1
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Delbono O, Wang Z, Messi ML. Brainstem noradrenergic neurons: Identifying a hub at the intersection of cognition, motility, and skeletal muscle regulation. Acta Physiol (Oxf) 2022; 236:e13887. [PMID: 36073023 PMCID: PMC9588743 DOI: 10.1111/apha.13887] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/31/2022] [Accepted: 09/05/2022] [Indexed: 01/29/2023]
Abstract
Brainstem noradrenergic neuron clusters form a node integrating efferents projecting to distinct areas such as those regulating cognition and skeletal muscle structure and function, and receive dissimilar afferents through established circuits to coordinate organismal responses to internal and environmental challenges. Genetic lineage tracing shows the remarkable heterogeneity of brainstem noradrenergic neurons, which may explain their varied functions. They project to the locus coeruleus, the primary source of noradrenaline in the brain, which supports learning and cognition. They also project to pre-ganglionic neurons, which lie within the spinal cord and form synapses onto post-ganglionic neurons. The synapse between descending brainstem noradrenergic neurons and pre-ganglionic spinal neurons, and these in turn with post-ganglionic noradrenergic neurons located at the paravertebral sympathetic ganglia, support an anatomical hierarchy that regulates skeletal muscle innervation, neuromuscular transmission, and muscle trophism. Whether any noradrenergic neuron subpopulation is more susceptible to damaged protein deposit and death with ageing and neurodegeneration is a relevant question that answer will help us to detect neurodegeneration at an early stage, establish prognosis, and anticipate disease progression. Loss of muscle mass and strength with ageing, termed sarcopenia, may predict impaired cognition with ageing and neurodegeneration and establish an early time to start interventions aimed at reducing central noradrenergic neurons hyperactivity. Complex multidisciplinary approaches, including genetic tracing, specific circuit labelling, optogenetics and chemogenetics, electrophysiology, and single-cell transcriptomics and proteomics, are required to test this hypothesis pre-clinical.
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Affiliation(s)
- Osvaldo Delbono
- Department of Internal MedicineSection on Gerontology and Geriatric Medicine. Wake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Zhong‐Min Wang
- Department of Internal MedicineSection on Gerontology and Geriatric Medicine. Wake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - María Laura Messi
- Department of Internal MedicineSection on Gerontology and Geriatric Medicine. Wake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
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2
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Liu Y, Xiao X, Liu H, Liao X, Zhou Y, Weng L, Zhou L, Liu X, Bi XY, Xu T, Zhu Y, Yang Q, Zhang S, Hao X, Zhang W, Wang J, Jiao B, Shen L. Clinical characteristics and genotype-phenotype correlation analysis of familial Alzheimer’s disease patients with pathogenic/likely pathogenic amyloid protein precursor mutations. Front Aging Neurosci 2022; 14:1013295. [PMID: 36313020 PMCID: PMC9616047 DOI: 10.3389/fnagi.2022.1013295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
Alzheimer’s disease (AD) is a progressive neurodegenerative disease associated with aging, environmental, and genetic factors. Amyloid protein precursor (APP) is a known pathogenic gene for familial Alzheimer’s disease (FAD), and now more than 70 APP mutations have been reported, but the genotype-phenotype correlation remains unclear. In this study, we collected clinical data from patients carrying APP mutations defined as pathogenic/likely pathogenic according to the American college of medical genetics and genomics (ACMG) guidelines. Then, we reanalyzed the clinical characteristics and identified genotype-phenotype correlations in APP mutations. Our results indicated that the clinical phenotypes of APP mutations are generally consistent with typical AD despite the fact that they show more non-demented symptoms and neurological symptoms. We also performed genotype-phenotype analysis according to the difference in APP processing caused by the mutations, and we found that there were indeed differences in onset age, behavioral and psychological disorders of dementia (BPSD) and myoclonus.
