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Fu H, Li J, Zhang C, Du P, Gao G, Ge Q, Guan X, Cui D. Aβ-Aggregation-Generated Blue Autofluorescence Illuminates Senile Plaques as well as Complex Blood and Vascular Pathologies in Alzheimer's Disease. Neurosci Bull 2024; 40:1115-1126. [PMID: 38345691 PMCID: PMC11306447 DOI: 10.1007/s12264-023-01175-x] [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: 07/12/2023] [Accepted: 10/02/2023] [Indexed: 08/09/2024] Open
Abstract
Senile plaque blue autofluorescence was discovered around 40 years ago, however, its impact on Alzheimer's disease (AD) pathology has not been fully examined. We analyzed senile plaques with immunohistochemistry and fluorescence imaging on AD brain sections and also Aβ aggregation in vitro. In DAPI or Hoechst staining, the nuclear blue fluorescence could only be correctly assigned after subtracting the blue plaque autofluorescence. The flower-like structures wrapping dense-core blue fluorescence formed by cathepsin D staining could not be considered central-nucleated neurons with defective lysosomes since there was no nuclear staining in the plaque core when the blue autofluorescence was subtracted. Both Aβ self-oligomers and Aβ/hemoglobin heterocomplexes generated blue autofluorescence. The Aβ amyloid blue autofluorescence not only labels senile plaques but also illustrates red cell aggregation, hemolysis, cerebral amyloid angiopathy, vascular plaques, vascular adhesions, and microaneurysms. In summary, we conclude that Aβ-aggregation-generated blue autofluorescence is an excellent multi-amyloidosis marker in Alzheimer's disease.
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Affiliation(s)
- Hualin Fu
- Institute of Nano Biomedicine and Engineering, School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China.
- Institute of Marine Equipment, Shanghai Jiao Tong University, Shanghai, 200240, China.
- National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, 200240, China.
| | - Jilong Li
- Institute of Nano Biomedicine and Engineering, School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Chunlei Zhang
- Institute of Nano Biomedicine and Engineering, School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
- National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Peng Du
- Department of Colorectal Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Guo Gao
- Institute of Nano Biomedicine and Engineering, School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
- National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Qiqi Ge
- Institute of Marine Equipment, Shanghai Jiao Tong University, Shanghai, 200240, China
- Department of Automation, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Xinping Guan
- Department of Automation, Shanghai Jiao Tong University, Shanghai, 200240, China
- The Key Laboratory of System Control and Information Processing, Ministry of Education, Shanghai, 200240, China
| | - Daxiang Cui
- Institute of Nano Biomedicine and Engineering, School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
- National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, 200240, China
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2
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Egle M, Deal JA, Walker KA, Wong DF, Sharrett AR, Gottesman RF. Association between retinal microvascular abnormalities and late-life brain amyloid-β deposition: the ARIC-PET study. Alzheimers Res Ther 2024; 16:100. [PMID: 38711107 PMCID: PMC11071225 DOI: 10.1186/s13195-024-01461-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 04/17/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Retinal microvascular signs are accessible measures of early alterations in microvascular dysregulation and have been associated with dementia; it is unclear if they are associated with AD (Alzheimer's disease) pathogenesis as a potential mechanistic link. This study aimed to test the association of retinal microvascular abnormalities in mid and late life and late life cerebral amyloid. METHODS Participants from the ARIC-PET (Atherosclerosis Risk in Communities-Positron Emission Tomography) study with a valid retinal measure (N = 285) were included. The associations of mid- and late-life retinal signs with late-life amyloid-β (Aβ) by florbetapir PET were tested. Two different measures of Aβ burden were included: (1) elevated amyloid (SUVR > 1.2) and (2) continuous amyloid SUVR. The retinal measures' association with Aβ burden was assessed using logistic and robust linear regression models. A newly created retinal score, incorporating multiple markers of retinal abnormalities, was also evaluated in association with greater Aβ burden. RESULTS Retinopathy in midlife (OR (95% CI) = 0.36 (0.08, 1.40)) was not significantly associated with elevated amyloid burden. In late life, retinopathy was associated with increased continuous amyloid standardized value uptake ratio (SUVR) (β (95%CI) = 0.16 (0.02, 0.32)) but not elevated amyloid burden (OR (95%CI) = 2.37 (0.66, 9.88)) when accounting for demographic, genetic and clinical risk factors. A high retinal score in late life, indicating a higher burden of retinal abnormalities, was also significantly associated with increased continuous amyloid SUVR (β (95% CI) = 0.16 (0.04, 0.32)) independent of vascular risk factors. CONCLUSIONS Retinopathy in late life may be an easily obtainable marker to help evaluate the mechanistic vascular pathway between retinal measures and dementia, perhaps acting via AD pathogenesis. Well-powered future studies with a greater number of retinal features and other microvascular signs are needed to test these findings.
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Affiliation(s)
- Marco Egle
- National Institute of Neurological Disorders and Stroke Intramural Research Program, National Institutes of Health, Bethesda, MD, 20814, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21231, USA
| | - Keenan A Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, 21224, USA
| | - Dean F Wong
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA
| | - A Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21231, USA
| | - Rebecca F Gottesman
- National Institute of Neurological Disorders and Stroke Intramural Research Program, National Institutes of Health, Bethesda, MD, 20814, USA.
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Gustafson D, Kalaria R, O'Brien J, van den Brink H, Hilal S, Marseglia A, ter Telgte A, Skoog I. VasCog 2023: 20 years of research on vascular behavioural and cognitive disorders. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2024; 6:100224. [PMID: 38868624 PMCID: PMC11167242 DOI: 10.1016/j.cccb.2024.100224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 05/03/2024] [Indexed: 06/14/2024]
Abstract
This Commentary describes the 20th Anniversary of VasCog 2023, held in Gothenburg, Sweden.
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Affiliation(s)
- D.R. Gustafson
- Department of Neurology, State University of New York Downstate Health Sciences University, MSC 1213, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - R. Kalaria
- Translational and Clinical Research Institute, Newcastle University, United Kingdom
| | - J. O'Brien
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, United Kingdom
| | - H. van den Brink
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - S. Hilal
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - A. Marseglia
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - A. ter Telgte
- VASCage – Center on Clinical Stroke Research, Innsbruck, Austria
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - I. Skoog
- Center for Ageing and Health, Institute for Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Hu Z, Li Z, Shi Y, Liu S, Shen Y, Hu F, Li Q, Liu X, Gou X, Chen Z, Yang D. Advancements in investigating the role of cerebral small vein loss in Alzheimer's disease-related pathological changes. Neurol Sci 2024; 45:1875-1883. [PMID: 38133856 DOI: 10.1007/s10072-023-07208-7] [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: 08/16/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023]
Abstract
Alzheimer's disease (AD) is the prevailing type of dementia in the elderly, yet a comprehensive comprehension of its precise underlying mechanisms remains elusive. The investigation of the involvement of cerebral small veins in the advancement of AD has yet to be sufficiently explored in previous studies, primarily due to constraints associated with pathological staining techniques. However, recent research has provided valuable insights into multiple pathophysiological occurrences concerning cerebral small veins in AD, which may manifest sequentially, concurrently, or in a self-perpetuating manner. These events are presumed to be among the initial processes in the disease's progression. The impact of cerebral small vein loss on amyloid beta (Aβ) clearance through the glial lymphatic system is noteworthy. There exists a potential interdependence between collagen deposition and Aβ deposition in cerebral small veins. The compromised functionality of cerebral small veins can result in decreased cerebral perfusion pressure, potentially leading to cerebral tissue ischemia and edema. Additionally, the reduction of cerebral small veins may facilitate the infiltration of inflammatory factors into the brain parenchyma, thereby eliciting neuroinflammatory responses. Susceptibility-weighted imaging (SWI) is a valuable modality for the efficient assessment of cerebral small veins, precisely the deep medullary vein (DMV), and holds promise for the identification of precise and reliable imaging biomarkers for AD. This review presents a comprehensive overview of the current advancements and obstacles to the impairment of cerebral small veins in AD. Additionally, we emphasize future research avenues and the importance of conducting further investigations in this domain.
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Affiliation(s)
- Zhenzhu Hu
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China
| | - Zhaoying Li
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China
| | - Yu Shi
- Department of Neurology, Xuzhou Cancer Hospital, Xuzhou, 221000, Jiangsu, China
| | - Shanyu Liu
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China
| | - Yuling Shen
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China
| | - Fangfang Hu
- Department of Neurology, Xuzhou Cancer Hospital, Xuzhou, 221000, Jiangsu, China
| | - Qingqing Li
- Department of Neurology, Xuzhou Cancer Hospital, Xuzhou, 221000, Jiangsu, China
| | - Xu Liu
- Department of Neurology, Xuzhou Cancer Hospital, Xuzhou, 221000, Jiangsu, China
| | - Xinyu Gou
- Department of Neurology, Guang'an People's Hospital, Guang'an, 638001, China
| | - Zhenwei Chen
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China
| | - Dongdong Yang
- Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610032, China.
