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Atef MM, Mostafa YM, Ahmed AAM, El-Sayed NM. Simvastatin attenuates aluminium chloride-induced neurobehavioral impairments through activation of TGF-β1/ SMAD2 and GSK3β/β-catenin signalling pathways. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2023; 102:104220. [PMID: 37454825 DOI: 10.1016/j.etap.2023.104220] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/19/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disease characterised by the presence of β-amyloid plaques and acetylcholine depletion leading to neurobehavioral defects. AD was contributed also with downregulation of TGF-β1/SMAD2 and GSK3β/β-catenin pathways. Simvastatin (SMV) improved memory function experimentally and clinically. Hence, this study aimed to investigate the mechanistic role of SMV against aluminium chloride (AlCl3) induced neurobehavioral impairments. AD was induced by AlCl3 (50 mg/kg) for 6 weeks. Mice received Simvastatin (10 or 20 mg/kg) or Donepezil (3 mg/kg) for 6 weeks after that the histopathological, immunohistochemical and biochemical test were examined. Treatment with SMV improved the memory deterioration induced by AlCl3 with significant recovery of the histopathological changes. This was concomitant with the decrease of AChE and Aβ (1-42). SMV provides its neuroprotective effect through upregulating the protein expression of β-catenin, TGF-β1 and downregulating the expression of GSK3β, TLR4 and p-SMAD2.
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Affiliation(s)
| | - Yasser M Mostafa
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt; Department of Pharmacology & Toxicology, Faculty of Pharmacy, Badr University in Cairo, Egypt
| | - Amal A M Ahmed
- Department of Cytology & Histology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Norhan M El-Sayed
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt.
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2
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Toledo JB, Abdelnour C, Weil RS, Ferreira D, Rodriguez-Porcel F, Pilotto A, Wyman-Chick KA, Grothe MJ, Kane JPM, Taylor A, Rongve A, Scholz S, Leverenz JB, Boeve BF, Aarsland D, McKeith IG, Lewis S, Leroi I, Taylor JP. Dementia with Lewy bodies: Impact of co-pathologies and implications for clinical trial design. Alzheimers Dement 2023; 19:318-332. [PMID: 36239924 PMCID: PMC9881193 DOI: 10.1002/alz.12814] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/29/2022] [Accepted: 09/09/2022] [Indexed: 02/01/2023]
Abstract
Dementia with Lewy bodies (DLB) is clinically defined by the presence of visual hallucinations, fluctuations, rapid eye movement (REM) sleep behavioral disorder, and parkinsonism. Neuropathologically, it is characterized by the presence of Lewy pathology. However, neuropathological studies have demonstrated the high prevalence of coexistent Alzheimer's disease, TAR DNA-binding protein 43 (TDP-43), and cerebrovascular pathologic cases. Due to their high prevalence and clinical impact on DLB individuals, clinical trials should account for these co-pathologies in their design and selection and the interpretation of biomarkers values and outcomes. Here we discuss the frequency of the different co-pathologies in DLB and their cross-sectional and longitudinal clinical impact. We then evaluate the utility and possible applications of disease-specific and disease-nonspecific biomarkers and how co-pathologies can impact these biomarkers. We propose a framework for integrating multi-modal biomarker fingerprints and step-wise selection and assessment of DLB individuals for clinical trials, monitoring target engagement, and interpreting outcomes in the setting of co-pathologies.
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Affiliation(s)
- Jon B Toledo
- Nantz National Alzheimer Center, Stanley H. Appel Department of Neurology, Houston Methodist Hospital, Houston, Texas, USA
| | - Carla Abdelnour
- Fundació ACE. Barcelona Alzheimer Treatment and Research Center, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Rimona S Weil
- Dementia Research Centre, Wellcome Centre for Human Neuroimaging, Movement Disorders Consortium, National Hospital for Neurology and Neurosurgery, University College London, London, UK
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer's Research, Karolinska Institutet, Stockholm, Sweden
| | | | - Andrea Pilotto
- Department of Clinical and Experimental Sciences, University of Brescia, Parkinson's Disease Rehabilitation Centre, FERB ONLUS-S, Isidoro Hospital, Trescore Balneario (BG), Italy
| | - Kathryn A Wyman-Chick
- HealthPartners Center for Memory and Aging and Struthers Parkinson's Center, Saint Paul, Minnesota, USA
| | - Michel J Grothe
- Instituto de Biomedicina de Sevilla (IBiS), Unidad de Trastornos del Movimiento, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Joseph P M Kane
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Angela Taylor
- Lewy Body Dementia Association, Lilburn, Georgia, USA
| | - Arvid Rongve
- Department of Research and Innovation, Institute of Clinical Medicine (K1), Haugesund Hospital, Norway and The University of Bergen, Bergen, Norway
| | - Sonja Scholz
- Department of Neurology, National Institute of Neurological Disorders and Stroke, Neurodegenerative Diseases Research Unit, Johns Hopkins University Medical Center, Baltimore, Maryland, USA
| | - James B Leverenz
- Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, Ohio, USA
| | - Bradley F Boeve
- Department of Neurology and Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Ian G McKeith
- Newcastle University Translational and Clinical Research Institute (NUTCRI, Newcastle upon Tyne, UK
| | - Simon Lewis
- ForeFront Parkinson's Disease Research Clinic, School of Medical Sciences, Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Iracema Leroi
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - John P Taylor
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
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3
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Zukotynski K, Black SE, Kuo PH, Bhan A, Adamo S, Scott CJM, Lam B, Masellis M, Kumar S, Fischer CE, Tartaglia MC, Lang AE, Tang-Wai DF, Freedman M, Vasdev N, Gaudet V. Exploratory Assessment of K-means Clustering to Classify 18F-Flutemetamol Brain PET as Positive or Negative. Clin Nucl Med 2021; 46:616-620. [PMID: 33883495 DOI: 10.1097/rlu.0000000000003668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
