMH, number of lacunes, right and left EC thickness), declarative memory, and confounding factors such as antihypertensive medication, obesity, and leisure activitiy. Thus, leisure activities and having good cognitive reserve counteracting this neurodegeneration. Several confounding factors seem to contribute to the extent or progression/decline of cSVD, which needs further investigation in the future. Since there is still no cure for cSVD, modifiable confounding factors should be studied more intensively in the future to maintain or promote brain health and thus cognitive abilities in older adults.
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Affiliation(s)
- Isabel Hotz
- Dynamics of Healthy Aging, University Research Priority Program (URPP), University of Zurich, Stampfenbachstrasse 73, Zurich CH-8006, Switzerland.
| | - Pascal Frédéric Deschwanden
- Dynamics of Healthy Aging, University Research Priority Program (URPP), University of Zurich, Stampfenbachstrasse 73, Zurich CH-8006, Switzerland
| | - Susan Mérillat
- Dynamics of Healthy Aging, University Research Priority Program (URPP), University of Zurich, Stampfenbachstrasse 73, Zurich CH-8006, Switzerland
| | - Lutz Jäncke
- Dynamics of Healthy Aging, University Research Priority Program (URPP), University of Zurich, Stampfenbachstrasse 73, Zurich CH-8006, Switzerland
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10
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Wu L, Jin L, Li L, Yu K, Wu J, Lei Y, Jiang S, He J. An examination of Alzheimer's disease and white matter from 1981 to 2023: a Bibliometric and visual analysis. Front Neurol 2023; 14:1268566. [PMID: 38033779 PMCID: PMC10683644 DOI: 10.3389/fneur.2023.1268566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/19/2023] [Indexed: 12/02/2023] Open
Abstract
Background Alzheimer's disease (AD) is characterized by the presence of gray matter lesions and alterations in white matter. This study aims to investigate the research related to white matter in the context of AD from a Bibliometric standpoint. Methods Regular and review articles focusing on the research pertaining to Alzheimer's disease (AD) and white matter were extracted from the Web of Science Core Collection (WOSCC) database, covering the period from its inception to 10th July 2023. The "Bibliometrix" R package was employed to summarize key findings, to quantify the occurrence of top keywords, and to visualize the collaborative network among countries. Furthermore, VOSviewer software was utilized to conduct co-authorship and co-occurrence analyses. CiteSpace was employed to identify the most influential references and keywords based on their citation bursts. The retrieval of AD- and white matter-related publications was conducted by the Web of Science Core Collection. Bibliometric analysis and visualization, including the examination of annual publication distribution, prominent countries, active institutions and authors, core journals, co-cited references, and keywords, were carried out by using VOSviewer, CiteSpace, the Bibliometrix Package, and the ggplot2 Package. The quality and impact of publications were assessed using the total global citation score and total local citation score. Results A total of 5,714 publications addressing the intersection of Alzheimer's disease (AD) and white matter were included in the analysis. The majority of publications originated from the United States, China, and the United Kingdom. Prominent journals were heavily featured in the publication output. In addition to "Alzheimer's disease" and "white matter," "mild cognitive impairment," "MRI" and "atrophy" had been frequently utilized as "keywords." Conclusion This Bibliometric investigation delineated a foundational knowledge framework that encompasses countries, institutions, authors, journals, and articles within the AD and white matter research domain spanning from 1981 to 2023. The outcomes provide a comprehensive perspective on the broader landscape of this research field.
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Affiliation(s)
- Linman Wu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- Nanchong Mental Health Center of Sichuan Province, Nanchong, China
| | - Liuyin Jin
- Lishui Second People’s Hospital, Wenzhou Medical University, Lishui, China
| | - Lixia Li
- Nanchong Mental Health Center of Sichuan Province, Nanchong, China
| | - Kai Yu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Junnan Wu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yuying Lei
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Shulan Jiang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jue He
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
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11
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Park H, Kim H, Kwak S, Youm Y, Chey J. Association between Loneliness and Memory Function through White Matter Hyperintensities in Older Adults: The Moderating Role of Gender. Behav Sci (Basel) 2023; 13:869. [PMID: 37887519 PMCID: PMC10604491 DOI: 10.3390/bs13100869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023] Open
Abstract
Loneliness has an important impact on memory function in late life. However, the neural mechanism by which loneliness detrimentally influences memory function remains elusive. Furthermore, it remains unclear whether the association between loneliness and memory function varies by gender. The current study aimed to investigate the neural mechanism underlying the association between loneliness and episodic memory function and explore whether it varies with gender among cognitively normal older adults. A total of 173 community-dwelling adults aged 60 years or older from the Korean Social Life, Health, and Aging Project (KSHAP) study (mean age = 71.87) underwent an assessment of loneliness, neuropsychological testing, and structural magnetic resonance imaging. The association between loneliness and episodic memory function was mediated by the volume of white matter hyperintensities (WMHs), but not by hippocampal or gray matter volumes. In addition, the association between loneliness and memory function through WMHs was significantly moderated by gender; specifically, the indirect effect was significant among men but not among women. The study suggests that WMHs may be a potential neurological mechanism that causes late-life memory dysfunction associated with loneliness in older men. The findings underscore the need for gender-specific interventions to mitigate memory impairment associated with late-life loneliness, with significant public health implications.
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Affiliation(s)
- Hyeyoung Park
- Department of Psychology, Seoul National University, Seoul 08826, Republic of Korea; (H.P.); (H.K.)
| | - Hairin Kim
- Department of Psychology, Seoul National University, Seoul 08826, Republic of Korea; (H.P.); (H.K.)
| | - Seyul Kwak
- Department of Psychology, Pusan National University, Busan 46241, Republic of Korea;
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul 03722, Republic of Korea;
| | - Jeanyung Chey
- Department of Psychology, Seoul National University, Seoul 08826, Republic of Korea; (H.P.); (H.K.)
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12
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Ahmed M, Chen J, Arani A, Senjem ML, Cogswell PM, Jack CR, Liu C. The diamagnetic component map from quantitative susceptibility mapping (QSM) source separation reveals pathological alteration in Alzheimer's disease-driven neurodegeneration. Neuroimage 2023; 280:120357. [PMID: 37661080 DOI: 10.1016/j.neuroimage.2023.120357] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 08/13/2023] [Accepted: 08/30/2023] [Indexed: 09/05/2023] Open
Abstract
A sensitive and accurate imaging technique capable of tracking the disease progression of Alzheimer's Disease (AD) driven amnestic dementia would be beneficial. A currently available method for pathology detection in AD with high accuracy is Positron Emission Tomography (PET) imaging, despite certain limitations such as low spatial resolution, off-targeting error, and radiation exposure. Non-invasive MRI scanning with quantitative magnetic susceptibility measurements can be used as a complementary tool. To date, quantitative susceptibility mapping (QSM) has widely been used in tracking deep gray matter iron accumulation in AD. The present work proposes that by compartmentalizing quantitative susceptibility into paramagnetic and diamagnetic components, more holistic information about AD pathogenesis can be acquired. Particularly, diamagnetic component susceptibility (DCS) can be a powerful indicator for tracking protein accumulation in the gray matter (GM), demyelination in the white matter (WM), and relevant changes in the cerebrospinal fluid (CSF). In the current work, voxel-wise group analysis of the WM and the CSF regions show significantly lower |DCS| (the absolute value of DCS) value for amnestic dementia patients compared to healthy controls. Additionally, |DCS| and τ PET standardized uptake value ratio (SUVr) were found to be associated in several GM regions typically affected by τ deposition in AD. Therefore, we propose that the separated diamagnetic susceptibility can be used to track pathological neurodegeneration in different tissue types and regions of the brain. With the initial evidence, we believe the usage of compartmentalized susceptibility demonstrates substantive potential as an MRI-based technique for tracking AD-driven neurodegeneration.
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Affiliation(s)
- Maruf Ahmed
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA 94720, USA
| | - Jingjia Chen
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA 94720, USA
| | - Arvin Arani
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Matthew L Senjem
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA; Department of Information Technology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Petrice M Cogswell
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Chunlei Liu
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA 94720, USA; Helen Wills Neuroscience Institute, University of California, Berkeley, CA 94720, USA.
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13
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Obis E, Sol J, Andres-Benito P, Martín-Gari M, Mota-Martorell N, Galo-Licona JD, Piñol-Ripoll G, Portero-Otin M, Ferrer I, Jové M, Pamplona R. Lipidomic Alterations in the Cerebral Cortex and White Matter in Sporadic Alzheimer's Disease. Aging Dis 2023; 14:1887-1916. [PMID: 37196109 PMCID: PMC10529741 DOI: 10.14336/ad.2023.0217] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/17/2023] [Indexed: 05/19/2023] Open
Abstract
Non-targeted LC-MS/MS-based lipidomic analysis was conducted in post-mortem human grey matter frontal cortex area 8 (GM) and white matter of the frontal lobe centrum semi-ovale (WM) to identify lipidome fingerprints in middle-aged individuals with no neurofibrillary tangles and senile plaques, and cases at progressive stages of sporadic Alzheimer's disease (sAD). Complementary data were obtained using RT-qPCR and immunohistochemistry. The results showed that WM presents an adaptive lipid phenotype resistant to lipid peroxidation, characterized by a lower fatty acid unsaturation, peroxidizability index, and higher ether lipid content than the GM. Changes in the lipidomic profile are more marked in the WM than in GM in AD with disease progression. Four functional categories are associated with the different lipid classes affected in sAD: membrane structural composition, bioenergetics, antioxidant protection, and bioactive lipids, with deleterious consequences affecting both neurons and glial cells favoring disease progression.
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Affiliation(s)
- Elia Obis
- Department of Experimental Medicine, Lleida University (UdL), Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.
| | - Joaquim Sol
- Department of Experimental Medicine, Lleida University (UdL), Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.
- Catalan Institute of Health (ICS), Lleida, Spain, Research Support Unit (USR), Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), Lleida, Spain.
| | - Pol Andres-Benito
- CIBERNED (Network Centre of Biomedical Research of Neurodegenerative Diseases), Institute of Health Carlos III, Ministry of Economy and Competitiveness, Madrid, Spain.
- Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL), E-08907 Hospitalet de Llobregat, Barcelona, Spain.
| | - Meritxell Martín-Gari
- Department of Experimental Medicine, Lleida University (UdL), Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.
| | - Natàlia Mota-Martorell
- Department of Experimental Medicine, Lleida University (UdL), Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.
| | - José Daniel Galo-Licona
- Department of Experimental Medicine, Lleida University (UdL), Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.
| | - Gerard Piñol-Ripoll
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Santa Maria University Hospital, IRBLleida, Lleida, Spain.
| | - Manuel Portero-Otin
- Department of Experimental Medicine, Lleida University (UdL), Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.
| | - Isidro Ferrer
- CIBERNED (Network Centre of Biomedical Research of Neurodegenerative Diseases), Institute of Health Carlos III, Ministry of Economy and Competitiveness, Madrid, Spain.
- Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL), E-08907 Hospitalet de Llobregat, Barcelona, Spain.
- Department of Pathology and Experimental Therapeutics, University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain.
| | - Mariona Jové
- Department of Experimental Medicine, Lleida University (UdL), Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.
| | - Reinald Pamplona
- Department of Experimental Medicine, Lleida University (UdL), Lleida Biomedical Research Institute (IRBLleida), Lleida, Spain.
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Kamal F, Morrison C, Maranzano J, Zeighami Y, Dadar M. White Matter Hyperintensity Trajectories in Patients With Progressive and Stable Mild Cognitive Impairment. Neurology 2023; 101:e815-e824. [PMID: 37407262 PMCID: PMC10449435 DOI: 10.1212/wnl.0000000000207514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/25/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES White matter hyperintensities (WMH) are pathologic brain changes that are associated with increased age and cognitive decline. However, the association of WMH burden with amyloid positivity and conversion to dementia in people with mild cognitive impairment (MCI) is unclear. The aim of this study was to expand on this research by examining whether change in WMH burden over time differs in amyloid-negative (Aβ-) and amyloid-positive (Aβ+) people with MCI who either remain stable or convert to dementia. To examine this question, we compared regional WMH burden in 4 groups: Aβ+ progressor, Aβ- progressor, Aβ+ stable, and Aβ- stable. METHODS Participants with MCI from the Alzheimer Disease Neuroimaging Initiative were included if they had APOE ɛ4 status and if amyloid measures were available to determine amyloid status (i.e., Aβ+, or Aβ-). Participants with a baseline diagnosis of MCI and who had APOE ɛ4 information and amyloid measures were included. An average of 5.7 follow-up time points per participant were included, with a total of 5,054 follow-up time points with a maximum follow-up duration of 13 years. Differences in total and regional WMH burden were examined using linear mixed-effects models. RESULTS A total of 820 participants (55-90 years of age) were included in the study (Aβ+ progressor, n = 239; Aβ- progressor, n = 22; Aβ+ stable, n = 343; Aβ- stable, n = 216). People who were Aβ- stable exhibited reduced baseline WMH compared with Aβ+ progressors and people who were Aβ+ stable at all regions of interest (β belongs to 0.20-0.33, CI belongs to 0.03-0.49, p < 0.02), except deep WMH. When examining longitudinal results, compared with people who were Aβ- stable, all groups had steeper accumulation in WMH burden with Aβ+ progressors (β belongs to -0.03 to 0.06, CI belongs to -0.05 to 0.09, p < 0.01) having the largest increase (i.e., largest increase in WMH accumulation over time). DISCUSSION These results indicate that WMH accumulation contributes to conversion to dementia in older adults with MCI who are Aβ+ and Aβ-.