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Chen Y, Lu P, Wu S, Yang J, Liu W, Zhang Z, Xu Q. CD163-Mediated Small-Vessel Injury in Alzheimer's Disease: An Exploration from Neuroimaging to Transcriptomics. Int J Mol Sci 2024; 25:2293. [PMID: 38396970 PMCID: PMC10888773 DOI: 10.3390/ijms25042293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/10/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
Patients with Alzheimer's disease (AD) often present with imaging features indicative of small-vessel injury, among which, white-matter hyperintensities (WMHs) are the most prevalent. However, the underlying mechanism of the association between AD and small-vessel injury is still obscure. The aim of this study is to investigate the mechanism of small-vessel injury in AD. Differential gene expression analyses were conducted to identify the genes related to WMHs separately in mild cognitive impairment (MCI) and cognitively normal (CN) subjects from the ADNI database. The WMH-related genes identified in patients with MCI were considered to be associated with small-vessel injury in early AD. Functional enrichment analyses and a protein-protein interaction (PPI) network were performed to explore the pathway and hub genes related to the mechanism of small-vessel injury in MCI. Subsequently, the Boruta algorithm and support vector machine recursive feature elimination (SVM-RFE) algorithm were performed to identify feature-selection genes. Finally, the mechanism of small-vessel injury was analyzed in MCI from the immunological perspectives; the relationship of feature-selection genes with various immune cells and neuroimaging indices were also explored. Furthermore, 5×FAD mice were used to demonstrate the genes related to small-vessel injury. The results of the logistic regression analyses suggested that WMHs significantly contributed to MCI, the early stage of AD. A total of 276 genes were determined as WMH-related genes in patients with MCI, while 203 WMH-related genes were obtained in CN patients. Among them, only 15 genes overlapped and were thus identified as the crosstalk genes. By employing the Boruta and SVM-RFE algorithms, CD163, ALDH3B1, MIR22HG, DTX2, FOLR2, ALDH2, and ZNF23 were recognized as the feature-selection genes linked to small-vessel injury in MCI. After considering the results from the PPI network, CD163 was finally determined as the critical WMH-related gene in MCI. The expression of CD163 was correlated with fractional anisotropy (FA) values in regions that are vulnerable to small-vessel injury in AD. The immunostaining and RT-qPCR results from the verifying experiments demonstrated that the indicators of small-vessel injury presented in the cortical tissue of 5×FAD mice and related to the upregulation of CD163 expression. CD163 may be the most pivotal candidates related to small-vessel injury in early AD.
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Affiliation(s)
- Yuewei Chen
- Health Management Center, Renji Hospital of Medical School, Shanghai Jiao Tong University, Shanghai 200127, China; (Y.C.); (P.L.); (W.L.)
- Department of Neurology, Renji Hospital of Medical School, Shanghai Jiao Tong University, Shanghai 200127, China
- Renji-UNSW CHeBA (Centre for Healthy Brain Ageing of University of New South Wales) Neurocognitive Center, Renji Hospital of Medical School, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Peiwen Lu
- Health Management Center, Renji Hospital of Medical School, Shanghai Jiao Tong University, Shanghai 200127, China; (Y.C.); (P.L.); (W.L.)
- Renji-UNSW CHeBA (Centre for Healthy Brain Ageing of University of New South Wales) Neurocognitive Center, Renji Hospital of Medical School, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Shengju Wu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Jie Yang
- Health Management Center, Renji Hospital of Medical School, Shanghai Jiao Tong University, Shanghai 200127, China; (Y.C.); (P.L.); (W.L.)
- Department of Neurology, Renji Hospital of Medical School, Shanghai Jiao Tong University, Shanghai 200127, China
- Renji-UNSW CHeBA (Centre for Healthy Brain Ageing of University of New South Wales) Neurocognitive Center, Renji Hospital of Medical School, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Wanwan Liu
- Health Management Center, Renji Hospital of Medical School, Shanghai Jiao Tong University, Shanghai 200127, China; (Y.C.); (P.L.); (W.L.)
| | - Zhijun Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Qun Xu
- Health Management Center, Renji Hospital of Medical School, Shanghai Jiao Tong University, Shanghai 200127, China; (Y.C.); (P.L.); (W.L.)
- Department of Neurology, Renji Hospital of Medical School, Shanghai Jiao Tong University, Shanghai 200127, China
- Renji-UNSW CHeBA (Centre for Healthy Brain Ageing of University of New South Wales) Neurocognitive Center, Renji Hospital of Medical School, Shanghai Jiao Tong University, Shanghai 200127, China
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Sin MK, Cheng Y, Roseman J, Zamrini E, Ahmed A. Relationship between Cerebral Microinfarcts and Dementia by Sex: Findings from a community-based Autopsy Study. INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASE AND STROKE 2024; 7:171. [PMID: 38689945 PMCID: PMC11060706 DOI: 10.29011/2688-8734.100171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Cerebral microinfarcts are common in older adults and are associated with cognitive impairment. Less is known about sex-related variation in the relationship between cerebral microinfarcts and dementia in older adults, the examination of which was the objective of this study. This case-control study was based on the 727 participants (419 women) in the Adult Changes in Thought (ACT) autopsy data. Microinfarcts were ascertained by blinded board-certified neuropathologists, and dementia diagnoses were made by the ACT Consensus Diagnosis Conference per DSM-IV. Multivariable logistic regression models were used to estimate adjusted odds ratio (aOR) and 95% confidence interval (CI). Microinfarcts were present in 49% (356/727) of the participants, which was numerically higher in women: 51% (213/419) vs 46% (143/308). aOR (95% CI) for dementia associated with any microinfarct for female and male participants were 1.45 (0.91-2.30) and 1.24 (0.75-2.06), respectively (p for interaction, 0.34). Respective aORs (95%CIs) associated with ≥2 microinfarcts were 1.37 (0.79-2.36) and 1.53 (0.84-2.78), with interaction p, 0.84. Subcortical microinfarcts were present in 36% (138/381) and 23% (78/346) of patients with and without dementia (aOR, 1.65; 95% CI, 1.14-2.38). Respective aOR (95% CI) in female and male participants were 1.70 (1.03-2.82) and 1.59 (0.90-2.80), (p for interaction, 0.55). There was no association with cortical microinfarcts (aOR, 1.19; 95% CI, 0.83-1.69). These findings suggest that association between microinfarcts and dementia is primarily mediated by subcortical microinfarcts, but we found no evidence of sex-related variation. Future studies with greater power are needed to determine if the associations we found are replicable.
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Affiliation(s)
- Mo-Kyung Sin
- College of Nursing, Seattle University, Seattle, USA
| | - Yan Cheng
- Biomedical Informatics Center, School of Medicine & Health Sciences, George Washington University, Washington, DC, USA
| | - Jeffrey Roseman
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Edward Zamrini
- Veterans Affairs Medical Center, Washington, DC, USA; George Washington University, Washington, DC, USA; Irvine Clinical Research, Irvine, CA, USA
| | - Ali Ahmed
- Veterans Affairs Medical Center, George Washington University, and School of Medicine, Georgetown University, Washington, DC, USA
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Liu J, van Beusekom H, Bu X, Chen G, Henrique Rosado de Castro P, Chen X, Chen X, Clarkson AN, Farr TD, Fu Y, Jia J, Jolkkonen J, Kim WS, Korhonen P, Li S, Liang Y, Liu G, Liu G, Liu Y, Malm T, Mao X, Oliveira JM, Modo MM, Ramos‐Cabrer P, Ruscher K, Song W, Wang J, Wang X, Wang Y, Wu H, Xiong L, Yang Y, Ye K, Yu J, Zhou X, Zille M, Masters CL, Walczak P, Boltze J, Ji X, Wang Y. Preserving cognitive function in patients with Alzheimer's disease: The Alzheimer's disease neuroprotection research initiative (ADNRI). NEUROPROTECTION 2023; 1:84-98. [PMID: 38223913 PMCID: PMC10783281 DOI: 10.1002/nep3.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 01/16/2024]
Abstract
The global trend toward aging populations has resulted in an increase in the occurrence of Alzheimer's disease (AD) and associated socioeconomic burdens. Abnormal metabolism of amyloid-β (Aβ) has been proposed as a significant pathomechanism in AD, supported by results of recent clinical trials using anti-Aβ antibodies. Nonetheless, the cognitive benefits of the current treatments are limited. The etiology of AD is multifactorial, encompassing Aβ and tau accumulation, neuroinflammation, demyelination, vascular dysfunction, and comorbidities, which collectively lead to widespread neurodegeneration in the brain and cognitive impairment. Hence, solely removing Aβ from the brain may be insufficient to combat neurodegeneration and preserve cognition. To attain effective treatment for AD, it is necessary to (1) conduct extensive research on various mechanisms that cause neurodegeneration, including advances in neuroimaging techniques for earlier detection and a more precise characterization of molecular events at scales ranging from cellular to the full system level; (2) identify neuroprotective intervention targets against different neurodegeneration mechanisms; and (3) discover novel and optimal combinations of neuroprotective intervention strategies to maintain cognitive function in AD patients. The Alzheimer's Disease Neuroprotection Research Initiative's objective is to facilitate coordinated, multidisciplinary efforts to develop systemic neuroprotective strategies to combat AD. The aim is to achieve mitigation of the full spectrum of pathological processes underlying AD, with the goal of halting or even reversing cognitive decline.