RATIONALE We evaluated K-means clustering to classify amyloid brain PETs as positive or negative. PATIENTS AND METHODS Sixty-six participants (31 men, 35 women; age range, 52-81 years) were recruited through a multicenter observational study: 19 cognitively normal, 25 mild cognitive impairment, and 22 dementia (11 Alzheimer disease, 3 subcortical vascular cognitive impairment, and 8 Parkinson-Lewy Body spectrum disorder). As part of the neurocognitive and imaging evaluation, each participant had an 18F-flutemetamol (Vizamyl, GE Healthcare) brain PET. All studies were processed using Cortex ID software (General Electric Company, Boston, MA) to calculate SUV ratios in 19 regions of interest and clinically interpreted by 2 dual-certified radiologists/nuclear medicine physicians, using MIM software (MIM Software Inc, Cleveland, OH), blinded to the quantitative analysis, with final interpretation based on consensus. K-means clustering was retrospectively used to classify the studies from the quantitative data. RESULTS Based on clinical interpretation, 46 brain PETs were negative and 20 were positive for amyloid deposition. Of 19 cognitively normal participants, 1 (5%) had a positive 18F-flutemetamol brain PET. Of 25 participants with mild cognitive impairment, 9 (36%) had a positive 18F-flutemetamol brain PET. Of 22 participants with dementia, 10 (45%) had a positive 18F-flutemetamol brain PET; 7 of 11 participants with Alzheimer disease (64%), 1 of 3 participants with vascular cognitive impairment (33%), and 2 of 8 participants with Parkinson-Lewy Body spectrum disorder (25%) had a positive 18F-flutemetamol brain PET. Using clinical interpretation as the criterion standard, K-means clustering (K = 2) gave sensitivity of 95%, specificity of 98%, and accuracy of 97%. CONCLUSIONS K-means clustering may be a powerful algorithm for classifying amyloid brain PET.
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Affiliation(s)
| | | | - Phillip H Kuo
- Departments of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona Cancer Center, University of Arizona, Tucson, AZ
| | - Aparna Bhan
- LC Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto
| | - Sabrina Adamo
- LC Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto
| | - Christopher J M Scott
- LC Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto
| | | | | | | | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, St Michael's Hospital, University of Toronto
| | | | | | | | | | | | - Vincent Gaudet
- Department of Electrical and Computer Engineering, University of Waterloo, Waterloo, Ontario, Canada
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Abstract
Dementia with Lewy bodies (DLB) is one of the most common forms of dementia. It can present as neurocognitive decline, visual hallucinations, and concomitant symptoms of rapid eye movement (REM) sleep behavior disorder. Early diagnosis remains one of the cornerstones of managing this form of neurocognitive disorder but, often, making an early and accurate diagnosis can prove to be challenging. For this article, our goal was to review the utility of various neuroimaging modalities in making a swift and accurate diagnosis of DLB. We used PubMed to look for helpful, informative, and peer-reviewed articles. We discussed the role of a plethora of different imaging techniques, ranging from structural imaging like computed tomography (CT) and magnetic resonance imaging (MRI) to molecular imaging (single-photon emission computed tomography, positron emission to- tomography) as a diagnostic tool for DLB. We arrived at the conclusion that these novel neuroimaging modalities have already proven to be very helpful in ruling out differentials and making an early diagnosis of DLB. However, ongoing research is required to increase the diagnostic accuracy, leading to the early identification and treatment of DLB.
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Affiliation(s)
- Abhishikta Saha
- General Medicine, Pennine Acute Hospitals NHS Trust, Manchester, GBR
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Abstract
Amyloid-β (Aβ) PET imaging has now been available for over 15 years. The ability to detect Aβ in vivo has greatly improved the clinical and research landscape of Alzheimer's disease (AD) and other neurodegenerative conditions. Aβ imaging provides very reliable, accurate, and reproducible measurements of regional and global Aβ burden in the brain. It has proved invaluable in anti-Aβ therapy trials, and is now recognized as a powerful diagnostic tool. The appropriate use of Aβ PET, when combined with comprehensive clinical evaluation by a dementia-trained specialist, can improve the accuracy of a clinical diagnosis of AD and substantially alter management. It can assist in differentiating AD from other neurodegenerative conditions, often by its ability to rule out the presence of Aβ. When combined with tau imaging, further increase in specificity for the diagnosis of AD can be achieved. The integration of Aβ PET, in conjunction with biomarkers of tau, neurodegeneration and neuroinflammation, into large, longitudinal, observational cohort studies continues to increase our understanding of the development of AD. Its incorporation into clinical trials has been pivotal in defining the most effective anti-Aβ biological therapies and optimal dosing so that effective disease modifying therapy now appears imminent. Aβ deposition is a gradual and protracted process, permitting a wide treatment window for anti-Aβ therapies and Aβ PET has made trials in this preclinical AD period feasible. Continuing improvement in Aβ tracer target to background ratio is allowing trials in earlier AD that tailor drug dosage to Aβ level. The quest to standardize quantification and define universally applicable thresholds for all Aβ tracers has produced the Centiloid method. Centiloid values that correlate well with neuropathologic findings and prognosis have been identified. Rapid cloud-based automated individual scan analysis is now possible and does not require MRI. Challenges remain, particularly around cross camera standardized uptake value ratio variation that need to be addressed. This review will compare available Aβ radiotracers, discuss approaches to quantification, as well as the clinical and research applications of Aβ PET.
