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Tang Y, Zhou X, Cao J, Li Z, Yin W, Wan K, Huang C, Zhu W, Yin J, Zhang W, Zhu X, Sun Z. Synergistic effect of folate and MTHFR C677T on hippocampal subfields and perfusion in Alzheimer's disease. Prog Neuropsychopharmacol Biol Psychiatry 2024; 134:111071. [PMID: 38908503 DOI: 10.1016/j.pnpbp.2024.111071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/09/2024] [Accepted: 06/19/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Low folate intake and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism have been suggested to increase the risk of Alzheimer's disease (AD). However, the synergistic effects and their impact on brain structure and perfusion remain unclear. METHODS This study explored the effects of dietary and genetic deficiencies in folate metabolism on the volume of the hippocampal subregions, cerebral perfusion, and cognitive decline in 71 cognitively unimpaired (CU) individuals and 102 patients with mild cognitive impairment (MCI) due to AD or AD. All participants underwent magnetic resonance imaging, laboratory examinations, and neuropsychological assessments. The hippocampal subfields were segmented using Freesurfer, and arterial spin labeling was used to measure the cerebral blood flow. RESULTS We found a significant group-by-MTHFR interaction effect on folate. Patients with AD and the 677 T allele showed hypoperfusion in the left precuneus compared to patients without this mutation, which mediated the relationship between low folate level and cognitive decline in patients carrying the 677 T allele. Moreover, a synergistic effect was observed for the combination of decreased folate concentrations and the presence of the MTHFR 677 T allele on the atrophy of specific hippocampal subregions in patients with AD. CONCLUSIONS In addition to offering insights into the neuronal mechanism underlying gene-dependent folate-induced cognitive impairment in AD, these findings may have clinical significance for the allocation of auxiliary folate supplementation therapy in patients with AD with low folate levels and carrying the MTHFR 677 T allele and may eventually promote the selection of early individualized AD drug therapy.
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Affiliation(s)
- Yating Tang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Xia Zhou
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Jing Cao
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Zhiwei Li
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Wenwen Yin
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Ke Wan
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Chaojuan Huang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Wenhao Zhu
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Jiabin Yin
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Wei Zhang
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Xiaoqun Zhu
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
| | - Zhongwu Sun
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
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Ioannou K, Bucci M, Tzortzakakis A, Savitcheva I, Nordberg A, Chiotis K. Tau PET positivity predicts clinically relevant cognitive decline driven by Alzheimer's disease compared to comorbid cases; proof of concept in the ADNI study. Mol Psychiatry 2024:10.1038/s41380-024-02672-9. [PMID: 39179903 DOI: 10.1038/s41380-024-02672-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/26/2024] [Accepted: 07/09/2024] [Indexed: 08/26/2024]
Abstract
β-amyloid (Aβ) pathology is not always coupled with Alzheimer's disease (AD) relevant cognitive decline. We assessed the accuracy of tau PET to identify Aβ(+) individuals who show prospective disease progression. 396 cognitively unimpaired and impaired individuals with baseline Aβ and tau PET and a follow-up of ≥ 2 years were selected from the Alzheimer's Disease Neuroimaging Initiative dataset. The participants were dichotomously grouped based on either clinical conversion (i.e., change of diagnosis) or cognitive deterioration (fast (FDs) vs. slow decliners (SDs)) using data-driven clustering of the individual annual rates of cognitive decline. To assess cognitive decline in individuals with isolated Aβ(+) or absence of both Aβ and tau (T) pathologies, we investigated the prevalence of non-AD comorbidities and FDG PET hypometabolism patterns suggestive of AD. Baseline tau PET uptake was higher in Aβ(+)FDs than in Aβ(-)FD/SDs and Aβ(+)SDs, independently of baseline cognitive status. Baseline tau PET uptake identified MCI Aβ(+) Converters and Aβ(+)FDs with an area under the curve of 0.85 and 0.87 (composite temporal region of interest) respectively, and was linearly related to the annual rate of cognitive decline in Aβ(+) individuals. The T(+) individuals constituted largely a subgroup of those being Aβ(+) and those clustered as FDs. The most common biomarker profiles in FDs (n = 70) were Aβ(+)T(+) (n = 34, 49%) and Aβ(+)T(-) (n = 19, 27%). Baseline Aβ load was higher in Aβ(+)T(+)FDs (M = 83.03 ± 31.42CL) than in Aβ(+)T(-)FDs (M = 63.67 ± 26.75CL) (p-value = 0.038). Depression diagnosis was more prevalent in Aβ(+)T(-)FDs compared to Aβ(+)T(+)FDs (47% vs. 15%, p-value = 0.021), as were FDG PET hypometabolism pattern not suggestive of AD (86% vs. 50%, p-value = 0.039). Our findings suggest that high tau PET uptake is coupled with both Aβ pathology and accelerated cognitive decline. In cases of isolated Aβ(+), cognitive decline may be associated with changes within the AD spectrum in a multi-morbidity context, i.e., mixed AD.
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Affiliation(s)
- Konstantinos Ioannou
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Marco Bucci
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Antonios Tzortzakakis
- Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Medical Radiation Physics and Nuclear Medicine, Section for Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Irina Savitcheva
- Medical Radiation Physics and Nuclear Medicine, Section for Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Konstantinos Chiotis
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
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Engstrom AC, Alitin JP, Kapoor A, Dutt S, Lohman T, Sible IJ, Marshall AJ, Shenasa F, Gaubert A, Ferrer F, Nguyen A, Bradford DR, Rodgers K, Sordo L, Head E, Shao X, Wang DJ, Nation DA. Spontaneous cerebrovascular reactivity at rest in older adults with and without mild cognitive impairment and memory deficits. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.18.24309109. [PMID: 38946941 PMCID: PMC11213117 DOI: 10.1101/2024.06.18.24309109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Background Older adults with mild cognitive impairment (MCI) exhibit deficits in cerebrovascular reactivity (CVR), suggesting CVR is a biomarker for vascular contributions to MCI. This study examined if spontaneous CVR is associated with MCI and memory impairment. Methods 161 older adults free of dementia or major neurological/psychiatric disorders were recruited. Participants underwent clinical interviews, cognitive testing, venipuncture for Alzheimer's biomarkers, and brain MRI. Spontaneous CVR was quantified during 5 minutes of rest. Results Whole brain CVR was negatively associated with age, but not MCI. Lower CVR in the parahippocampal gyrus (PHG) was found in participants with MCI and was linked to worse memory performance on memory tests. Results remained significant after adjusting for Alzheimer's biomarkers and vascular risk factors. Conclusion Spontaneous CVR deficits in the PHG are observed in older adults with MCI and memory impairment, indicating medial temporal microvascular dysfunction's role in cognitive decline.
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Affiliation(s)
- Allison C Engstrom
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - John Paul Alitin
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Arunima Kapoor
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Shubir Dutt
- Memory and Aging Center, Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Trevor Lohman
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Anisa J Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Fatemah Shenasa
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Aimée Gaubert
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Farrah Ferrer
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Amy Nguyen
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - David Robert Bradford
- Center for Innovations in Brain Science, Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - Kathleen Rodgers
- Center for Innovations in Brain Science, Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - Lorena Sordo
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA, USA
| | - Elizabeth Head
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA, USA
| | - Xingfeng Shao
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Danny Jj Wang
- Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Daniel A Nation
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Zhang J, Chen H, Wang J, Huang Q, Xu X, Wang W, Xu W, Guan Y, Liu J, Wardlaw JM, Deng Y, Xie F, Li B. Linking white matter hyperintensities to regional cortical thinning, amyloid deposition, and synaptic density loss in Alzheimer's disease. Alzheimers Dement 2024; 20:3931-3942. [PMID: 38648354 PMCID: PMC11180938 DOI: 10.1002/alz.13845] [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: 12/30/2023] [Revised: 02/16/2024] [Accepted: 03/21/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION We investigated the association between white matter hyperintensities (WMH) and regional cortical thickness, amyloid and tau deposition, and synaptic density in the WMH-connected cortex using multimodal images. METHODS We included 107 participants (59 with Alzheimer's disease [AD]; 27 with mild cognitive impairment; 21 cognitively normal controls) with amyloid beta (Aβ) positivity on amyloid positron emission tomography (PET). The cortex connected to WMH was identified using probabilistic tractography. RESULTS We found that WMH connected to the cortex with more severe regional degeneration as measured by cortical thickness, Aβ and tau deposition, and synaptic vesicle glycoprotein 2 A (SV2A) density using 18F-SynVesT-1 PET. In addition, higher ratios of Aβ in the deep WMH-connected versus WMH-unconnected cortex were significantly related to lower cognitive scores. Last, the cortical thickness of WMH-connected cortex reduced more than WMH-unconnected cortex over 12 months. DISCUSSION Our results suggest that WMH may be associated with AD-intrinsic processes of degeneration, in addition to vascular mechanisms. HIGHLIGHTS We studied white matter hyperintensities (WMHs) and WMH-connected cortical changes. WMHs are associated with more severe regional cortical degeneration. Findings suggest WMHs may be associated with Alzheimer's disease-intrinsic processes of degeneration.
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Affiliation(s)
- Junfang Zhang
- Department of Neurology & Institute of NeurologyRuijin Hospital affiliated with Shanghai Jiao Tong University School of MedicineShanghaiChina
- Clinical Neuroscience CenterRuijin Hospital LuWan BranchShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Haijuan Chen
- Department of Neurology & Institute of NeurologyRuijin Hospital affiliated with Shanghai Jiao Tong University School of MedicineShanghaiChina
- Clinical Neuroscience CenterRuijin Hospital LuWan BranchShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Jie Wang
- PET CenterHuashan HospitalFudan UniversityShanghaiChina
| | - Qi Huang
- PET CenterHuashan HospitalFudan UniversityShanghaiChina
| | - Xiaomeng Xu
- Department of Neurology & Institute of NeurologyRuijin Hospital affiliated with Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Wenjing Wang
- Department of Neurology & Institute of NeurologyRuijin Hospital affiliated with Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Wei Xu
- Department of Neurology & Institute of NeurologyRuijin Hospital affiliated with Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yihui Guan
- PET CenterHuashan HospitalFudan UniversityShanghaiChina
| | - Jun Liu
- Department of Neurology & Institute of NeurologyRuijin Hospital affiliated with Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Joanna M Wardlaw
- Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
- UK Dementia Research InstituteUniversity of EdinburghEdinburghUK
| | - Yulei Deng
- Department of Neurology & Institute of NeurologyRuijin Hospital affiliated with Shanghai Jiao Tong University School of MedicineShanghaiChina
- Clinical Neuroscience CenterRuijin Hospital LuWan BranchShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Fang Xie
- PET CenterHuashan HospitalFudan UniversityShanghaiChina
| | - Binyin Li
- Department of Neurology & Institute of NeurologyRuijin Hospital affiliated with Shanghai Jiao Tong University School of MedicineShanghaiChina
- Clinical Neuroscience CenterRuijin Hospital LuWan BranchShanghai Jiao Tong University School of MedicineShanghaiChina
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5
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Ferrari-Souza JP, Brum WS, Hauschild LA, Da Ros LU, Ferreira PCL, Bellaver B, Leffa DT, Bieger A, Tissot C, Lussier FZ, De Bastiani MA, Povala G, Benedet AL, Therriault J, Wang YT, Ashton NJ, Zetterberg H, Blennow K, Martins SO, Souza DO, Rosa-Neto P, Karikari TK, Pascoal TA, Zimmer ER. Vascular risk burden is a key player in the early progression of Alzheimer's disease. Neurobiol Aging 2024; 136:88-98. [PMID: 38335912 DOI: 10.1016/j.neurobiolaging.2023.12.008] [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: 02/14/2023] [Revised: 12/21/2023] [Accepted: 12/29/2023] [Indexed: 02/12/2024]
Abstract
Understanding whether vascular risk factors (VRFs) synergistically potentiate Alzheimer's disease (AD) progression is important in the context of emerging treatments for preclinical AD. In a group of 503 cognitively unimpaired individuals, we tested whether VRF burden interacts with AD pathophysiology to accelerate neurodegeneration and cognitive decline. Baseline VRF burden was calculated considering medical data and AD pathophysiology was assessed based on cerebrospinal fluid (CSF) amyloid-β1-42 (Aβ1-42) and tau phosphorylated at threonine 181 (p-tau181). Neurodegeneration was assessed with plasma neurofilament light (NfL) and global cognition with the modified version of the Preclinical Alzheimer's Cognitive Composite. The mean (SD) age of participants was 72.9 (6.1) years, and 220 (43.7%) were men. Linear mixed-effects models revealed that an elevated VRF burden synergistically interacted with AD pathophysiology to drive longitudinal plasma NfL increase and cognitive decline. Additionally, VRF burden was not associated with CSF Aβ1-42 or p-tau181 changes over time. Our results suggest that VRF burden and AD pathophysiology are independent processes; however, they synergistically lead to neurodegeneration and cognitive deterioration. In preclinical stages, the combination of therapies targeting VRFs and AD pathophysiology might potentiate treatment outcomes.
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Affiliation(s)
- João Pedro Ferrari-Souza
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Wagner S Brum
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lucas A Hauschild
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lucas U Da Ros
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Pâmela C L Ferreira
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bruna Bellaver
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Douglas T Leffa
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrei Bieger
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cécile Tissot
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal; Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
| | - Firoza Z Lussier
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal; Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
| | - Marco Antônio De Bastiani
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Guilherme Povala
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andréa L Benedet
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden; Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal; Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
| | - Joseph Therriault
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal; Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
| | - Yi-Ting Wang
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal; Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden; Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway; Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK; UK Dementia Research Institute at UCL, London, UK; Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China; UW Department of Medicine, School of Medicine and Public Health, Madison, WI, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sheila O Martins
- Department of Neurology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Diogo O Souza
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal; Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
| | - Thomas K Karikari
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tharick A Pascoal
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eduardo R Zimmer
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Pharmacology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Graduate Program in Biological Sciences: Pharmacology and Therapeuctis, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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Valletta M, Vetrano DL, Calderón‐Larrañaga A, Kalpouzos G, Canevelli M, Marengoni A, Laukka EJ, Grande G. Association of mild and complex multimorbidity with structural brain changes in older adults: A population-based study. Alzheimers Dement 2024; 20:1958-1965. [PMID: 38170758 PMCID: PMC10984455 DOI: 10.1002/alz.13614] [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: 09/08/2023] [Revised: 11/01/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION We quantified the association of mild (ie, involving one or two body systems) and complex (ie, involving ≥3 systems) multimorbidity with structural brain changes in older adults. METHODS We included 390 dementia-free participants aged 60+ from the Swedish National Study on Aging and Care in Kungsholmen who underwent brain magnetic resonance imaging at baseline and after 3 and/or 6 years. Using linear mixed models, we estimated the association between multimorbidity and changes in total brain tissue, ventricular, hippocampal, and white matter hyperintensities volumes. RESULTS Compared to non-multimorbid participants, those with complex multimorbidity showed the steepest reduction in total brain (β*time -0.03, 95% CI -0.05, -0.01) and hippocampal (β*time -0.05, 95% CI -0.08, -0.03) volumes, the greatest ventricular enlargement (β*time 0.03, 95% CI 0.01, 0.05), and the fastest white matter hyperintensities accumulation (β*time 0.04, 95% CI 0.01, 0.07). DISCUSSION Multimorbidity, particularly when involving multiple body systems, is associated with accelerated structural brain changes, involving both neurodegeneration and vascular pathology. HIGHLIGHTS Multimorbidity accelerates structural brain changes in cognitively intact older adults These brain changes encompass both neurodegeneration and cerebrovascular pathology The complexity of multimorbidity is associated with the rate of brain changes' progression.