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Affiliation(s)
- Jie Liu
- Department of Neurology, Daping HospitalThird Military Medical UniversityChongqingChina
- Chongqing Key Laboratory of Ageing and Brain DiseasesChongqingChina
| | - Heleen van Beusekom
- Division of Experimental Cardiology, Department of Cardiology, Erasmus MCUniversity Medical CenterRotterdamThe Netherlands
| | - Xian‐Le Bu
- Department of Neurology, Daping HospitalThird Military Medical UniversityChongqingChina
- Chongqing Key Laboratory of Ageing and Brain DiseasesChongqingChina
- Institute of Brain and IntelligenceThird Military Medical UniversityChongqingChina
| | - Gong Chen
- Guangdong‐HongKong‐Macau Institute of CNS Regeneration (GHMICR)Jinan UniversityGuangzhouGuangdongChina
| | | | - Xiaochun Chen
- Fujian Key Laboratory of Molecular Neurology, Department of Neurology and Geriatrics, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Institute of NeuroscienceFujian Medical UniversityFuzhouFujianChina
| | - Xiaowei Chen
- Institute of Brain and IntelligenceThird Military Medical UniversityChongqingChina
- Guangyang Bay LaboratoryChongqing Institute for Brain and IntelligenceChongqingChina
- Center for Excellence in Brain Science and Intelligence TechnologyChinese Academy of SciencesShanghaiChina
| | - Andrew N. Clarkson
- Department of Anatomy, Brain Health Research Centre and Brain Research New ZealandUniversity of OtagoDunedinNew Zealand
| | - Tracy D. Farr
- School of Life SciencesUniversity of NottinghamNottinghamUK
| | - Yuhong Fu
- Brain and Mind Centre & School of Medical SciencesThe University of SydneySydneyNew South WalesAustralia
| | - Jianping Jia
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, National Clinical Research Center for Geriatric DiseasesCapital Medical UniversityBeijingChina
| | - Jukka Jolkkonen
- A.I. Virtanen Institute for Molecular SciencesUniversity of Eastern FinlandKuopioFinland
| | - Woojin Scott Kim
- Brain and Mind Centre & School of Medical SciencesThe University of SydneySydneyNew South WalesAustralia
| | - Paula Korhonen
- A.I. Virtanen Institute for Molecular SciencesUniversity of Eastern FinlandKuopioFinland
| | - Shen Li
- Department of Neurology and Psychiatry, Beijing Shijitan HospitalCapital Medical UniversityBeijingChina
| | - Yajie Liang
- Department of Diagnostic Radiology and Nuclear MedicineUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Guang‐Hui Liu
- University of Chinese Academy of SciencesBeijingChina
- State Key Laboratory of Membrane Biology, Institute of ZoologyChinese Academy of SciencesBeijingChina
| | - Guiyou Liu
- Beijing Institute of Brain Disorders, Laboratory of Brain Disorders, Ministry of Science and Technology, Collaborative Innovation Center for Brain DisordersCapital Medical UniversityBeijingChina
| | - Yu‐Hui Liu
- Department of Neurology, Daping HospitalThird Military Medical UniversityChongqingChina
- Chongqing Key Laboratory of Ageing and Brain DiseasesChongqingChina
- Institute of Brain and IntelligenceThird Military Medical UniversityChongqingChina
| | - Tarja Malm
- A.I. Virtanen Institute for Molecular SciencesUniversity of Eastern FinlandKuopioFinland
| | - Xiaobo Mao
- Institute for Cell Engineering, Department of NeurologyThe Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Joaquim Miguel Oliveira
- 3B's Research Group, I3Bs—Research Institute on Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative MedicineUniversity of MinhoGuimarãesPortugal
- ICVS/3B's—PT Government Associate LaboratoryBraga/GuimarãesPortugal
| | - Mike M. Modo
- Department of Bioengineering, McGowan Institute for Regenerative MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Radiology, McGowan Institute for Regenerative MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Pedro Ramos‐Cabrer
- Magnetic Resonance Imaging LaboratoryCIC BiomaGUNE Research Center, Basque Research and Technology Alliance (BRTA)Donostia‐San SebastianSpain
| | - Karsten Ruscher
- Laboratory for Experimental Brain Research, Division of Neurosurgery, Department of Clinical SciencesLund UniversityLundSweden
| | - Weihong Song
- Institute of Aging, Key Laboratory of Alzheimer's Disease of Zhejiang Province. Zhejiang Clinical Research Center for Mental Disorders, School of Mental Health and The Affiliated Kangning Hospital, Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health)Wenzhou Medical UniversityZhejiangChina
| | - Jun Wang
- Department of Neurology, Daping HospitalThird Military Medical UniversityChongqingChina
- Chongqing Key Laboratory of Ageing and Brain DiseasesChongqingChina
| | - Xuanyue Wang
- School of Optometry and Vision ScienceUniversity of New South WalesSydneyNew South WalesAustralia
| | - Yun Wang
- Neuroscience Research Institute, Department of Neurobiology, School of Basic, Medical Sciences, Key Laboratory for Neuroscience, Ministry of Education/National, Health Commission and State Key Laboratory of Natural and Biomimetic DrugsPeking UniversityBeijingChina
- PKU‐IDG/McGovern Institute for Brain ResearchPeking UniversityBeijingChina
| | - Haitao Wu
- Department of NeurobiologyBeijing Institute of Basic Medical SciencesBeijingChina
| | - Lize Xiong
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain‐Like Intelligence, Shanghai Fourth People's Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Yi Yang
- Department of NeurologyThe First Hospital of Jilin University, Chang ChunJilinChina
| | - Keqiang Ye
- Faculty of Life and Health SciencesBrain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced TechnologyShenzhenChina
| | - Jin‐Tai Yu
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Xin‐Fu Zhou
- Division of Health Sciences, School of Pharmacy and Medical Sciences and Sansom InstituteUniversity of South AustraliaAdelaideSouth AustraliaAustralia
- Suzhou Auzone BiotechSuzhouJiangsuChina
| | - Marietta Zille
- Department of Pharmaceutical Sciences, Division of Pharmacology and ToxicologyUniversity of ViennaViennaAustria
| | - Colin L. Masters
- The Florey InstituteThe University of Melbourne, ParkvilleVictoriaAustralia
| | - Piotr Walczak
- Department of Diagnostic Radiology and Nuclear MedicineUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | | | - Xunming Ji
- Department of NeurosurgeryXuanwu Hospital, Capital Medical UniversityBeijingChina
| | - Yan‐Jiang Wang
- Department of Neurology, Daping HospitalThird Military Medical UniversityChongqingChina
- Chongqing Key Laboratory of Ageing and Brain DiseasesChongqingChina
- Institute of Brain and IntelligenceThird Military Medical UniversityChongqingChina
- Guangyang Bay LaboratoryChongqing Institute for Brain and IntelligenceChongqingChina
- Center for Excellence in Brain Science and Intelligence TechnologyChinese Academy of SciencesShanghaiChina
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8
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Freeze WM, van Veluw SJ, Jansen WJ, Bennett DA, Jacobs HIL. Locus coeruleus pathology is associated with cerebral microangiopathy at autopsy. Alzheimers Dement 2023; 19:5023-5035. [PMID: 37095709 PMCID: PMC10593911 DOI: 10.1002/alz.13096] [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: 10/14/2022] [Revised: 03/10/2023] [Accepted: 03/27/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION We investigated the link between locus coeruleus (LC) pathology and cerebral microangiopathy in two large neuropathology datasets. METHODS We included data from the National Alzheimer's Coordinating Center (NACC) database (n = 2197) and Religious Orders Study and Rush Memory and Aging Project (ROSMAP; n = 1637). Generalized estimating equations and logistic regression were used to examine associations between LC hypopigmentation and presence of cerebral amyloid angiopathy (CAA) or arteriolosclerosis, correcting for age at death, sex, cortical Alzheimer's disease (AD) pathology, ante mortem cognitive status, and presence of vascular and genetic risk factors. RESULTS LC hypopigmentation was associated with higher odds of overall CAA in the NACC dataset, leptomeningeal CAA in the ROSMAP dataset, and arteriolosclerosis in both datasets. DISCUSSION LC pathology is associated with cerebral microangiopathy, independent of cortical AD pathology. LC degeneration could potentially contribute to the pathways relating vascular pathology to AD. Future studies of the LC-norepinephrine system on cerebrovascular health are warranted. HIGHLIGHTS We associated locus coeruleus (LC) pathology and cerebral microangiopathy in two large autopsy datasets. LC hypopigmentation was consistently related to arteriolosclerosis in both datasets. LC hypopigmentation was related to cerebral amyloid angiopathy (CAA) presence in the National Alzheimer's Coordinating Center dataset. LC hypopigmentation was related to leptomeningeal CAA in the Religious Orders Study and Rush Memory and Aging Project dataset. LC degeneration may play a role in the pathways relating vascular pathology to Alzheimer's disease.
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Affiliation(s)
- WM Freeze
- Department of Radiology, Leiden University Medical Center, 2333 ZA, Leiden, the Netherlands
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, 6229 ET, Maastricht, the Netherlands
| | - SJ van Veluw
- Department of Radiology, Leiden University Medical Center, 2333 ZA, Leiden, the Netherlands
- Department of Neurology, J. Philip Kistler Stroke Research Center, MGH, Boston, MA 02114, USA
| | - WJ Jansen
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, 6229 ET, Maastricht, the Netherlands
- Banner Alzheimer’s Institute, Phoenix, AZ 85006, USA
| | - DA Bennett
- Department of Neurological Sciences, Rush Alzheimer’s Disease Center, Rush University Medical Center; Chicago, IL 60612, USA
| | - HIL Jacobs
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, 6229 ET, Maastricht, the Netherlands
- Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
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9
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Winslow NK, Olson EA, Bach SE, Maldonado AL. Neuropathologic changes associated with stereoelectroencephalography depth electrode placement. J Neurosurg Sci 2023; 67:631-637. [PMID: 35380201 DOI: 10.23736/s0390-5616.22.05616-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to detail the neuropathologic changes resulting from the surgical placement of stereoelectroencephalography (SEEG) leads in an initial small group of epilepsy cases and to raise awareness of this iatrogenic pathology, especially to those medical providers who specialize in the care of epilepsy patients. METHODS Five consecutive patients who underwent epilepsy resection surgery following SEEG monitoring at OSF Saint Francis Medical Center were included in our report. Resection specimens were examined grossly and entirely submitted for microscopic evaluation by a neuropathologist. Seizure-related pathologies, as well as histologic changes related to SEEG electrode placement, were documented. RESULTS The patient cohort included two females and three males, with an age range of 9 to 47 years. Neuropathologic examination revealed one or more seizure-related pathologies in each patient's resection specimen. In addition, all brain resection specimens showed multiple microinfarcts, which appeared to correlate with the placement and size of SEEG electrodes. Patchy leptomeningeal chronic inflammation was also seen in most cases. CONCLUSIONS SEEG electrode placement is an effective procedure for determining epileptogenic regions and guiding subsequent resection surgeries in medically refractory epilepsy. Multiple microinfarcts and chronic inflammation are commonly seen in brain resection specimens following SEEG electrode insertion, but studies detailing these iatrogenic histopathologic changes are lacking. The clinical significance and long-term implications of multiple small foci of electrode-induced injury that remain in the patient's brain after resection of the epileptogenic focus are unknown and may provide a welcome area for future study.