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Affiliation(s)
- Farooq Kamal
- From the Department of Psychiatry (F.K., Y.Z., M.D.), McGill University; Douglas Mental Health University Institute (F.K., Y.Z., M.D.); Department of Neurology and Neurosurgery (C.M., J.M.), Faculty of Medicine, and McConnell Brain Imaging Centre (C.M.), Montreal Neurological Institute, McGill University; and Department of Anatomy (J.M.), University of Quebec in Trois-Rivières, Canada.
| | - Cassandra Morrison
- From the Department of Psychiatry (F.K., Y.Z., M.D.), McGill University; Douglas Mental Health University Institute (F.K., Y.Z., M.D.); Department of Neurology and Neurosurgery (C.M., J.M.), Faculty of Medicine, and McConnell Brain Imaging Centre (C.M.), Montreal Neurological Institute, McGill University; and Department of Anatomy (J.M.), University of Quebec in Trois-Rivières, Canada
| | - Josefina Maranzano
- From the Department of Psychiatry (F.K., Y.Z., M.D.), McGill University; Douglas Mental Health University Institute (F.K., Y.Z., M.D.); Department of Neurology and Neurosurgery (C.M., J.M.), Faculty of Medicine, and McConnell Brain Imaging Centre (C.M.), Montreal Neurological Institute, McGill University; and Department of Anatomy (J.M.), University of Quebec in Trois-Rivières, Canada
| | - Yashar Zeighami
- From the Department of Psychiatry (F.K., Y.Z., M.D.), McGill University; Douglas Mental Health University Institute (F.K., Y.Z., M.D.); Department of Neurology and Neurosurgery (C.M., J.M.), Faculty of Medicine, and McConnell Brain Imaging Centre (C.M.), Montreal Neurological Institute, McGill University; and Department of Anatomy (J.M.), University of Quebec in Trois-Rivières, Canada
| | - Mahsa Dadar
- From the Department of Psychiatry (F.K., Y.Z., M.D.), McGill University; Douglas Mental Health University Institute (F.K., Y.Z., M.D.); Department of Neurology and Neurosurgery (C.M., J.M.), Faculty of Medicine, and McConnell Brain Imaging Centre (C.M.), Montreal Neurological Institute, McGill University; and Department of Anatomy (J.M.), University of Quebec in Trois-Rivières, Canada
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15
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Luo J, Ma Y, Agboola FJ, Grant E, Morris JC, McDade E, Fagan AM, Benzinger TLS, Hassenstab J, Bateman RJ, Perrin RJ, Gordon BA, Goyal M, Strain JF, Yakushev I, Day GS, Xiong C. Longitudinal Relationships of White Matter Hyperintensities and Alzheimer Disease Biomarkers Across the Adult Life Span. Neurology 2023; 101:e164-e177. [PMID: 37202169 PMCID: PMC10351551 DOI: 10.1212/wnl.0000000000207378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 03/20/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES White matter hyperintensities (WMH) correlate with Alzheimer disease (AD) biomarkers cross-sectionally and modulate AD pathogenesis. Longitudinal changes have been reported for AD biomarkers, including concentrations of CSF β-amyloid (Aβ) 42, Aβ40, total tau and phosphorylated tau181, standardized uptake value ratio from the molecular imaging of cerebral fibrillar Aβ with PET using [11C] Pittsburgh Compound-B, MRI-based hippocampal volume, and cortical thickness. Correlations between established AD biomarkers and the longitudinal change for WMH have not been fully evaluated, especially among cognitively normal individuals across the adult life span. METHODS We jointly analyzed the longitudinal data of WMH volume and each of the established AD biomarkers and cognition from 371 cognitively normal individuals whose baseline age spanned from 19.6 to 88.20 years from 4 longitudinal studies of aging and AD. A 2-stage algorithm was applied to identify the inflection point of baseline age whereby older participants had an accelerated longitudinal change in WMH volume, in comparison with the younger participants. The longitudinal correlations between WMH volume and AD biomarkers were estimated from the bivariate linear mixed-effects models. RESULTS A longitudinal increase in WMH volume was associated with a longitudinal increase in PET amyloid uptake and a decrease in MRI hippocampal volume, cortical thickness, and cognition. The inflection point of baseline age in WMH volume was identified at 60.46 (95% CI 56.43-64.49) years, with the annual increase for the older participants (83.12 [SE = 10.19] mm3 per year) more than 13 times faster (p < 0.0001) than that for the younger participants (6.35 [SE = 5.63] mm3 per year). Accelerated rates of change among the older participants were similarly observed in almost all the AD biomarkers. Longitudinal correlations of WMH volume with MRI, PET amyloid biomarkers, and cognition seemed to be numerically stronger for the younger participants, but not significantly different from those for the older participants. Carrying APOE ε4 alleles did not alter the longitudinal correlations between WMH and AD biomarkers. DISCUSSION Longitudinal increases in WMH volume started to accelerate around a baseline age of 60.46 years and correlated with the longitudinal change in PET amyloid uptake, MRI structural outcomes, and cognition.
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Affiliation(s)
- Jingqin Luo
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Yinjiao Ma
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Folasade Jane Agboola
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Elizabeth Grant
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - John C Morris
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Eric McDade
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Anne M Fagan
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Tammie L S Benzinger
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Jason Hassenstab
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Randall J Bateman
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Richard J Perrin
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Brian A Gordon
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Manu Goyal
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Jeremy F Strain
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Igor Yakushev
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Gregory S Day
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Chengjie Xiong
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL.
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Shaaban SG, LeCompte MC, Kleinberg LR, Redmond KJ, Page BR. Recognition and Management of the Long-term Effects of Cranial Radiation. Curr Treat Options Oncol 2023; 24:880-891. [PMID: 37145381 DOI: 10.1007/s11864-023-01078-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 05/06/2023]
Abstract
OPINION STATEMENT Cranial radiation is ubiquitous in the treatment of primary malignant and benign brain tumors as well as brain metastases. Improvement in radiotherapy targeting and delivery has led to prolongation of survival outcomes. As long-term survivorship improves, we also focus on prevention of permanent side effects of radiation and mitigating the impact when they do occur. Such chronic treatment-related morbidity is a major concern with significant negative impact on patient's and caregiver's respective quality of life. The actual mechanisms responsible for radiation-induced brain injury remain incompletely understood. Multiple interventions have been introduced to potentially prevent, minimize, or reverse the cognitive deterioration. Hippocampal-sparing intensity modulated radiotherapy and memantine represent effective interventions to avoid damage to regions of adult neurogenesis. Radiation necrosis frequently develops in the high radiation dose region encompassing the tumor and surrounding normal tissue. The radiographic findings in addition to the clinical course of the patients' symptoms are taken into consideration to differentiate between tissue necrosis and tumor recurrence. Radiation-induced neuroendocrine dysfunction becomes more pronounced when the hypothalamo-pituitary (HP) axis is included in the radiation treatment field. Baseline and post-treatment evaluation of hormonal profile is warranted. Radiation-induced injury of the cataract and optic system can develop when these structures receive an amount of radiation that exceeds their tolerance. Special attention should always be paid to avoid irradiation of these sensitive structures, if possible, or minimize their dose to the lowest limit.
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Affiliation(s)
- Sherif G Shaaban
- Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins Medicine, 401 North Broadway, Suite 1440, Baltimore, MD, 21287, USA
| | - Michael C LeCompte
- Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins Medicine, 401 North Broadway, Suite 1440, Baltimore, MD, 21287, USA
| | - Lawrence R Kleinberg
- Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins Medicine, 401 North Broadway, Suite 1440, Baltimore, MD, 21287, USA
| | - Kristin J Redmond
- Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins Medicine, 401 North Broadway, Suite 1440, Baltimore, MD, 21287, USA
| | - Brandi R Page
- Department of Radiation Oncology-National Capitol Region, Johns Hopkins Medicine, 6420 Rockledge Drive Suite 1200, Bethesda, MD, 20817, USA.
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17
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Ortner M, Lanz K, Goldhardt O, Müller-Sarnowski F, Diehl-Schmid J, Förstl H, Hedderich DM, Yakushev I, Logan CA, Weinberger JP, Simon M, Grimmer T. Elecsys Cerebrospinal Fluid Immunoassays Accurately Detect Alzheimer's Disease Regardless of Concomitant Small Vessel Disease. J Alzheimers Dis 2023:JAD221187. [PMID: 37212102 DOI: 10.3233/jad-221187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Differentiating dementia due to small vessel disease (SVD) from dementia due to Alzheimer's disease (AD) with concomitant SVD is challenging in clinical practice. Accurate and early diagnosis of AD is critical to delivering stratified patient care. OBJECTIVE We characterized the results of Elecsys ® cerebrospinal fluid (CSF) immunoassays (Roche Diagnostics International Ltd) in patients with early AD, diagnosed using core clinical criteria, with varying extent of SVD. METHODS Frozen CSF samples (n = 84) were measured using Elecsys β-Amyloid(1-42) (Aβ42), Phospho-Tau (181P) (pTau181), and Total-Tau (tTau) CSF immunoassays, adapted for use on the cobas ® e 411 analyzer (Roche Diagnostics International Ltd), and a robust prototype β-Amyloid(1-40) (Aβ40) CSF immunoassay. SVD was assessed by extent of white matter hyperintensities (WMH) using the lesion segmentation tool. Interrelations between WMH, biomarkers, fluorodeoxyglucose F18-positron emission tomography (FDG-PET), and other parameters (including age and Mini-Mental State examinations [MMSE]) were assessed using Spearman's correlation, sensitivity/specificity, and logistic/linear regression analyses. RESULTS The extent of WMH showed significant correlation with Aβ42/Aβ40 ratio (Rho=-0.250; p = 0.040), tTau (Rho = 0.292; p = 0.016), tTau/Aβ42 ratio (Rho = 0.247; p = 0.042), age (Rho = 0.373; p = 0.002), and MMSE (Rho=-0.410; p = 0.001). Sensitivity/specificity point estimates for Elecsys CSF immunoassays versus FDG-PET positivity for underlying AD pathophysiology were mostly comparable or greater in patients with high versus low WMH. WMH were not a significant predictor and did not interact with CSF biomarker positivity but modified the association between pTau181 and tTau. CONCLUSION Elecsys CSF immunoassays detect AD pathophysiology regardless of concomitant SVD and may help to identify patients with early dementia with underlying AD pathophysiology.
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Affiliation(s)
- Marion Ortner
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Korbinian Lanz
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Oliver Goldhardt
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Felix Müller-Sarnowski
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Hans Förstl
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Dennis M Hedderich
- Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | | | | | - Maryline Simon
- Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
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18
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Tarawneh R. Microvascular Contributions to Alzheimer Disease Pathogenesis: Is Alzheimer Disease Primarily an Endotheliopathy? Biomolecules 2023; 13:830. [PMID: 37238700 PMCID: PMC10216678 DOI: 10.3390/biom13050830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/07/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Alzheimer disease (AD) models are based on the notion that abnormal protein aggregation is the primary event in AD, which begins a decade or longer prior to symptom onset, and culminates in neurodegeneration; however, emerging evidence from animal and clinical studies suggests that reduced blood flow due to capillary loss and endothelial dysfunction are early and primary events in AD pathogenesis, which may precede amyloid and tau aggregation, and contribute to neuronal and synaptic injury via direct and indirect mechanisms. Recent data from clinical studies suggests that endothelial dysfunction is closely associated with cognitive outcomes in AD and that therapeutic strategies which promote endothelial repair in early AD may offer a potential opportunity to prevent or slow disease progression. This review examines evidence from clinical, imaging, neuropathological, and animal studies supporting vascular contributions to the onset and progression of AD pathology. Together, these observations support the notion that the onset of AD may be primarily influenced by vascular, rather than neurodegenerative, mechanisms and emphasize the importance of further investigations into the vascular hypothesis of AD.
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Affiliation(s)
- Rawan Tarawneh
- Department of Neurology, Center for Memory and Aging, University of New Mexico, Albuquerque, NM 87106, USA
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19
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Kamal F, Morrison C, Dadar M. Investigating the relationship between sleep disturbances and white matter hyperintensities in older adults on the Alzheimer's disease spectrum. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.13.23288544. [PMID: 37131746 PMCID: PMC10153314 DOI: 10.1101/2023.04.13.23288544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background While studies report that sleep disturbance can have negative effects on brain vasculature, its impact on cerebrovascular disease such as white matter hyperintensities (WMHs) in beta-amyloid positive older adults remains unexplored. Methods Linear regressions, mixed effects models, and mediation analysis examined the crosssectional and longitudinal associations between sleep disturbance, cognition, and WMH burden, and cognition in normal controls (NCs), mild cognitive impairment (MCI), and Alzheimer's disease (AD) at baseline and longitudinally. Results People with AD reported more sleep disturbance than NC and MCI. AD with sleep disturbance had more WMHs than AD without sleep disturbances. Mediation analysis revealed an effect of regional WMH burden on the relationship between sleep disturbance and future cognition. Conclusion These results suggest that WMH burden and sleep disturbance increases from aging to AD. Sleep disturbance decreases cognition through increases in WMH burden. Improved sleep could mitigate the impact of WMH accumulation and cognitive decline.
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Affiliation(s)
- Farooq Kamal
- Department of Psychiatry, McGill University, Montreal, Quebec, H3A 1A1, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, H4H 1R3, Canada
| | - Cassandra Morrison
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, H3A 2B4, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, H3A 2B4, Canada
| | - Mahsa Dadar
- Department of Psychiatry, McGill University, Montreal, Quebec, H3A 1A1, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, H4H 1R3, Canada
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20
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Alban SL, Lynch KM, Ringman JM, Toga AW, Chui HC, Sepehrband F, Choupan J. The association between white matter hyperintensities and amyloid and tau deposition. Neuroimage Clin 2023; 38:103383. [PMID: 36965457 PMCID: PMC10060905 DOI: 10.1016/j.nicl.2023.103383] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/09/2023] [Accepted: 03/16/2023] [Indexed: 03/22/2023]
Abstract
White matter hyperintensities (WMHs) frequently occur in Alzheimer's Disease (AD) and have a contribution from ischemia, though their relationship with β-amyloid and cardiovascular risk factors (CVRFs) is not completely understood. We used AT classification to categorize individuals based on their β-amyloid and tau pathologies, then assessed the effects of β-amyloid and tau on WMH volume and number. We then determined regions in which β-amyloid and WMH accumulation were related. Last, we analyzed the effects of various CVRFs on WMHs. As secondary analyses, we observed effects of age and sex differences, atrophy, cognitive scores, and APOE genotype. PET, MRI, FLAIR, demographic, and cardiovascular health data was collected from the Alzheimer's Disease Neuroimaging Initiative (ADNI-3) (N = 287, 48 % male). Participants were categorized as A + and T + if their Florbetapir SUVR and Flortaucipir SUVR were above 0.79 and 1.25, respectively. WMHs were mapped on MRI using a deep convolutional neural network (Sepehrband et al., 2020). CVRF scores were based on history of hypertension, systolic and diastolic blood pressure, pulse rate, respiration rate, BMI, and a cumulative score with 6 being the maximum score. Regression models and Pearson correlations were used to test associations and correlations between variables, respectively, with age, sex, years of education, and scanner manufacturer as covariates of no interest. WMH volume percent was significantly associated with global β-amyloid (r = 0.28, p < 0.001), but not tau (r = 0.05, p = 0.25). WMH volume percent was higher in individuals with either A + or T + pathology compared to controls, particularly within in the A+/T + group (p = 0.007, Cohen's d = 0.4, t = -2.5). Individual CVRFs nor cumulative CVRF scores were associated with increased WMH volume. Finally, the regions where β-amyloid and WMH count were most positively associated were the middle temporal region in the right hemisphere (r = 0.18, p = 0.002) and the fusiform region in the left hemisphere (r = 0.017, p = 0.005). β-amyloid and WMH have a clear association, though the mechanism facilitating this association is still not fully understood. The associations found between β-amyloid and WMH burden emphasizes the relationship between β-amyloid and vascular lesion formation while factors like CVRFs, age, and sex affect AD development through various mechanisms. These findings highlight potential causes and mechanisms of AD as targets for future preventions and treatments. Going forward, a larger emphasis may be placed on β-amyloid's vascular effects and the implications of impaired brain clearance in AD.