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Affiliation(s)
- Yingzi Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xuewen Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Hui Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xinxin Liao
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
| | - Yafang Zhou
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
| | - Ling Weng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
| | - Lu Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xixi Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiang-yun Bi
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Tianyan Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yuan Zhu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qijie Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Sizhe Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoli Hao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Weiwei Zhang
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Junling Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
| | - Bin Jiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- *Correspondence: Bin Jiao,
| | - Lu Shen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Central South University, Changsha, China
- Engineering Research Center of Hunan Province in Cognitive Impairment Disorders, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
- Lu Shen,
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3
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Romoli M, Sen A, Parnetti L, Calabresi P, Costa C. Amyloid-β: a potential link between epilepsy and cognitive decline. Nat Rev Neurol 2021; 17:469-485. [PMID: 34117482 DOI: 10.1038/s41582-021-00505-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2021] [Indexed: 02/05/2023]
Abstract
People with epilepsy - in particular, late-onset epilepsy of unknown aetiology - have an elevated risk of dementia, and seizures have been detected in the early stages of Alzheimer disease (AD), supporting the concept of an epileptic AD prodrome. However, the relationship between epilepsy and cognitive decline remains controversial, with substantial uncertainties about whether epilepsy drives cognitive decline or vice versa, and whether shared pathways underlie both conditions. Here, we review evidence that amyloid-β (Aβ) forms part of a shared pathway between epilepsy and cognitive decline, particularly in the context of AD. People with epilepsy show an increased burden of Aβ pathology in the brain, and Aβ-mediated epileptogenic alterations have been demonstrated in experimental studies, with evidence suggesting that Aβ pathology might already be pro-epileptogenic at the soluble stage, long before plaque deposition. We discuss the hypothesis that Aβ mediates - or is at least a major determinant of - a continuum spanning epilepsy and cognitive decline. Serial cognitive testing and assessment of Aβ levels might be worthwhile to stratify the risk of developing dementia in people with late-onset epilepsy. If seizures are a clinical harbinger of dementia, people with late-onset epilepsy could be an ideal group in which to implement preventive or therapeutic strategies to slow cognitive decline.
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Affiliation(s)
- Michele Romoli
- Neurology Clinic, Department of Medicine and Surgery, University of Perugia - S. Maria della Misericordia Hospital, Perugia, Italy.,Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK.,Neurology and Stroke Unit, "Maurizio Bufalini" Hospital, Cesena, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Neurologia e Rete Stroke Metropolitana, Ospedale Maggiore, Bologna, Italy
| | - Arjune Sen
- Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, UK
| | - Lucilla Parnetti
- Neurology Clinic, Department of Medicine and Surgery, University of Perugia - S. Maria della Misericordia Hospital, Perugia, Italy
| | - Paolo Calabresi
- Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Neurologia, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Rome, Italy
| | - Cinzia Costa
- Neurology Clinic, Department of Medicine and Surgery, University of Perugia - S. Maria della Misericordia Hospital, Perugia, Italy.
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4
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Neuronal Network Excitability in Alzheimer's Disease: The Puzzle of Similar versus Divergent Roles of Amyloid β and Tau. eNeuro 2021; 8:ENEURO.0418-20.2020. [PMID: 33741601 PMCID: PMC8174042 DOI: 10.1523/eneuro.0418-20.2020] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/02/2020] [Accepted: 12/18/2020] [Indexed: 12/12/2022] Open
Abstract
Alzheimer’s disease (AD) is the most frequent neurodegenerative disorder that commonly causes dementia in the elderly. Recent evidence indicates that network abnormalities, including hypersynchrony, altered oscillatory rhythmic activity, interneuron dysfunction, and synaptic depression, may be key mediators of cognitive decline in AD. In this review, we discuss characteristics of neuronal network excitability in AD, and the role of Aβ and tau in the induction of network hyperexcitability. Many patients harboring genetic mutations that lead to increased Aβ production suffer from seizures and epilepsy before the development of plaques. Similarly, pathologic accumulation of hyperphosphorylated tau has been associated with hyperexcitability in the hippocampus. We present common and divergent roles of tau and Aβ on neuronal hyperexcitability in AD, and hypotheses that could serve as a template for future experiments.
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5
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Cortini F, Cantoni C, Villa C. Epileptic seizures in autosomal dominant forms of Alzheimer's disease. Seizure 2018; 61:4-7. [PMID: 30041064 DOI: 10.1016/j.seizure.2018.07.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/17/2018] [Accepted: 07/19/2018] [Indexed: 12/25/2022] Open
Abstract
Alzheimer's disease (AD) is a heterogeneous neurodegenerative disorder and represents the most common form of dementia in the elderly. Mutations in genes encoding presenilin 1 (PSEN1), presenilin 2 (PSEN2) and amyloid precursor protein (APP) are responsible for early-onset familial AD (EOFAD). Several pieces of evidence report that patients with rare autosomal dominant forms of AD carry a significant risk to develop seizures. However, the molecular mechanisms linking epilepsy and AD are needed to be clarified: the pathophysiology of seizures in AD may be related to an increased production of amyloid-β (Aβ) peptide or structural alterations in neurons probably due to cerebrovascular changes, neurotransmitter or cytoskeletal dysfunctions. Seizures have traditionally been related to neuronal loss in the late stages of AD as a consequence of neurodegeneration, however, recent studies indicated that seizures may contribute to the emergence of AD symptoms in early stages of the disease, mainly in familial AD. So, a better understanding of possible common neural mechanisms might help to improve the clinical management of both conditions. This review aims to give a comprehensive overview and to analyze the association between epilepsy and EOFAD, focusing on possible overlapping pathological mechanisms.