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Affiliation(s)
- Natasha Krishnadas
- Florey Department of Neurosciences and Mental Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia; Department of Molecular Imaging & Therapy, Austin Health, Victoria, Australia
| | - Victor L Villemagne
- Department of Molecular Imaging & Therapy, Austin Health, Victoria, Australia
| | - Vincent Doré
- Department of Molecular Imaging & Therapy, Austin Health, Victoria, Australia; Health and Biosecurity Flagship, The Australian eHealth Research Centre, CSIRO, Victoria, Australia
| | - Christopher C Rowe
- Department of Molecular Imaging & Therapy, Austin Health, Victoria, Australia; The Australian Dementia Network (ADNeT), Melbourne, Australia; The University of Melbourne, Victoria, Australia.
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Saeed U, Lang AE, Masellis M. Neuroimaging Advances in Parkinson's Disease and Atypical Parkinsonian Syndromes. Front Neurol 2020; 11:572976. [PMID: 33178113 PMCID: PMC7593544 DOI: 10.3389/fneur.2020.572976] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/02/2020] [Indexed: 12/11/2022] Open
Abstract
Parkinson's disease (PD) and atypical Parkinsonian syndromes are progressive heterogeneous neurodegenerative diseases that share clinical characteristic of parkinsonism as a common feature, but are considered distinct clinicopathological disorders. Based on the predominant protein aggregates observed within the brain, these disorders are categorized as, (1) α-synucleinopathies, which include PD and other Lewy body spectrum disorders as well as multiple system atrophy, and (2) tauopathies, which comprise progressive supranuclear palsy and corticobasal degeneration. Although, great strides have been made in neurodegenerative disease research since the first medical description of PD in 1817 by James Parkinson, these disorders remain a major diagnostic and treatment challenge. A valid diagnosis at early disease stages is of paramount importance, as it can help accommodate differential prognostic and disease management approaches, enable the elucidation of reliable clinicopathological relationships ideally at prodromal stages, as well as facilitate the evaluation of novel therapeutics in clinical trials. However, the pursuit for early diagnosis in PD and atypical Parkinsonian syndromes is hindered by substantial clinical and pathological heterogeneity, which can influence disease presentation and progression. Therefore, reliable neuroimaging biomarkers are required in order to enhance diagnostic certainty and ensure more informed diagnostic decisions. In this article, an updated presentation of well-established and emerging neuroimaging biomarkers are reviewed from the following modalities: (1) structural magnetic resonance imaging (MRI), (2) diffusion-weighted and diffusion tensor MRI, (3) resting-state and task-based functional MRI, (4) proton magnetic resonance spectroscopy, (5) transcranial B-mode sonography for measuring substantia nigra and lentiform nucleus echogenicity, (6) single photon emission computed tomography for assessing the dopaminergic system and cerebral perfusion, and (7) positron emission tomography for quantifying nigrostriatal functions, glucose metabolism, amyloid, tau and α-synuclein molecular imaging, as well as neuroinflammation. Multiple biomarkers obtained from different neuroimaging modalities can provide distinct yet corroborative information on the underlying neurodegenerative processes. This integrative "multimodal approach" may prove superior to single modality-based methods. Indeed, owing to the international, multi-centered, collaborative research initiatives as well as refinements in neuroimaging technology that are currently underway, the upcoming decades will mark a pivotal and exciting era of further advancements in this field of neuroscience.
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Affiliation(s)
- Usman Saeed
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Anthony E Lang
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,Edmond J Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Mario Masellis
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.,L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Center, Toronto, ON, Canada.,Cognitive and Movement Disorders Clinic, Sunnybrook Health Sciences Center, Toronto, ON, Canada
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7
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Na S, Jeong H, Park JS, Chung YA, Song IU. The Impact of Amyloid-Beta Positivity with 18F-Florbetaben PET on Neuropsychological Aspects in Parkinson's Disease Dementia. Metabolites 2020; 10:metabo10100380. [PMID: 32977481 PMCID: PMC7598210 DOI: 10.3390/metabo10100380] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 01/23/2023] Open
Abstract
The neuropathology of Parkinson’s disease dementia (PDD) is heterogenous, and the impacts of each pathophysiology and their synergistic effects are not fully understood. The aim of this study was to evaluate the frequency and impacts of co-existence with Alzheimer’s disease in patients with PDD by using 18F-florbetaben PET imaging. A total of 23 patients with PDD participated in the study. All participants underwent 18F-florbetaben PET and completed a standardized neuropsychological battery and assessment of motor symptoms. The results of cognitive tests, neuropsychiatric symptoms, and motor symptoms were analyzed between the positive and negative 18F-florbetaben PET groups. Four patients (17.4%) showed significant amyloid burden. Patients with amyloid-beta showed poorer performance in executive function and more severe neuropsychiatric symptoms than those without amyloid-beta. Motor symptoms assessed by UPDRS part III and the modified H&Y Scale were not different between the two groups. The amyloid PET scan of a patient with PDD can effectively reflect a co-existing Alzheimer’s disease pathology. Amyloid PET scans might be able to help physicians of PDD patients showing rapid progression or severe cognitive/behavioral features.