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Affiliation(s)
- Sierra L Alban
- Laboratory of NeuroImaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kirsten M Lynch
- Laboratory of NeuroImaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - John M Ringman
- Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Arthur W Toga
- Laboratory of NeuroImaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Helena C Chui
- Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Farshid Sepehrband
- Laboratory of NeuroImaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jeiran Choupan
- Laboratory of NeuroImaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; NeuroScope Inc., Scarsdale, NY, USA
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21
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Amofa-Ho PA, Stickel AM, Chen R, Kobayashi LC, Glymour MM, Eng CW. The Mediating Roles of Neurobiomarkers in the Relationship Between Education and Late-Life Cognition. J Alzheimers Dis 2023; 95:1405-1416. [PMID: 37694365 PMCID: PMC10578223 DOI: 10.3233/jad-230244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND The mediating roles of neuropathologies and neurovascular damage in the relationship between early-life education and later-life cognitive function are unknown. OBJECTIVE To examine whether Alzheimer's and neurovascular biomarkers mediate the relationships between education and cognitive functions. METHODS Data were from 537 adults aged 55-94 in the Alzheimer's Disease Neuroimaging Initiative 3. We tested whether the relationships between education (continuous, years) and cognitive function (memory, executive functioning, and language composites) were mediated by neuroimaging biomarkers (hippocampal volumes, cortical gray matter volumes, meta-temporal tau PET standard uptake value ratio, and white matter hyperintensity volumes). Models were adjusted for age, race, sex/gender, cardiovascular history, body mass index, depression, and Apolipoprotein E-ɛ4 status. RESULTS Hippocampal volumes and white matter hyperintensities partially mediated the relationships between education and cognitive function across all domains (6.43% to 15.72% mediated). The direct effects of education on each cognitive domain were strong and statistically significant. CONCLUSIONS Commonly measured neurobiomarkers only partially mediate the relationships between education and multi-domain cognitive function.
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Affiliation(s)
- Priscilla A. Amofa-Ho
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Ariana M. Stickel
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Ruijia Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Lindsay C. Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Chloe W. Eng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Department of Epidemiology, Stanford University, Palo Alto, CA, USA
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22
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Rizvi B, Sathishkumar M, Kim S, Márquez F, Granger SJ, Larson MS, Miranda BA, Hollearn MK, McMillan L, Nan B, Tustison NJ, Lao PJ, Brickman AM, Greenia D, Corrada MM, Kawas CH, Yassa MA. Posterior white matter hyperintensities are associated with reduced medial temporal lobe subregional integrity and long-term memory in older adults. Neuroimage Clin 2022; 37:103308. [PMID: 36586358 PMCID: PMC9830310 DOI: 10.1016/j.nicl.2022.103308] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 12/29/2022]
Abstract
White matter hyperintensities are a marker of small vessel cerebrovascular disease that are strongly related to cognition in older adults. Similarly, medial temporal lobe atrophy is well-documented in aging and Alzheimer's disease and is associated with memory decline. Here, we assessed the relationship between lobar white matter hyperintensities, medial temporal lobe subregional volumes, and hippocampal memory in older adults. We collected MRI scans in a sample of 139 older adults without dementia (88 females, mean age (SD) = 76.95 (10.61)). Participants were administered the Rey Auditory Verbal Learning Test (RAVLT). Regression analyses tested for associations among medial temporal lobe subregional volumes, regional white matter hyperintensities and memory, while adjusting for age, sex, and education and correcting for multiple comparisons. Increased occipital white matter hyperintensities were related to worse RAVLT delayed recall performance, and to reduced CA1, dentate gyrus, perirhinal cortex (Brodmann area 36), and parahippocampal cortex volumes. These medial temporal lobe subregional volumes were related to delayed recall performance. The association of occipital white matter hyperintensities with delayed recall performance was fully mediated statistically only by perirhinal cortex volume. These results suggest that white matter hyperintensities may be associated with memory decline through their impact on medial temporal lobe atrophy. These findings provide new insights into the role of vascular pathologies in memory loss in older adults and suggest that future studies should further examine the neural mechanisms of these relationships in longitudinal samples.
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Affiliation(s)
- Batool Rizvi
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Mithra Sathishkumar
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Soyun Kim
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Freddie Márquez
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Steven J Granger
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Myra S Larson
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Blake A Miranda
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Martina K Hollearn
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Liv McMillan
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Bin Nan
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA; Department of Statistics, University of California, Irvine, Irvine, CA, USA
| | - Nicholas J Tustison
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA; Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA
| | - Patrick J Lao
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Dana Greenia
- Department of Neurology, School of Medicine, University of California, Irvine, CA, USA
| | - Maria M Corrada
- Department of Neurology, School of Medicine, University of California, Irvine, CA, USA; Department of Epidemiology, University of California, Irvine, CA, USA
| | - Claudia H Kawas
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA; Department of Neurology, School of Medicine, University of California, Irvine, CA, USA
| | - Michael A Yassa
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA; Department of Neurology, School of Medicine, University of California, Irvine, CA, USA.
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23
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Ahulló-Fuster MA, Ortiz T, Varela-Donoso E, Nacher J, Sánchez-Sánchez ML. The Parietal Lobe in Alzheimer’s Disease and Blindness. J Alzheimers Dis 2022; 89:1193-1202. [DOI: 10.3233/jad-220498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The progressive aging of the population will notably increase the burden of those diseases which leads to a disabling situation, such as Alzheimer’s disease (AD) and ophthalmological diseases that cause a visual impairment (VI). Eye diseases that cause a VI raise neuroplastic processes in the parietal lobe. Meanwhile, the aforementioned lobe suffers a severe decline throughout AD. From this perspective, diving deeper into the particularities of the parietal lobe is of paramount importance. In this article, we discuss the functions of the parietal lobe, review the parietal anatomical and pathophysiological peculiarities in AD, and also describe some of the changes in the parietal region that occur after VI. Although the alterations in the hippocampus and the temporal lobe have been well documented in AD, the alterations of the parietal lobe have been less thoroughly explored. Recent neuroimaging studies have revealed that some metabolic and perfusion impairments along with a reduction of the white and grey matter could take place in the parietal lobe during AD. Conversely, it has been speculated that blinding ocular diseases induce a remodeling of the parietal region which is observable through the improvement of the integration of multimodal stimuli and in the increase of the volume of this cortical region. Based on current findings concerning the parietal lobe in both pathologies, we hypothesize that the increased activity of the parietal lobe in people with VI may diminish the neurodegeneration of this brain region in those who are visually impaired by oculardiseases.
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Affiliation(s)
- Mónica Alba Ahulló-Fuster
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University Complutense of Madrid, Spain
| | - Tomás Ortiz
- Department of Legal Medicine, Psychiatry and Pathology, Faculty of Medicine, University Complutense of Madrid, Spain
| | - Enrique Varela-Donoso
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University Complutense of Madrid, Spain
| | - Juan Nacher
- Neurobiology Unit, Institute for Biotechnology and Biomedicine (BIOTECMED), University of Valencia, Spain
- CIBERSAM, Spanish National Network for Research in Mental Health, Spain
- Fundación Investigación Hospital Clínico de Valencia, INCLIVA, Valencia, Spain
| | - M. Luz Sánchez-Sánchez
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
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24
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Keuss SE, Coath W, Nicholas JM, Poole T, Barnes J, Cash DM, Lane CA, Parker TD, Keshavan A, Buchanan SM, Wagen AZ, Storey M, Harris M, Malone IB, Sudre CH, Lu K, James SN, Street R, Thomas DL, Dickson JC, Murray-Smith H, Wong A, Freiberger T, Crutch S, Richards M, Fox NC, Schott JM. Associations of β-Amyloid and Vascular Burden With Rates of Neurodegeneration in Cognitively Normal Members of the 1946 British Birth Cohort. Neurology 2022; 99:e129-e141. [PMID: 35410910 PMCID: PMC9280996 DOI: 10.1212/wnl.0000000000200524] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 03/01/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The goals of this work were to quantify the independent and interactive associations of β-amyloid (Aβ) and white matter hyperintensity volume (WMHV), a marker of presumed cerebrovascular disease (CVD), with rates of neurodegeneration and to examine the contributions of APOE ε4 and vascular risk measured at different stages of adulthood in cognitively normal members of the 1946 British Birth Cohort. METHODS Participants underwent brain MRI and florbetapir-Aβ PET as part of Insight 46, an observational population-based study. Changes in whole-brain, ventricular, and hippocampal volume were directly measured from baseline and repeat volumetric T1 MRI with the boundary shift integral. Linear regression was used to test associations with baseline Aβ deposition, baseline WMHV, APOE ε4, and office-based Framingham Heart Study Cardiovascular Risk Score (FHS-CVS) and systolic blood pressure (BP) at ages 36, 53, and 69 years. RESULTS Three hundred forty-six cognitively normal participants (mean [SD] age at baseline scan 70.5 [0.6] years; 48% female) had high-quality T1 MRI data from both time points (mean [SD] scan interval 2.4 [0.2] years). Being Aβ positive at baseline was associated with 0.87-mL/y faster whole-brain atrophy (95% CI 0.03, 1.72), 0.39-mL/y greater ventricular expansion (95% CI 0.16, 0.64), and 0.016-mL/y faster hippocampal atrophy (95% CI 0.004, 0.027), while each 10-mL additional WMHV at baseline was associated with 1.07-mL/y faster whole-brain atrophy (95% CI 0.47, 1.67), 0.31-mL/y greater ventricular expansion (95% CI 0.13, 0.60), and 0.014-mL/y faster hippocampal atrophy (95% CI 0.006, 0.022). These contributions were independent, and there was no evidence that Aβ and WMHV interacted in their effects. There were no independent associations of APOE ε4 with rates of neurodegeneration after adjustment for Aβ status and WMHV, no clear relationships between FHS-CVS or systolic BP and rates of neurodegeneration when assessed across the whole sample, and no evidence that FHS-CVS or systolic BP acted synergistically with Aβ. DISCUSSION Aβ and presumed CVD have distinct and additive effects on rates of neurodegeneration in cognitively normal elderly. These findings have implications for the use of MRI measures as biomarkers of neurodegeneration and emphasize the importance of risk management and early intervention targeting both pathways.
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Affiliation(s)
- Sarah E Keuss
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - William Coath
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Jennifer M Nicholas
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Teresa Poole
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Josephine Barnes
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - David M Cash
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Christopher A Lane
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Thomas D Parker
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Ashvini Keshavan
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Sarah M Buchanan
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Aaron Z Wagen
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Mathew Storey
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Matthew Harris
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Ian B Malone
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Carole H Sudre
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Kirsty Lu
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Sarah-Naomi James
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Rebecca Street
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - David L Thomas
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - John C Dickson
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Heidi Murray-Smith
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Andrew Wong
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Tamar Freiberger
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Sebastian Crutch
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Marcus Richards
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Nick C Fox
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Jonathan M Schott
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK.
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Lehrer EJ, Jones BM, Dickstein DR, Green S, Germano IM, Palmer JD, Laack N, Brown PD, Gondi V, Wefel JS, Sheehan JP, Trifiletti DM. The Cognitive Effects of Radiotherapy for Brain Metastases. Front Oncol 2022; 12:893264. [PMID: 35847842 PMCID: PMC9279690 DOI: 10.3389/fonc.2022.893264] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/27/2022] [Indexed: 12/24/2022] Open
Abstract
Brain metastases are the most common intracranial neoplasm and are seen in upwards of 10-30% of patients with cancer. For decades, whole brain radiation therapy (WBRT) was the mainstay of treatment in these patients. While WBRT is associated with excellent rates of intracranial tumor control, studies have demonstrated a lack of survival benefit, and WBRT is associated with higher rates of cognitive deterioration and detrimental effects on quality of life. In recent years, strategies to mitigate this risk, such as the incorporation of memantine and hippocampal avoidance have been employed with improved results. Furthermore, stereotactic radiosurgery (SRS) has emerged as an appealing treatment option over the last decade in the management of brain metastases and is associated with superior cognitive preservation and quality of life when compared to WBRT. This review article evaluates the pathogenesis and impact of cranial irradiation on cognition in patients with brain metastases, as well as current and future risk mitigation techniques.
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Affiliation(s)
- Eric J. Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Brianna M. Jones
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Daniel R. Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Sheryl Green
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Isabelle M. Germano
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Joshua D. Palmer
- Department of Radiation Oncology, Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Nadia Laack
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, United States
| | - Paul D. Brown
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, United States
| | - Vinai Gondi
- Department of Radiation Oncology, Northwestern Medicine Cancer Center Warrenville and Proton Center, Warrenville, IL, United States
| | - Jeffrey S. Wefel
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, United States
| | - Jason P. Sheehan
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA, United States
| | - Daniel M. Trifiletti
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, United States
- *Correspondence: Daniel M. Trifiletti,
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Morrison C, Dadar M, Villeneuve S, Collins DL. White matter lesions may be an early marker for age-related cognitive decline. Neuroimage Clin 2022; 35:103096. [PMID: 35764028 PMCID: PMC9241138 DOI: 10.1016/j.nicl.2022.103096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/16/2022] [Accepted: 06/19/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Research suggests that cerebral small vessel disease (CSVD), amyloid, and pTau contribute to age-related cognitive decline. It remains unknown how these factors relate to one another and how they jointly contribute to cognitive decline in normal aging. This project examines the association between these factors and their relationship to cognitive decline in cognitively unimpaired older adults without subjective cognitive decline. METHODS A total of 230 subjects with cerebrospinal fluid (CSF) Aß42, CSF pTau181, white matter lesions (WMLs) used as a proxy of CSVD, and cognitive scores from the Alzheimer's Disease Neuroimaging Initiative were included. Associations between each factor and cognitive score were investigated using regression models. Furthermore, relationships between the three pathologies were also examined using regression models. RESULTS At baseline, there was an inverse association between WML load and Aß42 (t = -4.20, p <.001). There was no association between WML load and pTau (t = 0.32, p = 0.75), nor with Aß42 and pTau (t = 0.51, p =.61). Correcting for age, sex and education, baseline WML load was associated with baseline ADAS-13 scores (t = 2.59, p =.01) and lower follow-up executive functioning (t = -2.84, p =.005). Baseline Aß42 was associated with executive function at baseline (t = 3.58, p<.004) but not at follow-up (t = 1.05, p = 0.30), nor with ADAS-13 at baseline (t = -0.24, p = 0.81) or follow-up (t = 0.09, p = 0.93). Finally, baseline pTau was not associated with any cognitive measure at baseline or follow-up. CONCLUSION Both baseline Aß42 and WML load are associated with some baseline cognition scores, but only baseline WML load is associated with follow-up executive functioning. This finding suggests that WMLs may be one of the earliest clinical manifestations that contributes to future cognitive decline in cognitively healthy older adults. Given that healthy older adults with WMLs exhibit declines in cognitive functioning, they may be less resilient to future pathology increasing their risk for cognitive impairment due to dementia than those without WMLs.