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Affiliation(s)
- Martina Valletta
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
| | - Davide Liborio Vetrano
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
- Stockholm Gerontology Research CenterStockholmSweden
| | - Amaia Calderón‐Larrañaga
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
- Stockholm Gerontology Research CenterStockholmSweden
| | - Grégoria Kalpouzos
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
| | - Marco Canevelli
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
- Department of Human NeuroscienceSapienza UniversityRomeItaly
| | - Alessandra Marengoni
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
- Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Erika J Laukka
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
- Stockholm Gerontology Research CenterStockholmSweden
| | - Giulia Grande
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
- Stockholm Gerontology Research CenterStockholmSweden
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7
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Li QY, Hu HY, Zhang GW, Hu H, Ou YN, Huang LY, Wang AY, Gao PY, Ma LY, Tan L, Yu JT. Associations between cardiometabolic multimorbidity and cerebrospinal fluid biomarkers of Alzheimer's disease pathology in cognitively intact adults: the CABLE study. Alzheimers Res Ther 2024; 16:28. [PMID: 38321520 PMCID: PMC10848421 DOI: 10.1186/s13195-024-01396-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/21/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Cardiometabolic multimorbidity is associated with an increased risk of dementia, but the pathogenic mechanisms linking them remain largely undefined. We aimed to assess the associations of cardiometabolic multimorbidity with cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease (AD) pathology to enhance our understanding of the underlying mechanisms linking cardiometabolic multimorbidity and AD. METHODS This study included 1464 cognitively intact participants from the Chinese Alzheimer's Biomarker and LifestylE (CABLE) database. Cardiometabolic diseases (CMD) are a group of interrelated disorders such as hypertension, diabetes, heart diseases (HD), and stroke. Based on the CMD status, participants were categorized as CMD-free, single CMD, or CMD multimorbidity. CMD multimorbidity is defined as the coexistence of two or more CMDs. The associations of cardiometabolic multimorbidity and CSF biomarkers were examined using multivariable linear regression models with demographic characteristics, the APOE ε4 allele, and lifestyle factors as covariates. Subgroup analyses stratified by age, sex, and APOE ε4 status were also performed. RESULTS A total of 1464 individuals (mean age, 61.80 years; age range, 40-89 years) were included. The markers of phosphorylated tau-related processes (CSF P-tau181: β = 0.165, P = 0.037) and neuronal injury (CSF T-tau: β = 0.065, P = 0.033) were significantly increased in subjects with CMD multimorbidity (versus CMD-free), but not in those with single CMD. The association between CMD multimorbidity with CSF T-tau levels remained significant after controlling for Aβ42 levels. Additionally, significantly elevated tau-related biomarkers were observed in patients with specific CMD combinations (i.e., hypertension and diabetes, hypertension and HD), especially in long disease courses. CONCLUSIONS The presence of cardiometabolic multimorbidity was associated with tau phosphorylation and neuronal injury in cognitively normal populations. CMD multimorbidity might be a potential independent target to alleviate tau-related pathologies that can cause cognitive impairment.
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Affiliation(s)
- Qiong-Yao Li
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, No.5 Donghai Middle Road, Qingdao, China
| | - He-Ying Hu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, No.5 Donghai Middle Road, Qingdao, China
| | - Gao-Wen Zhang
- Department of Thoracic Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Hao Hu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, No.5 Donghai Middle Road, Qingdao, China
| | - Ya-Nan Ou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, No.5 Donghai Middle Road, Qingdao, China
| | - Liang-Yu Huang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, No.5 Donghai Middle Road, Qingdao, China
| | - An-Yi Wang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, No.5 Donghai Middle Road, Qingdao, China
| | - Pei-Yang Gao
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, No.5 Donghai Middle Road, Qingdao, China
| | - Li-Yun Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, No.5 Donghai Middle Road, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, No.5 Donghai Middle Road, Qingdao, China.
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, No. 12 Wulumuqi Road, Shanghai, China.
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8
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Corradetti G, Oncel D, Kadomoto S, Arakaki X, Kloner RA, Sadun AA, Sadda SR, Chan JW. Choriocapillaris and Retinal Vascular Alterations in Presymptomatic Alzheimer's Disease. Invest Ophthalmol Vis Sci 2024; 65:47. [PMID: 38294804 PMCID: PMC10839815 DOI: 10.1167/iovs.65.1.47] [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: 07/15/2023] [Accepted: 01/08/2024] [Indexed: 02/01/2024] Open
Abstract
Purpose To compare optical coherence tomography angiography (OCTA) retina metrics between cognitively healthy subjects with pathological versus normal cerebrospinal fluid (CSF) Aβ42/tau ratios. Methods Swept-source OCTA scans were collected using the Zeiss PLEX Elite 9000 and analyzed on 23 cognitively healthy (CH) subjects who had previously undergone CSF analysis. Thirteen subjects had a pathological Aβ42/tau (PAT) ratio of <2.7132, indicative of presymptomatic Alzheimer's disease (AD), and 10 had a normal Aβ42/tau (NAT) ratio of ≥2.7132. OCTA en face images of the superficial vascular complex (SVC) and deep vascular complex were binarized and skeletonized to quantify the perfusion density (PD), vessel length density (VLD), and fractal dimension (FrD). The foveal avascular zone (FAZ) area was calculated using the SVC slab. Choriocapillaris flow deficits (CCFDs) were computed from the en face OCTA slab of the CC. The above parameters were compared between CH-PATs and CH-NATs. Results Compared to CH-NATs, CH-PATs showed significantly decreased PD, VLD, and FrD in the SVC, with a significantly increased FAZ area and CCFDs. Conclusions Swept-source OCTA analysis of the SVC and CC suggests a significant vascular loss at the CH stage of pre-AD that might be an indicator of a neurodegenerative process initiated by the impaired clearance of Aβ42 in the blood vessel wall and by phosphorylated tau accumulation in the perivascular spaces, a process that most likely mirrors that in the brain. If confirmed in larger longitudinal studies, OCTA retinal and inner choroidal metrics may be important biomarkers for assessing presymptomatic AD.
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Affiliation(s)
- Giulia Corradetti
- Doheny Eye Institute, Pasadena, California, United States
- Department of Ophthalmology David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States
| | - Deniz Oncel
- Doheny Eye Institute, Pasadena, California, United States
| | - Shin Kadomoto
- Doheny Eye Institute, Pasadena, California, United States
| | - Xianghong Arakaki
- Cognition and Brain Integration Laboratory, Department of Neurosciences, Huntington Medical Research Institutes, Pasadena, California, United States
| | - Robert A. Kloner
- Clinical Neuroscience, Department of Neurosciences, Huntington Medical Research Institutes, Pasadena, California, United States
- Cardiovascular Research Institute, Huntington Medical Research Institutes, Pasadena, California, United States
- Cardiovascular Division, Department of Medicine Keck School of Medicine of University of Southern California, Los Angeles, California, United States
| | - Alfredo A. Sadun
- Doheny Eye Institute, Pasadena, California, United States
- Department of Ophthalmology David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States
| | - SriniVas R. Sadda
- Doheny Eye Institute, Pasadena, California, United States
- Department of Ophthalmology David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States
| | - Jane W. Chan
- Doheny Eye Institute, Pasadena, California, United States
- Department of Ophthalmology David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States
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9
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Wang W, Yang Y, Sang F, Chen Y, Li X, Chen K, Wang J, Zhang Z. Vascular Risk Factors and Brain Health in Aging: Insights from a Community-Based Cohort Study. J Alzheimers Dis 2024; 99:1361-1374. [PMID: 38788079 DOI: 10.3233/jad-240240] [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] [Indexed: 05/26/2024]
Abstract
Background The aging population and high rates of Alzheimer's disease (AD) create significant medical burdens, prompting a need for early prevention. Targeting modifiable risk factors like vascular risk factors (VRFs), closely linked to AD, may provide a promising strategy for intervention. Objective This study investigates how VRFs influence cognitive performance and brain structures in a community-based cohort. Methods In this cross-sectional study, 4,667 participants over 50 years old, drawn from the Beijing Ageing Brain Rejuvenation Initiative project, were meticulously examined. Cognitive function and VRFs (diabetes mellitus, hypertension, hyperlipidemia, obesity, and smoking), were comprehensively assessed through one-to-one interviews. Additionally, a subset of participants (n = 719) underwent MRI, encompassing T1-weighted and diffusion-weighted scans, to elucidate gray matter volume and white matter structural network organization. Results The findings unveil diabetes as a potent detriment to memory, manifesting in atrophy within the right supramarginal gyrus and diminished nodal efficiency and degree centrality in the right inferior parietal lobe. Hypertension solely impaired memory without significant structural changes. Intriguingly, individuals with comorbid diabetes and hypertension exhibited the most pronounced deficits in both brain structure and cognitive performance. Remarkably, hyperlipidemia emerged as a factor associated with enhanced cognition, and preservation of brain structure. Conclusions This study illuminates the intricate associations between VRFs and the varied patterns of cognitive and brain structural damage. Notably, the synergistic effect of diabetes and hypertension emerges as particularly deleterious. These findings underscore the imperative to tailor interventions for patients with distinct VRF comorbidities, especially when addressing cognitive decline and structural brain changes.
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Affiliation(s)
- Wenxiao Wang
- Faculty of Psychology, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- School of Systems Science, Beijing Normal University, Beijing, China
| | - Yiru Yang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Feng Sang
- Faculty of Psychology, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Beijing Aging Brain Rejuvenation Initiative (BABRI Centre), Beijing Normal University, Beijing, China
| | - Yaojing Chen
- Faculty of Psychology, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Beijing Aging Brain Rejuvenation Initiative (BABRI Centre), Beijing Normal University, Beijing, China
| | - Xin Li
- Faculty of Psychology, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Beijing Aging Brain Rejuvenation Initiative (BABRI Centre), Beijing Normal University, Beijing, China
| | - Kewei Chen
- Beijing Aging Brain Rejuvenation Initiative (BABRI Centre), Beijing Normal University, Beijing, China
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Jun Wang
- Faculty of Psychology, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Beijing Aging Brain Rejuvenation Initiative (BABRI Centre), Beijing Normal University, Beijing, China
| | - Zhanjun Zhang
- Faculty of Psychology, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Beijing Aging Brain Rejuvenation Initiative (BABRI Centre), Beijing Normal University, Beijing, China
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10
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Aborode AT, Karra-Aly A, Ogunleye SC, Olorunshola MM, Folorunso TN, Aloba CO, Ogunware AE. Overcoming hurdles: Enhancing post-mortem capabilities for neurological investigations in Africa. AGING BRAIN 2023; 4:100099. [PMID: 37809277 PMCID: PMC10556755 DOI: 10.1016/j.nbas.2023.100099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023] Open
Affiliation(s)
| | - Ayah Karra-Aly
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Seto Charles Ogunleye
- Department of Comparative Biomedical Sciences, College of Veterinary Medicine, Mississippi State University, 39760 MS, USA
| | | | | | | | - Adedayo Emmanuel Ogunware
- Department of Neuroscience, Development and Regenerative Biology, The University of Texas at San Antonio, TX, USA
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Bubu OM, Kam K, Parekh A, Ayappa I. Editorial: Additive or synergistic impacts of sleep, circadian rhythm disturbances and other modifiable risk factors on established and novel plasma biomarkers of Alzheimer's disease pathology. Front Aging Neurosci 2023; 15:1168062. [PMID: 36998316 PMCID: PMC10043465 DOI: 10.3389/fnagi.2023.1168062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/16/2023] Open
Affiliation(s)
- Omonigho M. Bubu
- Department of Psychiatry, Healthy Brain Aging and Sleep Center, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, New York University Grossman School of Medicine, Center for Healthful Behavior Change, New York, NY, United States
| | - Korey Kam
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ankit Parekh
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Indu Ayappa
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
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12
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Ying C, Kang P, Binkley MM, Ford AL, Chen Y, Hassenstab J, Wang Q, Strain J, Morris JC, Lee JM, Benzinger TLS, An H. Neuroinflammation and amyloid deposition in the progression of mixed Alzheimer and vascular dementia. Neuroimage Clin 2023; 38:103373. [PMID: 36933348 PMCID: PMC10036862 DOI: 10.1016/j.nicl.2023.103373] [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: 10/29/2022] [Revised: 01/18/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) and vascular contributions to cognitive impairment and dementia (VCID) pathologies coexist in patients with cognitive impairment. Abnormal amyloid beta (Aβ) deposition is the hallmark pathologic biomarker for AD. Neuroinflammation may be a pathophysiological mechanism in both AD and VCID. In this study, we aimed to understand the role of neuroinflammation and Aβ deposition in white matter hyperintensities (WMH) progression and cognitive decline over a decade in patients with mixed AD and VCID pathologies. METHODS Twenty-four elderly participants (median [interquartile range] age 78 [64.8, 83] years old, 14 female) were recruited from the Knight Alzheimer Disease Research Center. 11C-PK11195 standard uptake value ratio (SUVR) and 11C-PiB mean cortical binding potential (MCBP) were used to evaluate neuroinflammation and Aβ deposition in-vivo, respectively. Fluid-attenuated inversion recovery MR images were acquired to obtain baseline WMH volume and its progression over 11.5 years. Composite cognitive scores (global, processing speed and memory) were computed at baseline and follow-up over 7.5 years. Multiple linear regression models evaluated the association between PET biomarkers (11C-PK11195 SUVR and 11C-PiB MCBP) and baseline WMH volume and cognitive function. Moreover, linear mixed-effects models evaluated whether PET biomarkers predicted greater WMH progression or cognitive decline over a decade. RESULTS Fifteen participants (62.5%) had mixed AD (positive PiB) and VCID (at least one vascular risk factor) pathologies. Elevated 11C-PK11195 SUVR, but not 11C-PiB MCBP, was associated with greater baseline WMH volume and predicted greater WMH progression. Elevated 11C-PiB MCBP was associated with baseline memory and global cognition. Elevated 11C-PK11195 SUVR and elevated 11C-PiB MCBP independently predicted greater global cognition and processing speed declines. No association was found between 11C-PK11195 SUVR and 11C-PiB MCBP. CONCLUSIONS Neuroinflammation and Aβ deposition may represent two distinct pathophysiological pathways, and both independently contributed to the progression of cognitive impairment in mixed AD and VCID pathologies. Neuroinflammation, but not Aβ deposition, contributed to WMH volume and progression.