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Affiliation(s)
- Seunghee Na
- Department of Neurology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea; (S.N.); (J.-S.P.)
| | - Hyeonseok Jeong
- Department of Radiology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea;
- Department of Nuclear Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea
| | - Jong-Sik Park
- Department of Neurology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea; (S.N.); (J.-S.P.)
| | - Yong-An Chung
- Department of Radiology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea;
- Department of Nuclear Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea
- Correspondence: (Y.-A.C.); (I.-U.S.); Tel.: +82-32-280-5242 (Y.-A.C.); Tel.: +82-32-280-5010 (I.-U.S.); Fax: +82-32-280-5244 (Y.-A.C. & I.-U.S.)
| | - In-Uk Song
- Department of Neurology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 21431, Korea; (S.N.); (J.-S.P.)
- Correspondence: (Y.-A.C.); (I.-U.S.); Tel.: +82-32-280-5242 (Y.-A.C.); Tel.: +82-32-280-5010 (I.-U.S.); Fax: +82-32-280-5244 (Y.-A.C. & I.-U.S.)
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8
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Fujishiro H, Kosaka K. When does cerebral β‐amyloid deposition begin in Lewy body dementia? ACTA ACUST UNITED AC 2020. [DOI: 10.1111/ncn3.12372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Hiroshige Fujishiro
- Department of Psychiatry Kawasaki Memorial Hospital Miyamae Kawasaki Japan
- Department of Psychiatry Nagoya University Graduate School of Medicine Showa, Nagoya Japan
- Department of Psychiatry Yokohama City University School of Medicine Kanazawa, Yokohama Japan
| | - Kenji Kosaka
- Department of Psychiatry Yokohama City University School of Medicine Kanazawa, Yokohama Japan
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9
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Kantarci K, Lowe VJ, Chen Q, Przybelski SA, Lesnick TG, Schwarz CG, Senjem ML, Gunter JL, Jack CR, Graff-Radford J, Jones DT, Knopman DS, Graff-Radford N, Ferman TJ, Parisi JE, Dickson DW, Petersen RC, Boeve BF, Murray ME. β-Amyloid PET and neuropathology in dementia with Lewy bodies. Neurology 2020; 94:e282-e291. [PMID: 31862783 PMCID: PMC7108811 DOI: 10.1212/wnl.0000000000008818] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/07/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE β-Amyloid (Aβ) pathology is common in patients with probable dementia with Lewy bodies (DLB). However, the pathologic basis and the differential diagnostic performance of Aβ PET are not established in DLB. Our objective was to investigate the pathologic correlates of 11C-Pittsburgh compound B(PiB) uptake on PET in cases with antemortem diagnosis of probable DLB or Lewy body disease (LBD) at autopsy. METHODS Autopsied cases who underwent antemortem PiB-PET and were assigned a clinical diagnosis of probable DLB or LBD at autopsy were included (n = 39). The primary endpoint was pathologic diagnosis of LBD, Alzheimer disease (AD), or mixed (LBD and AD) pathology; the secondary endpoints included Thal Aβ phase and diffuse and neuritic Aβ plaques. RESULTS Lower global cortical PiB standardized uptake value ratio (SUVr) distinguished cases with LBD from cases with AD or mixed pathology with an accuracy of 93%. Greater global cortical PiB SUVr correlated with higher Thal Aβ phase (r = 0.75, p ≤ 0.001). Voxel-based analysis demonstrated that Aβ pathology relatively spared the occipital lobes in cases with mixed pathology and LBD compared to cases with AD without LBD, in whom the entire cerebral cortex was involved. Global cortical PiB SUVr was associated primarily with the abundance of diffuse Aβ plaques in cases with LBD in a multivariable regression model. CONCLUSION Lower PiB uptake accurately distinguishes cases with LBD from cases with AD or mixed pathology, correlating with the Thal Aβ phase. The severity of diffuse Aβ pathology is the primary contributor to elevated PiB uptake in LBD. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that lower PiB uptake accurately distinguishes patients with LBD from those with AD or mixed pathology.