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Affiliation(s)
- Francesca Cortini
- Department of Clinical Sciences and Community Health, University of Milan, IRCCS Ca' Granda Foundation, Milano, Italy; Genetics Laboratory, IRCCS Ca' Granda Foundation, Milan, Italy
| | - Claudia Cantoni
- Department of Neurology, Washington University School of Medicine, St Louis, USA
| | - Chiara Villa
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
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6
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Sánchez MP, García-Cabrero AM, Sánchez-Elexpuru G, Burgos DF, Serratosa JM. Tau-Induced Pathology in Epilepsy and Dementia: Notions from Patients and Animal Models. Int J Mol Sci 2018; 19:ijms19041092. [PMID: 29621183 PMCID: PMC5979593 DOI: 10.3390/ijms19041092] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 03/23/2018] [Accepted: 04/03/2018] [Indexed: 12/24/2022] Open
Abstract
Patients with dementia present epilepsy more frequently than the general population. Seizures are more common in patients with Alzheimer’s disease (AD), dementia with Lewy bodies (LBD), frontotemporal dementia (FTD) and progressive supranuclear palsy (PSP) than in other dementias. Missense mutations in the microtubule associated protein tau (MAPT) gene have been found to cause familial FTD and PSP, while the P301S mutation in MAPT has been associated with early-onset fast progressive dementia and the presence of seizures. Brains of patients with AD, LBD, FTD and PSP show hyperphosphorylated tau aggregates, amyloid-β plaques and neuropil threads. Increasing evidence suggests the existence of overlapping mechanisms related to the generation of network hyperexcitability and cognitive decline. Neuronal overexpression of tau with various mutations found in FTD with parkinsonism-linked to chromosome 17 (FTDP-17) in mice produces epileptic activity. On the other hand, the use of certain antiepileptic drugs in animal models with AD prevents cognitive impairment. Further efforts should be made to search for plausible common targets for both conditions. Moreover, attempts should also be made to evaluate the use of drugs targeting tau and amyloid-β as suitable pharmacological interventions in epileptic disorders. The diagnosis of dementia and epilepsy in early stages of those diseases may be helpful for the initiation of treatments that could prevent the generation of epileptic activity and cognitive deterioration.
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Affiliation(s)
- Marina P Sánchez
- Laboratory of Neurology, IIS (Instituto Investigación Sanitaria/Health Research Institute)-Jiménez Díaz Foundation, UAM (Universidad Autonoma de Madrid/Autonomous University of Madrid) and Biomedical Research Network Center on Rare Diseases (CIBERER), 28045 Madrid, Spain.
| | - Ana M García-Cabrero
- Laboratory of Neurology, IIS (Instituto Investigación Sanitaria/Health Research Institute)-Jiménez Díaz Foundation, UAM (Universidad Autonoma de Madrid/Autonomous University of Madrid) and Biomedical Research Network Center on Rare Diseases (CIBERER), 28045 Madrid, Spain.
- Department of Immunology and Oncology and Protein Tools Unit, Biotechnology National Center (CNB/CSIC), 28049 Madrid, Spain.
| | - Gentzane Sánchez-Elexpuru
- Laboratory of Neurology, IIS (Instituto Investigación Sanitaria/Health Research Institute)-Jiménez Díaz Foundation, UAM (Universidad Autonoma de Madrid/Autonomous University of Madrid) and Biomedical Research Network Center on Rare Diseases (CIBERER), 28045 Madrid, Spain.
| | - Daniel F Burgos
- Laboratory of Neurology, IIS (Instituto Investigación Sanitaria/Health Research Institute)-Jiménez Díaz Foundation, UAM (Universidad Autonoma de Madrid/Autonomous University of Madrid) and Biomedical Research Network Center on Rare Diseases (CIBERER), 28045 Madrid, Spain.
| | - José M Serratosa
- Laboratory of Neurology, IIS (Instituto Investigación Sanitaria/Health Research Institute)-Jiménez Díaz Foundation, UAM (Universidad Autonoma de Madrid/Autonomous University of Madrid) and Biomedical Research Network Center on Rare Diseases (CIBERER), 28045 Madrid, Spain.