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Affiliation(s)
- Nolan K Winslow
- Department of Neurosurgery, OSF Saint Francis Medical Center, Peoria, IL, USA -
| | - Elsa A Olson
- College of Medicine, University of Illinois, Peoria, IL, USA
| | - Sarah E Bach
- Department of Pathology, OSF Saint Francis Medical Center, Peoria, IL, USA
| | - Andres L Maldonado
- Department of Neurosurgery, OSF Saint Francis Medical Center, Peoria, IL, USA
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10
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Das M, Mao W, Voskobiynyk Y, Necula D, Lew I, Petersen C, Zahn A, Yu GQ, Yu X, Smith N, Sayed FA, Gan L, Paz JT, Mucke L. Alzheimer risk-increasing TREM2 variant causes aberrant cortical synapse density and promotes network hyperexcitability in mouse models. Neurobiol Dis 2023; 186:106263. [PMID: 37591465 PMCID: PMC10681293 DOI: 10.1016/j.nbd.2023.106263] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/12/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023] Open
Abstract
The R47H variant of triggering receptor expressed on myeloid cells 2 (TREM2) increases the risk of Alzheimer's disease (AD). To investigate potential mechanisms, we analyzed knockin mice expressing human TREM2-R47H from one mutant mouse Trem2 allele. TREM2-R47H mice showed increased seizure activity in response to an acute excitotoxin challenge, compared to wildtype controls or knockin mice expressing the common variant of human TREM2. TREM2-R47H also increased spontaneous thalamocortical epileptiform activity in App knockin mice expressing amyloid precursor proteins bearing autosomal dominant AD mutations and a humanized amyloid-β sequence. In mice with or without such App modifications, TREM2-R47H increased the density of putative synapses in cortical regions without amyloid plaques. TREM2-R47H did not affect synaptic density in hippocampal regions with or without plaques. We conclude that TREM2-R47H increases AD-related network hyperexcitability and that it may do so, at least in part, by causing an imbalance in synaptic densities across brain regions.
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Affiliation(s)
- Melanie Das
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Wenjie Mao
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Yuliya Voskobiynyk
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Deanna Necula
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA; Neuroscience Graduate Program, University of California, San Francisco, CA 94158, USA
| | - Irene Lew
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Cathrine Petersen
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA; Neuroscience Graduate Program, University of California, San Francisco, CA 94158, USA
| | - Allie Zahn
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Gui-Qiu Yu
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Xinxing Yu
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Nicholas Smith
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Faten A Sayed
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA
| | - Li Gan
- Helen and Robert Appel Alzheimer's Disease Research Institute, Weill Cornell Medicine, New York City, NY 10065, USA
| | - Jeanne T Paz
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA; Neuroscience Graduate Program, University of California, San Francisco, CA 94158, USA; Department of Neurology and Weill Institute for Neurosciences, University of California, San Francisco, CA 94158, USA
| | - Lennart Mucke
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, CA 94158, USA; Neuroscience Graduate Program, University of California, San Francisco, CA 94158, USA; Department of Neurology and Weill Institute for Neurosciences, University of California, San Francisco, CA 94158, USA.
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11
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Kuneš J, Hojná S, Mráziková L, Montezano A, Touyz RM, Maletínská L. Obesity, Cardiovascular and Neurodegenerative Diseases: Potential Common Mechanisms. Physiol Res 2023; 72:S73-S90. [PMID: 37565414 PMCID: PMC10660578 DOI: 10.33549/physiolres.935109] [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: 04/04/2023] [Accepted: 05/12/2023] [Indexed: 12/01/2023] Open
Abstract
The worldwide increase in the incidence of obesity and cardiovascular and neurodegenerative diseases, e.g. Alzheimer's disease, is related to many factors, including an unhealthy lifestyle and aging populations. However, the interconnection between these diseases is not entirely clear, and it is unknown whether common mechanisms underlie these conditions. Moreover, there are currently no fully effective therapies for obesity and neurodegeneration. While there has been extensive research in preclinical models addressing these issues, the experimental findings have not been translated to the clinic. Another challenge relates to the time of onset of individual diseases, which may not be easily identified, since there are no specific indicators or biomarkers that define disease onset. Hence knowing when to commence preventive treatment is unclear. This is especially pertinent in neurodegenerative diseases, where the onset of the disease may be subtle and occur decades before the signs and symptoms manifest. In metabolic and cardiovascular disorders, the risk may occur in-utero, in line with the concept of fetal programming. This review provides a brief overview of the link between obesity, cardiovascular and neurodegenerative diseases and discusses potential common mechanisms including the role of the gut microbiome.
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Affiliation(s)
- J Kuneš
- Institute of Physiology AS CR, Prague, Czech Republic. . Research Institute of McGill University Health Centre (RI-MUHC), Québac, Canada,
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12
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Duering M, Biessels GJ, Brodtmann A, Chen C, Cordonnier C, de Leeuw FE, Debette S, Frayne R, Jouvent E, Rost NS, Ter Telgte A, Al-Shahi Salman R, Backes WH, Bae HJ, Brown R, Chabriat H, De Luca A, deCarli C, Dewenter A, Doubal FN, Ewers M, Field TS, Ganesh A, Greenberg S, Helmer KG, Hilal S, Jochems ACC, Jokinen H, Kuijf H, Lam BYK, Lebenberg J, MacIntosh BJ, Maillard P, Mok VCT, Pantoni L, Rudilosso S, Satizabal CL, Schirmer MD, Schmidt R, Smith C, Staals J, Thrippleton MJ, van Veluw SJ, Vemuri P, Wang Y, Werring D, Zedde M, Akinyemi RO, Del Brutto OH, Markus HS, Zhu YC, Smith EE, Dichgans M, Wardlaw JM. Neuroimaging standards for research into small vessel disease-advances since 2013. Lancet Neurol 2023; 22:602-618. [PMID: 37236211 DOI: 10.1016/s1474-4422(23)00131-x] [Citation(s) in RCA: 155] [Impact Index Per Article: 155.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/03/2023] [Accepted: 03/28/2023] [Indexed: 05/28/2023]
Abstract
Cerebral small vessel disease (SVD) is common during ageing and can present as stroke, cognitive decline, neurobehavioural symptoms, or functional impairment. SVD frequently coexists with neurodegenerative disease, and can exacerbate cognitive and other symptoms and affect activities of daily living. Standards for Reporting Vascular Changes on Neuroimaging 1 (STRIVE-1) categorised and standardised the diverse features of SVD that are visible on structural MRI. Since then, new information on these established SVD markers and novel MRI sequences and imaging features have emerged. As the effect of combined SVD imaging features becomes clearer, a key role for quantitative imaging biomarkers to determine sub-visible tissue damage, subtle abnormalities visible at high-field strength MRI, and lesion-symptom patterns, is also apparent. Together with rapidly emerging machine learning methods, these metrics can more comprehensively capture the effect of SVD on the brain than the structural MRI features alone and serve as intermediary outcomes in clinical trials and future routine practice. Using a similar approach to that adopted in STRIVE-1, we updated the guidance on neuroimaging of vascular changes in studies of ageing and neurodegeneration to create STRIVE-2.
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Affiliation(s)
- Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany; Medical Image Analysis Center, University of Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland.