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Affiliation(s)
- Kejal Kantarci
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL.
| | - Val J Lowe
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Qin Chen
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Scott A Przybelski
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Timothy G Lesnick
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Christopher G Schwarz
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Matthew L Senjem
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Jeffrey L Gunter
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Clifford R Jack
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Jonathan Graff-Radford
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - David T Jones
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - David S Knopman
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Neill Graff-Radford
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Tanis J Ferman
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Joseph E Parisi
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Dennis W Dickson
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Ronald C Petersen
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Bradley F Boeve
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
| | - Melissa E Murray
- From the Departments of Radiology (K.K., V.J.L., Q.C., C.G.S., C.R.J.), Health Sciences Research (S.A.P., T.G.L.), Information Technology (M.L.S., J.L.G.), Neurology (J.G.-R., D.T.J., D.S.K., R.C.P., B.F.B.), and Laboratory Medicine and Pathology (J.E.P.), Mayo Clinic, Rochester, MN; Department of Neurology (Q.C.), West China Hospital, Chengdu, Sichuan; and Departments of Neurology (N.G.-R.), Psychiatry and Psychology (T.J.F.), and Laboratory Medicine and Pathology (D.W.D., M.E.M.), Mayo Clinic, Jacksonville, FL
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10
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Palermo G, Tommasini L, Aghakhanyan G, Frosini D, Giuntini M, Tognoni G, Bonuccelli U, Volterrani D, Ceravolo R. Clinical Correlates of Cerebral Amyloid Deposition in Parkinson’s Disease Dementia: Evidence from a PET Study. J Alzheimers Dis 2019; 70:597-609. [DOI: 10.3233/jad-190323] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Giovanni Palermo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Luca Tommasini
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gayanè Aghakhanyan
- Regional Center of Nuclear Medicine, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Daniela Frosini
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Martina Giuntini
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gloria Tognoni
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Duccio Volterrani
- Regional Center of Nuclear Medicine, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberto Ceravolo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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11
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Perani D, Iaccarino L, Lammertsma AA, Windhorst AD, Edison P, Boellaard R, Hansson O, Nordberg A, Jacobs AH. A new perspective for advanced positron emission tomography-based molecular imaging in neurodegenerative proteinopathies. Alzheimers Dement 2019; 15:1081-1103. [PMID: 31230910 DOI: 10.1016/j.jalz.2019.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/21/2019] [Accepted: 02/20/2019] [Indexed: 12/12/2022]
Abstract
Recent studies in neurodegenerative conditions have increasingly highlighted that the same neuropathology can trigger different clinical phenotypes or, vice-versa, that similar phenotypes can be triggered by different neuropathologies. This evidence has called for the adoption of a pathology spectrum-based approach to study neurodegenerative proteinopathies. These conditions share brain deposition of abnormal protein aggregates, leading to aberrant biochemical, metabolic, functional, and structural changes. Positron emission tomography (PET) is a well-recognized and unique tool for the in vivo assessment of brain neuropathology, and novel PET techniques are emerging for the study of specific protein species. Today, key applications of PET range from early research and clinical diagnostic tools to their use in clinical trials for both participants screening and outcome evaluation. This position article critically reviews the role of distinct PET molecular tracers for different neurodegenerative proteinopathies, highlighting their strengths, weaknesses, and opportunities, with special emphasis on methodological challenges and future applications.
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Affiliation(s)
- Daniela Perani
- Vita-Salute San Raffaele University, Nuclear Medicine Unit San Raffaele Hospital, Division of Neuroscience San Raffaele Scientific Institute, Milan, Italy
| | - Leonardo Iaccarino
- Vita-Salute San Raffaele University, Nuclear Medicine Unit San Raffaele Hospital, Division of Neuroscience San Raffaele Scientific Institute, Milan, Italy
| | - Adriaan A Lammertsma
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Albert D Windhorst
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Paul Edison
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK; Neurology Imaging Unit, Imperial College London, London, UK
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
| | - Andreas H Jacobs
- European Institute for Molecular Imaging, University of Münster, Münster, Germany; Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Bonn, Germany.
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12
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Skin Fibroblasts as the Object for Clinical Diagnosis of Parkinson's Disease in Persons of Different Ages. Bull Exp Biol Med 2019; 167:177-181. [PMID: 31183656 DOI: 10.1007/s10517-019-04485-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Indexed: 12/26/2022]
Abstract
We compared the expression of Aβ42 peptide, τ-protein, and α-synuclein in the substantia nigra and skin fibroblasts of elderly and senile patients with Parkinson's disease and subjects without neuropathology. Expression of markers in the studied tissues was assessed by immunohistochemical and immunocytochemical methods. The expression of Aβ42 peptide, τ-protein, and α-synuclein in the substantia nigra of elderly and senile patients with Parkinson's disease was higher by 11-31 times than in subjects without neuropathology. In skin fibroblasts of patients with Parkinson's disease, the expression of Aβ42 peptide and α-synuclein was 3-14 times higher than in subjects without neuropathology, and expression of τ-protein did not significantly differ in the studied groups. Thus, immunocytochemical analysis of the expression Aβ42 peptide and α-synuclein in skin fibroblasts can be a simple method of early diagnosis of Parkinson's disease in elderly persons.