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7
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Hunter S, Brayne C. Understanding the roles of mutations in the amyloid precursor protein in Alzheimer disease. Mol Psychiatry 2018; 23:81-93. [PMID: 29112196 DOI: 10.1038/mp.2017.218] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 08/23/2017] [Accepted: 08/24/2017] [Indexed: 12/16/2022]
Abstract
Many models of disease progression in Alzheimer's disease (AD) have been proposed to help guide experimental design and aid the interpretation of results. Models focussing on the genetic evidence include the amyloid cascade (ACH) and presenilin (PSH) hypotheses and the amyloid precursor protein (APP) matrix approach (AMA), of which the ACH has held a dominant position for over two decades. However, the ACH has never been fully accepted and has not yet delivered on its therapeutic promise. We review the ACH, PSH and AMA in relation to levels of APP proteolytic fragments reported from AD-associated mutations in APP. Different APP mutations have diverse effects on the levels of APP proteolytic fragments. This evidence is consistent with at least three disease pathways that can differ between familial and sporadic AD and two pathways associated with cerebral amyloid angiopathy. We cannot fully evaluate the ACH, PSH and AMA in relation to the effects of mutations in APP as the APP proteolytic system has not been investigated systematically. The confounding effects of sequence homology, complexity of competing cleavages and antibody cross reactivities all illustrate limitations in our understanding of the roles these fragments and the APP proteolytic system as a whole in normal aging and disease play. Current experimental design should be refined to generate clearer evidence, addressing both aging and complex disorders with standardised reporting formats. A more flexible theoretical framework capable of accommodating the complexity of the APP proteolytic system is required to integrate available evidence.
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Affiliation(s)
- S Hunter
- Department of Public Health and Primary Care, Institute of Public Health, Forvie Site University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - C Brayne
- Department of Public Health and Primary Care, Institute of Public Health, Forvie Site University of Cambridge, School of Clinical Medicine, Cambridge, UK
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8
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Palop JJ, Mucke L. Network abnormalities and interneuron dysfunction in Alzheimer disease. Nat Rev Neurosci 2016; 17:777-792. [PMID: 27829687 DOI: 10.1038/nrn.2016.141] [Citation(s) in RCA: 618] [Impact Index Per Article: 77.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The function of neural circuits and networks can be controlled, in part, by modulating the synchrony of their components' activities. Network hypersynchrony and altered oscillatory rhythmic activity may contribute to cognitive abnormalities in Alzheimer disease (AD). In this condition, network activities that support cognition are altered decades before clinical disease onset, and these alterations predict future pathology and brain atrophy. Although the precise causes and pathophysiological consequences of these network alterations remain to be defined, interneuron dysfunction and network abnormalities have emerged as potential mechanisms of cognitive dysfunction in AD and related disorders. Here, we explore the concept that modulating these mechanisms may help to improve brain function in these conditions.
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Affiliation(s)
- Jorge J Palop
- Gladstone Institute of Neurological Disease, 1650 Owens Street, San Francisco, California 94158, USA.,Department of Neurology, University of California, San Francisco, 1650 Owens Street, San Francisco, California 94158, USA
| | - Lennart Mucke
- Gladstone Institute of Neurological Disease, 1650 Owens Street, San Francisco, California 94158, USA.,Department of Neurology, University of California, San Francisco, 1650 Owens Street, San Francisco, California 94158, USA
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9
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Bagyinszky E, Youn YC, An SSA, Kim S. Mutations, associated with early-onset Alzheimer's disease, discovered in Asian countries. Clin Interv Aging 2016; 11:1467-1488. [PMID: 27799753 PMCID: PMC5074729 DOI: 10.2147/cia.s116218] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Alzheimer's disease (AD), the most common form of senile dementia, is a genetically complex disorder. In most Asian countries, the population and the number of AD patients are growing rapidly, and the genetics of AD has been extensively studied, except in Japan. However, recent studies have been started to investigate the genes and mutations associated with AD in Korea, the People's Republic of China, and Malaysia. This review describes all of the known mutations in three early-onset AD (EOAD) causative genes (APP, PSEN1, and PSEN2) that were discovered in Asian countries. Most of the EOAD-associated mutations have been detected in PSEN1, and several novel PSEN1 mutations were recently identified in patients from various parts of the world, including Asia. Until 2014, no PSEN2 mutations were found in Asian patients; however, emerging studies from Korea and the People's Republic of China discovered probably pathogenic PSEN2 mutations. Since several novel mutations were discovered in these three genes, we also discuss the predictions on their pathogenic nature. This review briefly summarizes genome-wide association studies of late-onset AD and the genes that might be associated with AD in Asian countries. Standard sequencing is a widely used method, but it has limitations in terms of time, cost, and efficacy. Next-generation sequencing strategies could facilitate genetic analysis and association studies. Genetic testing is important for the accurate diagnosis and for understanding disease-associated pathways and might also improve disease therapy and prevention.