| | - Geert Jan Biessels
- Department of Neurology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Amy Brodtmann
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne, VIC, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Christopher Chen
- Department of Pharmacology, Memory Aging and Cognition Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Psychological Medicine, Memory Aging and Cognition Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Charlotte Cordonnier
- Université de Lille, INSERM, CHU Lille, U1172-Lille Neuroscience and Cognition (LilNCog), Lille, France
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Center for Medical Neuroscience, Radboudumc, Nijmegen, Netherlands
| | - Stéphanie Debette
- Bordeaux Population Health Research Center, University of Bordeaux, INSERM, UMR 1219, Bordeaux, France; Department of Neurology, Institute for Neurodegenerative Diseases, CHU de Bordeaux, Bordeaux, France
| | - Richard Frayne
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada; Seaman Family MR Research Centre, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada
| | - Eric Jouvent
- AP-HP, Lariboisière Hospital, Translational Neurovascular Centre, FHU NeuroVasc, Université Paris Cité, Paris, France; Université Paris Cité, INSERM UMR 1141, NeuroDiderot, Paris, France
| | - Natalia S Rost
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Walter H Backes
- School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, Netherlands; School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea; Cerebrovascular Disease Center, Seoul National University Bundang Hospital, Seongn-si, South Korea
| | - Rosalind Brown
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Hugues Chabriat
- Centre Neurovasculaire Translationnel, CERVCO, INSERM U1141, FHU NeuroVasc, Université Paris Cité, Paris, France
| | - Alberto De Luca
- Image Sciences Institute, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Charles deCarli
- Department of Neurology and Center for Neuroscience, University of California, Davis, CA, USA
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Fergus N Doubal
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Thalia S Field
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada; Vancouver Stroke Program, Division of Neurology, University of British Columbia, Vancouver, BC, Canada
| | - Aravind Ganesh
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada; Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB, Canada
| | - Steven Greenberg
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Karl G Helmer
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Athinoula A Martinos Center for Biomedical Imaging, Boston, MA, USA; Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Saima Hilal
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Angela C C Jochems
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Hanna Jokinen
- Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital, University of Helsinki, Helsinki, Finland; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Hugo Kuijf
- Image Sciences Institute, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Bonnie Y K Lam
- Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Margaret KL Cheung Research Centre for Management of Parkinsonism, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Therese Pei Fong Chow Research Centre for Prevention of Dementia, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Lau Tat-chuen Research Centre of Brain Degenerative Diseases in Chinese, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Jessica Lebenberg
- AP-HP, Lariboisière Hospital, Translational Neurovascular Centre, FHU NeuroVasc, Université Paris Cité, Paris, France; Université Paris Cité, INSERM UMR 1141, NeuroDiderot, Paris, France
| | - Bradley J MacIntosh
- Sandra E Black Centre for Brain Resilience and Repair, Hurvitz Brain Sciences, Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada; Computational Radiology and Artificial Intelligence Unit, Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Pauline Maillard
- Department of Neurology and Center for Neuroscience, University of California, Davis, CA, USA
| | - Vincent C T Mok
- Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Margaret KL Cheung Research Centre for Management of Parkinsonism, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Therese Pei Fong Chow Research Centre for Prevention of Dementia, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Lau Tat-chuen Research Centre of Brain Degenerative Diseases in Chinese, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Leonardo Pantoni
- Department of Biomedical and Clinical Science, University of Milan, Milan, Italy
| | - Salvatore Rudilosso
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Claudia L Satizabal
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Department of Population Health Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Department of Neurology, Boston University Medical Center, Boston, MA, USA; Framingham Heart Study, Framingham, MA, USA
| | - Markus D Schirmer
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Colin Smith
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Julie Staals
- School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, Netherlands; Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Michael J Thrippleton
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; Edinburgh Imaging and Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | | | | | - Yilong Wang
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - David Werring
- Stroke Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Marialuisa Zedde
- Neurology Unit, Stroke Unit, Department of Neuromotor Physiology and Rehabilitation, Azienda Unità Sanitaria-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Rufus O Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oscar H Del Brutto
- School of Medicine and Research Center, Universidad de Especialidades Espiritu Santo, Ecuador
| | - Hugh S Markus
- Stroke Research Group, Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
| | - Yi-Cheng Zhu
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Eric E Smith
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada; Department of Radiology, University of Calgary, Calgary, AB, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; German Centre for Cardiovascular Research (DZHK), Munich, Germany
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK; UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
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Sin MK, Cheng Y, Roseman JM, Zamrini E, Ahmed A. Relationships between Cerebral Vasculopathies and Microinfarcts in a Community-Based Cohort of Older Adults. J Clin Med 2023; 12:3807. [PMID: 37298002 PMCID: PMC10253407 DOI: 10.3390/jcm12113807] [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: 04/27/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
Cerebral microinfarcts are associated with cognitive impairment and dementia. Small vessel diseases such as cerebral arteriolosclerosis and cerebral amyloid angiography (CAA) have been found to be associated with microinfarcts. Less is known about the associations of these vasculopathies with the presence, numbers, and location of microinfarcts. These associations were examined in the clinical and autopsy data of 842 participants in the Adult Changes in Thought (ACT) study. Both vasculopathies were categorized by severity (none, mild, moderate, and severe) and region (cortical and subcortical). Odds ratios (OR) and 95% CIs for microinfarcts associated with arteriolosclerosis and CAA adjusted for possible modifying covariates such as age at death, sex, blood pressure, APOE genotype, Braak, and CERAD were estimated. 417 (49.5%) had microinfarcts (cortical, 301; subcortical, 249), 708 (84.1%) had cerebral arteriolosclerosis, 320 (38%) had CAA, and 284 (34%) had both. Ors (95% CI) for any microinfarct were 2.16 (1.46-3.18) and 4.63 (2.90-7.40) for those with moderate (n = 183) and severe (n = 124) arteriolosclerosis, respectively. Respective Ors (95% CI) for the number of microinfarcts were 2.25 (1.54-3.30) and 4.91 (3.18-7.60). Similar associations were observed for cortical and subcortical microinfarcts. Ors (95% Cis) for the number of microinfarcts associated with mild (n = 75), moderate (n = 73), and severe (n = 15) amyloid angiopathy were 0.95 (0.66-1.35), 1.04 (0.71-1.52), and 2.05 (0.94-4.45), respectively. Respective Ors (95% Cis) for cortical microinfarcts were 1.05 (0.71-1.56), 1.50 (0.99-2.27), and 1.69 (0.73-3.91). Respective Ors (95% Cis) for subcortical microinfarcts were 0.84 (0.55-1.28), 0.72 (0.46-1.14), and 0.92 (0.37-2.28). These findings suggest a significant association of cerebral arteriolosclerosis with the presence, number, and location (cortical and subcortical) of microinfarcts, and a weak and non-significant association of CAA with each microinfarct, highlighting the need for future research to better understand the role of small vessel diseases in the pathogenesis of cerebral microinfarcts.
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Affiliation(s)
- Mo-Kyung Sin
- College of Nursing, Seattle University, Seattle, WA 98122, USA
| | - Yan Cheng
- Biomedical Informatics Center, School of Medicine & Health Sciences, George Washington University, Washington, DC 20052, USA; (Y.C.); (E.Z.); (A.A.)
| | - Jeffrey M. Roseman
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Edward Zamrini
- Biomedical Informatics Center, School of Medicine & Health Sciences, George Washington University, Washington, DC 20052, USA; (Y.C.); (E.Z.); (A.A.)
- Division of Neurology, Irvine Clinical Research, Irvine, CA 92614, USA
- Health and Aging, VA Medical Center, Washington, DC 20060, USA
| | - Ali Ahmed
- Biomedical Informatics Center, School of Medicine & Health Sciences, George Washington University, Washington, DC 20052, USA; (Y.C.); (E.Z.); (A.A.)
- Health and Aging, VA Medical Center, Washington, DC 20060, USA
- School of Medicine, Georgetown University, Washington, DC 20057, USA
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14
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Evlice A, Sanli ZS, Boz PB. The importance of Vitamin-D and Neutrophil-Lymphocyte Ratio for Alzheimer's Disease. Pak J Med Sci 2023; 39:799-803. [PMID: 37250565 PMCID: PMC10214823 DOI: 10.12669/pjms.39.3.7024] [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: 08/22/2022] [Revised: 10/31/2022] [Accepted: 01/29/2023] [Indexed: 11/02/2023] Open
Abstract
Objective Ischemia and inflammation play a role in the pathophysiology of Alzheimer's disease (AD). Plasma neutrophil-lymphocyte ratio (NLR), and 25- hydroxyvitamin D (vitamin D) were used as a biomarker for inflammation and atherosclerosis. The present study aimed to investigate a link between NLR, vitamin D and ischemia in AD. Methods The subjects with AD and control groups were enrolled to this retrospective study between 2017-2022 at Cukurova University Hospital. The cognitive assessment (MMSE), and blood tests (NLR, vitamin D) were collected from all subjects. In first part of the study, AD (n:132) and the control group (n:38) were compared. In second part of the study, magnetic resonance imaging (MRI) was used for evaluating ischemic lesions with scoring method of Fazekas. The control group (n:38) and AD subjects with mild ischemic lesions (Fazekas-1 and Fazekas-2) (n:64) were excluded. AD subjects with severe ischemic lesions (Fazekas-3) (n:34) and without ischemic lesions (Fazekas-0) (n:34) were compared again. SPSS 20.0 was used for all analyses. The threshold for statistical significance was set at 0.05. Results In the first part of the study, 132 AD patients (69 female and 63 male; mean age 70.83±9.35 (49-87) and age-matched 38 controls were compared. The mean NLR in AD [2.96±2.46 (1.17-19.43)] was higher than the control group [1.9±0.66 (0.9-3.56)] (p=0.005). In the second part of the study, the mean Vitamin D of Fazekas-3 AD group [16.15±9.64 (4.7-35)] was lower than Fazekas-0 AD group [16.27±6.81(4.6-29.7)] (p=0.024). Conclusion NLR was higher in AD while there was no difference between the Fazekas-0 and Fazekas-3 AD groups. Vitamin D was lower in the Fazekas-3 AD group. These data suggested that NLR increased independently of ischemia in AD. Also vitamin D deficiency could trigger ischemia in AD.
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Affiliation(s)
- Ahmet Evlice
- Ahmet Evlice, MD. Department of Neurology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Zeynep Selcan Sanli
- Zeynep Selcan Sanli, MD., Faculty of Medicine, Neurology Clinic Health Sciences University Adana, Adana City Training and Research Hospital, Adana, Turkey
| | - Pinar Bengi Boz
- Pinar Bengi Boz, MD., Faculty of Medicine, Neurology Clinic Health Sciences University Adana, Adana City Training and Research Hospital, Adana, Turkey
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15
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Eisenmenger LB, Peret A, Famakin BM, Spahic A, Roberts GS, Bockholt JH, Johnson KM, Paulsen JS. Vascular contributions to Alzheimer's disease. Transl Res 2023; 254:41-53. [PMID: 36529160 PMCID: PMC10481451 DOI: 10.1016/j.trsl.2022.12.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/05/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
Alzheimer's disease (AD) is the most common cause of dementia and is characterized by progressive neurodegeneration and cognitive decline. Understanding the pathophysiology underlying AD is paramount for the management of individuals at risk of and suffering from AD. The vascular hypothesis stipulates a relationship between cardiovascular disease and AD-related changes although the nature of this relationship remains unknown. In this review, we discuss several potential pathological pathways of vascular involvement in AD that have been described including dysregulation of neurovascular coupling, disruption of the blood brain barrier, and reduced clearance of metabolite waste such as beta-amyloid, a toxic peptide considered the hallmark of AD. We will also discuss the two-hit hypothesis which proposes a 2-step positive feedback loop in which microvascular insults precede the accumulation of Aß and are thought to be at the origin of the disease development. At neuroimaging, signs of vascular dysfunction such as chronic cerebral hypoperfusion have been demonstrated, appearing early in AD, even before cognitive decline and alteration of traditional biomarkers. Cerebral small vessel disease such as cerebral amyloid angiopathy, characterized by the aggregation of Aß in the vessel wall, is highly prevalent in vascular dementia and AD patients. Current data is unclear whether cardiovascular disease causes, precipitates, amplifies, precedes, or simply coincides with AD. Targeted imaging tools to quantitatively evaluate the intracranial vasculature and longitudinal studies in individuals at risk for or in the early stages of the AD continuum could be critical in disentangling this complex relationship between vascular disease and AD.
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Affiliation(s)
- Laura B Eisenmenger
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Anthony Peret
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Bolanle M Famakin
- Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin
| | - Alma Spahic
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Grant S Roberts
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Jeremy H Bockholt
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, Georgia
| | - Kevin M Johnson
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin
| | - Jane S Paulsen
- Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin.