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13
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Sestini S, Alongi P, Berti V, Calcagni ML, Cecchin D, Chiaravalloti A, Chincarini A, Cistaro A, Guerra UP, Pappatà S, Tiraboschi P, Nobili F. The role of molecular imaging in the frame of the revised dementia with Lewy body criteria. Clin Transl Imaging 2019. [DOI: 10.1007/s40336-019-00321-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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14
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Prell T, Witte OW, Grosskreutz J. Biomarkers for Dementia, Fatigue, and Depression in Parkinson's Disease. Front Neurol 2019; 10:195. [PMID: 30906277 PMCID: PMC6418014 DOI: 10.3389/fneur.2019.00195] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 02/15/2019] [Indexed: 12/26/2022] Open
Abstract
Parkinson's disease is a common multisystem neurodegenerative disorder characterized by typical motor and non-motor symptoms. There is an urgent need for biomarkers for assessment of disease severity, complications and prognosis. In addition, biomarkers reporting the underlying pathophysiology assist in understanding the disease and developing neuroprotective therapies. Ultimately, biomarkers could be used to develop a more efficient personalized approach for clinical trials and treatment strategies. With the goal to improve quality of life in Parkinson's disease it is essential to understand and objectively monitor non-motor symptoms. This narrative review provides an overview of recent developments of biomarkers (biofluid samples and imaging) for three common neuropsychological syndromes in Parkinson's disease: dementia, fatigue, and depression.
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Affiliation(s)
- Tino Prell
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
| | - Otto W Witte
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
| | - Julian Grosskreutz
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
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15
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Cohen AD, Landau SM, Snitz BE, Klunk WE, Blennow K, Zetterberg H. Fluid and PET biomarkers for amyloid pathology in Alzheimer's disease. Mol Cell Neurosci 2018; 97:3-17. [PMID: 30537535 DOI: 10.1016/j.mcn.2018.12.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 12/05/2018] [Indexed: 02/04/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by amyloid plaques and tau pathology (neurofibrillary tangles and neuropil threads). Amyloid plaques are primarily composed of aggregated and oligomeric β-amyloid (Aβ) peptides ending at position 42 (Aβ42). The development of fluid and PET biomarkers for Alzheimer's disease (AD), has allowed for detection of Aβ pathology in vivo and marks a major advancement in understanding the role of Aβ in Alzheimer's disease (AD). In the recent National Institute on Aging and Alzheimer's Association (NIA-AA) Research Framework, AD is defined by the underlying pathology as measured in patients during life by biomarkers (Jack et al., 2018), while clinical symptoms are used for staging of the disease. Therefore, sensitive, specific and robust biomarkers to identify brain amyloidosis are central in AD research. Here, we discuss fluid and PET biomarkers for Aβ and their application.
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Affiliation(s)
- Ann D Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America.
| | - Susan M Landau
- Neurology Helen Wills Neuroscience Institute, University of California, Berkeley, United States of America; Lawrence Berkeley National Laboratory, Molecular Biophysics and Integrated Bioimaging Functional Imaging Department, Life Sciences Division, United States of America
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, United States of America
| | - William E Klunk
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Molndal, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, University College, London, United Kingdom of Great Britain and Northern Ireland
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Molndal, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, University College, London, United Kingdom of Great Britain and Northern Ireland; Department of Molecular Neuroscience, UCL Institute of Neurology, United Kingdom of Great Britain and Northern Ireland; UK Dementia Research Institute at UCL, United Kingdom of Great Britain and Northern Ireland
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16
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Delgado-Alvarado M, Dacosta-Aguayo R, Navalpotro-Gómez I, Gago B, Gorostidi A, Jiménez-Urbieta H, Quiroga-Varela A, Ruiz-Martínez J, Bergareche A, Rodríguez-Oroz MC. Ratios of proteins in cerebrospinal fluid in Parkinson's disease cognitive decline: prospective study. Mov Disord 2018; 33:1809-1813. [PMID: 30423201 DOI: 10.1002/mds.27518] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 08/10/2018] [Accepted: 08/22/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND There is a need for biomarkers of dementia in PD. OBJECTIVES To determine if the levels of the main CSF proteins and their ratios are associated with deterioration in cognition and progression to dementia in the short to mid term. METHODS The Parkinson's Progression Markers Initiative database was used as an exploratory cohort, and a center-based cohort was used as a replication cohort. Amyloid ß1-42, total tau, threonine-181 phosphorylated tau, and α-synuclein in the CSF and the ratios of these proteins were assessed. RESULTS In the Parkinson's Progression Markers Initiative cohort (n = 281), the total tau/amyloid ß1-42, total tau/α-synuclein, total tau/amyloid ß1-42+α-synuclein, and amyloid ß1-42/total tau ratios were associated with a risk of progression to dementia over a 3-year follow-up. In the replication cohort (n = 40), the total tau/α-synuclein and total tau/amyloid ß1-42+α-synuclein ratios were associated with progression to dementia over a 41-month follow-up. CONCLUSION Ratios of the main proteins found in PD patient brain inclusions that can be measured in the CSF appear to have value as short- to mid-term predictors of dementia. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Manuel Delgado-Alvarado
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Rosalía Dacosta-Aguayo