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Affiliation(s)
- Eva Bagyinszky
- Department of BioNano Technology, Gachon University, Gyeonggi-do
| | - Young Chul Youn
- Department of Neurology, College of Medicine, Chung-Ang University, Seoul
| | - Seong Soo A An
- Department of BioNano Technology, Gachon University, Gyeonggi-do
| | - SangYun Kim
- Department of Neurology, Seoul National University Budang Hospital, Gyeonggi-do, South Korea
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10
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Jensen-Dahm C, Waldemar G, Staehelin Jensen T, Malmqvist L, Moeller MM, Andersen BB, Høgh P, Ballegaard M. Autonomic Dysfunction in Patients with Mild to Moderate Alzheimer's Disease. J Alzheimers Dis 2016; 47:681-9. [PMID: 26401703 DOI: 10.3233/jad-150169] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Autonomic function has received little attention in Alzheimer's disease (AD). AD pathology has an impact on brain regions which are important for central autonomic control, but it is unclear if AD is associated with disturbance of autonomic function. OBJECTIVE To investigate autonomic function using standardized techniques in patients with AD and healthy age-matched controls. METHOD Thirty-three patients with mild to moderate AD and 30 age- and gender-matched healthy controls, without symptoms of autonomic dysfunction, underwent standardized autonomic testing with deep breathing, Valsalva maneuver, head-up tilt, and isometric handgrip test. Brachial pressure curve and electrocardiogram were recorded for off-line analysis of blood pressure and beat-to-beat heart rate (HR). RESULTS AD patients had impaired blood pressure responses to Vasalva maneuver (p < 0.0001) and HR response to isometric contraction (p = 0.0001). A modified composite autonomic scoring scale showed greater degree of autonomic impairment in patients compared to controls (patient: 2.1 ± 1.6; controls: 0.9 ± 1.1, p = 0.001). HR response to deep breathing and Valsalva ratio were similar in the two groups. CONCLUSION We identified autonomic impairment ranging from mild to severe in patients with mild to moderate AD, who did not report autonomic symptoms. Autonomic impairment was mainly related to impairment of sympathetic function and evident by impaired blood pressure response to the Vasalva maneuver. The clinical implications of this finding are that AD may be associated with autonomic disturbances, but patients with AD may rarely report symptoms of autonomic dysfunction. Future research should systematically evaluate symptoms of autonomic function and characterize risk factors associated with autonomic dysfunction.
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Affiliation(s)
- Christina Jensen-Dahm
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | | | - Lasse Malmqvist
- Department of Clinical Neurophysiology, Rigshospitalet, University of Copenhagen, Denmark
| | - Michelle Mai Moeller
- Department of Clinical Neurophysiology, Rigshospitalet, University of Copenhagen, Denmark
| | - Birgitte Bo Andersen
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Peter Høgh
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Martin Ballegaard
- Department of Clinical Neurophysiology, Rigshospitalet, University of Copenhagen, Denmark
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11
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Noroozian M, Azadfar P, Akbari L, Sadeghi A, Houshmand M, Vousooghi N, Zarrindast MR, Minagar A. Early-onset Alzheimer's disease in two Iranian families: a genetic study. Dement Geriatr Cogn Disord 2015; 38:330-6. [PMID: 25138979 DOI: 10.1159/000358232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Early-onset Alzheimer's disease (EOAD) represents less than 5% of all AD cases. Autosomal dominant EOAD has been defined as the occurrence of at least three cases in three generations. Mutations in the amyloid precursor protein (APP), presenilin-1 and presenilin-2 genes have been recognized to be the cause of EOAD. OBJECTIVE We investigated the genotype of EOAD in two generations of two families with EOAD living in an Iranian village. METHODS The polymerase chain reaction method was used to study the presenilin-1 and APP genes in 25 subjects of these generations. RESULTS A guanine-to-adenine transition in exon 17 of the APP gene resulting in a valine-to-isoleucine substitution at codon 717 was detected in 14 subjects including 6 patients with EOAD. CONCLUSION This mutation demonstrates the importance of γ-secretase, the necessity of early detection of patients with memory decline in the susceptible population and raising public awareness of consanguinity marriages.