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16
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Fang C, Magaki SD, Kim RC, Kalaria RN, Vinters HV, Fisher M. Arteriolar neuropathology in cerebral microvascular disease. Neuropathol Appl Neurobiol 2023; 49:e12875. [PMID: 36564356 DOI: 10.1111/nan.12875] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 11/14/2022] [Accepted: 12/13/2022] [Indexed: 12/25/2022]
Abstract
Cerebral microvascular disease (MVD) is an important cause of vascular cognitive impairment. MVD is heterogeneous in aetiology, ranging from universal ageing to the sporadic (hypertension, sporadic cerebral amyloid angiopathy [CAA] and chronic kidney disease) and the genetic (e.g., familial CAA, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy [CADASIL] and cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy [CARASIL]). The brain parenchymal consequences of MVD predominantly consist of lacunar infarcts (lacunes), microinfarcts, white matter disease of ageing and microhaemorrhages. MVD is characterised by substantial arteriolar neuropathology involving ubiquitous vascular smooth muscle cell (SMC) abnormalities. Cerebral MVD is characterised by a wide variety of arteriolar injuries but only a limited number of parenchymal manifestations. We reason that the cerebral arteriole plays a dominant role in the pathogenesis of each type of MVD. Perturbations in signalling and function (i.e., changes in proliferation, apoptosis, phenotypic switch and migration of SMC) are prominent in the pathogenesis of cerebral MVD, making 'cerebral angiomyopathy' an appropriate term to describe the spectrum of pathologic abnormalities. The evidence suggests that the cerebral arteriole acts as both source and mediator of parenchymal injury in MVD.
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Affiliation(s)
- Chuo Fang
- Department of Neurology, University of California, Irvine Medical Center, 101 The City Drive South Shanbrom Hall (Building 55), Room 121, Orange, 92868, California, USA
| | - Shino D Magaki
- Department of Pathology & Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Ronald C Kim
- Department of Pathology & Laboratory Medicine, University of California, Irvine, Orange, California, USA
| | - Raj N Kalaria
- Translational and Clinical Research Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| | - Harry V Vinters
- Department of Pathology & Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA.,Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Mark Fisher
- Department of Neurology, University of California, Irvine Medical Center, 101 The City Drive South Shanbrom Hall (Building 55), Room 121, Orange, 92868, California, USA.,Department of Pathology & Laboratory Medicine, University of California, Irvine, Orange, California, USA
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17
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Adewale BA, Coker MM, Ogunniyi A, Kalaria RN, Akinyemi RO. Biomarkers and Risk Assessment of Alzheimer's Disease in Low- and Middle-Income Countries. J Alzheimers Dis 2023; 95:1339-1349. [PMID: 37694361 DOI: 10.3233/jad-221030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Dementia is a chronic syndrome which is common among the elderly and is associated with significant morbidity and mortality for patients and their caregivers. Alzheimer's disease (AD), the most common form of clinical dementia, is biologically characterized by the deposition of amyloid-β plaques and neurofibrillary tangles in the brain. The onset of AD begins decades before manifestation of symptoms and clinical diagnosis, underlining the need to shift from clinical diagnosis of AD to a more objective diagnosis using biomarkers. Having performed a literature search of original articles and reviews on PubMed and Google Scholar, we present this review detailing the existing biomarkers and risk assessment tools for AD. The prevalence of dementia in low- and middle-income countries (LMICs) is predicted to increase over the next couple of years. Thus, we aimed to identify potential biomarkers that may be appropriate for use in LMICs, considering the following factors: sensitivity, specificity, invasiveness, and affordability of the biomarkers. We also explored risk assessment tools and the potential use of artificial intelligence/machine learning solutions for diagnosing, assessing risks, and monitoring the progression of AD in low-resource settings. Routine use of AD biomarkers has yet to gain sufficient ground in clinical settings. Therefore, clinical diagnosis of AD will remain the mainstay in LMICs for the foreseeable future. Efforts should be made towards the development of low-cost, easily administered risk assessment tools to identify individuals who are at risk of AD in the population. We recommend that stakeholders invest in education, research and development targeted towards effective risk assessment and management.
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Affiliation(s)
- Boluwatife Adeleye Adewale
- Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Motunrayo Mojoyin Coker
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adesola Ogunniyi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
| | - Rajesh N Kalaria
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan, Ibadan, Nigeria
- Translational and Clinical Research Institute, Newcastle University, United Kingdom
| | - Rufus Olusola Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Neurology, University College Hospital, Ibadan, Nigeria
- Centre for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Translational and Clinical Research Institute, Newcastle University, United Kingdom
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18
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Sun Y, Hu HY, Hu H, Huang LY, Tan L, Yu JT. Cerebral Small Vessel Disease Burden Predicts Neurodegeneration and Clinical Progression in Prodromal Alzheimer's Disease. J Alzheimers Dis 2023; 93:283-294. [PMID: 36970905 DOI: 10.3233/jad-221207] [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: 05/09/2023]
Abstract
BACKGROUND Cerebral small vessel disease (CSVD) has been suggested to contribute to the pathogenesis of Alzheimer's disease (AD). OBJECTIVE This study aimed to comprehensively investigated the associations of CSVD burden with cognition and AD pathologies. METHODS A total of 546 non-demented participants (mean age, 72.1 years, range, 55-89; 47.4% female) were included. The longitudinal neuropathological and clinical correlates of CSVD burden were assessed using linear mixed-effects and Cox proportional-hazard models. Partial least squares structural equation model (PLS-SEM) was used to assess the direct and indirect effects of CSVD burden on cognition. RESULTS We found that higher CSVD burden was associated with worse cognition (MMSE, β= -0.239, p = 0.006; MoCA, β= -0.493, p = 0.013), lower cerebrospinal fluid (CSF) Aβ level (β= -0.276, p < 0.001) and increased amyloid burden (β= 0.048, p = 0.002). In longitudinal, CSVD burden contributed to accelerated rates of hippocampus atrophy, cognitive decline, and higher risk of AD dementia. Furthermore, as the results of PLS-SEM, we observed both significant direct and indirect impact of advanced age (direct, β= -0.206, p < 0.001; indirect, β= -0.002, p = 0.043) and CSVD burden (direct, β= -0.096, p = 0.018; indirect, β= -0.005, p = 0.040) on cognition by Aβ-p-tau-tau pathway. CONCLUSION CSVD burden could be a prodromal predictor for clinical and pathological progression. Simultaneously, we found that the effects were mediated by the one-direction-only sequence of pathological biomarker changes starting with Aβ, through abnormal p-tau, and neurodegeneration.
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Affiliation(s)
- Yan Sun
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - He-Ying Hu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Hao Hu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Liang-Yu Huang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
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19
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Schoemaker D, Zanon Zotin MC, Chen K, Igwe KC, Vila-Castelar C, Martinez J, Baena A, Fox-Fuller JT, Lopera F, Reiman EM, Brickman AM, Quiroz YT. White matter hyperintensities are a prominent feature of autosomal dominant Alzheimer’s disease that emerge prior to dementia. Alzheimers Res Ther 2022; 14:89. [PMID: 35768838 PMCID: PMC9245224 DOI: 10.1186/s13195-022-01030-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/06/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
To promote the development of effective therapies, there is an important need to characterize the full spectrum of neuropathological changes associated with Alzheimer’s disease. In line with this need, this study examined white matter abnormalities in individuals with early-onset autosomal dominant Alzheimer’s disease, in relation to age and symptom severity.
Methods
This is a cross-sectional analysis of data collected in members of a large kindred with a PSEN1 E280A mutation. Participants were recruited between September 2011 and July 2012 from the Colombian Alzheimer’s Prevention Initiative registry. The studied cohort comprised 50 participants aged between 20 and 55 years, including 20 cognitively unimpaired mutation carriers, 9 cognitively impaired mutation carriers, and 21 non-carriers. Participants completed an MRI, a lumbar puncture for cerebrospinal fluid collection, a florbetapir PET scan, and neurological and neuropsychological examinations. The volume of white matter hyperintensities (WMH) was compared between cognitively unimpaired carriers, cognitively impaired carriers, and non-carriers. Relationships between WMH, age, and cognitive performance were further examined in mutation carriers.
Results
The mean (SD) age of participants was 35.8 (9.6) years and 64% were women. Cardiovascular risk factors were uncommon and did not differ across groups. Cognitively impaired carriers [median, 6.37; interquartile range (IQR), 9.15] had an increased volume of WMH compared to both cognitively unimpaired carriers [median, 0.85; IQR, 0.79] and non-carriers [median, 1.07; IQR, 0.71]. In mutation carriers, the volume of WMH strongly correlated with cognition and age, with evidence for an accelerated rate of changes after the age of 43 years, 1 year earlier than the estimated median age of symptom onset. In multivariable regression models including cortical amyloid retention, superior parietal lobe cortical thickness, and cerebrospinal fluid phospho-tau, the volume of WMH was the only biomarker independently and significantly contributing to the total explained variance in cognitive performance.
Conclusions
The volume of WMH is increased among individuals with symptomatic autosomal-dominant Alzheimer’s disease, begins to increase prior to clinical symptom onset, and is an independent determinant of cognitive performance in this group. These findings suggest that WMH are a key component of autosomal-dominant Alzheimer’s disease that is closely related to the progression of clinical symptoms.