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Affiliation(s)
- Chunwei Ying
- Department of Biomedical Engineering, Washington University in St. Louis, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, USA
| | - Peter Kang
- Department of Neurology, Washington University School of Medicine, USA
| | - Michael M Binkley
- Department of Neurology, Washington University School of Medicine, USA
| | - Andria L Ford
- Department of Neurology, Washington University School of Medicine, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, USA
| | - Yasheng Chen
- Department of Neurology, Washington University School of Medicine, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University School of Medicine, USA; Knight Alzheimer Disease Research Center, Washington University School of Medicine, USA
| | - Qing Wang
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, USA; Knight Alzheimer Disease Research Center, Washington University School of Medicine, USA
| | - Jeremy Strain
- Department of Neurology, Washington University School of Medicine, USA
| | - John C Morris
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, USA
| | - Jin-Moo Lee
- Department of Biomedical Engineering, Washington University in St. Louis, USA; Department of Neurology, Washington University School of Medicine, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, USA
| | - Tammie L S Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, USA; Knight Alzheimer Disease Research Center, Washington University School of Medicine, USA; Department of Neurosurgery, Washington University School of Medicine, USA
| | - Hongyu An
- Department of Biomedical Engineering, Washington University in St. Louis, USA; Department of Neurology, Washington University School of Medicine, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, USA.
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13
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Nakase T, Tatewaki Y, Thyreau B, Odagiri H, Tomita N, Yamamoto S, Takano Y, Muranaka M, Taki Y. Impact of atrial fibrillation on the cognitive decline in Alzheimer's disease. Alzheimers Res Ther 2023; 15:15. [PMID: 36635728 PMCID: PMC9838038 DOI: 10.1186/s13195-023-01165-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/08/2023] [Indexed: 01/14/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is a strong risk factor for Alzheimer's disease (AD) independent of ischemic stroke. However, the clinicopathological impact of AF on the severity of AD has not been well elucidated. We aimed to investigate the clinical differences between dementia patients with AF and those without AF by means of imaging data. METHODS Following approval from the institutional ethics committee, patients with newly diagnosed AD or amnestic mild cognitive impairment (aMCI) were retrospectively screened (n = 170, 79.5 ± 7.4 years old). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Based on the MRI data, the cerebral volume, cerebral microbleeds (CMBs), periventricular white matter lesions (WMLs), and deep WMLs were evaluated. The regional cerebral blood flow (rCBF) was measured using 123I-IMP SPECT. RESULTS Of the patients, 14 (8.2%) and 156 (91.8%) had AF (AF group) and sinus rhythm (SR group), respectively. The AF group had significantly lower MMSE scores than the SR group (average [standard deviation (SD)]: 19.4 [4.4] and 22.0 [4.4], respectively; p = 0.0347). Cerebral volume and CMBs did not differ between the two groups. The periventricular WMLs, but not the deep WMLs, were significantly larger in the AF group than in the SR group (mean [SD] mL: 6.85 [3.78] and 4.37 [3.21], respectively; p = 0.0070). However, there was no significant difference in rCBF in the areas related to AD pathology between the two groups. CONCLUSION AD and aMCI patients with AF showed worse cognitive decline along with larger periventricular WMLs compared to those with SR, although the reduction of rCBF was not different between patients with AF and SR. The white matter lesions may be a more important pathology than the impairment of cerebral blood flow in dementia patients with AF. A larger study is needed to confirm our findings in the future.
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Affiliation(s)
- Taizen Nakase
- grid.69566.3a0000 0001 2248 6943Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo Machi, Sendai, Miyagi 980-8575 Japan ,grid.69566.3a0000 0001 2248 6943Smart Aging Research Center, Tohoku University, Sendai, Japan
| | - Yasuko Tatewaki
- grid.69566.3a0000 0001 2248 6943Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo Machi, Sendai, Miyagi 980-8575 Japan
| | - Benjamin Thyreau
- grid.69566.3a0000 0001 2248 6943Smart Aging Research Center, Tohoku University, Sendai, Japan
| | - Hayato Odagiri
- grid.412757.20000 0004 0641 778XDivision of Radiology, Tohoku University Hospital, Sendai, Japan
| | - Naoki Tomita
- grid.69566.3a0000 0001 2248 6943Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo Machi, Sendai, Miyagi 980-8575 Japan
| | - Shuzo Yamamoto
- grid.69566.3a0000 0001 2248 6943Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo Machi, Sendai, Miyagi 980-8575 Japan
| | - Yumi Takano
- grid.69566.3a0000 0001 2248 6943Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo Machi, Sendai, Miyagi 980-8575 Japan
| | - Michiho Muranaka
- grid.69566.3a0000 0001 2248 6943Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo Machi, Sendai, Miyagi 980-8575 Japan
| | - Yasuyuki Taki
- grid.69566.3a0000 0001 2248 6943Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo Machi, Sendai, Miyagi 980-8575 Japan ,grid.69566.3a0000 0001 2248 6943Smart Aging Research Center, Tohoku University, Sendai, Japan
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Pacheco Pachado M, Casas AI, Elbatreek MH, Nogales C, Guney E, Espay AJ, Schmidt HH. Re-Addressing Dementia by Network Medicine and Mechanism-Based Molecular Endotypes. J Alzheimers Dis 2023; 96:47-56. [PMID: 37742653 PMCID: PMC10657714 DOI: 10.3233/jad-230694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/26/2023]
Abstract
Alzheimer's disease (AD) and other forms of dementia are together a leading cause of disability and death in the aging global population, imposing a high personal, societal, and economic burden. They are also among the most prominent examples of failed drug developments. Indeed, after more than 40 AD trials of anti-amyloid interventions, reduction of amyloid-β (Aβ) has never translated into clinically relevant benefits, and in several cases yielded harm. The fundamental problem is the century-old, brain-centric phenotype-based definitions of diseases that ignore causal mechanisms and comorbidities. In this hypothesis article, we discuss how such current outdated nosology of dementia is a key roadblock to precision medicine and articulate how Network Medicine enables the substitution of clinicopathologic phenotypes with molecular endotypes and propose a new framework to achieve precision and curative medicine for patients with neurodegenerative disorders.
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Affiliation(s)
- Mayra Pacheco Pachado
- Department of Pharmacology and Personalised Medicine, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Ana I. Casas
- Department of Pharmacology and Personalised Medicine, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Universitätsklinikum Essen, Klinik für Neurologie, Essen, Germany
| | - Mahmoud H. Elbatreek
- Department of Pharmacology and Personalised Medicine, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, Egypt
| | - Cristian Nogales
- Department of Pharmacology and Personalised Medicine, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Emre Guney
- Discovery and Data Science (DDS) Unit, STALICLA R&D SL, Barcelona, Spain
| | - Alberto J. Espay
- James J. and Joan A. Gardner Family Center for Parkinson’s Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
| | - Harald H.H.W. Schmidt
- Department of Pharmacology and Personalised Medicine, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
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15
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Sible IJ, Nation DA. Visit-to-Visit Blood Pressure Variability and Cognitive Decline in Apolipoprotein ɛ4 Carriers versus Apolipoprotein ɛ3 Homozygotes. J Alzheimers Dis 2023; 93:533-543. [PMID: 37066910 PMCID: PMC10852980 DOI: 10.3233/jad-221103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
BACKGROUND Blood pressure variability (BPV) is associated with cognitive decline and Alzheimer's disease (AD), but relationships with AD risk gene apolipoprotein (APOE) ɛ4 remain understudied. OBJECTIVE Examined the longitudinal relationship between BPV and cognitive change in APOE ɛ4 carriers and APOE ɛ3 homozygotes. METHODS 1,194 Alzheimer's Disease Neuroimaging Initiative participants (554 APOE ɛ4 carriers) underwent 3-4 blood pressure measurements between study baseline and 12-month follow-up. Visit-to-visit BPV was calculated as variability independent of mean over these 12 months. Participants subsequently underwent ≥1 neuropsychological exam at 12-month follow-up or later (up to 156 months later). Composite scores for the domains of memory, language, executive function, and visuospatial abilities were determined. Linear mixed models examined the 3-way interaction of BPV×APOE ɛ4 carrier status x time predicting change in composite scores. RESULTS Higher systolic BPV predicted greater decline in memory (+1 SD increase of BPV: β= -0.001, p < 0.001) and language (β= -0.002, p < 0.0001) among APOE ɛ4 carriers, but not APOE ɛ3 homozygotes (memory: +1 SD increase of BPV: β= 0.0001, p = 0.57; language: β= 0.0001, p = 0.72). Systolic BPV was not significantly associated with change in executive function or visuospatial abilities in APOE ɛ4 carriers (ps = 0.08-0.16) or APOE ɛ3 homozygotes (ps = 0.48-0.12). CONCLUSION Cognitive decline associated with high BPV may be specifically accelerated among APOE ɛ4 carriers.
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Affiliation(s)
- Isabel J. Sible
- Department of Psychology, University of Southern California, Los Angeles, CA 90007, USA
| | - Daniel A. Nation
- Institute for Memory Impairments and Neurological Disorders, University of California Irvine, Irvine, CA 92697, USA
- Department of Psychological Science, University of California Irvine, Irvine, CA 92697, USA
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16
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Phuah CL, Chen Y, Strain JF, Yechoor N, Laurido-Soto OJ, Ances BM, Lee JM. Association of Data-Driven White Matter Hyperintensity Spatial Signatures With Distinct Cerebral Small Vessel Disease Etiologies. Neurology 2022; 99:e2535-e2547. [PMID: 36123127 PMCID: PMC9754646 DOI: 10.1212/wnl.0000000000201186] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/15/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Topographical distribution of white matter hyperintensities (WMH) are hypothesized to vary by cerebrovascular risk factors. We used an unbiased pattern discovery approach to identify distinct WMH spatial patterns and investigate their association with different WMH etiologies. METHODS We performed a cross-sectional study on participants of the Alzheimer's Disease Neuroimaging Initiative (ADNI) to identify spatially distinct WMH distribution patterns using voxel-based spectral clustering analysis of aligned WMH probability maps. We included all participants from the ADNI Grand Opportunity/ADNI 2 study with available baseline 2D-FLAIR MRI scans, without history of stroke or presence of infarction on imaging. We evaluated the associations of these WMH spatial patterns with vascular risk factors, amyloid-β PET, and imaging biomarkers of cerebral amyloid angiopathy (CAA), characterizing different forms of cerebral small vessel disease (CSVD) using multivariable regression. We also used linear regression models to investigate whether WMH spatial distribution influenced cognitive impairment. RESULTS We analyzed MRI scans of 1,046 ADNI participants with mixed vascular and amyloid-related risk factors (mean age 72.9, 47.7% female, 31.4% hypertensive, 48.3% with abnormal amyloid PET). We observed unbiased partitioning of WMH into 5 unique spatial patterns: deep frontal, periventricular, juxtacortical, parietal, and posterior. Juxtacortical WMH were independently associated with probable CAA, deep frontal WMH were associated with risk factors for arteriolosclerosis (hypertension and diabetes), and parietal WMH were associated with brain amyloid accumulation, consistent with an Alzheimer disease (AD) phenotype. Juxtacortical, deep frontal, and parietal WMH spatial patterns were associated with cognitive impairment. Periventricular and posterior WMH spatial patterns were unrelated to any disease phenotype or cognitive decline. DISCUSSION Data-driven WMH spatial patterns reflect discrete underlying etiologies including arteriolosclerosis, CAA, AD, and normal aging. Global measures of WMH volume may miss important spatial distinctions. WMH spatial signatures may serve as etiology-specific imaging markers, helping to resolve WMH heterogeneity, identify the dominant underlying pathologic process, and improve prediction of clinical-relevant trajectories that influence cognitive decline.