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain.,Biomedical Research Networking Centre Consortium for the area of Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Irene Navalpotro-Gómez
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain.,Biomedical Research Networking Centre Consortium for the area of Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Belén Gago
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain.,Biomedical Research Networking Centre Consortium for the area of Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Ana Gorostidi
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain.,Biomedical Research Networking Centre Consortium for the area of Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Genomics Platform, Biodonostia Research Institute, San Sebastián, Spain
| | - Haritz Jiménez-Urbieta
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain.,Biomedical Research Networking Centre Consortium for the area of Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Ana Quiroga-Varela
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain.,Biomedical Research Networking Centre Consortium for the area of Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Clinica Universidad de Navarra, Center for Applied Medical Research (CIMA)-Universidad de Navarra, Pamplona, Spain
| | - Javier Ruiz-Martínez
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain.,Biomedical Research Networking Centre Consortium for the area of Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Movement Disorders Unit, Department of Neurology, University Hospital Donostia, San Sebastián, Spain
| | - Alberto Bergareche
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain.,Biomedical Research Networking Centre Consortium for the area of Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Movement Disorders Unit, Department of Neurology, University Hospital Donostia, San Sebastián, Spain
| | - María C Rodríguez-Oroz
- Neurodegenerative Disorders Area, Biodonostia Health Research Institute, San Sebastián, Spain.,Biomedical Research Networking Centre Consortium for the area of Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Clinica Universidad de Navarra, Center for Applied Medical Research (CIMA)-Universidad de Navarra, Pamplona, Spain.,Movement Disorders Unit, Department of Neurology, University Hospital Donostia, San Sebastián, Spain.,Ikerbasque (Basque Foundation for Science), Bilbao, Spain.,Basque Center on Cognition Brain and Language (BCBL), San Sebastián, Spain
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17
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Abstract
Positron emission tomography (PET) has revealed key insights into the pathophysiology of movement disorders. This paper will focus on how PET investigations of pathophysiology are particularly relevant to Parkinson disease, a neurodegenerative condition usually starting later in life marked by a varying combination of motor and nonmotor deficits. Various molecular imaging modalities help to determine what changes in brain herald the onset of pathology; can these changes be used to identify presymptomatic individuals who may be appropriate for to-be-developed treatments that may forestall onset of symptoms or slow disease progression; can PET act as a biomarker of disease progression; can molecular imaging help enrich homogenous cohorts for clinical studies; and what other pathophysiologic mechanisms relate to nonmotor manifestations. PET methods include measurements of regional cerebral glucose metabolism and blood flow, selected receptors, specific neurotransmitter systems, postsynaptic signal transducers, and abnormal protein deposition. We will review each of these methodologies and how they are relevant to important clinical issues pertaining to Parkinson disease.
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Affiliation(s)
- Baijayanta Maiti
- Department of Neurology, Washington University in St. Louis, St Louis, MO.
| | - Joel S Perlmutter
- Department of Neurology, Washington University in St. Louis, St Louis, MO; Department of Radiology, Washington University in St. Louis, St Louis, MO; Department of Neuroscience, Washington University in St. Louis, St Louis, MO; Department of Physical Therapy, Washington University in St. Louis, St Louis, MO; Department of Occupational Therapy, Washington University in St. Louis, St Louis, MO
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18
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Lim EW, Aarsland D, Ffytche D, Taddei RN, van Wamelen DJ, Wan YM, Tan EK, Ray Chaudhuri K. Amyloid-β and Parkinson's disease. J Neurol 2018; 266:2605-2619. [PMID: 30377818 DOI: 10.1007/s00415-018-9100-8] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 12/16/2022]
Abstract
Parkinson's disease (PD) is the second commonest neurodegenerative disorder in the world with a rising prevalence. The pathophysiology is multifactorial but aggregation of misfolded α-synuclein is considered to be a key underpinning mechanism. Amyloid-β (Aβ) and tau deposition are also comorbid associations and especially Aβ deposition is associated with cognitive decline in PD. Some existing evidence suggests that low cerebrospinal fluid (CSF) Aβ42 is predictive of future cognitive impairment in PD. Recent studies also show that CSF Aβ is associated with the postural instability and gait difficulties (PIGD) or the newly proposed cholinergic subtype of PD, a possible risk factor for cognitive decline in PD. The glial-lymphatic system, responsible for convective solute clearance driven by active fluid transport through aquaporin-4 water channels, may be implicated in brain amyloid deposition. A better understanding of the role of this system and more specifically the role of Aβ in PD symptomatology, could introduce new treatment and repurposing drug-based strategies. For instance, apomorphine infusion has been shown to promote the degradation of Aβ in rodent models. This is further supported in a post-mortem study in PD patients although clinical implications are unclear. In this review, we address the clinical implication of cerebral Aβ deposition in PD and elaborate on its metabolism, its role in cognition and motor function/gait, and finally assess the potential effect of apomorphine on Aβ deposition in PD.