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Affiliation(s)
- Cassandra Morrison
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University, H3A 2B4 Montreal, Quebec, Canada.
| | - Mahsa Dadar
- Department of Psychiatry, McGill University, H3A 1A1 Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3 Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University, H3A 2B4 Montreal, Quebec, Canada; Department of Psychiatry, McGill University, H3A 1A1 Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3 Montreal, Quebec, Canada
| | - D Louis Collins
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University, H3A 2B4 Montreal, Quebec, Canada
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Koncz R, Wen W, Makkar SR, Lam BCP, Crawford JD, Rowe CC, Sachdev P. The Interaction Between Vascular Risk Factors, Cerebral Small Vessel Disease, and Amyloid Burden in Older Adults. J Alzheimers Dis 2022; 86:1617-1628. [PMID: 35213365 DOI: 10.3233/jad-210358] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cerebral small vessel disease (SVD) and Alzheimer's disease pathology, namely amyloid-β (Aβ) deposition, commonly co-occur. Exactly how they interact remains uncertain. OBJECTIVE Using participants from the Alzheimer's Disease Neuroimaging Initiative (n = 216; mean age 73.29±7.08 years, 91 (42.1%) females), we examined whether the presence of vascular risk factors and/or baseline cerebral SVD was related to a greater burden of Aβ cross-sectionally, and at 24 months follow-up. METHOD Amyloid burden, assessed using 18F-florbetapir PET, was quantified as the global standardized uptake value ratio (SUVR). Multimodal imaging was used to strengthen the quantification of baseline SVD as a composite variable, which included white matter hyperintensity volume using MRI, and peak width of skeletonized mean diffusivity using diffusion tensor imaging. Structural equation modelling was used to analyze the associations between demographic factors, Apolipoprotein E ɛ4 carrier status, vascular risk factors, SVD burden and cerebral amyloid. RESULTS SVD burden had a direct association with Aβ burden cross-sectionally (coeff. = 0.229, p = 0.004), and an indirect effect over time (indirect coeff. = 0.235, p = 0.004). Of the vascular risk factors, a history of hypertension (coeff. = 0.094, p = 0.032) and a lower fasting glucose at baseline (coeff. = -0.027, p = 0.014) had a direct effect on Aβ burden at 24 months, but only the direct effect of glucose persisted after regularization. CONCLUSION While Aβ and SVD burden have an association cross-sectionally, SVD does not appear to directly influence the accumulation of Aβ longitudinally. Glucose regulation may be an important modifiable risk factor for Aβ accrual over time.
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Affiliation(s)
- Rebecca Koncz
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, UNSW Sydney, NSW, Australia.,The University of Sydney Specialty of Psychiatry, Faculty of Medicine and Health, Concord, NSW, Australia.,Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, UNSW Sydney, NSW, Australia
| | - Steve R Makkar
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, UNSW Sydney, NSW, Australia
| | - Ben C P Lam
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, UNSW Sydney, NSW, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, UNSW Sydney, NSW, Australia
| | - Christopher C Rowe
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, Victoria, Australia.,Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, UNSW Sydney, NSW, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
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28
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Kellar D, Register T, Lockhart SN, Aisen P, Raman R, Rissman RA, Brewer J, Craft S. Intranasal insulin modulates cerebrospinal fluid markers of neuroinflammation in mild cognitive impairment and Alzheimer's disease: a randomized trial. Sci Rep 2022; 12:1346. [PMID: 35079029 PMCID: PMC8789895 DOI: 10.1038/s41598-022-05165-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/05/2022] [Indexed: 12/14/2022] Open
Abstract
Intranasal insulin (INI) has shown promise as a treatment for Alzheimer's disease (AD) in pilot clinical trials. In a recent phase 2 trial, participants with mild cognitive impairment (MCI) or AD who were treated with INI with one of two delivery devices showed improved cerebral spinal fluid (CSF) biomarker profiles and slower symptom progression compared with placebo. In the cohort which showed benefit, we measured changes in CSF markers of inflammation, immune function and vascular integrity and assessed their relationship with changes in cognition, brain volume, and CSF amyloid and tau concentrations. The insulin-treated group had increased CSF interferon-γ (p = 0.032) and eotaxin (p = 0.049), and reduced interleukin-6 (p = 0.048) over the 12 month trial compared to placebo. Trends were observed for increased CSF macrophage-derived chemokine for the placebo group (p = 0.083), and increased interleukin-2 in the insulin-treated group (p = 0.093). Insulin-treated and placebo groups showed strikingly different patterns of associations between changes in CSF immune/inflammatory/vascular markers and changes in cognition, brain volume, and amyloid and tau concentrations. In summary, INI treatment altered the typical progression of markers of inflammation and immune function seen in AD, suggesting that INI may promote a compensatory immune response associated with therapeutic benefit.
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Affiliation(s)
- Derek Kellar
- Department of Internal Medicine-Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Thomas Register
- Department of Internal Medicine-Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Samuel N Lockhart
- Department of Internal Medicine-Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Paul Aisen
- Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, USA
| | - Rema Raman
- Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, USA
| | - Robert A Rissman
- Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, USA
- Department of Neurosciences, University of California, San Diego, La Jolla, USA
| | - James Brewer
- Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, USA
- Department of Neurosciences, University of California, San Diego, La Jolla, USA
| | - Suzanne Craft
- Department of Internal Medicine-Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA.
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Yang D, Masurkar A. Early-Stage MRI Volumetric Differences in White Matter Hyperintensity and Temporal Lobe Volumes between Autopsy-Confirmed Alzheimer's Disease, Cerebral Small Vessel Disease, and Mixed Pathologies. Dement Geriatr Cogn Dis Extra 2022; 12:69-75. [PMID: 35702161 PMCID: PMC9149438 DOI: 10.1159/000524499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 04/02/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Alzheimer's disease (AD) and cerebral small vessel disease (CVSD) both contribute to age-related cognitive decline but can be difficult to clinically distinguish at early stages. At mild cognitive impairment (MCI), we investigated brain MRI volumetric differences in white matter hyperintensities (WMH), frontal and temporal lobe volumes between neuropathologically defined groups of cerebral arteriolosclerosis alone (pARTE), AD alone (pAD), and mixed (ADARTE). Methods From the National Alzheimer's Coordinating Center, we defined neuropathology groups of pARTE (n = 18), pAD (n = 36), and ADARTE (n = 55) who had MRI brain volumetrics within 1 year of clinical evaluation with Clinical Dementia Rating score of 0.5, corresponding to MCI. We included moderate-to-severe arteriolosclerosis and/or ABC score 2-3 for AD, after excluding other major neuropathologies. We compared WMH and frontal and temporal lobe volumes between neuropathology groups using regression analysis. Results Adjusted regression models show AD-related groups associated with less WMH when compared to pARTE (pAD adjusted odds ratio (aOR) (95% confidence interval [CI]): 0.94 (0.90-0.98); ADARTE aOR (95% CI): 0.96 (0.93-0.99)). The mixed pathology group, but not pAD, had smaller right temporal lobe volumes than pARTE (pAD aOR [95% CI]: 0.86 [0.74-1.00]; ADARTE aOR [95% CI]: 0.83 [0.72-0.96]). There were no differences in frontal lobe volumes. Discussion/Conclusions Findings from this neuropathologically confirmed cohort suggest volumetric differences in WMH and temporal lobe volumes between AD- and CVSD-related MCI. Moreover, our results suggest a differential atrophy susceptibility of the right versus left temporal lobe to the additive effect of AD and vascular pathologies.
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Affiliation(s)
- Dixon Yang
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Arjun Masurkar
- Department of Neurology, Center for Cognitive Neurology, New York University Grossman School of Medicine, New York, New York, USA
- Department of Neuroscience & Physiology, New York University Grossman School of Medicine, New York, New York, USA
- Neuroscience Institute, New York University Grossman School of Medicine, New York, New York, USA
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30
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Jung Y, Viviano RP, van Rooden S, van der Grond J, Rombouts SARB, Damoiseaux JS. White Matter Hyperintensities and Apolipoprotein E Affect the Association Between Mean Arterial Pressure and Objective and Subjective Cognitive Functioning in Older Adults. J Alzheimers Dis 2021; 84:1337-1350. [PMID: 34657884 DOI: 10.3233/jad-210695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND White matter hyperintensities (WMH) show a robust relationship with arterial pressure as well as objective and subjective cognitive functioning. In addition, APOE ɛ4 carriership may influence how arterial pressure affects cognitive functioning. OBJECTIVE To determine the role of region-specific WMH burden and APOE ɛ4 carriership on the relationship between mean arterial pressure (MAP) and cognitive function as well as subjective cognitive decline (SCD). METHODS The sample consisted of 87 cognitively unimpaired middle-aged to older adults aged 50-85. We measured WMH volume for the whole brain, anterior thalamic radiation (ATR), forceps minor, and superior longitudinal fasciculus (SLF). We examined whether WMH burden mediated the relationship between MAP and cognition (i.e., TMT-A score for processing speed; Stroop performance for executive function) as well as SCD (i.e., Frequency of Forgetting (FoF)), and whether APOE ɛ4 carriership moderated that mediation. RESULTS WMH burden within SLF mediated the effect of MAP on Stroop performance. Both whole brain and ATR WMH burden mediated the effect of MAP on FoF score. In the MAP-WMH-Stroop relationship, the mediation effect of SLF WMH and the effect of MAP on SLF WMH were significant only in APOE ɛ4 carriers. In the MAP-WMH-FoF relationship, the effect of MAP on whole brain WMH burden was significant only in ɛ4 carriers. CONCLUSION WMH burden and APOE genotype explain the link between blood pressure and cognitive function and may enable a more accurate assessment of the effect of high blood pressure on cognitive decline and risk for dementia.
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Affiliation(s)
- Youjin Jung
- Department of Psychology, Wayne State University, Detroit, MI, USA.,Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Raymond P Viviano
- Department of Psychology, Wayne State University, Detroit, MI, USA.,Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Sanneke van Rooden
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Serge A R B Rombouts
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands.,Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Jessica S Damoiseaux
- Department of Psychology, Wayne State University, Detroit, MI, USA.,Institute of Gerontology, Wayne State University, Detroit, MI, USA
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31
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van Waalwijk van Doorn LJC, Ghafoorian M, van Leijsen EMC, Claassen JAHR, Arighi A, Bozzali M, Cannas J, Cavedo E, Eusebi P, Farotti L, Fenoglio C, Fortea J, Frisoni GB, Galimberti D, Greco V, Herukka SK, Liu Y, Lleó A, de Mendonça A, Nobili FM, Parnetti L, Picco A, Pikkarainen M, Salvadori N, Scarpini E, Soininen H, Tarducci R, Urbani A, Vilaplana E, Meulenbroek O, Platel B, Verbeek MM, Kuiperij HB. White Matter Hyperintensities Are No Major Confounder for Alzheimer's Disease Cerebrospinal Fluid Biomarkers. J Alzheimers Dis 2021; 79:163-175. [PMID: 33252070 PMCID: PMC7902951 DOI: 10.3233/jad-200496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: The cerebrospinal fluid (CSF) biomarkers amyloid-β 1–42 (Aβ42), total and phosphorylated tau (t-tau, p-tau) are increasingly used to assist in the clinical diagnosis of Alzheimer’s disease (AD). However, CSF biomarker levels can be affected by confounding factors. Objective: To investigate the association of white matter hyperintensities (WMHs) present in the brain with AD CSF biomarker levels. Methods: We included CSF biomarker and magnetic resonance imaging (MRI) data of 172 subjects (52 controls, 72 mild cognitive impairment (MCI), and 48 AD patients) from 9 European Memory Clinics. A computer aided detection system for standardized automated segmentation of WMHs was used on MRI scans to determine WMH volumes. Association of WMH volume with AD CSF biomarkers was determined using linear regression analysis. Results: A small, negative association of CSF Aβ42, but not p-tau and t-tau, levels with WMH volume was observed in the AD (r2 = 0.084, p = 0.046), but not the MCI and control groups, which was slightly increased when including the distance of WMHs to the ventricles in the analysis (r2 = 0.105, p = 0.025). Three global patterns of WMH distribution, either with 1) a low, 2) a peak close to the ventricles, or 3) a high, broadly-distributed WMH volume could be observed in brains of subjects in each diagnostic group. Conclusion: Despite an association of WMH volume with CSF Aβ42 levels in AD patients, the occurrence of WMHs is not accompanied by excess release of cellular proteins in the CSF, suggesting that WMHs are no major confounder for AD CSF biomarker assessment.