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Affiliation(s)
- Chia-Ling Phuah
- From the Department of Neurology (C.-L.P., Y.C., J.F.S., N.Y., O.J.L.-S., B.M.A., J.-M.L.), Washington University School of Medicine & Barnes-Jewish Hospital, St. Louis, MO; NeuroGenomics and Informatics Center (C.-L.P.), Washington University School of Medicine, St. Louis, MO; Mallinckrodt Institute of Radiology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; and Department of Biomedical Engineering (J.-M.L.), Washington University School of Medicine, St. Louis, MO
| | - Yasheng Chen
- From the Department of Neurology (C.-L.P., Y.C., J.F.S., N.Y., O.J.L.-S., B.M.A., J.-M.L.), Washington University School of Medicine & Barnes-Jewish Hospital, St. Louis, MO; NeuroGenomics and Informatics Center (C.-L.P.), Washington University School of Medicine, St. Louis, MO; Mallinckrodt Institute of Radiology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; and Department of Biomedical Engineering (J.-M.L.), Washington University School of Medicine, St. Louis, MO
| | - Jeremy F Strain
- From the Department of Neurology (C.-L.P., Y.C., J.F.S., N.Y., O.J.L.-S., B.M.A., J.-M.L.), Washington University School of Medicine & Barnes-Jewish Hospital, St. Louis, MO; NeuroGenomics and Informatics Center (C.-L.P.), Washington University School of Medicine, St. Louis, MO; Mallinckrodt Institute of Radiology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; and Department of Biomedical Engineering (J.-M.L.), Washington University School of Medicine, St. Louis, MO
| | - Nirupama Yechoor
- From the Department of Neurology (C.-L.P., Y.C., J.F.S., N.Y., O.J.L.-S., B.M.A., J.-M.L.), Washington University School of Medicine & Barnes-Jewish Hospital, St. Louis, MO; NeuroGenomics and Informatics Center (C.-L.P.), Washington University School of Medicine, St. Louis, MO; Mallinckrodt Institute of Radiology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; and Department of Biomedical Engineering (J.-M.L.), Washington University School of Medicine, St. Louis, MO
| | - Osvaldo J Laurido-Soto
- From the Department of Neurology (C.-L.P., Y.C., J.F.S., N.Y., O.J.L.-S., B.M.A., J.-M.L.), Washington University School of Medicine & Barnes-Jewish Hospital, St. Louis, MO; NeuroGenomics and Informatics Center (C.-L.P.), Washington University School of Medicine, St. Louis, MO; Mallinckrodt Institute of Radiology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; and Department of Biomedical Engineering (J.-M.L.), Washington University School of Medicine, St. Louis, MO
| | - Beau M Ances
- From the Department of Neurology (C.-L.P., Y.C., J.F.S., N.Y., O.J.L.-S., B.M.A., J.-M.L.), Washington University School of Medicine & Barnes-Jewish Hospital, St. Louis, MO; NeuroGenomics and Informatics Center (C.-L.P.), Washington University School of Medicine, St. Louis, MO; Mallinckrodt Institute of Radiology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; and Department of Biomedical Engineering (J.-M.L.), Washington University School of Medicine, St. Louis, MO
| | - Jin-Moo Lee
- From the Department of Neurology (C.-L.P., Y.C., J.F.S., N.Y., O.J.L.-S., B.M.A., J.-M.L.), Washington University School of Medicine & Barnes-Jewish Hospital, St. Louis, MO; NeuroGenomics and Informatics Center (C.-L.P.), Washington University School of Medicine, St. Louis, MO; Mallinckrodt Institute of Radiology (J.-M.L.), Washington University School of Medicine, St. Louis, MO; and Department of Biomedical Engineering (J.-M.L.), Washington University School of Medicine, St. Louis, MO.
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17
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Calcetas AT, Thomas KR, Edmonds EC, Holmqvist SL, Edwards L, Bordyug M, Delano-Wood L, Brickman AM, Bondi MW, Bangen KJ, For The Alzheimer's Disease Neuroimaging Initiative. Increased regional white matter hyperintensity volume in objectively-defined subtle cognitive decline and mild cognitive impairment. Neurobiol Aging 2022; 118:1-8. [PMID: 35809348 PMCID: PMC9838569 DOI: 10.1016/j.neurobiolaging.2022.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 02/03/2023]
Abstract
White matter hyperintensities (WMH), a marker of small vessel cerebrovascular disease, increase risk of developing mild cognitive impairment (MCI) and Alzheimer's disease (AD). Less is known about the extent and pattern of WMH in pre-MCI stages, such as among those with objectively-defined subtle cognitive decline (Obj-SCD). Five hundred and fifty-nine Alzheimer's Disease Neuroimaging Initiative participants (170 cognitively unimpaired [CU]; 83 Obj-SCD; 306 MCI) free of clinical dementia or stroke completed neuropsychological testing and MRI exams. ANCOVA models compared cognitive groups on regional WMH adjusting for age, sex, and apolipoprotein E (APOE) ɛ4 frequency. Compared with the CU group, those with Obj-SCD had greater temporal, occipital, and frontal WMH whereas those with MCI had higher WMH volume across all regions (p's < 0.01). No differences in WMH volume were observed between the Obj-SCD and MCI groups (p's > 0.05). Findings add to growing evidence of associations between Obj-SCD and imaging biomarkers, providing support for utility of these criteria to capture subtle cognitive changes that are biologically based.
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Affiliation(s)
- Amanda T Calcetas
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Kelsey R Thomas
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Emily C Edmonds
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | | | - Lauren Edwards
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Maria Bordyug
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Lisa Delano-Wood
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Mark W Bondi
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Katherine J Bangen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
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18
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Ottoy J, Ozzoude M, Zukotynski K, Adamo S, Scott C, Gaudet V, Ramirez J, Swardfager W, Cogo-Moreira H, Lam B, Bhan A, Mojiri P, Kang MS, Rabin JS, Kiss A, Strother S, Bocti C, Borrie M, Chertkow H, Frayne R, Hsiung R, Laforce RJ, Noseworthy MD, Prato FS, Sahlas DJ, Smith EE, Kuo PH, Sossi V, Thiel A, Soucy JP, Tardif JC, Black SE, Goubran M. Vascular burden and cognition: Mediating roles of neurodegeneration and amyloid PET. Alzheimers Dement 2022; 19:1503-1517. [PMID: 36047604 DOI: 10.1002/alz.12750] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 11/06/2022]
Abstract
It remains unclear to what extent cerebrovascular burden relates to amyloid beta (Aβ) deposition, neurodegeneration, and cognitive dysfunction in mixed disease populations with small vessel disease and Alzheimer's disease (AD) pathology. In 120 subjects, we investigated the association of vascular burden (white matter hyperintensity [WMH] volumes) with cognition. Using mediation analyses, we tested the indirect effects of WMH on cognition via Aβ deposition (18 F-AV45 positron emission tomography [PET]) and neurodegeneration (cortical thickness or 18 F fluorodeoxyglucose PET) in AD signature regions. We observed that increased total WMH volume was associated with poorer performance in all tested cognitive domains, with the strongest effects observed for semantic fluency. These relationships were mediated mainly via cortical thinning, particularly of the temporal lobe, and to a lesser extent serially mediated via Aβ and cortical thinning of AD signature regions. WMH volumes differentially impacted cognition depending on lobar location and Aβ status. In summary, our study suggests mainly an amyloid-independent pathway in which vascular burden affects cognitive function via localized neurodegeneration. HIGHLIGHTS: Alzheimer's disease often co-exists with vascular pathology. We studied a unique cohort enriched for high white matter hyperintensities (WMH). High WMH related to cognitive impairment of semantic fluency and executive function. This relationship was mediated via temporo-parietal atrophy rather than metabolism. This relationship was, to lesser extent, serially mediated via amyloid beta and atrophy.
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Affiliation(s)
- Julie Ottoy
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Miracle Ozzoude
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Katherine Zukotynski
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Departments of Medicine and Radiology, McMaster University, Hamilton, Ontario, Canada.,Department of Medical Imaging, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.,Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sabrina Adamo
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Christopher Scott
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Gaudet
- Department of Electrical and Computer Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Joel Ramirez
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Walter Swardfager
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Hugo Cogo-Moreira
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Education, ICT and Learning, Østfold University College, Halden, Norway
| | - Benjamin Lam
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Aparna Bhan
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Parisa Mojiri
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Min Su Kang
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer S Rabin
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Alex Kiss
- Department of Research Design and Biostatistics, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Stephen Strother
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.,The Rotman Research Institute Baycrest, University of Toronto, Toronto, Ontario, Canada
| | - Christian Bocti
- Département de Médecine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Michael Borrie
- Lawson Health Research Institute, Western University, London, Ontario, Canada
| | - Howard Chertkow
- Jewish General Hospital and Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Richard Frayne
- Departments of Radiology and Clinical Neuroscience, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Robin Hsiung
- Physics and Astronomy Department and DM Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robert Jr Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, Université Laval, Quebec City, Quebec, Canada
| | - Michael D Noseworthy
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, Ontario, Canada
| | - Frank S Prato
- Lawson Health Research Institute, Western University, London, Ontario, Canada
| | | | - Eric E Smith
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Phillip H Kuo
- Department of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona, Tucson, Arizona, USA
| | - Vesna Sossi
- Physics and Astronomy Department and DM Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexander Thiel
- Jewish General Hospital and Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Jean-Paul Soucy
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Jean-Claude Tardif
- Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Sandra E Black
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine (Division of Neurology), University of Toronto, Toronto, Ontario, Canada.,Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Maged Goubran
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
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19
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Xi YD, Chi YF, Han J, Li HR, Wang XY, Wang X, Li TT, Yu HY, Xiao R. Keap1 as Target of Genistein on Nrf2 Signaling Pathway Antagonizing Aβ induced Oxidative Damage of Cerebrovascular Endothelial Cells. Curr Neurovasc Res 2022; 19:73-82. [PMID: 35388754 DOI: 10.2174/1567202619666220406100320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 01/28/2022] [Accepted: 02/02/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND β-amyloid peptides (Aβ) induced oxidative damage contributes to the pathogenesis of neurodegenerative diseases and cerebrovascular system is more vulnerable to oxidative stress. Our earlier study showed a clue that Genistein (Gen) might activate Nf-E2 related factor 2 (Nrf2) pathway to protect cerebrovascular cells from oxidative damage induced by Aβ, but the specific mechanisms and regulation targets are unclear. OBJECTIVE In this study, the anti-oxidative effects and the possible targets of Gen on regulating Nrf2 pathway in bEnd.3 cells were investigated. Cells were divided into control, Aβ25-35, Gen and Gen+Aβ25-35 groups. METHODS Cell viability, levels of malondialdehyde (MDA), Superoxide Dismutase (SOD) activity and nitrotyrosine were evaluated. Moreover, mRNA and/or protein expressions of Nrf2 and kelch-like ECH-associated protein 1 (Keap1) were measured. Then we transfected Keap1 over-expressed plasmid into bEnd.3 cells and measured the protein expressions of Nrf2 pathway related factors. Data showed that Gen could inhibit the over-production of MDA and nitrotyrosine and activate SOD activity. Besides we got the phenomenon that Gen could up-regulate the mRNA and protein expressions of Nrf2 and down-regulate Keap1 protein expression, the Keap1 over-expressed plasmid study indicated that the up-regulation of Nrf2 protein expression induced by pretreatment of Gen could be blocked by the transfection of Keap1 over-expressed plasmid, and the same results also occurred in Nrf2 downstream factors. CONCLUSION Gen could alleviate the cerebrovascular cells oxidative damage induced by Aβ25-35 through regulating Nrf2 pathway, and Keap1 might be one of the targets of Gen on activating Nrf2 pathway.
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Affiliation(s)
- Yuan-Di Xi
- Department of Nutrition and Food Hygiene, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Ya-Fei Chi
- Laboratory Animal Center, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing, P.R.China
| | - Jing Han
- Department of Nutrition and Food Hygiene, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Hong-Rui Li
- Department of Nutrition and Food Hygiene, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Xian-Yun Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Xuan Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Tian-Tian Li
- Department of Nutrition and Food Hygiene, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Hui-Yan Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Rong Xiao
- Department of Nutrition and Food Hygiene, School of Public Health, Capital Medical University, Beijing 100069, China
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20
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Thomas KR, Weigand AJ, Cota IH, Edmonds EC, Wierenga CE, Bondi MW, Bangen KJ. Intrusion errors moderate the relationship between blood glucose and regional cerebral blood flow in cognitively unimpaired older adults. Brain Imaging Behav 2022; 16:219-227. [PMID: 34415491 PMCID: PMC8825619 DOI: 10.1007/s11682-021-00495-8] [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] [Accepted: 06/29/2021] [Indexed: 02/03/2023]
Abstract
Regional cerebral blood flow (CBF) has a complex relationship with cognitive functioning such that cognitively unimpaired individuals at risk for Alzheimer's disease (AD) may show regional hyperperfusion, while those with cognitive impairment typically show hypoperfusion. Diabetes and word-list intrusion errors are both linked to greater risk of cognitive decline and dementia. Our study examined associations between fasting blood glucose, word-list intrusion errors, and regional CBF. 113 cognitively unimpaired older adults had arterial spin labeling MRI to measure CBF in a priori AD vulnerable regions: medial temporal lobe (MTL), inferior parietal lobe (IPL), precuneus, medial orbitofrontal cortex (mOFC), and pericalcarine (control region). Hierarchical linear regressions, adjusting for demographics, vascular risk, and reference CBF region, examined the main effect of blood glucose on regional CBF as well as whether intrusions moderated this relationship. Higher glucose was associated with higher CBF in the precuneus (β = .134, 95% CI = .007 to .261, p = .039), IPL (β = .173, 95% CI = .072 to .276, p = .001), and mOFC (β = .182, 95% CI = .047 to .320, p = .009). There was no main effect of intrusions on CBF across regions. However, the glucose x intrusions interaction was significant such that having higher glucose levels and more intrusion errors was associated with reduced CBF in the MTL (β = -.186, 95% CI = -.334 to -.040, p = .013) and precuneus (β = -.146, 95% CI = -.273 to -.022, p = .022). These findings may reflect early neurovascular dysregulation, whereby higher CBF is needed to maintain unimpaired cognition in individuals with higher glucose levels. However, lower regional CBF in unimpaired participants with both higher glucose and more intrusions suggests a failure in this early compensatory mechanism that may signal a decrease in neural activity in AD vulnerable regions.
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Affiliation(s)
- Kelsey R Thomas
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive (151), San Diego, CA, USA.
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
| | - Alexandra J Weigand
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Isabel H Cota
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive (151), San Diego, CA, USA
| | - Emily C Edmonds
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive (151), San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Christina E Wierenga
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive (151), San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Mark W Bondi
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Katherine J Bangen
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive (151), San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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21
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Gao P, Liu R, Jin Q, Wang X. Key chemical composition of walnut (Juglans regia. L) Oils generated with different processing methods and their cholesterol-lowering effects in HepG2 cells. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2021.101436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Eglit GML, Elman JA, Panizzon MS, Sanderson-Cimino M, Williams ME, Dale AM, Eyler LT, Fennema-Notestine C, Gillespie NA, Gustavson DE, Hatton SN, Hagler DJ, Hauger RL, Jak AJ, Logue MW, McEvoy LK, McKenzie RE, Neale MC, Puckett O, Reynolds CA, Toomey R, Tu XM, Whitsel N, Xian H, Lyons MJ, Franz CE, Kremen WS. Paradoxical cognitive trajectories in men from earlier to later adulthood. Neurobiol Aging 2022; 109:229-238. [PMID: 34785406 PMCID: PMC8715388 DOI: 10.1016/j.neurobiolaging.2021.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 10/07/2021] [Accepted: 10/07/2021] [Indexed: 01/03/2023]
Abstract
Because longitudinal studies of aging typically lack cognitive data from earlier ages, it is unclear how general cognitive ability (GCA) changes throughout the life course. In 1173 Vietnam Era Twin Study of Aging (VETSA) participants, we assessed young adult GCA at average age 20 and current GCA at 3 VETSA assessments beginning at average age 56. The same GCA index was used throughout. Higher young adult GCA and better GCA maintenance were associated with stronger specific cognitive abilities from age 51 to 73. Given equivalent GCA at age 56, individuals who had higher age 20 GCA outperformed those whose GCA remained stable in terms of memory, executive function, and working memory abilities from age 51 to 73. Thus, paradoxically, despite poorer maintenance of GCA, high young adult GCA still conferred benefits. Advanced predicted brain age and the combination of elevated vascular burden and APOE-ε4 status were associated with poorer maintenance of GCA. These findings highlight the importance of distinguishing between peak and current GCA for greater understanding of cognitive aging.