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Affiliation(s)
- Maryam Noroozian
- Memory and Behavioral Neurology Department (MBND), Roozbeh Hospital, Tehran, Iran
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12
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Born HA. Seizures in Alzheimer's disease. Neuroscience 2014; 286:251-63. [PMID: 25484360 DOI: 10.1016/j.neuroscience.2014.11.051] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 11/12/2014] [Accepted: 11/24/2014] [Indexed: 10/24/2022]
Abstract
Alzheimer's disease (AD) increases the risk for late-onset seizures and neuronal network abnormalities. An elevated co-occurrence of AD and seizures has been established in the more prevalent sporadic form of AD. Recent evidence suggests that nonconvulsive network abnormalities, including seizures and other electroencephalographic abnormalities, may be more commonly found in patients than previously thought. Patients with familial AD are at an even greater risk for seizures, which have been found in patients with mutations in PSEN1, PSEN2, or APP, as well as with APP duplication. This review also provides an overview of seizure and electroencephalography studies in AD mouse models. The amyloid-β (Aβ) peptide has been identified as a possible link between AD and seizures, and while Aβ is known to affect neuronal activity, the full-length amyloid precursor protein (APP) and other APP cleavage products may be important for the development and maintenance of cortical network hyperexcitability. Nonconvulsive epileptiform activity, such as seizures or network abnormalities that are shorter in duration but may occur with higher frequency, may contribute to cognitive impairments characteristic of AD, such as amnestic wandering. Finally, the review discusses recent studies using antiepileptic drugs to rescue cognitive deficits in AD mouse models and human patients. Understanding the mechanistic link between epileptiform activity and AD is a research area of growing interest. Further understanding of the connection between neuronal hyperexcitability and Alzheimer's as well as the potential role of epileptiform activity in the progression of AD will be beneficial for improving treatment strategies.
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Affiliation(s)
- H A Born
- Department of Neuroscience, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
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Sherzai D, Losey T, Vega S, Sherzai A. Seizures and dementia in the elderly: Nationwide Inpatient Sample 1999-2008. Epilepsy Behav 2014; 36:53-6. [PMID: 24857809 DOI: 10.1016/j.yebeh.2014.04.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 04/01/2014] [Accepted: 04/18/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This study aimed to examine the association between incidence of admission for a primary diagnosis of "seizure" or "epilepsy" and dementia in a nationally representative database, the Nationwide Inpatient Sample, among the elderly population (55 years of age and above) and to determine whether this relationship is different in individuals with Alzheimer's dementia versus those with non-Alzheimer's dementia. METHODS Data were obtained from the Nationwide Inpatient Sample using appropriate ICD-9 codes. Frequencies and descriptive analysis adjusting for influence of comorbidities and confounders were utilized. A multivariate logistic regression model adjusted for age, gender, and race was used to further explore the relationship. RESULTS Those with AD had a higher risk of developing seizures or epilepsy (OR=3.07, 95% CI=2.98-3.16) as compared with cases with NAD (OR=2.20, 95% CI=2.14-2.27). After adjusting for age, the association increased for patients with AD (OR=4.065, 95% CI=3.95-4.17) but not appreciably for patients with NAD (OR=2.68, 95% CI=2.60-2.75). Adding gender and race to the model did not change the relationship for either AD or NAD. Further adjustment for African-American race did not further change the relationship for AD and seizure (OR=3.96, 95% CI=3.854-4.077) as well as for NAD and seizure (OR=2.652, 95% CI=2.575-2.731). Similarly, Hispanic race did not change the relationship significantly for AD (OR=4.1, 95% CI=4.01-4.25) and NAD (OR=2.65, 95% CI=2.56-2.74). CONCLUSION Patients with AD have a higher prevalence of a seizure compared with patients with NAD. Younger patients with AD were more likely to have seizures. Race, when analyzed as a whole and separately as African-American and Hispanic race, did not alter this relationship.