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Affiliation(s)
- Linda J C van Waalwijk van Doorn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mohsen Ghafoorian
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Esther M C van Leijsen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jurgen A H R Claassen
- Department of Geriatrics, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Andrea Arighi
- Fondazione IRCCS Ca' Granda, Ospedale Policlinico, Milan, Italy
| | - Marco Bozzali
- IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Jorge Cannas
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Enrica Cavedo
- Laboratory of Epidemiology, Neuroimaging and Telemedicine, IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris, France; Qynapse, Paris, France
| | - Paolo Eusebi
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Lucia Farotti
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | | | - Juan Fortea
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Giovanni B Frisoni
- Laboratory of Epidemiology, Neuroimaging and Telemedicine, IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,University Hospitals and University of Geneva, Geneva, Switzerland
| | - Daniela Galimberti
- Fondazione IRCCS Ca' Granda, Ospedale Policlinico, Milan, Italy.,University of Milan, Dino Ferrari Center, Milan, Italy
| | - Viviana Greco
- Fondazione Policlinica Universitario "A. Gemelli" -IRCCS, Rome, Italy.,Department of Basic Biotechnological Sciences, Intensivological and Perioperative Clinics, Università Cattolica, Rome, Italy
| | - Sanna-Kaisa Herukka
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Yawu Liu
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Alberto Lleó
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | | | - Flavio M Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucilla Parnetti
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Agnese Picco
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Maria Pikkarainen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Nicola Salvadori
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Elio Scarpini
- Fondazione IRCCS Ca' Granda, Ospedale Policlinico, Milan, Italy.,University of Milan, Dino Ferrari Center, Milan, Italy
| | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Roberto Tarducci
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Andrea Urbani
- Fondazione Policlinica Universitario "A. Gemelli" -IRCCS, Rome, Italy.,Department of Basic Biotechnological Sciences, Intensivological and Perioperative Clinics, Università Cattolica, Rome, Italy
| | - Eduard Vilaplana
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,Center of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Olga Meulenbroek
- Department of Geriatrics, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Bram Platel
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marcel M Verbeek
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - H Bea Kuiperij
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
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32
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Ortega G, Espinosa A, Alegret M, Monté-Rubio GC, Sotolongo-Grau O, Sanabria A, Tartari JP, Rodríguez-Gómez O, Marquié M, Vivas A, Gómez-Chiari M, Alarcón-Martín E, Pérez-Cordón A, Roberto N, Hernández I, Rosende-Roca M, Vargas L, Mauleón A, Abdelnour C, Esteban De Antonio E, López-Cuevas R, Alonso-Lana S, Moreno-Grau S, de Rojas I, Orellana A, Montrreal L, Tárraga L, Ruiz A, Boada M, Valero S. Combination of white matter hyperintensities and Aβ burden is related to cognitive composites domain scores in subjective cognitive decline: the FACEHBI cohort. Alzheimers Res Ther 2021; 13:141. [PMID: 34404456 PMCID: PMC8371791 DOI: 10.1186/s13195-021-00877-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/13/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND To explore whether the combination of white matter hyperintensities (WMHs) and amyloid-beta (Aβ) deposition is associated with worse cognitive performance on cognitive composites (CCs) domain scores in individuals with subjective cognitive decline (SCD). METHODS Two hundred participants from the FACEHBI cohort underwent structural magnetic resonance imaging (MRI), 18F-florbetaben positron emission tomography (FBB-PET), and neuropsychological assessment. WMHs were addressed through the Fazekas scale, the Age-Related White Matter Changes (ARWMC) scale, and the FreeSurfer pipeline. Eight CCs domain scores were created using the principal component analysis (PCA). Age, sex, education, and apolipoprotein E (APOE) were used as adjusting variables. RESULTS Adjusted multiple linear regression models showed that FreeSurfer (B - .245; 95% CI - .1.676, - .393, p = .016) and β burden (SUVR) (B - .180; 95% CI - 2.140, - .292; p = .070) were associated with face-name associative memory CCs domain score, although the latest one was not statistically significant after correction for multiple testing (p = .070). There was non-significant interaction of these two factors on this same CCs domain score (p = .54). However, its cumulative effects on face-name associative performance indicated that those individuals with either higher WMH load or higher Aβ burden showed the worst performance on the face-name associative memory CCs domain score. CONCLUSIONS Our results suggest that increased WMH load and increased Aβ are independently associated with poorer episodic memory performance in SCD individuals, indicating a cumulative effect of the combination of these two pathological conditions in promoting lower cognitive performance, an aspect that could help in terms of treatment and prevention.
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Affiliation(s)
- G Ortega
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain.
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.
| | - A Espinosa
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Alegret
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - G C Monté-Rubio
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - O Sotolongo-Grau
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - A Sanabria
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - J P Tartari
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - O Rodríguez-Gómez
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Marquié
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - A Vivas
- Departament de Diagnòstic Per La Imatge, Clínica Corachan, Barcelona, Spain
| | - M Gómez-Chiari
- Departament de Diagnòstic Per La Imatge, Clínica Corachan, Barcelona, Spain
| | - E Alarcón-Martín
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - A Pérez-Cordón
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - N Roberto
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - I Hernández
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Rosende-Roca
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - L Vargas
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - A Mauleón
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - C Abdelnour
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - E Esteban De Antonio
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - R López-Cuevas
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - S Alonso-Lana
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - S Moreno-Grau
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - I de Rojas
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - A Orellana
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - L Montrreal
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
| | - L Tárraga
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - A Ruiz
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - M Boada
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - S Valero
- Fundació ACE, Institut Català de Neurociències Aplicades, Research Center and Memory Clinic, Universitat Internacional de Catalunya, C/ Gran Via de Carles III, 85 bis- 08028, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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Garnier-Crussard A, Bougacha S, Wirth M, Dautricourt S, Sherif S, Landeau B, Gonneaud J, De Flores R, de la Sayette V, Vivien D, Krolak-Salmon P, Chételat G. White matter hyperintensity topography in Alzheimer's disease and links to cognition. Alzheimers Dement 2021; 18:422-433. [PMID: 34322985 PMCID: PMC9292254 DOI: 10.1002/alz.12410] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 01/18/2023]
Abstract
Introduction White matter hyperintensities (WMH) are often described in Alzheimer's disease (AD), but their topography and specific relationships with cognition remain unclear. Methods Regional WMH were estimated in 54 cognitively impaired amyloid beta–positive AD (Aβpos‐AD), compared to 40 cognitively unimpaired amyloid beta–negative older controls (Aβneg‐controls) matched for vascular risk factors. The cross‐sectional association between regional WMH volume and cognition was assessed within each group, controlling for cerebral amyloid burden, global cortical atrophy, and hippocampal atrophy. Results WMH volume was larger in Aβpos‐AD compared to Aβneg‐controls in all regions, with the greatest changes in the splenium of the corpus callosum (S‐CC). In Aβpos‐AD patients, larger total and regional WMH volume, especially in the S‐CC, was strongly associated with decreased cognition. Discussion WMH specifically contribute to lower cognition in AD, independently from amyloid deposition and atrophy. This study emphasizes the clinical relevance of WMH in AD, especially posterior WMH, and most notably S‐CC WMH.
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Affiliation(s)
- Antoine Garnier-Crussard
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders,", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France.,Clinical and Research Memory Center of Lyon, Lyon Institute For Elderly, Hospices Civils de Lyon, Lyon, France.,University of Lyon, Lyon, France
| | - Salma Bougacha
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders,", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Miranka Wirth
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Sophie Dautricourt
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders,", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France.,Department of Neurology, CHU de Caen, Caen, France
| | - Siya Sherif
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders,", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Brigitte Landeau
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders,", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Julie Gonneaud
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders,", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Robin De Flores
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders,", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Vincent de la Sayette
- Department of Neurology, CHU de Caen, Caen, France.,Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, Caen, France
| | - Denis Vivien
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders,", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France.,Department of Clinical Research, CHU de Caen, Caen, France
| | - Pierre Krolak-Salmon
- Clinical and Research Memory Center of Lyon, Lyon Institute For Elderly, Hospices Civils de Lyon, Lyon, France.,University of Lyon, Lyon, France.,Neuroscience Research Centre of Lyon, INSERM 1048, CNRS 5292, Lyon, France
| | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders,", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
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Feng T, Yamashita T, Sasaki R, Tadokoro K, Matsumoto N, Hishikawa N, Abe K. Protective effects of edaravone on white matter pathology in a novel mouse model of Alzheimer's disease with chronic cerebral hypoperfusion. J Cereb Blood Flow Metab 2021; 41:1437-1448. [PMID: 33106078 PMCID: PMC8142121 DOI: 10.1177/0271678x20968927] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
White matter lesions (WMLs) caused by cerebral chronic hypoperfusion (CCH) may contribute to the pathophysiology of Alzheimer's disease (AD). However, the underlying mechanisms and therapeutic approaches have yet to be totally identified. In the present study, we investigated a potential therapeutic effect of the free radical scavenger edaravone (EDA) on WMLs in our previously reported novel mouse model of AD (APP23) plus CCH with motor and cognitive deficits. Relative to AD with CCH mice at 12 months (M) of age, EDA strongly improved CCH-induced WMLs in the corpus callosum of APP23 mice at 12 M by improving the disruption of white matter integrity, enhancing the proliferation of oligodendrocyte progenitor cells, attenuating endothelium/astrocyte unit dysfunction, and reducing neuroinflammation and oxidative stress. The present study demonstrates that the long-term administration of EDA may provide a promising therapeutic approach for WMLs in AD plus CCH disease with cognitive deficits.
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Affiliation(s)
- Tian Feng
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Toru Yamashita
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Ryo Sasaki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Koh Tadokoro
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Namiko Matsumoto
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Nozomi Hishikawa
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Koji Abe
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Lam S, Lipton RB, Harvey DJ, Zammit AR, Ezzati A. White matter hyperintensities and cognition across different Alzheimer's biomarker profiles. J Am Geriatr Soc 2021; 69:1906-1915. [PMID: 33891712 DOI: 10.1111/jgs.17173] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/15/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND/OBJECTIVES To examine the association between white matter hyperintensities (WMH) and cognitive domains such as memory and executive function (EF) across different clinical and biomarker categories of Alzheimer's disease (AD). DESIGN Cross-sectional study. SETTING Alzheimer's Disease Neuroimaging Initiative. PARTICIPANTS A total of 216 cognitively normal (CN) participants and 407 participants with mild cognitive impairment (MCI) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) at baseline. MEASUREMENTS Based on the 2018 research framework, participants were classified using AT(N) (amyloid-β deposition [A], pathologic tau [T], and neurodegeneration [(N)]) biomarkers into one of three categories: biomarker negative [A - T- (N)-], amyloid negative but other biomarker positive [A - T ± (N)+ or A - T + (N)±] or amyloid positive [A + T ± (N)±]. Linear regression models were then used to examine the association between WMH and memory composite scores and EF composite scores. RESULTS Higher WMH burden was associated with worse EF in both CN and MCI subgroups while a significant association between WMH and memory was only found in the MCI subgroup. Furthermore, WMH was associated with EF in the group with A - T ± (N)+ or A - T + (N)± biomarker category, but not for A - T - (N)- (normal biomarker) and A + T ± (N) ± (AD pathology). The association between higher WMH and worse memory was independent of amyloid levels in individuals with MCI with evidence of AD pathology. CONCLUSION Vascular disease, as indexed by WMH, independent of AD pathology affects cognitive function in both CN and MCI subgroups. Future studies using the AT(N) research framework should consider white matter lesions as a key biomarker contributing to the clinical presentation of AD.
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Affiliation(s)
- Sharon Lam
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Neurology, Montefiore Medical Center, Bronx, New York, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Danielle J Harvey
- Department of Public Health Sciences, University of California-Davis, Davis, California, USA
| | - Andrea R Zammit
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Ali Ezzati
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.,Department of Neurology, Montefiore Medical Center, Bronx, New York, USA
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Arfanakis K, Evia AM, Leurgans SE, Cardoso LFC, Kulkarni A, Alqam N, Lopes LF, Vieira D, Bennett DA, Schneider JA. Neuropathologic Correlates of White Matter Hyperintensities in a Community-Based Cohort of Older Adults. J Alzheimers Dis 2021; 73:333-345. [PMID: 31771057 PMCID: PMC6996196 DOI: 10.3233/jad-190687] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND The association of white matter hyperintensities (WMH) with age-related vascular and neurodegenerative pathologies remains incompletely understood. OBJECTIVE The objective of this work was to elucidate the neuropathologic correlates of WMH in a large community-based cohort of older adults. METHODS Cerebral hemispheres from 603 community-based older adults were imaged with MRI ex vivo. All participants underwent annual clinical evaluation, cognitive assessment, and neuropathologic examination. WMH burden was assessed using a modified Fazekas rating scale. Multiple ordinal logistic regression was used to test the association of WMH burden with an array of age-related neuropathologies, adjusting for demographics. Mixed effects models of cognition controlling for neuropathologies and demographics were used to determine whether WMH burden contributes to cognitive decline beyond measured pathologies. RESULTS WMH burden in the whole group was associated with both vascular and Alzheimer's disease (AD) pathologies: arteriolosclerosis (p < 10-4), gross (p < 10-4), and microscopic infarcts (p = 0.04), and amyloid-β plaques (p = 0.028). In non-demented participants (mild or no cognitive impairment) (N = 332), WMH burden was related to gross infarcts (p = 10-4) and arteriolosclerosis (p < 10-4), but not to AD pathology. Similarly, in those with no cognitive impairment (N = 178), WMH burden was related to gross infarcts (p = 8×10-4) and arteriolosclerosis (p = 0.014). WMH burden was associated with faster decline in perceptual speed in both the whole (p = 0.038) and non-demented (p = 0.006) groups. CONCLUSION WMH burden has independent associations with vascular pathologies in older adults regardless of clinical status, and with AD pathology later in the progression of AD. Moreover, WMH burden may reflect additional tissue injury not captured with traditional neuropathologic indices.
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Affiliation(s)
- Konstantinos Arfanakis
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Arnold M Evia
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Luis F C Cardoso
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Arman Kulkarni
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Nabil Alqam
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Lucas F Lopes
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Diego Vieira
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.,Department of Pathology, Rush University Medical Center, Chicago, IL, USA
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Stefanovski L, Meier JM, Pai RK, Triebkorn P, Lett T, Martin L, Bülau K, Hofmann-Apitius M, Solodkin A, McIntosh AR, Ritter P. Bridging Scales in Alzheimer's Disease: Biological Framework for Brain Simulation With The Virtual Brain. Front Neuroinform 2021; 15:630172. [PMID: 33867964 PMCID: PMC8047422 DOI: 10.3389/fninf.2021.630172] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/08/2021] [Indexed: 12/18/2022] Open
Abstract
Despite the acceleration of knowledge and data accumulation in neuroscience over the last years, the highly prevalent neurodegenerative disease of AD remains a growing problem. Alzheimer's Disease (AD) is the most common cause of dementia and represents the most prevalent neurodegenerative disease. For AD, disease-modifying treatments are presently lacking, and the understanding of disease mechanisms continues to be incomplete. In the present review, we discuss candidate contributing factors leading to AD, and evaluate novel computational brain simulation methods to further disentangle their potential roles. We first present an overview of existing computational models for AD that aim to provide a mechanistic understanding of the disease. Next, we outline the potential to link molecular aspects of neurodegeneration in AD with large-scale brain network modeling using The Virtual Brain (www.thevirtualbrain.org), an open-source, multiscale, whole-brain simulation neuroinformatics platform. Finally, we discuss how this methodological approach may contribute to the understanding, improved diagnostics, and treatment optimization of AD.