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20
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Dunn PJ, Lea RA, Maksemous N, Smith RA, Sutherland HG, Haupt LM, Griffiths LR. Investigating a Genetic Link Between Alzheimer's Disease and CADASIL-Related Cerebral Small Vessel Disease. Mol Neurobiol 2022; 59:7293-7302. [PMID: 36175824 PMCID: PMC9616771 DOI: 10.1007/s12035-022-03039-3] [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: 07/01/2022] [Accepted: 09/19/2022] [Indexed: 10/14/2022]
Abstract
Monogenic forms of Alzheimer's disease (AD) have been identified through mutations in genes such as APP, PSEN1, and PSEN2, whilst other genetic markers such as the APOE ε carrier allele status have been shown to increase the likelihood of having the disease. Mutations in these genes are not limited to AD, as APP mutations can also cause an amyloid form of cerebral small vessel disease (CSVD) known as cerebral amyloid angiopathy, whilst PSEN1 and PSEN2 are involved in NOTCH3 signalling, a process known to be dysregulated in the monogenic CSVD, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). The overlap between AD genes and causes of CSVD led to the hypothesis that mutations in other genes within the PANTHER AD-presenilin pathway may be novel causes of CSVD in a cohort of clinically suspicious CADASIL patients without a pathogenic NOTCH3 mutation. To investigate this, whole exome sequencing was performed on 50 suspected CADASIL patients with no NOTCH3 mutations, and a targeted gene analysis was completed on the PANTHER. ERN1 was identified as a novel candidate CSVD gene following predicted pathogenic gene mutation analysis. Rare variant burden testing failed to identify an association with any gene; however, it did show a nominally significant link with ERN1 and TRPC3. This study provides evidence to support a genetic overlap between CSVD and Alzheimer's disease.
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Affiliation(s)
- Paul J Dunn
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia.,Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia
| | - Rodney A Lea
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
| | - Neven Maksemous
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
| | - Robert A Smith
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
| | - Heidi G Sutherland
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
| | - Larisa M Haupt
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
| | - Lyn R Griffiths
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia.
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21
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Littau JL, Velilla L, Hase Y, Villalba‐Moreno ND, Hagel C, Drexler D, Osorio Restrepo S, Villegas A, Lopera F, Vargas S, Glatzel M, Krasemann S, Quiroz YT, Arboleda‐Velasquez JF, Kalaria R, Sepulveda‐Falla D. Evidence of beta amyloid independent small vessel disease in familial Alzheimer's disease. Brain Pathol 2022; 32:e13097. [PMID: 35695802 PMCID: PMC9616091 DOI: 10.1111/bpa.13097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 05/24/2022] [Indexed: 12/04/2022] Open
Abstract
We studied small vessel disease (SVD) pathology in Familial Alzheimer's disease (FAD) subjects carrying the presenilin 1 (PSEN1) p.Glu280Ala mutation in comparison to those with sporadic Alzheimer's disease (SAD) as a positive control for Alzheimer's pathology and Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) bearing different NOTCH3 mutations, as positive controls for SVD pathology. Upon magnetic resonance imaging (MRI) in life, some FAD showed mild white matter hyperintensities and no further radiologic evidence of SVD. In post-mortem studies, total SVD pathology in cortical areas and basal ganglia was similar in PSEN1 FAD and CADASIL subjects, except for the feature of arteriosclerosis which was higher in CADASIL subjects than in PSEN1 FAD subjects. Further only a few SAD subjects showed a similar degree of SVD pathology as observed in CADASIL. Furthermore, we found significantly enlarged perivascular spaces in vessels devoid of cerebral amyloid angiopathy in FAD compared with SAD and CADASIL subjects. As expected, there was greater fibrinogen-positive perivascular reactivity in CADASIL but similar reactivity in PSEN1 FAD and SAD groups. Fibrinogen immunoreactivity correlated with onset age in the PSEN1 FAD cases, suggesting increased vascular permeability may contribute to cognitive decline. Additionally, we found reduced perivascular expression of PDGFRβ AQP4 in microvessels with enlarged PVS in PSEN1 FAD cases. We demonstrate that there is Aβ-independent SVD pathology in PSEN1 FAD, that was marginally lower than that in CADASIL subjects although not evident by MRI. These observations suggest presence of covert SVD even in PSEN1, contributing to disease progression. As is the case in SAD, these consequences may be preventable by early recognition and actively controlling vascular disease risk, even in familial forms of dementia.
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Affiliation(s)
- Jessica Lisa Littau
- Institute of NeuropathologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Lina Velilla
- Neuroscience Group of AntioquiaUniversity of AntioquiaMedellín
| | - Yoshiki Hase
- Neurovascular Research GroupTranslational and Clinical Research Institute, Newcastle UniversityNewcastle upon Tyne
| | | | - Christian Hagel
- Institute of NeuropathologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Dagmar Drexler
- Institute of NeuropathologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | | | - Andres Villegas
- Neuroscience Group of AntioquiaUniversity of AntioquiaMedellín
| | | | - Sergio Vargas
- Department of Radiology, Neuroradiology SectionUniversidad de AntioquiaMedellínColombia
| | - Markus Glatzel
- Institute of NeuropathologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Susanne Krasemann
- Institute of NeuropathologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Yakeel T. Quiroz
- Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Joseph F. Arboleda‐Velasquez
- Schepens Eye Research Institute of Mass Eye and Ear and the Department of Ophthalmology at Harvard Medical SchoolBostonMassachusetts
| | - Rajesh Kalaria
- Neurovascular Research GroupTranslational and Clinical Research Institute, Newcastle UniversityNewcastle upon Tyne
| | - Diego Sepulveda‐Falla
- Institute of NeuropathologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
- Neuroscience Group of AntioquiaUniversity of AntioquiaMedellín
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22
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Low A, Prats-Sedano MA, McKiernan E, Carter SF, Stefaniak JD, Nannoni S, Su L, Dounavi ME, Muniz-Terrera G, Ritchie K, Lawlor B, Naci L, Malhotra P, Mackay C, Koychev I, Ritchie CW, Markus HS, O’Brien JT. Modifiable and non-modifiable risk factors of dementia on midlife cerebral small vessel disease in cognitively healthy middle-aged adults: the PREVENT-Dementia study. Alzheimers Res Ther 2022; 14:154. [PMID: 36224605 PMCID: PMC9554984 DOI: 10.1186/s13195-022-01095-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
Abstract
Background Considerable overlap exists between the risk factors of dementia and cerebral small vessel disease (SVD). However, studies remain limited to older cohorts wherein pathologies of both dementia (e.g. amyloid) and SVD (e.g. white matter hyperintensities) already co-exist. In younger asymptomatic adults, we investigated differential associations and interactions of modifiable and non-modifiable inherited risk factors of (future) late-life dementia to (present-day) mid-life SVD. Methods Cognitively healthy middle-aged adults (aged 40–59; mean 51.2 years) underwent 3T MRI (n = 630) as part of the PREVENT-Dementia study. To assess SVD, we quantified white matter hyperintensities, enlarged perivascular spaces, microbleeds, lacunes, and computed composite scores of SVD burden and subtypes of hypertensive arteriopathy and cerebral amyloid angiopathy (CAA). Non-modifiable (inherited) risk factors were APOE4 status and parental family history of dementia. Modifiable risk factors were derived from the 2020 Lancet Commission on dementia prevention (early/midlife: education, hypertension, obesity, alcohol, hearing impairment, head injuries). Confirmatory factor analysis (CFA) was used to evaluate the latent variables of SVD and risk factors. Structural equation modelling (SEM) of the full structural assessed associations of SVD with risk factors and APOE4*risk interaction. Results In SEM, the latent variable of global SVD related to the latent variable of modifiable midlife risk SVD (β = 0.80, p = .009) but not non-modifiable inherited risk factors of APOE4 or family history of dementia. Interaction analysis demonstrated that the effect of modifiable risk on SVD was amplified in APOE4 non-carriers (β = − 0.31, p = .009), rather than carriers. These associations and interaction effects were observed in relation to the SVD subtype of hypertensive arteriopathy, rather than CAA. Sensitivity analyses using separate general linear models validated SEM results. Conclusions Established modifiable risk factors of future (late-life) dementia related to present-day (mid-life) SVD, suggesting that early lifestyle modifications could potentially reduce rates of vascular cognitive impairment attributed to SVD, a major ‘silent’ contributor to global dementia cases. This association was amplified in APOE4 non-carriers, suggesting that lifestyle modifications could be effective even in those with genetic predisposition to dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01095-4.
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Affiliation(s)
- Audrey Low
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - Maria A. Prats-Sedano
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - Elizabeth McKiernan
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - Stephen F. Carter
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - James D. Stefaniak
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK ,grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Stefania Nannoni
- grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Li Su
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK ,grid.11835.3e0000 0004 1936 9262Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Maria-Eleni Dounavi
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK
| | - Graciela Muniz-Terrera
- grid.4305.20000 0004 1936 7988Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Karen Ritchie
- grid.4305.20000 0004 1936 7988Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK ,grid.457377.5INSERM, Montpellier, France
| | - Brian Lawlor
- grid.8217.c0000 0004 1936 9705Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Lorina Naci
- grid.8217.c0000 0004 1936 9705Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Paresh Malhotra
- grid.417895.60000 0001 0693 2181Division of Brain Science, Imperial College Healthcare NHS Trust, London, UK
| | - Clare Mackay
- grid.4991.50000 0004 1936 8948Department of Psychiatry, Oxford University, Oxford, UK
| | - Ivan Koychev
- grid.4991.50000 0004 1936 8948Department of Psychiatry, Oxford University, Oxford, UK
| | - Craig W. Ritchie
- grid.4305.20000 0004 1936 7988Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Hugh S. Markus
- grid.5335.00000000121885934Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - John T. O’Brien
- grid.5335.00000000121885934Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Box 189, Level E4 Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0SP UK ,grid.450563.10000 0004 0412 9303Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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Zou C, Huang X, Zhang Y, Pan M, Xie J, Chen L, Meng Y, Zou D, Luo J. Potential biomarkers of Alzheimer’s disease and cerebral small vessel disease. Front Mol Neurosci 2022; 15:996107. [PMID: 36299860 PMCID: PMC9588985 DOI: 10.3389/fnmol.2022.996107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/26/2022] [Indexed: 12/02/2022] Open
Abstract
Background Cerebral small vessel disease (CSVD) is associated with the pathogenesis of Alzheimer’s disease (AD). Effective treatments to alleviate AD are still not currently available. Hence, we explored markers and underlying molecular mechanisms associated with AD by utilizing gene expression profiles of AD and CSVD patients from public databases, providing more options for early diagnosis and its treatment. Methods Gene expression profiles were collected from GSE63060 (for AD) and GSE162790 (for CSVD). Differential analysis was performed between AD and mild cognitive impairment (MCI) or CSVD progression and CSVD no-progression. In both datasets, differentially expressed genes (DEGs) with the same expression direction were identified as common DEGs. Then protein-protein interaction (PPI) network was constructed for common DEGs. Differential immune cells and checkpoints were calculated between AD and MCI. Results A total of 146 common DEGs were identified. Common DEGs were mainly enriched in endocytosis and oxytocin signaling pathways. Interestingly, endocytosis and metabolic pathways were shown both from MCI to AD and from CSVD no-progression to CSVD progression. Moreover, SIRT1 was identified as a key gene by ranking degree of connectivity in the PPI network. SIRT1 was associated with obesity-related genes and metabolic disorders. Additionally, SIRT1 showed correlations with CD8 T cells, NK CD56 bright cells, and checkpoints in AD. Conclusion The study revealed that the progression of AD is associated with abnormalities in gene expression and metabolism and that the SIRT1 gene may serve as a promising therapeutic target for the treatment of AD.