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Affiliation(s)
- Dean Sherzai
- Department of Neurology, Loma Linda University Medical Center, 11175 Campus St., CP 11108, Loma Linda, CA 92354, USA.
| | - Travis Losey
- Department of Neurology, Loma Linda University Medical Center, 11175 Campus St., CP 11108, Loma Linda, CA 92354, USA
| | - Sonia Vega
- Department of Epidemiology and Biostatistics, Loma Linda School of Public Health, 24951 North Circle Drive, Loma Linda, CA 92350, USA
| | - Ayesha Sherzai
- Department of Neurology, Loma Linda University Medical Center, 11175 Campus St., CP 11108, Loma Linda, CA 92354, USA
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Noebels J. A perfect storm: Converging paths of epilepsy and Alzheimer's dementia intersect in the hippocampal formation. Epilepsia 2011; 52 Suppl 1:39-46. [PMID: 21214538 DOI: 10.1111/j.1528-1167.2010.02909.x] [Citation(s) in RCA: 165] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Seizures in the human temporal lobe transiently impair cognition and steadily damage hippocampal circuitry, leading to progressive memory loss. Similarly, the toxic accumulation of Aβ peptides underlying Alzheimer's disease (AD) triggers synaptic degeneration, circuit remodeling, and abnormal synchronization within the same networks. Because neuronal hyperexcitability amplifies the synaptic release of Aβ, seizures create a vicious spiral that accelerates cell death and cognitive decline in the AD brain. The confluence of hyperexcitability and excitotoxicity, combined with the challenge of seizure detection in the human hippocampus, make epilepsy in these individuals extremely important to correctly diagnose and treat. Emerging clinical evidence reveals an elevated comorbidity of epilepsy in AD, particularly when linked to mutations in the APP/Aβ gene pathway. Experimental models in genetically engineered mice confirm and extend these findings, highlighting the presence of subclinical seizures and overlapping pathophysiologic cascades. There is an urgent need for more clinical and basic investigation to improve the early recognition of hippocampal seizures arising during the course of dementing disorders, and to validate molecular blockers of Aβ-induced aberrant excitability that can slow and potentially reverse the progression of cognitive decline.
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Affiliation(s)
- Jeffrey Noebels
- Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA.
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Lindquist SG, Schwartz M, Batbayli M, Waldemar G, Nielsen JE. Genetic testing in familial AD and FTD: mutation and phenotype spectrum in a Danish cohort. Clin Genet 2009; 76:205-9. [PMID: 19659892 DOI: 10.1111/j.1399-0004.2009.01191.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Autosomal dominantly transmitted Alzheimer's disease (AD) and frontotemporal dementia (FTD) are genetically heterogeneous disorders. To date, three genes have been identified in which mutations cause early-onset autosomal dominant inherited AD: APP, PSEN1, and PSEN2. Mutations in two genes on chromosome 17, the MAPT and the PGRN genes, are associated with autosomal dominant inherited FTD. The aim of this study was to characterize the mutation spectrum and describe genotype-phenotype correlations in families with inherited dementia. The identification of novel mutations and/or atypical genotype-phenotype correlations contributes to further characterizing the disorders. DNA-samples from the 90 index cases from a Danish referral-based cohort representing families with presumed autosomal dominant inherited AD or FTD were screened for mutations in the known genes with sequencing, denaturing high-performance liquid chromatography (DHPLC) and multiplex ligation-dependent probe amplification (MLPA) techniques. Seven presumed pathogenic mutations (two PSEN1, one PSEN2, one APP, one MAPT, and two PGRN) were identified, including a novel PSEN2 mutation (V393M). No dosage aberrations were identified.
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Affiliation(s)
- S G Lindquist
- Neurogenetics Clinic, Memory Disorders Research Group, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
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Gankam Kengne F, Vokaer M, Fery P, Abramowicz M, Massat I, Van den Broeck M, Van Broeckhoven C, Bier JC. Pure progressive amnesia as variant of genetically proven Alzheimer disease. Eur J Neurol 2009; 16:e9-10. [DOI: 10.1111/j.1468-1331.2008.02391.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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