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Affiliation(s)
- Leon Stefanovski
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurology with Experimental Neurology, Brain Simulation Section, Berlin, Germany
| | - Jil Mona Meier
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurology with Experimental Neurology, Brain Simulation Section, Berlin, Germany
| | - Roopa Kalsank Pai
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurology with Experimental Neurology, Brain Simulation Section, Berlin, Germany
- Bernstein Center for Computational Neuroscience Berlin, Berlin, Germany
| | - Paul Triebkorn
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurology with Experimental Neurology, Brain Simulation Section, Berlin, Germany
- Institut de Neurosciences des Systèmes, Aix Marseille Université, Marseille, France
| | - Tristram Lett
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurology with Experimental Neurology, Brain Simulation Section, Berlin, Germany
| | - Leon Martin
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurology with Experimental Neurology, Brain Simulation Section, Berlin, Germany
| | - Konstantin Bülau
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurology with Experimental Neurology, Brain Simulation Section, Berlin, Germany
| | - Martin Hofmann-Apitius
- Fraunhofer Institute for Algorithms and Scientific Computing SCAI, Sankt Augustin, Germany
| | - Ana Solodkin
- Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, United States
| | | | - Petra Ritter
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neurology with Experimental Neurology, Brain Simulation Section, Berlin, Germany
- Bernstein Center for Computational Neuroscience Berlin, Berlin, Germany
- Einstein Center for Neuroscience Berlin, Berlin, Germany
- Einstein Center Digital Future, Berlin, Germany
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Van Etten EJ, Bharadwaj PK, Hishaw GA, Huentelman MJ, Trouard TP, Grilli MD, Alexander GE. Influence of regional white matter hyperintensity volume and apolipoprotein E ε4 status on hippocampal volume in healthy older adults. Hippocampus 2021; 31:469-480. [PMID: 33586848 PMCID: PMC9119498 DOI: 10.1002/hipo.23308] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 12/22/2020] [Accepted: 01/23/2021] [Indexed: 11/08/2022]
Abstract
While total white matter hyperintensity (WMH) volume on magnetic resonance imaging (MRI) has been associated with hippocampal atrophy, less is known about how the regional distribution of WMH volume may differentially affect the hippocampus in healthy aging. Additionally, apolipoprotein E (APOE) ε4 carriers may be at an increased risk for greater WMH volumes and hippocampal atrophy in aging. The present study sought to investigate whether regional WMH volume mediates the relationship between age and hippocampal volume and if this association is moderated by APOE ε4 status in a group of 190 cognitively healthy adults (APOE ε4 status [carrier/non-carrier] = 59/131), ages 50-89. Analyses revealed that temporal lobe WMH volume significantly mediated the relationship between age and average bilateral hippocampal volume, and this effect was moderated by APOE ε4 status (-0.020 (SE = 0.009), 95% CI, [-0.039, -0.003]). APOE ε4 carriers, but not non-carriers, showed negative indirect effects of age on hippocampal volume through temporal lobe WMH volume (APOE ε4 carriers: -0.016 (SE = 0.007), 95% CI, [-0.030, -0.003]; APOE ε4 non-carriers: .005 (SE = 0.006), 95% CI, [-0.006, 0.017]). These findings remained significant after additionally adjusting for sex, years of education, hypertension status and duration, cholesterol status, diabetes status, Body Mass Index, history of smoking, and the Wechsler Adult Intelligence Scale-IV Full Scale IQ. There were no significant moderated mediation effects for frontal, parietal, and occipital lobe WMH volumes, with or without covariates. Our findings indicate that in cognitively healthy older adults, elevated WMH volume regionally localized to the temporal lobes in APOE ε4 carriers is associated with reduced hippocampal volume, suggesting greater vulnerability to brain aging and the risk for Alzheimer's disease.
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Affiliation(s)
- Emily J Van Etten
- Department of Psychology, University of Arizona, Tucson, Arizona, USA.,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona, USA
| | - Pradyumna K Bharadwaj
- Department of Psychology, University of Arizona, Tucson, Arizona, USA.,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona, USA
| | - Georg A Hishaw
- Department of Neurology, University of Arizona, Tucson, Arizona, USA
| | - Matthew J Huentelman
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona, USA.,Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, Arizona, USA.,Arizona Alzheimer's Consortium, Phoenix, Arizona, USA
| | - Theodore P Trouard
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona, USA.,Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA.,Arizona Alzheimer's Consortium, Phoenix, Arizona, USA
| | - Matthew D Grilli
- Department of Psychology, University of Arizona, Tucson, Arizona, USA.,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona, USA.,Department of Neurology, University of Arizona, Tucson, Arizona, USA
| | - Gene E Alexander
- Department of Psychology, University of Arizona, Tucson, Arizona, USA.,Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, Arizona, USA.,Department of Psychiatry, University of Arizona, Tucson, Arizona, USA.,Neuroscience Graduate Interdisciplinary Program, University of Arizona, Tucson, Arizona, USA.,Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, Arizona, USA.,Arizona Alzheimer's Consortium, Phoenix, Arizona, USA
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White matter hyperintensities and patterns of atrophy in early onset Alzheimer's disease with causative gene mutations. Clin Neurol Neurosurg 2021; 203:106552. [PMID: 33601235 DOI: 10.1016/j.clineuro.2021.106552] [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] [Received: 07/14/2020] [Revised: 01/25/2021] [Accepted: 02/06/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE White matter hyperintensities could be found in many degenerative dementias including Alzheimer's disease (AD). Pathogenesis of white matter hyperintensities in AD is complicated. We aim to identify the features of white matter hyperintensities and the atrophy pattern in early onset Alzheimer's disease with causative gene mutations. METHODS 7 AD dementia patients with causative mutations were included and the clinical history, neuropsychology, neuroimaging,APOE genotype and whole-genome sequencing (WGS) were analyzed. Axial T1-weighted images and Fluid attenuated inversion recovery (FLAIR) were analyzed with visual rating scale to examine cortical atrophy and white matter hyperintensities. RESULTS 5 female and 2 male patients with 4PSEN1, 2PSEN2 and 1APP mutation were included. The average age of onset was 46.7y/o (44-52) and the duration of disease was 28.6 months (8-60). Clinical phenotype included memory loss (100 %), visual/spatial disorder (100 %), executive dysfunction (100 %), calculation disorder (85.7 %), disorientation (85.7 %), language problem (57.1 %), personality change (28.6 %) and movement disorder (14.3 %). The grading of posterior cortex atrophy was higher than medial temporal lobe atrophy. Periventricular hyperintensities surrounding occipital and frontal horn of ventricle and sub-ventricular bands were most common, while small foci of lesions were also detected in deep white matter, sub-cortical and juxta-cortical area. Mutations carriers in the APP gene or PSEN1 gene postcodon 200 had more severe white matter hyperintensities than other mutations. CONCLUSION White matter hyperintensities were found in early onset AD with causative mutations. The severity was related to genotypes and spatial distributions. Axon degeneration following neuronal loss and ischemic injury might be the pathogenesis of white matter damage. Severer atrophy in the posterior cortex than medial temporal lobe can present in early onset AD.
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40
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Miao R, Chen HY, Robert P, Smith EE, Ismail Z. White matter hyperintensities and mild behavioral impairment: Findings from the MEMENTO cohort study. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2021; 2:100028. [PMID: 36324720 PMCID: PMC9616384 DOI: 10.1016/j.cccb.2021.100028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/24/2021] [Accepted: 09/11/2021] [Indexed: 11/16/2022]
Abstract
In this MCI sample, mild behavioral impairment is associated with greater WMH volume. MBI may be more sensitive to WMH than MMSE-measured global cognition. Global assessment of MBI outperforms individual MBI domains at detecting WMH.
Background White matter hyperintensities (WMH) contribute to cognitive decline and increase risk for dementia. Mild behavioral impairment (MBI) is a neurobehavioral syndrome characterized by the emergence and persistence of neuropsychiatric symptoms (NPS) in later life as an at-risk state for incident cognitive decline and dementia. Both WMH and MBI are common in patients with mild cognitive impairment (MCI), but few studies have established the link between these two risk markers in this population. Methods Participants were memory clinic patients with MCI from the French MEMENTO study. WMH volume was quantified using brain magnetic resonance imaging. Participants were categorized into MBI+ and MBI- status based on NPS persistence, and the association between MBI status and domains with WMH volume was assessed with linear regression. Results A total of 768 participants [mean age 72.8 (SD=8.00); 57% female] were included. MBI (i.e., persistent NPS) was present in 229 participants (29.8%). MBI+ status was significantly associated with lower MMSE score and male sex. Compared to MBI-, MBI+ status was associated with 9.4% higher WMH volume [p = 0.01 (95% CI 2.0% to 16.7%)]. In this model, MMSE score was not associated with WMH volume. None of the MBI domains individually predicted greater WMH volume, although emotional dysregulation, impulse dyscontrol, and apathy trended towards significance. Conclusions In a memory clinic sample of older adults with MCI, MBI was associated with higher WMH volume. Global MBI status outperformed MMSE and individual MBI domains, supporting the utility of MBI, a multi-NPS-domain composite assessment, for predicting WMH volume.
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Affiliation(s)
- Ruxin Miao
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Hung-Yu Chen
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Philippe Robert
- Clinique Gériatrique du Cerveau et du Mouvement, CMRR, CHU, COBTEK lab Université Côte d’Azur, Nice France
| | - Eric E. Smith
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Zahinoor Ismail
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Corresponding author at: 3280 Hospital Drive NW, TRW Building 1st Floor Calgary, AB, T2N 4Z6, Canada.
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Sargurupremraj M, Suzuki H, Jian X, Sarnowski C, Evans TE, Bis JC, Eiriksdottir G, Sakaue S, Terzikhan N, Habes M, Zhao W, Armstrong NJ, Hofer E, Yanek LR, Hagenaars SP, Kumar RB, van den Akker EB, McWhirter RE, Trompet S, Mishra A, Saba Y, Satizabal CL, Beaudet G, Petit L, Tsuchida A, Zago L, Schilling S, Sigurdsson S, Gottesman RF, Lewis CE, Aggarwal NT, Lopez OL, Smith JA, Valdés Hernández MC, van der Grond J, Wright MJ, Knol MJ, Dörr M, Thomson RJ, Bordes C, Le Grand Q, Duperron MG, Smith AV, Knopman DS, Schreiner PJ, Evans DA, Rotter JI, Beiser AS, Maniega SM, Beekman M, Trollor J, Stott DJ, Vernooij MW, Wittfeld K, Niessen WJ, Soumaré A, Boerwinkle E, Sidney S, Turner ST, Davies G, Thalamuthu A, Völker U, van Buchem MA, Bryan RN, Dupuis J, Bastin ME, Ames D, Teumer A, Amouyel P, Kwok JB, Bülow R, Deary IJ, Schofield PR, Brodaty H, Jiang J, Tabara Y, Setoh K, Miyamoto S, Yoshida K, Nagata M, Kamatani Y, Matsuda F, Psaty BM, Bennett DA, De Jager PL, Mosley TH, Sachdev PS, Schmidt R, Warren HR, Evangelou E, Trégouët DA, Ikram MA, Wen W, DeCarli C, Srikanth VK, Jukema JW, Slagboom EP, Kardia SLR, Okada Y, Mazoyer B, Wardlaw JM, Nyquist PA, Mather KA, Grabe HJ, Schmidt H, Van Duijn CM, Gudnason V, Longstreth WT, Launer LJ, Lathrop M, Seshadri S, Tzourio C, Adams HH, Matthews PM, Fornage M, Debette S. Cerebral small vessel disease genomics and its implications across the lifespan. Nat Commun 2020; 11:6285. [PMID: 33293549 PMCID: PMC7722866 DOI: 10.1038/s41467-020-19111-2] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 09/10/2020] [Indexed: 12/14/2022] Open
Abstract
White matter hyperintensities (WMH) are the most common brain-imaging feature of cerebral small vessel disease (SVD), hypertension being the main known risk factor. Here, we identify 27 genome-wide loci for WMH-volume in a cohort of 50,970 older individuals, accounting for modification/confounding by hypertension. Aggregated WMH risk variants were associated with altered white matter integrity (p = 2.5×10-7) in brain images from 1,738 young healthy adults, providing insight into the lifetime impact of SVD genetic risk. Mendelian randomization suggested causal association of increasing WMH-volume with stroke, Alzheimer-type dementia, and of increasing blood pressure (BP) with larger WMH-volume, notably also in persons without clinical hypertension. Transcriptome-wide colocalization analyses showed association of WMH-volume with expression of 39 genes, of which four encode known drug targets. Finally, we provide insight into BP-independent biological pathways underlying SVD and suggest potential for genetic stratification of high-risk individuals and for genetically-informed prioritization of drug targets for prevention trials.