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Affiliation(s)
- Chun Zou
- Department of Neurology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaohua Huang
- Department of Neurology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Yilong Zhang
- Clinical Research Center, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Mika Pan
- Department of Neurology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jieqiong Xie
- Department of Neurology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Liechun Chen
- Department of Neurology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Youshi Meng
- Department of Neurology, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Donghua Zou
- Department of Neurology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
- Clinical Research Center, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
- *Correspondence: Donghua Zou,
| | - Jiefeng Luo
- Department of Neurology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
- Jiefeng Luo,
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24
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Chen TB, Lee WJ, Chen JP, Chang SY, Lin CF, Chen HC. Imaging markers of cerebral amyloid angiopathy and hypertensive arteriopathy differentiate Alzheimer disease subtypes synergistically. Alzheimers Res Ther 2022; 14:141. [PMID: 36180874 PMCID: PMC9524061 DOI: 10.1186/s13195-022-01083-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022]
Abstract
Background Both cerebral amyloid angiopathy (CAA) and hypertensive arteriopathy (HA) are related to cognitive impairment and dementia. This study aimed to clarify CAA- and HA-related small vessel disease (SVD) imaging marker associations with cognitive dysfunction and Alzheimer disease (AD) subtypes. Methods A sample of 137 subjects with clinically diagnosed late-onset AD identified from the dementia registry of a single center from January 2017 to October 2021 were enrolled. Semi-quantitative imaging changes (visual rating scale grading) suggestive of SVD were analyzed singularly and compositely, and their correlations with cognitive domains and AD subtypes were examined. Results Patients with typical and limbic-predominant AD subtypes had worse cognitive performance and higher dementia severity than minimal-atrophy subtype patients. Deep white matter hyperintensity (WMH) presence correlated inversely with short-term memory (STM) performance. The three composite SVD scores correlated with different cognitive domains and had distinct associations with AD subtypes. After adjusting for relevant demographic factors, multivariate logistic regression (using minimal-atrophy subtype as the reference condition) revealed the following: associations of the typical subtype with periventricular WMH [odds ratio (OR) 2.62; 95% confidence interval (CI), 1.23–5.57, p = 0.012], global SVD score (OR 1.67; 95%CI, 1.11–2.52, p = 0.009), and HA-SVD score (OR 1.93; 95%CI, 1.10–3.52, p = 0.034); associations of limbic-predominant subtype with HA-SVD score (OR 2.57; 95%CI, 1.23–5.37, p = 0.012) and most global and domain-specific cognitive scores; and an association of hippocampal-sparing subtype with HA-SVD score (OR 3.30; 95%CI, 1.58–6.85, p = 0.001). Conclusion Composite SVD imaging markers reflect overall CAA and/or HA severity and may have differential associations with cognitive domains and AD subtypes. Our finding supports the possibility that the clinical AD subtypes may reflect differing burdens of underlying CAA and HA microangiopathologies. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01083-8.
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ICA1L Is Associated with Small Vessel Disease: A Proteome-Wide Association Study in Small Vessel Stroke and Intracerebral Haemorrhage. Int J Mol Sci 2022; 23:ijms23063161. [PMID: 35328582 PMCID: PMC8951240 DOI: 10.3390/ijms23063161] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 12/01/2022] Open
Abstract
Small vessel strokes (SVS) and intracerebral haemorrhages (ICH) are acute outcomes of cerebral small vessel disease (SVD). Genetic studies combining both phenotypes have identified three loci associated with both traits. However, the genetic cis-regulation at the protein level associated with SVD has not been studied before. We performed a proteome-wide association study (PWAS) using FUSION to integrate a genome-wide association study (GWAS) and brain proteomic data to discover the common mechanisms regulating both SVS and ICH. Dorsolateral prefrontal cortex (dPFC) brain proteomes from the ROS/MAP study (N = 376 subjects and 1443 proteins) and the summary statistics for the SVS GWAS from the MEGASTROKE study (N = 237,511) and multi-trait analysis of GWAS (MTAG)-ICH−SVS from Chung et al. (N = 240,269) were selected. We performed PWAS and then a co-localization analysis with COLOC. The significant and nominal results were validated using a replication dPFC proteome (N = 152). The replicated results (q-value < 0.05) were further investigated for the causality relationship using summary data-based Mendelian randomization (SMR). One protein (ICA1L) was significantly associated with SVS (z-score = −4.42 and p-value = 9.6 × 10−6) and non-lobar ICH (z-score = −4.8 and p-value = 1.58 × 10−6) in the discovery PWAS, with a high co-localization posterior probability of 4. In the validation PWAS, ICA1L remained significantly associated with both traits. The SMR results for ICA1L indicated a causal association of protein expression levels in the brain with SVS (p-value = 3.66 × 10−5) and non-lobar ICH (p-value = 1.81 × 10−5). Our results show that the association of ICA1L with SVS and non-lobar ICH is conditioned by the cis-regulation of its protein levels in the brain.
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Fisher RA, Miners JS, Love S. Pathological changes within the cerebral vasculature in Alzheimer's disease: New perspectives. Brain Pathol 2022; 32:e13061. [PMID: 35289012 PMCID: PMC9616094 DOI: 10.1111/bpa.13061] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/11/2022] [Accepted: 02/21/2022] [Indexed: 12/14/2022] Open
Abstract
Cerebrovascular disease underpins vascular dementia (VaD), but structural and functional changes to the cerebral vasculature contribute to disease pathology and cognitive decline in Alzheimer's disease (AD). In this review, we discuss the contribution of cerebral amyloid angiopathy and non‐amyloid small vessel disease in AD, and the accompanying changes to the density, maintenance and remodelling of vessels (including alterations to the composition and function of the cerebrovascular basement membrane). We consider how abnormalities of the constituent cells of the neurovascular unit – particularly of endothelial cells and pericytes – and impairment of the blood‐brain barrier (BBB) impact on the pathogenesis of AD. We also discuss how changes to the cerebral vasculature are likely to impair Aβ clearance – both intra‐periarteriolar drainage (IPAD) and transport of Aβ peptides across the BBB, and how impaired neurovascular coupling and reduced blood flow in relation to metabolic demand increase amyloidogenic processing of APP and the production of Aβ. We review the vasoactive properties of Aβ peptides themselves, and the probable bi‐directional relationship between vascular dysfunction and Aβ accumulation in AD. Lastly, we discuss recent methodological advances in transcriptomics and imaging that have provided novel insights into vascular changes in AD, and recent advances in assessment of the retina that allow in vivo detection of vascular changes in the early stages of AD.
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Affiliation(s)
- Robert A Fisher
- Dementia Research Group, University of Bristol Medical School, Bristol, UK
| | - J Scott Miners
- Dementia Research Group, University of Bristol Medical School, Bristol, UK
| | - Seth Love
- Dementia Research Group, University of Bristol Medical School, Bristol, UK
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27
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Xu X, Ruan X, Ju R, Wang Z, Yang Y, Cheng J, Gu M, Mueck AO. Progesterone Receptor Membrane Component-1 May Promote Survival of Human Brain Microvascular Endothelial Cells in Alzheimer's Disease. Am J Alzheimers Dis Other Demen 2022; 37:15333175221109749. [PMID: 35730360 PMCID: PMC10581101 DOI: 10.1177/15333175221109749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cerebrovascular changes occur in Alzheimer's disease (AD). The progesterone receptor membrane component-1 (PGRMC1) is a well identified hormone receptor with multiple functions in AD. This study aims to explore the involvement of PGRMC1 in the regulation of vascular endothelial function, providing new therapy options for AD. Single-cell sequencing revealed that the expression of PGRMC1 is lower in AD. By bioinformatics analysis, we found PGRMC1 was associated with regulation of cell proliferation, angiogenesis and etc. To understand the functional significance of PGRMC1, knockdown and overexpression were performed using human brain microvascular endothelial cells (HBMVECs), respectively. Cell proliferation assay, migration assay, tube formation assay were performed in experiments. We demonstrated that the overexpression of PGRMC1 promoted the cellular processes associated with endothelia cell proliferation, migration, and angiogenesis, significantly. In conclusion, PGRMC1 may contribute to the modulation of HBMVECs function in AD. This finding may offer novel targets for AD treatment.
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Affiliation(s)
- Xin Xu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China; Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China; Beijing Maternal and Child Health Care Hospital, Beijing, China
- Research Centre for Women’s Health and University Women’s Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
| | - Rui Ju
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China; Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Zhikun Wang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China; Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yu Yang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China; Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jiaojiao Cheng
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China; Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Muqing Gu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China; Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Alfred O. Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China; Beijing Maternal and Child Health Care Hospital, Beijing, China
- Research Centre for Women’s Health and University Women’s Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
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Safe and Effective Disease-Modifying Therapies for Small Blood Vessel Disease in the Brain. THE AMERICAN JOURNAL OF PATHOLOGY 2021; 191:1852-1855. [PMID: 34529949 DOI: 10.1016/j.ajpath.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/09/2021] [Indexed: 11/20/2022]
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