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Affiliation(s)
- Graham M L Eglit
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA.
| | - Jeremy A Elman
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Mathew S Panizzon
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Mark Sanderson-Cimino
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA; San Diego State University/University of California, San Diego Joint Doctoral Program, San Diego, CA, USA
| | - McKenna E Williams
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA; San Diego State University/University of California, San Diego Joint Doctoral Program, San Diego, CA, USA
| | - Anders M Dale
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Christine Fennema-Notestine
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA; Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Daniel E Gustavson
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Sean N Hatton
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Donald J Hagler
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Richard L Hauger
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Amy J Jak
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | - Mark W Logue
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, MA, USA; Psychiatry and Biomedical Genetics, Boston University School of Medicine, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Linda K McEvoy
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Ruth E McKenzie
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA; School of Education and Social Policy, Merrimack College, North Andover, MA, USA
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Olivia Puckett
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Chandra A Reynolds
- Department of Psychology, University of California Riverside, Riverside, CA, USA
| | - Rosemary Toomey
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Xin M Tu
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Nathan Whitsel
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Hong Xian
- Department of Epidemiology and Biostatistics, St. Louis University, St. Louis, MO, USA
| | - Michael J Lyons
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Carol E Franz
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - William S Kremen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
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23
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Bubu OM, Williams ET, Umasabor-Bubu OQ, Kaur SS, Turner AD, Blanc J, Cejudo JR, Mullins AE, Parekh A, Kam K, Osakwe ZT, Nguyen AW, Trammell AR, Mbah AK, de Leon M, Rapoport DM, Ayappa I, Ogedegbe G, Jean-Louis G, Masurkar AV, Varga AW, Osorio RS. Interactive Associations of Neuropsychiatry Inventory-Questionnaire Assessed Sleep Disturbance and Vascular Risk on Alzheimer's Disease Stage Progression in Clinically Normal Older Adults. Front Aging Neurosci 2021; 13:763264. [PMID: 34955813 PMCID: PMC8704133 DOI: 10.3389/fnagi.2021.763264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: To determine whether sleep disturbance (SD) and vascular-risk interact to promote Alzheimer's disease (AD) stage-progression in normal, community-dwelling older adults and evaluate their combined risk beyond that of established AD biomarkers. Methods: Longitudinal data from the National Alzheimer's Coordinating Center Uniform-Dataset. SD data (i.e., SD+ vs. SD-), as characterized by the Neuropsychiatric Inventory-Questionnaire, were derived from 10,600 participants at baseline, with at-least one follow-up visit. A subset (n = 361) had baseline cerebrospinal fluid (CSF) biomarkers and MRI data. The Framingham heart study general cardiovascular disease (FHS-CVD) risk-score was used to quantify vascular risk. Amnestic mild cognitive impairment (aMCI) diagnosis during follow-up characterized AD stage-progression. Logistic mixed-effects models with random intercept and slope examined the interaction of SD and vascular risk on prospective aMCI diagnosis. Results: Of the 10,600 participants, 1,017 (9.6%) reported SD and 6,572 (62%) were female. The overall mean (SD) age was 70.5 (6.5), and follow-up time was 5.1 (2.7) years. SD and the FHS-CVD risk-score were each associated with incident aMCI (aOR: 1.42 and aOR: 2.11, p < 0.01 for both). The interaction of SD and FHS-CVD risk-score with time was significant (aOR: 2.87, p < 0.01), suggesting a synergistic effect. SD and FHS-CVD risk-score estimates remained significantly associated with incident aMCI even after adjusting for CSF (Aβ, T-tau, P-tau) and hippocampal volume (n = 361) (aOR: 2.55, p < 0.01), and approximated risk-estimates of each biomarker in the sample where data was available. Conclusions: Clinical measures of sleep and vascular risk may complement current AD biomarkers in assessing risk of cognitive decline in older adults.
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Affiliation(s)
- Omonigho M Bubu
- Department of Psychiatry, Center for Sleep and Brain Health, NYU Grossman School of Medicine, New York, NY, United States.,Department of Population Health, Center for Healthful Behavior Change, NYU Grossman School of Medicine, New York, NY, United States
| | - Ellita T Williams
- Department of Population Health, Center for Healthful Behavior Change, NYU Grossman School of Medicine, New York, NY, United States
| | - Ogie Q Umasabor-Bubu
- Division of Epidemiology and Infection Control, State University New York (SUNY) Downstate Medical Center, Brooklyn, NY, United States
| | - Sonya S Kaur
- Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Arlener D Turner
- Department of Psychiatry and Behavioral Sciences, Center for Translational Sleep and Circadian Sciences (TSCS), University of Miami Miller School of Medicine, Miami, FL, United States
| | - Judite Blanc
- Department of Psychiatry and Behavioral Sciences, Center for Translational Sleep and Circadian Sciences (TSCS), University of Miami Miller School of Medicine, Miami, FL, United States
| | - Jaime Ramos Cejudo
- Department of Psychiatry, Center for Sleep and Brain Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Anna E Mullins
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ankit Parekh
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Korey Kam
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Zainab T Osakwe
- College of Nursing and Public Health, Adelphi University, Garden City, NY, United States
| | - Ann W Nguyen
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Antoine R Trammell
- Division of General Medicine and Geriatrics, Department of Medicine, Emory Brain Health Center, Emory University School of Medicine, Atlanta, GA, United States
| | - Alfred K Mbah
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, United States
| | - Mony de Leon
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - David M Rapoport
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Indu Ayappa
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Gbenga Ogedegbe
- Department of Population Health, Center for Healthful Behavior Change, NYU Grossman School of Medicine, New York, NY, United States
| | - Girardin Jean-Louis
- Department of Psychiatry, Center for Sleep and Brain Health, NYU Grossman School of Medicine, New York, NY, United States.,Department of Psychiatry and Behavioral Sciences, Center for Translational Sleep and Circadian Sciences (TSCS), University of Miami Miller School of Medicine, Miami, FL, United States
| | - Arjun V Masurkar
- Department of Neurology, Center for Cognitive Neurology, New York University School of Medicine, New York, NY, United States
| | - Andrew W Varga
- Division of Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ricardo S Osorio
- Department of Psychiatry, Center for Sleep and Brain Health, NYU Grossman School of Medicine, New York, NY, United States.,Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, United States
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24
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Spatial variation of perfusion MRI reflects cognitive decline in mild cognitive impairment and early dementia. Sci Rep 2021; 11:23325. [PMID: 34857793 PMCID: PMC8639710 DOI: 10.1038/s41598-021-02313-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 11/09/2021] [Indexed: 12/03/2022] Open
Abstract
Cerebral blood flow (CBF) measured with arterial spin labelling (ASL) magnetic resonance imaging (MRI) reflects cerebral perfusion, related to metabolism, and arterial transit time (ATT), related to vascular health. Our aim was to investigate the spatial coefficient of variation (sCoV) of CBF maps as a surrogate for ATT, in volunteers meeting criteria for subjective cognitive decline (SCD), amnestic mild cognitive impairment (MCI) and probable Alzheimer’s dementia (AD). Whole-brain pseudo continuous ASL MRI was performed at 3 T in 122 participants (controls = 20, SCD = 44, MCI = 45 and AD = 13) across three sites in New Zealand. From CBF maps that included all grey matter, sCoV progressively increased across each group with increased cognitive deficit. A similar overall trend was found when examining sCoV solely in the temporal lobe. We conclude that sCoV, a simple to compute imaging metric derived from ASL MRI, is sensitive to varying degrees of cognitive changes and supports the view that vascular health contributes to cognitive decline associated with Alzheimer’s disease.
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25
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Burnham TS, Scott ML, Steinberg BA, Varela DL, Zenger B, Bunch TJ. Impact of Catheter Ablation on Stroke, Cognitive Decline and Dementia. Arrhythm Electrophysiol Rev 2021; 10:205-210. [PMID: 34777826 PMCID: PMC8576494 DOI: 10.15420/aer.2021.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/19/2021] [Indexed: 11/04/2022] Open
Abstract
AF has been consistently associated with multiple forms of dementia, including idiopathic dementia. Outcomes after catheter ablation for AF are favourable and patients experience a better quality of life, arrhythmia-free survival, and lower rates of hospitalisation compared to patients treated with antiarrhythmic drugs. Catheter ablation is consistently associated with lower rates of stroke compared to AF management without ablation in large national and healthcare system databases. Multiple observational trials have shown that catheter ablation is also associated with a lower risk of cognitive decline, dementia and improved cognitive testing that can be explained through a variety of pathways. Long-term, adequately powered, randomised trials are required to define the role of catheter ablation in the management of AF as a means to lower the risk of cognitive decline, stroke and dementia.
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Affiliation(s)
- Tyson S Burnham
- Department of Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, US
| | - Monte L Scott
- Department of Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, US
| | - Benjamin A Steinberg
- Department of Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, US
| | - Daniel L Varela
- Department of Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, US
| | - Brian Zenger
- Department of Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, US
| | - T Jared Bunch
- Department of Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, US
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26
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Dounavi ME, Low A, McKiernan EF, Mak E, Muniz-Terrera G, Ritchie K, Ritchie CW, Su L, O’Brien JT. Evidence of cerebral hemodynamic dysregulation in middle-aged APOE ε4 carriers: The PREVENT-Dementia study. J Cereb Blood Flow Metab 2021; 41:2844-2855. [PMID: 34078163 PMCID: PMC8543665 DOI: 10.1177/0271678x211020863] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 11/22/2022]
Abstract
Accumulating evidence suggests vascular dysregulation in preclinical Alzheimer's disease. In this study, cerebral hemodynamics and their coupling with cognition in middle-aged apolipoprotein ε4 carriers (APOEε4+) were investigated. Longitudinal 3 T T1-weighted and arterial spin labelling MRI data from 158 participants (40-59 years old) in the PREVENT-Dementia study were analysed (125 two-year follow-up). Cognition was evaluated using the COGNITO battery. Cerebral blood flow (CBF) and cerebrovascular resistance index (CVRi) were quantified for the flow territories of the anterior, middle and posterior cerebral arteries. CBF was corrected for underlying atrophy and individual hematocrit. Hemodynamic measures were the dependent variables in linear regression models, with age, sex, years of education and APOEε4 carriership as predictors. Further analyses were conducted with cognitive outcomes as dependent variables, using the same model as before with additional APOEε4 × hemodynamics interactions. At baseline, APOEε4+ showed increased CBF and decreased CVRi compared to non-carriers in the anterior and middle cerebral arteries, suggestive of potential vasodilation. Hemodynamic changes were similar between groups. Interaction analysis revealed positive associations between CBF changes and performance changes in delayed recall (for APOEε4 non-carriers) and verbal fluency (for APOEε4 carriers) cognitive tests. These observations are consistent with neurovascular dysregulation in middle-aged APOEε4+.
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Affiliation(s)
- Maria-Eleni Dounavi
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Audrey Low
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Elizabeth F McKiernan
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Elijah Mak
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - Karen Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
- INSERM, Montpellier, France
| | - Craig W Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Li Su
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - John T. O’Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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27
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Bangen KJ, Smirnov DS, Delano-Wood L, Wierenga CE, Bondi MW, Salmon DP, Galasko D. Arterial stiffening acts synergistically with APOE genotype and AD biomarker status to influence memory in older adults without dementia. Alzheimers Res Ther 2021; 13:121. [PMID: 34210365 PMCID: PMC8246656 DOI: 10.1186/s13195-021-00851-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/31/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND Arterial stiffening has emerged as an important risk factor for Alzheimer's disease (AD) and related dementias. Carotid-femoral pulse wave velocity has been proposed as a non-invasive and reproducible method to assess arterial stiffness. However, the association of pulse wave velocity with performance across multiple cognitive domains as well as interactions with in vivo AD biomarkers and apolipoprotein E (APOE) genotype has received limited study. METHOD We studied 193 older adult volunteers (167 with normal cognition and 26 with mild cognitive impairment) who underwent comprehensive medical and neuropsychological evaluation at the University of California, San Diego Alzheimer's Disease Research Center. Cerebrospinal fluid (CSF) biomarkers were available on 123 participants (63%). Linear models examined whether pulse wave velocity significantly interacted with APOE ε4 status and CSF AD biomarker positivity (based on the ratio of total tau over beta-amyloid [tau/Aβ42]) on memory, language, executive functioning, attention, and visuospatial abilities. RESULTS After adjusting for demographic characteristics and vascular risk burden, across the entire sample, pulse wave velocity was associated with poorer executive functioning but not the performance in the other cognitive domains. When the modifying effects of AD genetic risk and CSF AD biomarkers were considered, pulse wave velocity interacted with APOE genotype and CSF tau/Aβ ratio such that a stronger association between elevated pulse wave velocity and poorer memory performance was found among those positive for CSF and genetic AD markers. There were no significant interaction effects for non-memory cognitive domains. CONCLUSION The findings suggest that pulse wave velocity, a non-invasive method to assess arterial wall properties, may be a useful marker of risk for cognitive decline, particularly among individuals who are APOE ε4 carriers or CSF AD biomarke0r-positive.
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Affiliation(s)
- Katherine J Bangen
- Research Service, VA San Diego Healthcare System, Building 13, 3350 La Jolla Village Drive (151A), San Diego, CA, 92161, USA.