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Affiliation(s)
- Muralidharan Sargurupremraj
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Hideaki Suzuki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo, Aoba, Sendai, 980-8573, Japan
- Department of Cardiovascular Medicine, Tohoku University Hospital, 1-1, Seiryo, Aoba, Sendai, 980-8574, Japan
- Department of Brain Sciences, Imperial College London, London, W12 0NN, UK
| | - Xueqiu Jian
- University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, 77030, USA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, 78229, USA
| | - Chloé Sarnowski
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Tavia E Evans
- Department of Clinical Genetics, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, 98101, USA
| | | | - Saori Sakaue
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Tsurumi-ku, Yokohama City, Kanagawa, 230-0045, Japan
- Department of Allergy and Rheumatology, Graduate School of Medicine, the University of Tokyo, Tokyo, 113-0033, Japan
| | - Natalie Terzikhan
- Department of Epidemiology, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
| | - Mohamad Habes
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, 78229, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Institute for Community Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
| | - Nicola J Armstrong
- Mathematics and Statistics, Murdoch University, Murdoch, WA, 6150, Australia
| | - Edith Hofer
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, 8036, Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036, Graz, Austria
| | - Lisa R Yanek
- GeneSTAR Research Program, Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Saskia P Hagenaars
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Social Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Rajan B Kumar
- Department of Public Health Sciences, University of California at Davis, Davis, CA, 95616, USA
| | - Erik B van den Akker
- Section of Molecular Epidemiology, Biomedical Sciences, Leiden university Medical Center, 2333 ZA, Leiden, The Netherlands
- Pattern Recognition & Bioinformatics, Delft University of Technology, Delft, NL, 2629 HS, USA
- Leiden Computational Biology Centre, Leiden University Medical Centre, 2333 ZA, Leiden, The Netherlands
| | - Rebekah E McWhirter
- Centre for Law and Genetics, Faculty of Law, University of Tasmania, Hobart, TAS, 7005, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia
| | - Stella Trompet
- Department of Internal Medicine, section of gerontology and geriatrics, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
- Department of Cardiology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Aniket Mishra
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Yasaman Saba
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
- Gottfried Schatz Research Center, Department of Molecular Biology and Biochemistry, Medical University of Graz, 8010, Graz, Austria
| | - Claudia L Satizabal
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, 78229, USA
- Boston University and the NHLBI's Framingham Heart Study, Boston, MA, 02215, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Gregory Beaudet
- University of Bordeaux, IMN, UMR 5293, 33000, Bordeaux, France
| | - Laurent Petit
- University of Bordeaux, IMN, UMR 5293, 33000, Bordeaux, France
| | - Ami Tsuchida
- University of Bordeaux, IMN, UMR 5293, 33000, Bordeaux, France
| | - Laure Zago
- University of Bordeaux, IMN, UMR 5293, 33000, Bordeaux, France
| | - Sabrina Schilling
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | | | | | - Cora E Lewis
- University of Alabama at Birmingham School of Medicine, Birmingham, AL, 35233, USA
| | - Neelum T Aggarwal
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Oscar L Lopez
- Departments of Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Jennifer A Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, 48104, USA
| | - Maria C Valdés Hernández
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK
- Row Fogo Centre for Ageing and The Brain, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Jeroen van der Grond
- Department of Radiology, Leiden University medical Center, 2333 ZA, Leiden, The Netherlands
| | - Margaret J Wright
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, 4072, Australia
- Centre for Advanced Imaging, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Maria J Knol
- Department of Epidemiology, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, 17475, Greifswald, Germany
| | - Russell J Thomson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia
- Centre for Research in Mathematics and Data Science, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Constance Bordes
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Quentin Le Grand
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Marie-Gabrielle Duperron
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | | | | | - Pamela J Schreiner
- University of Minnesota School of Public Health, Minneapolis, MN, 55455, USA
| | - Denis A Evans
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Pediatrics at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
| | - Alexa S Beiser
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
- Boston University and the NHLBI's Framingham Heart Study, Boston, MA, 02215, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Susana Muñoz Maniega
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK
| | - Marian Beekman
- Section of Molecular Epidemiology, Biomedical Sciences, Leiden university Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Julian Trollor
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, 2052, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Sydney, NSW, 2052, Australia
| | - David J Stott
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Meike W Vernooij
- Department of Radiology & Nuclear Medicine, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
| | - Katharina Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, 17489, Greifswald, Germany
| | - Wiro J Niessen
- Department of Radiology & Nuclear Medicine, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
- Faculty of Applied Sciences, Delft University of Technology, Delft, NL, 2629 HS, USA
| | - Aicha Soumaré
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Eric Boerwinkle
- University of Texas Health Science Center at Houston School of Public Health, Houston, TX, 77030, USA
| | - Stephen Sidney
- Kaiser Permanente Division of Research, Oakland, CA, 94612, USA
| | - Stephen T Turner
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, 55905, USA
| | - Gail Davies
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036, Graz, Austria
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Anbupalam Thalamuthu
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Pediatrics at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Mark A van Buchem
- Row Fogo Centre for Ageing and The Brain, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - R Nick Bryan
- The University of Texas at Austin Dell Medical School, Austin, TX, 78712, USA
| | - Josée Dupuis
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, 78229, USA
- Department of Cardiology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Mark E Bastin
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036, Graz, Austria
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, 48104, USA
| | - David Ames
- National Ageing Research Institute Royal Melbourne Hospital, Parkville, VIC, 3052, Australia
- Academic Unit for Psychiatry of Old Age, University of Melbourne, St George's Hospital, Kew, VIC, 3101, Australia
| | - Alexander Teumer
- Department of Epidemiology, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
- Department of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Philippe Amouyel
- Inserm U1167, 59000, Lille, France
- Department of Epidemiology and Public Health, Pasteur Institute of Lille, 59000, Lille, France
| | - John B Kwok
- Brain and Mind Centre - The University of Sydney, Camperdown, NSW, 2050, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Robin Bülow
- Department of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17489, Greifswald, Germany
| | - Ian J Deary
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036, Graz, Austria
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Peter R Schofield
- School of Medical Sciences, University of New South Wales, Sydney, NSW, 2052, Australia
- Neuroscience Research Australia, Randwick, NSW, 2031, Australia
| | - Henry Brodaty
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Pediatrics at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
- Dementia Centre for Research Collaboration, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Jiyang Jiang
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Pediatrics at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Kazuya Setoh
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Manabu Nagata
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Yoichiro Kamatani
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Tsurumi-ku, Yokohama City, Kanagawa, 230-0045, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Bruce M Psaty
- Departments of Epidemiology, Medicine and Health Services, University of Washington, Seattle, WA, 98195, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, 98101, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Philip L De Jager
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Medical Center, New York, NY, 10032, USA
- Program in Population and Medical Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - Thomas H Mosley
- Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS, 39216, USA
| | - Perminder S Sachdev
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Pediatrics at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, 2031, Australia
| | - Reinhold Schmidt
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
| | - Helen R Warren
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 4NS, UK
- National Institute for Health Research Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Evangelos Evangelou
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, SW7 2AZ, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Mpizani, 455 00, Greece
| | - David-Alexandre Trégouët
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Mohammad A Ikram
- Department of Epidemiology, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Charles DeCarli
- Department of Neurology and Center for Neuroscience, University of California at Davis, Sacramento, CA, 95817, USA
| | - Velandai K Srikanth
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, 3004, Australia
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Eline P Slagboom
- Section of Molecular Epidemiology, Biomedical Sciences, Leiden university Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Sharon L R Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
| | - Yukinori Okada
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Tsurumi-ku, Yokohama City, Kanagawa, 230-0045, Japan
- Laboratory of Statistical Immunology, Immunology Frontier Research Center (WPI-IFReC), Osaka University, Suita, 565-0871, Osaka, Japan
| | - Bernard Mazoyer
- University of Bordeaux, IMN, UMR 5293, 33000, Bordeaux, France
| | - Joanna M Wardlaw
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK
- Row Fogo Centre for Ageing and The Brain, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- MRC UK Dementia Research Institute at the University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Paul A Nyquist
- Department of Neurology, Johns Hopkins School of Medicine, Baltimone, MD, 21205, USA
- General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Karen A Mather
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, 2052, Australia
- Neuroscience Research Australia, Randwick, NSW, 2031, Australia
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, 17475, Greifswald, Germany
| | - Helena Schmidt
- Gottfried Schatz Research Center, Department of Molecular Biology and Biochemistry, Medical University of Graz, 8010, Graz, Austria
| | - Cornelia M Van Duijn
- Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Vilmundur Gudnason
- Icelandic Heart Association, IS-201, Kópavogur, Iceland
- University of Iceland, Faculty of Medicine, 101, Reykjavík, Iceland
| | - William T Longstreth
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, 98104-2420, USA
| | - Lenore J Launer
- Laboratory of Epidemiology, Demography, and Biometry, National Institute of Aging, The National Institutes of Health, Bethesda, MD, 20892, USA
- Intramural Research Program/National Institute on Aging/National Institutes of Health, Bethesda, MD, 20892, USA
| | - Mark Lathrop
- University of McGill Genome Center, Montreal, QC, H3A 0G1, Canada
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, 78229, USA
- Boston University and the NHLBI's Framingham Heart Study, Boston, MA, 02215, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Christophe Tzourio
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
- CHU de Bordeaux, Pole de santé publique, Service d'information médicale, 33000, Bordeaux, France
| | - Hieab H Adams
- Department of Clinical Genetics, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
| | - Paul M Matthews
- Department of Brain Sciences, Imperial College London, London, W12 0NN, UK
- UK Dementia Research Institute, London, WC1E 6BT, UK
- Data Science Institute, Imperial College London, London, SW7 2AZ, UK
| | - Myriam Fornage
- University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, 77030, USA.
| | - Stéphanie Debette
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France.
- Department of Neurology, Boston University School of Medicine, Boston, MA, 02118, USA.
- Department of Neurology, CHU de Bordeaux, 33000, Bordeaux, France.
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Thalman S, Van Pelt KL, Lin AL, Johnson NF, Jicha G, Caban-Holt A, Robertson W, Lightner D, Powell D, Head E, Schmitt F. A preliminary study of cerebral blood flow, aging and dementia in people with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:934-945. [PMID: 32996650 PMCID: PMC8244721 DOI: 10.1111/jir.12784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 07/28/2020] [Accepted: 09/06/2020] [Indexed: 05/02/2023]
Abstract
BACKGROUND People with Down syndrome (DS) develop Alzheimer's disease (AD) at an earlier age of onset than those with sporadic AD. AD neuropathology is typically present in DS by 40 years of age with an onset of dementia approximately 10 years later. This early onset is due to the overexpression of amyloid precursor protein from the third copy of chromosome 21. Cerebrovascular neuropathology is thought to contribute in 40-60% of cases sporadic AD. However, the vascular contribution to dementia in people with DS has been relatively unexplored. We hypothesised that vascular perfusion is compromised in older adults with DS relative to younger individuals and is further exacerbated in those with dementia. METHOD Cerebral blood flow (CBF) was measured using pulsed arterial spin labelling in 35 cognitively characterised adults with DS (26-65 years). DS participants were also compared with 15 control subjects without DS or dementia (26-65 years). Linear regression evaluated the difference in CBF across groups and diagnosis along with assessing the association between CBF and cognitive measures within the DS cohort. RESULTS Cerebral blood flow was significantly lower among DS participants with probable AD compared with controls (P = 0.02) and DS participants with no dementia (P = 0.01). Within the DS cohort, CBF was significantly associated with the Severe Impairment Battery (SIB) measure and the Dementia Questionnaire for People with Learning Disabilities (DLD) rating (F3,25 = 5.13; P = 0.007). Both the SIB (β = 0.74; t = 2.71; P = 0.01) and DLD (β = -0.96; t = -3.87; P < 0.001) indicated greater impairment as global CBF decreased. Age was significantly associated with CBF among participants with DS. There was a non-linear effect of age, whereby CBF declined more rapidly after 45 years of age. CONCLUSIONS This preliminary study of CBF in DS indicates that cerebrovascular pathology may be a significant contributor to dementia in DS. CBF was associated with diagnosis, cognition and age. Notably, CBF decreases at a greater rate after age 45 and may represent a significant prodromal event in AD progression.
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Affiliation(s)
- S Thalman
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - K L Van Pelt
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - A-L Lin
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Pharmacology & Nutritional Sciences, University of Kentucky, Lexington, KY, USA
| | - N F Johnson
- College of Health Sciences, Department of Physical Therapy, University of Kentucky, Lexington, KY, USA
| | - G Jicha
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Neurology, University of Kentucky, Lexington, KY, USA
| | - A Caban-Holt
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - W Robertson
- Department of Neurology, University of Kentucky, Lexington, KY, USA
| | - D Lightner
- Department of Neurology, University of Kentucky, Lexington, KY, USA
| | - D Powell
- Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky, Lexington, KY, USA
| | - E Head
- Department of Pathology & Laboratory Medicine, Institute for Memory Impairments and Neurological Disorders, University of California Irvine, Irvine, CA, USA
| | - F Schmitt
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
- Department of Neurology, University of Kentucky, Lexington, KY, USA
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Lao PJ, Gutierrez J, Keator D, Rizvi B, Banerjee A, Igwe KC, Laing KK, Sathishkumar M, Moni F, Andrews H, Krinsky-McHale S, Head E, Lee JH, Lai F, Yassa MA, Rosas HD, Silverman W, Lott IT, Schupf N, Brickman AM. Alzheimer-Related Cerebrovascular Disease in Down Syndrome. Ann Neurol 2020; 88:1165-1177. [PMID: 32944999 PMCID: PMC7729262 DOI: 10.1002/ana.25905] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/15/2020] [Accepted: 09/15/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Adults with Down syndrome (DS) develop Alzheimer disease (AD) pathology by their 5th decade. Compared with the general population, traditional vascular risks in adults with DS are rare, allowing examination of cerebrovascular disease in this population and insight into its role in AD without the confound of vascular risk factors. We examined in vivo magnetic resonance imaging (MRI)-based biomarkers of cerebrovascular pathology in adults with DS, and determined their cross-sectional relationship with age, beta-amyloid pathology, and mild cognitive impairment or clinical AD diagnostic status. METHODS Participants from the Biomarkers of Alzheimer's Disease in Down Syndrome study (n = 138, 50 ± 7 years, 39% women) with MRI data and a subset (n = 90) with amyloid positron emission tomography (PET) were included. We derived MRI-based biomarkers of cerebrovascular pathology, including white matter hyperintensities (WMH), infarcts, cerebral microbleeds, and enlarged perivascular spaces (PVS), as well as PET-based biomarkers of amyloid burden. Participants were characterized as cognitively stable (CS), mild cognitive impairment-DS (MCI-DS), possible AD dementia, or definite AD dementia based on in-depth assessments of cognition, function, and health status. RESULTS There were detectable WMH, enlarged PVS, infarcts, and microbleeds as early as the 5th decade of life. There was a monotonic increase in WMH volume, enlarged PVS, and presence of infarcts across diagnostic groups (CS < MCI-DS < possible AD dementia < definite AD dementia). Higher amyloid burden was associated with a higher likelihood of an infarct. INTERPRETATION The findings highlight the prevalence of cerebrovascular disease in adults with DS and add to a growing body of evidence that implicates cerebrovascular disease as a core feature of AD and not simply a comorbidity. ANN NEUROL 2020;88:1165-1177.
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Affiliation(s)
- Patrick J. Lao
- Gertrude H. Sergievsky Center and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
| | - José Gutierrez
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY
| | - David Keator
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - Batool Rizvi
- Gertrude H. Sergievsky Center and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Arit Banerjee
- Gertrude H. Sergievsky Center and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Kay C. Igwe
- Gertrude H. Sergievsky Center and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Krystal K. Laing
- Gertrude H. Sergievsky Center and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Mithra Sathishkumar
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - Fahmida Moni
- Gertrude H. Sergievsky Center and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Howard Andrews
- Gertrude H. Sergievsky Center and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY;,Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY
| | - Sharon Krinsky-McHale
- Gertrude H. Sergievsky Center and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY;,Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY;,Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY
| | - Elizabeth Head
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - Joseph H. Lee
- Gertrude H. Sergievsky Center and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY;,Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY;,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Florence Lai
- Department of Neurology, Massachusetts General Hospital, Harvard University, Boston, MA
| | - Michael A. Yassa
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA
| | - H. Diana Rosas
- Department of Neurology, Massachusetts General Hospital, Harvard University, Boston, MA;,Department of Radiology, Athinoula Martinos Center, Massachusetts General Hospital, Harvard University, Charlestown, MA
| | - Wayne Silverman
- Department of Pediatrics, University of California, Irvine, Irvine, CA
| | - Ira T. Lott
- Department of Pediatrics, University of California, Irvine, Irvine, CA
| | - Nicole Schupf
- Gertrude H. Sergievsky Center and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY;,Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY;,Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Adam M. Brickman
- Gertrude H. Sergievsky Center and Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY;,Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY
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Common Brain Structural Alterations Associated with Cardiovascular Disease Risk Factors and Alzheimer's Dementia: Future Directions and Implications. Neuropsychol Rev 2020; 30:546-557. [PMID: 33011894 DOI: 10.1007/s11065-020-09460-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 09/24/2020] [Indexed: 01/18/2023]
Abstract
Recent reports suggest declines in the age-specific risk of Alzheimer's dementia in higher income Western countries. At the same time, investigators believe that worldwide trends of increasing mid-life modifiable risk factors [e.g., cardiovascular disease (CVD) risk factors] coupled with the growth of the world's oldest age groups may nonetheless lead to an increase in Alzheimer's dementia. Thus, understanding the overlap in neuroanatomical profiles associated with CVD risk factors and AD may offer more relevant targets for investigating ways to reduce the growing dementia epidemic than current targets specific to isolated AD-related neuropathology. We hypothesized that a core group of common brain structural alterations exist between CVD risk factors and Alzheimer's dementia. Two co-authors conducted independent literature reviews in PubMed using search terms for CVD risk factor burden (separate searches for 'cardiovascular disease risk factors', 'hypertension', and 'Type 2 diabetes') and 'aging' or 'Alzheimer's dementia' with either 'grey matter volumes' or 'white matter'. Of studies that reported regionally localized results, we found support for our hypothesis, determining 23 regions commonly associated with both CVD risk factors and Alzheimer's dementia. Within this context, we outline future directions for research as well as larger cerebrovascular implications for these commonalities. Overall, this review supports previous as well as more recent calls for the consideration that both vascular and neurodegenerative factors contribute to the pathogenesis of dementia.
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Kaskikallio A, Karrasch M, Koikkalainen J, Lötjönen J, Rinne JO, Tuokkola T, Parkkola R, Grönholm-Nyman P. White Matter Hyperintensities and Cognitive Impairment in Healthy and Pathological Aging: A Quantified Brain MRI Study. Dement Geriatr Cogn Disord 2020; 48:297-307. [PMID: 32209796 DOI: 10.1159/000506124] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/23/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Brain changes involving the white matter (WM), often an indication of cerebrovascular pathology, are frequently seen in patients with mild cognitive impairment (MCI) and Alzheimer disease (AD). Few studies have examined possible cognitive domain- or group-specific cognitive effects of WM pathology in old age, MCI, and AD. OBJECTIVE Our purpose was to examine the relationship between WM hyperintensities (WMH), a typical marker for WM pathology, and cognitive functioning in healthy old age and pathological aging using quantified MRI data. METHODS We utilized multidomain neuropsychological data and quantified MRI data from a sample of 42 cognitively healthy older adults and 44 patients with MCI/AD (total n = 86). RESULTS After controlling for age and education, WMH in the temporal and parieto-occipital lobes was associated with impairments in processing speed and parieto-occipital pathology with verbal memory impairment in the whole sample. Additionally, temporal WMH was associated with impaired processing speed in the patient group specifically. CONCLUSIONS WM pathology is strongly associated with impaired processing speed, and our results indicate that these impairments arise from WMH in the temporal and parieto-occipital regions. In MCI and AD patients with temporal WMH, processing speed impairments are especially prominent. The results of this study increase our knowledge of cognitive repercussions stemming from temporal and/or parieto-occipital WM pathology in healthy and pathological aging.
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Affiliation(s)
| | | | | | | | - Juha O Rinne
- Turku PET Centre, University of Turku, Turku, Finland.,Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland
| | | | - Riitta Parkkola
- Department of Radiology, University and University Hospital of Turku, Turku, Finland
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Whole brain radiotherapy induces cognitive dysfunction in mice: key role of gut microbiota. Psychopharmacology (Berl) 2020; 237:2089-2101. [PMID: 32494972 DOI: 10.1007/s00213-020-05520-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/10/2020] [Indexed: 12/16/2022]
Abstract
RATIONALE Approximately 20-40% of patients with cancer will experience brain metastasis (BM), which has a great impact on the quality of life and survival rates of patients. Whole brain radiotherapy (WBRT) is an effective method for the treatment of BM. However, it cannot be ignored that WBRT might induce a series of neuropsychiatric side effects, including cognitive dysfunction (CD). Accumulating evidence shows that the gut microbiota and the gut-microbiota-brain axis may play a vital role in the pathogenesis of CD. OBJECTIVE AND METHODS We adopted WBRT to mimic CD after a hierarchical cluster analysis of the Morris water maze test (MWMT) results. In addition, we observed the effects of antibiotics and prebiotics on WBRT-induced CD. Variations were revealed via the 16S rRNA sequencing analysis at different levels. RESULTS The 16S rRNA sequencing analysis revealed an altered composition of gut microbiota between CD and non-CD phenotypes. Furthermore, we observed a decrease in the levels of Phylum-Bacteroidete, Class-Bacteroidia, and Order-Bacteroidales in the CD group and an increase in the Genus-Allobaculum level after WBRT. Pretreatment with antibiotics caused a significant decrease in the level of Phylum-TM7 01, whereas an increase in the levels of Class-Gammaproteobacteria, Order-Enterobacteriales, and Species-Escherichia coli. After pretreatment with probiotics, the levels of Phylum-Cyanobacteria, Class-4C0d-2, and Order-YS2 were decreased, while the levels of Family-Bacteroidaceae, Genus-Bacteroides, and Species-Parabacteroides distasonis were increased. CONCLUSIONS WBRT-induced CD might be highly related to abnormal composition of gut microbiota. Strategies improving the composition of the gut microbiota may provide beneficial effects on CD in individuals exposed to WBRT.
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Van Etten EJ, Bharadwaj PK, Nguyen LA, Hishaw GA, Trouard TP, Alexander GE. Right hippocampal volume mediation of subjective memory complaints differs by hypertension status in healthy aging. Neurobiol Aging 2020; 94:271-280. [PMID: 32688134 DOI: 10.1016/j.neurobiolaging.2020.06.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 06/13/2020] [Accepted: 06/15/2020] [Indexed: 12/28/2022]
Abstract
Subjective memory complaints (SMCs) may be an important early indicator of cognitive aging and preclinical Alzheimer's disease risk. This study investigated whether age-related differences in right or left hippocampal volume underlie SMCs, if these relationships differ by hypertension status, and how they are related to objective memory performance in a group of 190 healthy older adults, 50-89 years of age. Analyses revealed a significant mediation of the relationship between age and mild SMCs by right hippocampal volume that was moderated by hypertension status. This moderated mediation effect was not observed with left hippocampal volume. Additionally, a moderated serial mediation model showed that age predicted right hippocampal volume, which predicted SMCs, and in turn predicted objective memory performance on several measures of verbal selective reminding in individuals with hypertension, but not in non-hypertensives. Together, these findings suggest that even mild SMCs, in the context of hypertension, provide an early indicator of cognitive aging, reflecting a potential link among vascular risk, SMCs, and the preclinical risk for Alzheimer's disease.
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Affiliation(s)
- Emily J Van Etten
- Department of Psychology, University of Arizona, Tucson, AZ, USA; Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Pradyumna K Bharadwaj
- Department of Psychology, University of Arizona, Tucson, AZ, USA; Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Lauren A Nguyen
- Department of Psychology, University of Arizona, Tucson, AZ, USA; Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Georg A Hishaw
- Department of Neurology, University of Arizona, Tucson, AZ, USA
| | - Theodore P Trouard
- Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA; Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Gene E Alexander
- Department of Psychology, University of Arizona, Tucson, AZ, USA; Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA; Department of Psychiatry, University of Arizona, Tucson, AZ, USA; Neuroscience Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA; Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ, USA.
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48
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Ferrer I, Andrés-Benito P. White matter alterations in Alzheimer's disease without concomitant pathologies. Neuropathol Appl Neurobiol 2020; 46:654-672. [PMID: 32255227 PMCID: PMC7754505 DOI: 10.1111/nan.12618] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/23/2020] [Indexed: 12/14/2022]
Abstract
Aims Most individuals with AD neuropathological changes have co‐morbidities which have an impact on the integrity of the WM. This study analyses oligodendrocyte and myelin markers in the frontal WM in a series of AD cases without clinical or pathological co‐morbidities. Methods From a consecutive autopsy series, 206 cases had neuropathological changes of AD; among them, only 33 were AD without co‐morbidities. WM alterations were first evaluated in coronal sections of the frontal lobe in every case. Then, RT‐qPCR and immunohistochemistry were carried out in the frontal WM of AD cases without co‐morbidities to analyse the expression of selected oligodendrocyte and myelin markers. Results WM demyelination was more marked in AD with co‐morbidities when compared with AD cases without co‐morbidities. Regarding the later, mRNA expression levels of MBP, PLP1, CNP, MAG, MAL, MOG and MOBP were preserved at stages I–II/0–A when compared with middle‐aged (MA) individuals, but significantly decreased at stages III–IV/0–C. This was accompanied by reduced expression of NG2 and PDGFRA mRNA, reduced numbers of NG2‐, Olig2‐ and HDAC2‐immunoreactive cells and reduced glucose transporter immunoreactivity. Partial recovery of some of these markers occurred at stages V–VI/B–C. Conclusions The present observations demonstrate that co‐morbidities have an impact on WM integrity in the elderly and in AD, and that early alterations in oligodendrocytes and transcription of genes linked to myelin proteins in WM occur in AD cases without co‐morbidities. These are followed by partial recovery attempts at advanced stages. These observations suggest that oligodendrocytopathy is part of AD.
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Affiliation(s)
- I Ferrer
- Department of Pathology and Experimental Therapeutics, University of Barcelona, Barcelona, Spain.,Bellvitge University Hospital, Barcelona, Spain.,Ministry of Economy and Competitiveness, CIBERNED (Network Centre of Biomedical Research of Neurodegenerative Diseases), Institute of Health Carlos III, Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - P Andrés-Benito
- Department of Pathology and Experimental Therapeutics, University of Barcelona, Barcelona, Spain.,Ministry of Economy and Competitiveness, CIBERNED (Network Centre of Biomedical Research of Neurodegenerative Diseases), Institute of Health Carlos III, Barcelona, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
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Wasserman V, Emrani S, Matusz EF, Peven J, Cleary S, Price CC, Ginsberg TB, Swenson R, Heilman KM, Lamar M, Libon DJ. Visuospatial performance in patients with statistically-defined mild cognitive impairment. J Clin Exp Neuropsychol 2020; 42:319-328. [PMID: 31973657 PMCID: PMC7224008 DOI: 10.1080/13803395.2020.1714550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 12/26/2019] [Indexed: 02/08/2023]
Abstract
Introduction: The Oblique Effect denotes superior performance for perceiving horizontal or vertical rather than diagonal or oblique stimuli. The current research investigated responding to oblique test stimuli in patients with mild cognitive impairment (MCI).Method: Four statistically-determined groups (n = 112) were studied; patients with little to no cognitive impairment (non-MCI, n = 39); subtle cognitive impairment (SCI, n = 15); amnestic MCI (aMCI, n = 28); and a combined mixed/dysexecutive MCI (mixed/dys MCI, n = 30). The ability to respond to oblique versus non-oblique test stimuli was assessed using the Judgment of Line Orientation Test (JOLO). Comprehensive neuropsychological assessment was also obtained. Between-group differences for JOLO oblique and non-oblique test stimuli were analyzed. Hierarchical linear regression models were constructed to identify relations between accuracy for oblique and non-oblique test items and neurocognitive domains.Results: The mixed/dys MCI group demonstrated lower accuracy for oblique test items compared to non-MCI patients. Accurate responding to oblique test items was associated with better performance on tests measuring executive control, processing speed, naming/lexical retrieval, and verbal concept formation. No between-group differences were seen for non-oblique items and these items were not associated with cognition.Conclusions:Significant impairment on oblique test items distinguished patients with multi-domain/dysexecutive MCI from non-MCI patients. Accurate responding to oblique test items was associated with a complex array of neuropsychological tests suggesting that multidimensional neuropsychological skills underlie the visuospatial reasoning abilities necessary for successful oblique line identification. Research associating responding to oblique versus non-oblique test stimuli using additional neuropsychological test paradigms, and MRI-defined neuroanatomical regions of interest may provide additional information about the brain-behavior relations that underlie MCI subtypes.
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Affiliation(s)
| | - Sheina Emrani
- Department of Psychology, Rowan University, Stratford, NF
| | - Emily F. Matusz
- New Jersey Institute for Successful Aging, School of Osteopathic Medicine, Rowan University, Stratford, NJ
| | - Jamie Peven
- Department of Psychology and Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA
| | - Seana Cleary
- New Jersey Institute for Successful Aging, School of Osteopathic Medicine, Rowan University, Stratford, NJ
| | - Catherine C. Price
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Terrie Beth Ginsberg
- New Jersey Institute for Successful Aging, School of Osteopathic Medicine, Rowan University, Stratford, NJ
| | - Rod Swenson
- University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND
| | - Kenneth M. Heilman
- Department of Neurology, University of Florida College of Medicine, Neurologist-Geriatric Research, Education and Clinical Center, Malcom Randall Veterans Affairs Medical Center, Gainesville, FL
| | - Melissa Lamar
- Department of Behavioral Sciences and the Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
| | - David J. Libon
- Department of Psychology, Rowan University, Stratford, NF
- New Jersey Institute for Successful Aging, School of Osteopathic Medicine, Rowan University, Stratford, NJ
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Neurovascular unit dysregulation, white matter disease, and executive dysfunction: the shared triad of vascular cognitive impairment and Alzheimer disease. GeroScience 2020; 42:445-465. [PMID: 32002785 DOI: 10.1007/s11357-020-00164-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 01/22/2020] [Indexed: 01/07/2023] Open
Abstract
Executive dysfunction is the most important predictor for loss of independence in dementia. As executive function involves the coordination of distributed cerebral functions, executive function requires healthy white matter. However, white matter is highly vulnerable to cerebrovascular insults, with executive dysfunction being a core feature of vascular cognitive impairment (VCI). At the same time, cerebrovascular pathology, white matter disease, and executive dysfunction are all increasingly recognized as features of Alzheimer disease (AD). Recent studies have characterized the crucial role of glial cells in the pathological changes observed in both VCI and AD. In comorbid VCI and AD, the glial cells of the neurovascular unit (NVU) emerge as important therapeutic targets for the preservation of white matter integrity and executive function. Our synthesis from current research identifies dysregulation of the NVU, white matter disease, and executive dysfunction as a fundamental triad that is common to both VCI and AD. Further study of this triad will be critical for advancing the prevention and management of dementia.
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