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
| | - Denis S Smirnov
- Medical Scientist Training Program, University of California, San Diego, La Jolla, CA, USA
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Lisa Delano-Wood
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Christina E Wierenga
- Research Service, VA San Diego Healthcare System, Building 13, 3350 La Jolla Village Drive (151A), San Diego, CA, 92161, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Mark W Bondi
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - David P Salmon
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Douglas Galasko
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
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28
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Jurcau A, Simion A. Oxidative Stress in the Pathogenesis of Alzheimer's Disease and Cerebrovascular Disease with Therapeutic Implications. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2021; 19:94-108. [PMID: 32124703 DOI: 10.2174/1871527319666200303121016] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 01/18/2020] [Accepted: 01/28/2020] [Indexed: 12/15/2022]
Abstract
The significant gain in life expectancy led to an increase in the incidence and prevalence of dementia. Although vascular risk factors have long and repeatedly been shown to increase the risk of Alzheimer's Disease (AD), translating these findings into effective preventive measures has failed. In addition, the finding that incident ischemic stroke approximately doubles the risk of a patient to develop AD has been recently reinforced. Current knowledge and pathogenetic hypotheses of AD are discussed. The implication of oxidative stress in the development of AD is reviewed, with special emphasis on its sudden burst in the setting of acute ischemic stroke and the possible link between this increase in oxidative stress and consequent cognitive impairment. Current knowledge and future directions in the prevention and treatment of AD are discussed outlining the hypothesis of a possible beneficial effect of antioxidant treatment in acute ischemic stroke in delaying the onset/progression of dementia.
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Affiliation(s)
- Anamaria Jurcau
- Faculty of Medicine and Pharmacy, University of Oradea, 410154 Oradea, Romania.,Clinical Municipal Hospital "Dr. G Curteanu", Neurology Ward, Oradea, Romania
| | - Aurel Simion
- Faculty of Medicine and Pharmacy, University of Oradea, 410154 Oradea, Romania.,Clinical Municipal Hospital "Dr. G Curteanu", Neurological Rehabilitation Ward, Oradea, Romania
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29
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Snyder BD, Simone SM, Giovannetti T, Floyd TF. Cerebral Hypoxia: Its Role in Age-Related Chronic and Acute Cognitive Dysfunction. Anesth Analg 2021; 132:1502-1513. [PMID: 33780389 PMCID: PMC8154662 DOI: 10.1213/ane.0000000000005525] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Postoperative cognitive dysfunction (POCD) has been reported with widely varying frequency but appears to be strongly associated with aging. Outside of the surgical arena, chronic and acute cerebral hypoxia may exist as a result of respiratory, cardiovascular, or anemic conditions. Hypoxia has been extensively implicated in cognitive impairment. Furthermore, disease states associated with hypoxia both accompany and progress with aging. Perioperative cerebral hypoxia is likely underdiagnosed, and its contribution to POCD is underappreciated. Herein, we discuss the various disease processes and forms in which hypoxia may contribute to POCD. Furthermore, we outline hypoxia-related mechanisms, such as hypoxia-inducible factor activation, cerebral ischemia, cerebrovascular reserve, excitotoxicity, and neuroinflammation, which may contribute to cognitive impairment and how these mechanisms interact with aging. Finally, we discuss opportunities to prevent and manage POCD related to hypoxia.
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Affiliation(s)
- Brina D. Snyder
- Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX
| | | | | | - Thomas F. Floyd
- Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX
- Department of Cardiothoracic Surgery, UT Southwestern Medical Center, Dallas, TX
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30
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Thomas KR, Osuna JR, Weigand AJ, Edmonds EC, Clark AL, Holmqvist S, Cota IH, Wierenga CE, Bondi MW, Bangen KJ. Regional hyperperfusion in older adults with objectively-defined subtle cognitive decline. J Cereb Blood Flow Metab 2021; 41:1001-1012. [PMID: 32615887 PMCID: PMC8054731 DOI: 10.1177/0271678x20935171] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/21/2020] [Accepted: 05/16/2020] [Indexed: 11/16/2022]
Abstract
Although cerebral blood flow (CBF) alterations are associated with Alzheimer's disease (AD), CBF patterns across prodromal stages of AD remain unclear. Therefore, we investigated patterns of regional CBF in 162 Alzheimer's Disease Neuroimaging Initiative participants characterized as cognitively unimpaired (CU; n = 80), objectively-defined subtle cognitive decline (Obj-SCD; n = 31), or mild cognitive impairment (MCI; n = 51). Arterial spin labeling MRI quantified regional CBF in a priori regions of interest: hippocampus, inferior temporal gyrus, inferior parietal lobe, medial orbitofrontal cortex, and rostral middle frontal gyrus. Obj-SCD participants had increased hippocampal and inferior parietal CBF relative to CU and MCI participants and increased inferior temporal CBF relative to MCI participants. CU and MCI groups did not differ in hippocampal or inferior parietal CBF, but CU participants had increased inferior temporal CBF relative to MCI participants. There were no CBF group differences in the two frontal regions. Thus, we found an inverted-U pattern of CBF signal across prodromal AD stages in regions susceptible to early AD pathology. Hippocampal and inferior parietal hyperperfusion in Obj-SCD may reflect early neurovascular dysregulation, whereby higher CBF is needed to maintain cognitive functioning relative to MCI participants, yet is also reflective of early cognitive inefficiencies that distinguish Obj-SCD from CU participants.
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Affiliation(s)
- Kelsey R Thomas
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Jessica R Osuna
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Alexandra J Weigand
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Emily C Edmonds
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Alexandra L Clark
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Sophia Holmqvist
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Isabel H Cota
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Christina E Wierenga
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Mark W Bondi
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Katherine J Bangen
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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31
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Aryal R, Patabendige A. Blood-brain barrier disruption in atrial fibrillation: a potential contributor to the increased risk of dementia and worsening of stroke outcomes? Open Biol 2021; 11:200396. [PMID: 33878948 PMCID: PMC8059575 DOI: 10.1098/rsob.200396] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Atrial fibrillation (AF) has become one of the most significant health problems worldwide, warranting urgent answers to currently pending questions on the effects of AF on brain function. Recent evidence has emerged to show an association between AF and an increased risk of developing dementia and worsening of stroke outcomes. A healthy brain is protected by the blood–brain barrier (BBB), which is formed by the endothelial cells that line cerebral capillaries. These endothelial cells are continuously exposed to shear stress (the frictional force generated by blood flow), which affects endothelial cell structure and function. Flow disturbances as experienced during AF can disrupt the BBB and leave the brain vulnerable to damage. Investigating the plausible mechanisms in detail, linking AF to cerebrovascular damage is difficult in humans, leading to paucity of available clinical data. Here, we discuss the available evidence for BBB disruption during AF due to altered cerebral blood flow, and how this may contribute to an increased risk of dementia and worsening of stroke outcomes.
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Affiliation(s)
- Ritambhara Aryal
- Brain Barriers Group, School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW 2308, Australia.,Brain and Mental Health Research Programme, Hunter Medical Research Institute, Newcastle, Australia
| | - Adjanie Patabendige
- Brain Barriers Group, School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW 2308, Australia.,Brain and Mental Health Research Programme, Hunter Medical Research Institute, Newcastle, Australia.,Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
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32
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The pleiotropic effects of antithrombotic drugs in the metabolic-cardiovascular-neurodegenerative disease continuum: impact beyond reduced clotting. Clin Sci (Lond) 2021; 135:1015-1051. [PMID: 33881143 DOI: 10.1042/cs20201445] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/07/2021] [Accepted: 04/13/2021] [Indexed: 12/25/2022]
Abstract
Antithrombotic drugs are widely used for primary and secondary prevention, as well as treatment of many cardiovascular disorders. Over the past few decades, major advances in the pharmacology of these agents have been made with the introduction of new drug classes as novel therapeutic options. Accumulating evidence indicates that the beneficial outcomes of some of these antithrombotic agents are not solely related to their ability to reduce thrombosis. Here, we review the evidence supporting established and potential pleiotropic effects of four novel classes of antithrombotic drugs, adenosine diphosphate (ADP) P2Y12-receptor antagonists, Glycoprotein IIb/IIIa receptor Inhibitors, and Direct Oral Anticoagulants (DOACs), which include Direct Factor Xa (FXa) and Direct Thrombin Inhibitors. Specifically, we discuss the molecular evidence supporting such pleiotropic effects in the context of cardiovascular disease (CVD) including endothelial dysfunction (ED), atherosclerosis, cardiac injury, stroke, and arrhythmia. Importantly, we highlight the role of DOACs in mitigating metabolic dysfunction-associated cardiovascular derangements. We also postulate that DOACs modulate perivascular adipose tissue inflammation and thus, may reverse cardiovascular dysfunction early in the course of the metabolic syndrome. In this regard, we argue that some antithrombotic agents can reverse the neurovascular damage in Alzheimer's and Parkinson's brain and following traumatic brain injury (TBI). Overall, we attempt to provide an up-to-date comprehensive review of the less-recognized, beneficial molecular aspects of antithrombotic therapy beyond reduced thrombus formation. We also make a solid argument for the need of further mechanistic analysis of the pleiotropic effects of antithrombotic drugs in the future.
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33
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Bangen KJ, Delano-Wood L, Deoni SCL, Clark AL, Evangelista ND, Hoffman SN, Sorg SF, Holmqvist S, Osuna J, Weigand AJ, Jak AJ, Bondi MW, Lamar M. Decreased myelin content of the fornix predicts poorer memory performance beyond vascular risk, hippocampal volume, and fractional anisotropy in nondemented older adults. Brain Imaging Behav 2021; 15:2563-2571. [PMID: 33638111 PMCID: PMC8500888 DOI: 10.1007/s11682-021-00458-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/18/2022]
Abstract
Alterations to cerebral white matter tracts have been associated with cognitive decline in aging and Alzheimer's disease (AD). In particular, the fornix has been implicated as especially vulnerable given that it represents the primary outflow tract of the hippocampus. Despite this, little work has focused on the fornix using a potential early marker of white matter degeneration-myelin water fraction (MWF; an in vivo marker of myelin content). Therefore, we sought to (1) clarify associations between MWF in the fornix and memory functioning, and (2) examine whether fornix MWF relates to memory performance above and beyond hippocampal volume and conventional imaging measures of white matter that may not be as specific to alterations in myelin content. Forty nondemented older adults (mean age = 72.9 years) underwent an MRI exam and neuropsychological assessment. Multicomponent driven equilibrium single pulse observation of T1 and T2 (mcDESPOT) was used to quantify fornix MWF and diffusion tensor imaging (DTI) was used to measure fornix fractional anisotropy (FA). Adjusting for age, sex, education, and vascular risk factors, linear regression models revealed that, lower fornix MWF was significantly associated with poorer memory functioning (β = 0.405, p = .007) across our sample of older adults. Notably, fornix MWF remained a significant predictor of memory functioning (β = 0.380, p = .015) even after adjusting for fornix DTI FA and hippocampal volume (in addition to the above covariates). Given the observed associations between myelin and memory in older adults without dementia, MWF may be a useful early marker of dementia risk.
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Affiliation(s)
- Katherine J Bangen
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA. .,Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, Mail Code 151B, La Jolla, CA, 92093-9151, USA.
| | - Lisa Delano-Wood
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, Mail Code 151B, La Jolla, CA, 92093-9151, USA.,Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Sean C L Deoni
- Department of Pediatrics, Brown University, Providence, RI, USA
| | - Alexandra L Clark
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, Mail Code 151B, La Jolla, CA, 92093-9151, USA.,Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Nicole D Evangelista
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Samantha N Hoffman
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Scott F Sorg
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, Mail Code 151B, La Jolla, CA, 92093-9151, USA
| | - Sophia Holmqvist
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Jessica Osuna
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, Mail Code 151B, La Jolla, CA, 92093-9151, USA
| | - Alexandra J Weigand
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Amy J Jak
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, Mail Code 151B, La Jolla, CA, 92093-9151, USA.,Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Mark W Bondi
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, Mail Code 151B, La Jolla, CA, 92093-9151, USA.,Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Melissa Lamar
- Rush Alzheimer's Disease Center, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
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de la Torre JC. Deciphering Alzheimer's Disease Pathogenic Pathway: Role of Chronic Brain Hypoperfusion on p-Tau and mTOR. J Alzheimers Dis 2021; 79:1381-1396. [PMID: 33459641 DOI: 10.3233/jad-201165] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This review examines new biomolecular findings that lend support to the hemodynamic role played by chronic brain hypoperfusion (CBH) in driving a pathway to Alzheimer's disease (AD). CBH is a common clinical feature of AD and the current topic of intense investigation in AD models. CBH is also the basis for the vascular hypothesis of AD which we originally proposed in 1993. New biomolecular findings reveal the interplay of CBH in increasing tau phosphorylation (p-Tau) in the hippocampus and cortex of AD mice, damaging fast axonal transport, increasing signaling of mammalian target of rapamycin (mTOR), impairing learning-memory function, and promoting the formation of neurofibrillary tangles, a neuropathologic hallmark of AD. These pathologic elements have been singularly linked with neurodegeneration and AD but their abnormal, collective participation during brain aging have not been fully examined. The format for this review will provide a consolidated analysis of each pathologic phase contributing to cognitive decline and AD onset, summarized in nine chronological steps. These steps galvanize each factor's active participation and contribution in constructing a biomolecular pathway to AD onset generated by CBH.
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Affiliation(s)
- Jack C de la Torre
- Department of Psychology, University of Texas at Austin, Austin, TX, USA.,Department of Physiology, University of Valencia Faculty of Medicine, Valencia, Spain
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35
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Scicutella A. Letter to the editor concerning the pharmacological management of behavioral disturbances in patients with Alzheimer’s disease. Expert Opin Pharmacother 2020; 21:2325-2326. [DOI: 10.1080/14656566.2020.1808354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Angela Scicutella
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
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36
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Parodi-Rullán R, Sone JY, Fossati S. Endothelial Mitochondrial Dysfunction in Cerebral Amyloid Angiopathy and Alzheimer's Disease. J Alzheimers Dis 2020; 72:1019-1039. [PMID: 31306129 DOI: 10.3233/jad-190357] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Alzheimer's disease (AD) is the most prevalent form of dementia. Cerebrovascular dysfunction is one of the earliest events in the pathogenesis of AD, as well as in vascular and mixed dementias. Cerebral amyloid angiopathy (CAA), the deposition of amyloid around cerebral vessels, is observed in up to 90% of AD patients and in approximately 50% of elderly individuals over 80 years of age. CAA is a strong contributor to vascular dysfunction in AD. CAA-laden brain vessels are characterized by dysfunctional hemodynamics and leaky blood-brain barrier (BBB), contributing to clearance failure and further accumulation of amyloid-β (Aβ) in the cerebrovasculature and brain parenchyma. Mitochondrial dysfunction is increasingly recognized as an important early initiator of the pathogenesis of AD and CAA. The objective of this review is to discuss the effects of Aβ on cerebral microvascular cell function, focusing on its impact on endothelial mitochondria. After introducing CAA and its etiology and genetic risk factors, we describe the pathological relationship between cerebrovascular amyloidosis and brain microvascular endothelial cell dysfunction, critically analyzing its roles in disease progression, hypoperfusion, and BBB integrity. Then, we focus on discussing the effect of Aβ challenge on endothelial mitochondrial dysfunction pathways, and their contribution to the progression of neurovascular dysfunction in AD and dementia. Finally, we report potential pharmacological and non-pharmacological mitochondria-targeted therapeutic strategies which may help prevent or delay cerebrovascular failure.
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Affiliation(s)
- Rebecca Parodi-Rullán
- Alzheimer's Center at Temple, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Je Yeong Sone
- Department of Psychiatry, Center for Brain Health, NYU School of Medicine, New York, NY, USA
| | - Silvia Fossati
- Alzheimer's Center at Temple, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
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37
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Rahman MA, Rahman MS, Uddin MJ, Mamum-Or-Rashid ANM, Pang MG, Rhim H. Emerging risk of environmental factors: insight mechanisms of Alzheimer's diseases. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:44659-44672. [PMID: 32201908 DOI: 10.1007/s11356-020-08243-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/25/2020] [Indexed: 06/10/2023]
Abstract
Neurodegenerative disorders are typically sporadic in nature in addition to usually influenced through an extensive range of environmental factors, lifestyle, and genetic elements. Latest observations have hypothesized that exposure of environmental factors may increase the prospective risk of Alzheimer's diseases (AD). However, the role of environmental factors as a possible dangerous issue has extended importance concerned in AD pathology, although actual etiology of the disorder is still not yet clear. Thus, the aim of this review is to highlight the possible correlation between environmental factors and AD, based on the present literature view. Environmental risk factors might play an important role in decelerating or accelerating AD progression. Among well-known environmental risk factors, prolonged exposure to several heavy metals, for example, aluminum, arsenic, cadmium, lead, and mercury; particulate air, and some pesticides as well as metal-containing nanoparticles have been participated to cause AD. These heavy metals have the capacity to enhance amyloid β (Aβ) peptide along with tau phosphorylation, initiating amyloid/senile plaques, as well as neurofibrillary tangle formation; therefore, neuronal cell death has been observed. Furthermore, particulate air, pesticides, and heavy metal exposure have been recommended to lead AD susceptibility and phenotypic diversity though epigenetic mechanisms. Therefore, this review deliberates recent findings detailing the mechanisms for a better understanding the relationship between AD and environmental risk factors along with their mechanisms of action on the brain functions.
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Affiliation(s)
- Md Ataur Rahman
- Center for Neuroscience, Korea Institute of Science and Technology (KIST), 5 Hwarang-ro 14-gil, Seongbuk-gu, Seoul, 02792, Republic of Korea.
- Department of Biotechnology and Genetic Engineering, Global Biotechnology & Biomedical Research Network (GBBRN), Faculty of Biological Sciences, Islamic University, Kushtia, 7003, Bangladesh.
| | - Md Saidur Rahman
- Department of Animal Science & Technology and BET Research Institute, Chung-Ang University, Anseong, 456-756, Republic of Korea
| | - Md Jamal Uddin
- Graduate School of Pharmaceutical Sciences, College of Pharmacy, Ewha Womans University, Seoul, 03760, Republic of Korea
- ABEx Bio-Research Center, East Azampur, Dhaka, 1230, Bangladesh
| | - A N M Mamum-Or-Rashid
- Anti-Aging Medical Research Center and Glycation Stress Research Center, Graduate School of Life and Medical Sciences, Doshisha University, Kyoto, Japan
| | - Myung-Geol Pang
- Department of Animal Science & Technology and BET Research Institute, Chung-Ang University, Anseong, 456-756, Republic of Korea
| | - Hyewhon Rhim
- Center for Neuroscience, Korea Institute of Science and Technology (KIST), 5 Hwarang-ro 14-gil, Seongbuk-gu, Seoul, 02792, Republic of Korea.
- Division of Bio-Medical Science and Technology, KIST School, Korea University of Science and Technology (UST), Seoul, 02792, Republic of Korea.
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38
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Sanchez DL, Thomas KR, Edmonds EC, Bondi MW, Bangen KJ. Regional Hypoperfusion Predicts Decline in Everyday Functioning at Three-Year Follow-Up in Older Adults without Dementia. J Alzheimers Dis 2020; 77:1291-1304. [PMID: 32831202 DOI: 10.3233/jad-200490] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Increasing evidence indicates that cerebrovascular dysfunction may precede cognitive decline in aging and Alzheimer's disease (AD). Reduced cerebral blood flow (CBF) is associated with cognitive impairment in older adults. However, less is known regarding the association between CBF and functional decline, and whether CBF predicts functional decline beyond cerebrovascular and metabolic risk factors. OBJECTIVE To examine the association between regional CBF and functional decline in nondemented older adults. METHOD One hundred sixty-six (N = 166) participants without dementia from the Alzheimer's Disease Neuroimaging Initiative underwent neuropsychological testing and neuroimaging. Pulsed arterial spin labeling magnetic resonance imaging was acquired to quantify resting CBF. Everyday functioning was measured using the Functional Assessment Questionnaire at baseline and annual follow-up visit across three years. RESULTS Adjusting for age, education, sex, cognitive status, depression, white matter hyperintensity volume, cerebral metabolism, and reference (precentral) CBF, linear mixed effects models showed that lower resting CBF at baseline in the medial temporal, inferior temporal, and inferior parietal lobe was significantly associated with accelerated decline in everyday functioning. Results were similar after adjusting for conventional AD biomarkers, including cerebrospinal fluid (CSF) amyloid-β (Aβ) and hyperphosphorylated tau (p-tau) and apolipoprotein E (APOE) ɛ4 positivity. Individuals who later converted to dementia had lower resting CBF in the inferior temporal and parietal regions compared to those who did not. CONCLUSION Lower resting CBF in AD vulnerable regions including medial temporal, inferior temporal, and inferior parietal lobes predicted faster rates of decline in everyday functioning. CBF has utility as a biomarker in predicting functional declines in everyday life and conversion to dementia.
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Affiliation(s)
- Danielle L Sanchez
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Kelsey R Thomas
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Emily C Edmonds
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Mark W Bondi
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Psychology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Katherine J Bangen
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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39
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Puccio D, Vizzini MC, Baiamonte V, Lunetta M, Evola S, Galassi AR, Novo G. Atrial fibrillation and cognitive disorders: An overview on possible correlation. Mech Ageing Dev 2020; 191:111326. [PMID: 32768444 DOI: 10.1016/j.mad.2020.111326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/21/2020] [Accepted: 08/02/2020] [Indexed: 10/23/2022]
Abstract
Atrial Fibrillation is the most common cardiac arrhythmia affecting people of all ages, principally the elderly. Cognitive decline and dementia are also prevalent diseases in elderly. The scientific community always showed interest in the possible association between these two pathological entities, both implicating social and economic burden. This has been confirmed by several longitudinal population-based studies. Some studies also revealed that the association between atrial fibrillation and dementia may be not related to history of stroke. Therefore, other pathophysiological mechanisms are likely implicated, so far unclear or undefined. The aim of the present review is to analyse the possible mechanisms underlying the frequent association between atrial fibrillation and cognitive impairment.
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Affiliation(s)
- Danilo Puccio
- Cardiology Unit, University Hospital Paolo Giaccone, Palermo, Italy.
| | - M Chiara Vizzini
- Cardiology Unit, University Hospital Paolo Giaccone, Palermo, Italy; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy
| | | | - Monica Lunetta
- Cardiology Unit, University Hospital Paolo Giaccone, Palermo, Italy
| | - Salvatore Evola
- Cardiology Unit, University Hospital Paolo Giaccone, Palermo, Italy
| | - Alfredo Ruggero Galassi
- Cardiology Unit, University Hospital Paolo Giaccone, Palermo, Italy; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy
| | - Giuseppina Novo
- Cardiology Unit, University Hospital Paolo Giaccone, Palermo, Italy; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Palermo, Italy
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40
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Cortical atrophy mediates the accumulating effects of vascular risk factors on cognitive decline in the Alzheimer's disease spectrum. Aging (Albany NY) 2020; 12:15058-15076. [PMID: 32726298 PMCID: PMC7425455 DOI: 10.18632/aging.103573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 06/13/2020] [Indexed: 12/17/2022]
Abstract
There are increasing concerns regarding the association of vascular risk factors (VRFs) and cognitive decline in the Alzheimer's disease (AD) spectrum. Currently, we investigated whether the accumulating effects of VRFs influenced gray matter volumes and subsequently led to cognitive decline in the AD spectrum. Mediation analysis was used to explore the association among VRFs, cortical atrophy, and cognition in the AD spectrum. 123 AD spectrum were recruited and VRF scores were constructed. Multivariate linear regression analysis revealed that higher VRF scores were correlated with lower Mini-Mental State Examination scores and higher Alzheimer's Disease Assessment Scale-Cognitive Subscale scores, indicating higher VRF scores lead to severer cognitive decline in the AD spectrum. In addition, subjects with higher VRF scores suffered severe cortical atrophy, especially in medial prefrontal cortex and medial temporal lobe. More importantly, common circuits of VRFs- and cognitive decline associated with gray matter atrophy were identified. Further, using mediation analysis, we demonstrated that cortical atrophy regions significantly mediated the relationship between VRF scores and cognitive decline in the AD spectrum. These findings highlight the importance of accumulating risk in the vascular contribution to AD spectrum, and targeting VRFs may provide new strategies for the therapeutic and prevention of AD.
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Niedziela N, Nowak MM, Lis M, Blaszkowska M, Kośmider R, Adamczyk-Sowa M. Atrial fibrillation as an important clinical condition of cognitive decline; diagnosis, comorbidities and severity of symptoms in patients with dementia. Neurol Res 2020; 42:430-438. [DOI: 10.1080/01616412.2020.1738648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Natalia Niedziela
- Faculty of Medical Sciences in Zabrze, Department of Neurology, Medical University of Silesia in Katowice, Poland
| | - Maria Magdalena Nowak
- Faculty of Medical Sciences in Zabrze, Department of Neurology, Medical University of Silesia in Katowice, Poland
| | - Martyna Lis
- Faculty of Medical Sciences in Zabrze, Department of Neurology, Medical University of Silesia in Katowice, Poland
| | - Maria Blaszkowska
- Faculty of Medical Sciences in Zabrze, Department of Neurology, Medical University of Silesia in Katowice, Poland
| | - Rozalia Kośmider
- Faculty of Medical Sciences in Zabrze, Department of Neurology, Medical University of Silesia in Katowice, Poland
| | - Monika Adamczyk-Sowa
- Faculty of Medical Sciences in Zabrze, Department of Neurology, Medical University of Silesia in Katowice, Poland
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42
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Montagne A, Nation DA, Sagare AP, Barisano G, Sweeney MD, Chakhoyan A, Pachicano M, Joe E, Nelson AR, D'Orazio LM, Buennagel DP, Harrington MG, Benzinger TLS, Fagan AM, Ringman JM, Schneider LS, Morris JC, Reiman EM, Caselli RJ, Chui HC, Tcw J, Chen Y, Pa J, Conti PS, Law M, Toga AW, Zlokovic BV. APOE4 leads to blood-brain barrier dysfunction predicting cognitive decline. Nature 2020; 581:71-76. [PMID: 32376954 PMCID: PMC7250000 DOI: 10.1038/s41586-020-2247-3] [Citation(s) in RCA: 683] [Impact Index Per Article: 170.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 04/01/2020] [Indexed: 01/13/2023]
Abstract
Vascular contributions to dementia and Alzheimer's disease are increasingly recognized1-6. Recent studies have suggested that breakdown of the blood-brain barrier (BBB) is an early biomarker of human cognitive dysfunction7, including the early clinical stages of Alzheimer's disease5,8-10. The E4 variant of apolipoprotein E (APOE4), the main susceptibility gene for Alzheimer's disease11-14, leads to accelerated breakdown of the BBB and degeneration of brain capillary pericytes15-19, which maintain BBB integrity20-22. It is unclear, however, whether the cerebrovascular effects of APOE4 contribute to cognitive impairment. Here we show that individuals bearing APOE4 (with the ε3/ε4 or ε4/ε4 alleles) are distinguished from those without APOE4 (ε3/ε3) by breakdown of the BBB in the hippocampus and medial temporal lobe. This finding is apparent in cognitively unimpaired APOE4 carriers and more severe in those with cognitive impairment, but is not related to amyloid-β or tau pathology measured in cerebrospinal fluid or by positron emission tomography23. High baseline levels of the BBB pericyte injury biomarker soluble PDGFRβ7,8 in the cerebrospinal fluid predicted future cognitive decline in APOE4 carriers but not in non-carriers, even after controlling for amyloid-β and tau status, and were correlated with increased activity of the BBB-degrading cyclophilin A-matrix metalloproteinase-9 pathway19 in cerebrospinal fluid. Our findings suggest that breakdown of the BBB contributes to APOE4-associated cognitive decline independently of Alzheimer's disease pathology, and might be a therapeutic target in APOE4 carriers.
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Affiliation(s)
- Axel Montagne
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Daniel A Nation
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
- Institute for Memory Disorders and Neurological Impairments, University of California, Irvine, Irvine, CA, USA
| | - Abhay P Sagare
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Giuseppe Barisano
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Melanie D Sweeney
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ararat Chakhoyan
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Maricarmen Pachicano
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Elizabeth Joe
- Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Amy R Nelson
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lina M D'Orazio
- Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
- The Hope Center for Neurodegenerative Disorders, Washington University School of Medicine, St Louis, MO, USA
| | - Anne M Fagan
- The Hope Center for Neurodegenerative Disorders, Washington University School of Medicine, St Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
- The Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St Louis, MO, USA
| | - John M Ringman
- Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lon S Schneider
- Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
- The Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St Louis, MO, USA
| | | | | | - Helena C Chui
- Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Julia Tcw
- Department of Neuroscience & Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yining Chen
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Judy Pa
- Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Laboratory of Neuroimaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Peter S Conti
- Molecular Imaging Center, Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Meng Law
- Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Neuroscience and Radiology, Monash University, Alfred Health, Melbourne, Victoria, Australia
| | - Arthur W Toga
- Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Laboratory of Neuroimaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Berislav V Zlokovic
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
- Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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Wijesinghe P, Steinbusch HWM, Shankar SK, Yasha TC, De Silva KRD. Circle of Willis abnormalities and their clinical importance in ageing brains: A cadaveric anatomical and pathological study. J Chem Neuroanat 2020; 106:101772. [PMID: 32165168 DOI: 10.1016/j.jchemneu.2020.101772] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/24/2020] [Accepted: 02/27/2020] [Indexed: 01/30/2023]
Abstract
The circle of Willis (CW) located at the base of the brain forms an important collateral network to maintain adequate cerebral perfusion, especially in clinical situations requiring compensatory changes in blood flow. Morphopathological changes in the CW may relate to the severity of the symptoms of certain neurodegenerative and cerebrovascular disorders. The purpose of this study was to investigate the CW abnormalities and their clinical importance in ageing brains. The CW was examined macroscopically in 73 formalin-fixed samples to determine the degree of stenosis of each CW component, atherosclerosis of the CW, hypoplasia (threshold diameter < 1 mm), anatomical variations and aneurysms. Age-related neurodegenerative and cerebrovascular pathologies were screened using immunohistopathological techniques on specific neuroanatomical regions based on standard guidelines. The majority of the elderly brains -93 % (68/73) presented at least a single hypoplastic CW component at death. Anatomical variations were mostly identified in communicating arteries, followed by proximal posterior and anterior cerebral arteries. Arterial bifurcations were found to be the predominant sites for cerebral aneurysms. More than 90 % of the elderly brains presented CW atherosclerosis at death. CW abnormalities did not show any strong associations with neurodegenerative pathologies except for an "at risk" significant association observed between Braak's neurofibrillary tangle (NFT) stages 1-VI and CW atherosclerosis grades ≥ mild (p = 0.05). However, a significant association was observed between microscopic infarcts in deep white matter and hypoplasia in communicating arteries with Fisher's exact test (p < 0.05). Overall, CW abnormalities were predominant in the ageing brains, however their relationships to the occurrence and severity of the symptoms of neurodegenerative pathologies were found to be low.
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Affiliation(s)
- P Wijesinghe
- Interdisciplinary Center for Innovation in Biotechnology & Neuroscience, Genetic Diagnostic & Research Laboratory and Human Brain Tissue and DNA Repository, Dept. Anatomy, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka; EURON - European Graduate School of Neuroscience, Maastricht, The Netherlands
| | - H W M Steinbusch
- Dept. Translational Neuroscience, Faculty Health, Medicine & Life Sciences, University of Maastricht, Maastricht, Netherlands; EURON - European Graduate School of Neuroscience, Maastricht, The Netherlands
| | - S K Shankar
- Dept. Neuropathology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - T C Yasha
- Dept. Neuropathology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - K R D De Silva
- Interdisciplinary Center for Innovation in Biotechnology & Neuroscience, Genetic Diagnostic & Research Laboratory and Human Brain Tissue and DNA Repository, Dept. Anatomy, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka; EURON - European Graduate School of Neuroscience, Maastricht, The Netherlands.
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44
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Weissberger GH, Gollan TH, Bondi MW, Nation DA, Hansen LA, Galasko D, Salmon DP. Neuropsychological Deficit Profiles, Vascular Risk Factors, and Neuropathological Findings in Hispanic Older Adults with Autopsy-Confirmed Alzheimer's Disease. J Alzheimers Dis 2020; 67:291-302. [PMID: 30636736 DOI: 10.3233/jad-180351] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
This study aimed to determine if patterns of neuropsychological deficits, vascular risk factors, and neuropathology differ in Hispanic and Non-Hispanic patients with autopsy-confirmed Alzheimer's disease (AD). Participants were enrolled in a longitudinal study at the Shiley-Marcos AD Research Center at the University of California, San Diego. Hispanic (n = 14) and Non-Hispanic (n = 20) patients with autopsy-confirmed AD who scored ≥95 on the Dementia Rating Scale (DRS) were included. Patient groups were matched on age, education, global mental status, and severity of functional decline; they were compared to Hispanic (n = 14) or Non-Hispanic (n = 20) cognitively-normal controls of similar age and education. Ethnicity (Hispanic, Non-Hispanic) by disease state (autopsy-confirmed AD or cognitively normal) comparisons were made for cognitive test performance and vascular risk factors. Patient groups were further compared on measures of AD (Braak stage, neuritic plaques, neurofibrillary tangles), vascular neuropathology, and performance across cognitive domains of memory, language, attention, executive functions, and visuospatial abilities after scores were z-transformed based on respective culturally-appropriate control groups. Patient groups had similar overall AD pathology burden, whereas Hispanics with AD had more small parenchymal arteriolar disease and amyloid angiopathy than Non-Hispanics with AD. Despite largely similar pathology, Hispanics with AD were less cognitively impaired (relative to respective NC groups) than Non-Hispanics with AD, and exhibited a different pattern of deficits across cognitive domains. Findings suggest that cognitive deficits that are usually prominent in AD may be less salient in Hispanic patients and this may adversely impact the ability to clinically detect the disease in mild to moderate stages.
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Affiliation(s)
- Gali H Weissberger
- Department of Family Medicine, USC Keck School of Medicine, Alhambra, CA, USA
| | - Tamar H Gollan
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,Department of Psychology, University of California, San Diego, La Jolla, CA, USA
| | - Mark W Bondi
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,Neurology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Daniel A Nation
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Lawrence A Hansen
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA.,Department of Neuropathology, University of California, San Diego, La Jolla, CA, USA
| | - Douglas Galasko
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA.,Neurology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - David P Salmon
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
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46
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Román G, Jackson R, Reis J, Román A, Toledo J, Toledo E. Extra-virgin olive oil for potential prevention of Alzheimer disease. Rev Neurol (Paris) 2019; 175:705-723. [DOI: 10.1016/j.neurol.2019.07.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/12/2019] [Accepted: 07/12/2019] [Indexed: 02/07/2023]
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Baseline White Matter Hyperintensities and Hippocampal Volume are Associated With Conversion From Normal Cognition to Mild Cognitive Impairment in the Framingham Offspring Study. Alzheimer Dis Assoc Disord 2019; 32:50-56. [PMID: 28984639 DOI: 10.1097/wad.0000000000000215] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION We examined associations between magnetic resonance imaging (MRI) markers of cerebrovascular disease and neurodegeneration with mild cognitive impairment (MCI) diagnosis at baseline and conversion from normal cognition to MCI at follow-up. METHODS Framingham Offspring participants underwent brain MRI and neuropsychological assessment at baseline (n=1049) and follow-up (n=561). Participants were classified at baseline and at follow-up as cognitively normal or MCI using sensitive neuropsychological criteria. White matter hyperintensity (WMH) volume, covert brain infarcts, hippocampal volume, and total cerebral brain volume were quantified. RESULTS Baseline measures of WMH and hippocampal volume were associated with MCI status cross-sectionally and also with conversion from normal cognition to MCI at 6.5-year follow-up. Annualized change rates in total cerebral brain volume and hippocampal volume were associated with conversion from normal cognition to MCI to follow-up. DISCUSSION Baseline WMH and hippocampal volume are markers that are both associated with conversion from normal cognition to MCI, highlighting the role of both vascular lesions and neurodegeneration in MCI.
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Shu ZY, Shao Y, Xu YY, Ye Q, Cui SJ, Mao DW, Pang PP, Gong XY. Radiomics nomogram based on MRI for predicting white matter hyperintensity progression in elderly adults. J Magn Reson Imaging 2019; 51:535-546. [PMID: 31187560 DOI: 10.1002/jmri.26813] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/17/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND White matter hyperintensity (WMH) is widely observed in aging brain and is associated with various diseases. A pragmatic and handy method in the clinic to assess and follow up white matter disease is strongly in need. PURPOSE To develop and validate a radiomics nomogram for the prediction of WMH progression. STUDY TYPE Retrospective. POPULATION Brain images of 193 WMH patients from the Picture Archiving and Communication Systems (PACS) database in the A Medical Center (Zhejiang Provincial People's Hospital). MRI data of 127 WMH patients from the PACS database in the B Medical Center (Zhejiang Lishui People's Hospital) were included for external validation. All of the patients were at least 60 years old. FIELD STRENGTH/SEQUENCE T1 -fluid attenuated inversion recovery images were acquired using a 3T scanner. ASSESSMENT WMH was evaluated utilizing the Fazekas scale based on MRI. WMH progression was assessed with a follow-up MRI using a visual rating scale. Three neuroradiologists, who were blinded to the clinical data, assessed the images independently. Moreover, interobserver and intraobserver reproducibility were performed for the regions of interest for segmentation and feature extraction. STATISTICAL TESTS A receiver operating characteristic (ROC) curve, the area under the curve (AUC) of the ROC was calculated, along with sensitivity and specificity. Also, a Hosmer-Lemeshow test was performed. RESULTS The AUC of radiomics signature in the primary, internal validation cohort, external validation cohort were 0.886, 0.816, and 0.787, respectively; the specificity were 71.79%, 72.22%, and 81%, respectively; the sensitivity were 92.68%, 87.94% and 78.3%, respectively. The radiomics nomogram in the primary cohort (AUC = 0.899) and the internal validation cohort (AUC = 0.84). The Hosmer-Lemeshow test showed no significant difference between the primary cohort and the internal validation cohort (P > 0.05). The AUC of the radiomics nomogram, radiomics signature, and hyperlipidemia in all patients from the primary and internal validation cohort was 0.878, 0.848, and 0.626, respectively. DATA CONCLUSION This multicenter study demonstrated the use of a radiomics nomogram in predicting the progression of WMH with elderly adults (an age of at least 60 years) based on conventional MRI. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:535-546.
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Affiliation(s)
- Zhen-Yu Shu
- Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Yuan Shao
- Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Yu-Yun Xu
- Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Qin Ye
- Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, China.,Second Clinical College, Zhejiang Chinese Medical University, China
| | - Si-Jia Cui
- Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, China.,Second Clinical College, Zhejiang Chinese Medical University, China
| | - De-Wang Mao
- Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, China
| | | | - Xiang-Yang Gong
- Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital of Hangzhou Medical College, Hangzhou, China.,Institute of Artificial Intelligence and Remote Imaging, Hangzhou Medical College, Hangzhou, China
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Berman JP, Norby FL, Mosley T, Soliman EZ, Gottesman RF, Lutsey PL, Alonso A, Chen LY. Atrial Fibrillation and Brain Magnetic Resonance Imaging Abnormalities. Stroke 2019; 50:783-788. [PMID: 30908155 PMCID: PMC6662638 DOI: 10.1161/strokeaha.118.024143] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 02/04/2019] [Indexed: 11/16/2022]
Abstract
Background and Purpose- Atrial fibrillation (AF) is associated with dementia independent of clinical stroke. The mechanisms underlying this association remain unclear. In a community-based cohort, the ARIC study (Atherosclerosis Risk in Communities), we evaluated (1) the longitudinal association of incident AF and (2) the cross-sectional association of prevalent AF with brain magnetic resonance imaging (MRI) abnormalities. Methods- The longitudinal analysis included 963 participants (mean age, 73±4.4 years; 62% women; 51% black) without prevalent stroke or AF who underwent a brain MRI in 1993 to 1995 and a second MRI in 2004 to 2006 (mean, 10.6±0.8 years). Outcomes included subclinical cerebral infarctions, sulcal size, ventricular size, and, for the cross-sectional analysis, white matter hyperintensity volume and total brain volume. Results- In the longitudinal analysis, 29 (3.0%) participants developed AF after the first brain MRI. Those who developed AF had higher odds of increase in subclinical cerebral infarctions (odds ratio [OR], 3.08; 95% CI, 1.39-6.83), worsening sulcal grade (OR, 3.56; 95% CI, 1.04-12.2), and worsening ventricular grade (OR, 9.34; 95% CI, 1.24-70.2). In cross-sectional analysis, of 969 participants, 35 (3.6%) had prevalent AF at the time of the 2004 to 2006 MRI scan. Those with AF had greater odds of higher sulcal (OR, 3.9; 95% CI, 1.7-9.1) and ventricular grade (OR, 2.4; 95% CI, 1.0-5.7) after multivariable adjustment and no difference in white matter hyperintensity or total brain volume. Conclusions- AF is independently associated with increase in subclinical cerebral infarction and worsening sulcal and ventricular grade-morphological changes associated with aging and dementia. More research is needed to define the mechanisms underlying AF-related neurodegeneration.
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Affiliation(s)
- Jeremy P. Berman
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA
| | - Faye L. Norby
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Thomas Mosley
- Department of Neurology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Elsayed Z. Soliman
- Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Rebecca F. Gottesman
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pamela L. Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lin Y. Chen
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA
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Chen J, Huang W, Cheng CH, Zhou L, Jiang GB, Hu YY. Association Between Aldehyde dehydrogenase-2 Polymorphisms and Risk of Alzheimer's Disease and Parkinson's Disease: A Meta-Analysis Based on 5,315 Individuals. Front Neurol 2019; 10:290. [PMID: 30984100 PMCID: PMC6448532 DOI: 10.3389/fneur.2019.00290] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 03/06/2019] [Indexed: 11/21/2022] Open
Abstract
Objective: A number of studies have reported that aldehyde dehydrogenase-2 (ALDH2) polymorphisms maybe associated with the risk of Alzheimer's disease (AD) and Parkinson's disease (PD). However, the results of such studies are inconsistent. We therefore conducted a meta-analysis to clarify the association between ALDH2 polymorphisms and the risk of AD and PD. Methods: Five online databases were searched and the relevant studies were reviewed from inception through May 10, 2018. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated in each genetic model of the general population and various subgroups. Furthermore, we simultaneously performed heterogeneity, cumulative, sensitivity, and publication bias analyses. Results: Overall, nine case-control studies involving 5,315 subjects were included in this meta-analysis. Potential associations were found between the ALDH2 rs671 G>A polymorphism and the risk of AD (A vs. G: OR = 1.46, 95%CI = 1.01–2.11, P = 0.05, I2 = 84.2%; AA vs. GG: OR = 2.22, 95%CI = 1.03–4.77, P = 0.04, I2 = 79.2%; AA vs. GG+GA: OR = 1.94, 95%CI = 1.03–3.64, P =0.04, I2 = 71.1%). In addition, some similar results were observed in other subgroups. Moreover, no significant association between ALDH2 polymorphisms and PD risk. Conclusions: In conclusion, our meta-analysis indicated that the ALDH2 rs671 G>A polymorphism plays an important role in AD development.
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Affiliation(s)
- Jun Chen
- Department of Neurology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Wei Huang
- Department of Neurology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Chao-Hui Cheng
- Department of Neurology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Lan Zhou
- Department of Neurology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Guang-Bin Jiang
- Department of Radiology, Suizhou Central Hospital, Suizhou, China
| | - Yuan-Yuan Hu
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
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