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Affiliation(s)
- Ee Wei Lim
- Parkinson Foundation International Centre of Excellence at King's College Hospital, Denmark Hill, London, SE5 9RS, UK. .,Department of Neurology, National Neuroscience Institute (Singapore General Hospital Campus), 20 College Road, Singapore, 169856, Singapore. .,Duke-National University of Singapore Graduate Medical School, Singapore, 169857, Singapore.
| | - Dag Aarsland
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience at King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Dominic Ffytche
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience at King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Raquel Natalia Taddei
- Parkinson Foundation International Centre of Excellence at King's College Hospital, Denmark Hill, London, SE5 9RS, UK
| | - Daniel J van Wamelen
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience at King's College London, De Crespigny Park, London, SE5 8AF, UK.,Parkinson Foundation International Centre of Excellence at King's College Hospital, Denmark Hill, London, SE5 9RS, UK.,Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Reinier Postlaan 4, Postbus 9101, 6500HB, Nijmegen, The Netherlands
| | - Yi-Min Wan
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience at King's College London, De Crespigny Park, London, SE5 8AF, UK.,Parkinson Foundation International Centre of Excellence at King's College Hospital, Denmark Hill, London, SE5 9RS, UK.,Department of Psychiatry, Ng Teng Fong General Hospital, 1 Jurong East Street 21, Singapore, 609606, Singapore
| | - Eng King Tan
- Department of Neurology, National Neuroscience Institute (Singapore General Hospital Campus), 20 College Road, Singapore, 169856, Singapore.,Duke-National University of Singapore Graduate Medical School, Singapore, 169857, Singapore
| | - Kallol Ray Chaudhuri
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience at King's College London, De Crespigny Park, London, SE5 8AF, UK.,Parkinson Foundation International Centre of Excellence at King's College Hospital, Denmark Hill, London, SE5 9RS, UK
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20
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Abstract
Lewy body dementia (DLB) is a common form of cognitive impairment, accounting for 30% of dementia cases in ages over 65 years. Early diagnosis of DLB has been challenging; particularly in the context of differentiation with Parkinson’s disease dementia and other forms of dementias, such as Alzheimer’s disease and rapidly progressive dementias. Current practice involves the use of [123I]FP-CIT-SPECT, [18F]FDG PET and [123I]MIBG molecular imaging to support diagnostic procedures. Structural imaging techniques have an essential role for excluding structural causes, which could lead to a DLB-like phenotype, as well as aiding differential diagnosis through illustrating disease-specific patterns of atrophy. Novel PET molecular imaging modalities, such as amyloid and tau imaging, may provide further insights into DLB pathophysiology and may aid in early diagnosis. A multimodal approach, through combining various established techniques and possibly using novel radioligands, might further aid towards an in-depth understanding of this highly disabling disease. In this review, we will provide an overview of neuroimaging applications in patients with DLB.
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21
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Lyoo CH, Cho H, Choi JY, Ryu YH, Lee MS. Tau Positron Emission Tomography Imaging in Degenerative Parkinsonisms. J Mov Disord 2018; 11:1-12. [PMID: 29381890 PMCID: PMC5790630 DOI: 10.14802/jmd.17071] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 11/20/2017] [Indexed: 01/08/2023] Open
Abstract
In recent years, several radiotracers that selectively bind to pathological tau proteins have been developed. Evidence is emerging that binding patterns of in vivo tau positron emission tomography (PET) studies in Alzheimer’s disease (AD) patients closely resemble the distribution patterns of known neurofibrillary tangle pathology, with the extent of tracer binding reflecting the clinical and pathological progression of AD. In Lewy body diseases (LBD), tau PET imaging has clearly revealed cortical tau burden with a distribution pattern distinct from AD and increased cortical binding within the LBD spectrum. In progressive supranuclear palsy, the globus pallidus and midbrain have shown increased binding most prominently. Tau PET patterns in patients with corticobasal syndrome are characterized by asymmetrical uptake in the motor cortex and underlying white matter, as well as in the basal ganglia. Even in the patients with multiple system atrophy, which is basically a synucleinopathy, 18F-flortaucipir, a widely used tau PET tracer, also binds to the atrophic posterior putamen, possibly due to off-target binding. These distinct patterns of tau-selective radiotracer binding in the various degenerative parkinsonisms suggest its utility as a potential imaging biomarker for the differential diagnosis of parkinsonisms.
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Affiliation(s)
- Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.,Division of RI-Convergence Research, Korea Institute Radiological and Medical Sciences, Seoul, Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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22
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Liu ZY, Liu FT, Zuo CT, Koprich JB, Wang J. Update on Molecular Imaging in Parkinson's Disease. Neurosci Bull 2017; 34:330-340. [PMID: 29282614 DOI: 10.1007/s12264-017-0202-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 11/04/2017] [Indexed: 12/14/2022] Open
Abstract
Advances in radionuclide tracers have allowed for more accurate imaging that reflects the actions of numerous neurotransmitters, energy metabolism utilization, inflammation, and pathological protein accumulation. All of these achievements in molecular brain imaging have broadened our understanding of brain function in Parkinson's disease (PD). The implementation of molecular imaging has supported more accurate PD diagnosis as well as assessment of therapeutic outcome and disease progression. Moreover, molecular imaging is well suited for the detection of preclinical or prodromal PD cases. Despite these advances, future frontiers of research in this area will focus on using multi-modalities combining positron emission tomography and magnetic resonance imaging along with causal modeling with complex algorithms.
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Affiliation(s)
- Zhen-Yang Liu
- Department of Neurology and National Clinical Research Center for Ageing and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Feng-Tao Liu
- Department of Neurology and National Clinical Research Center for Ageing and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Chuan-Tao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China
| | - James B Koprich
- Department of Neurology and National Clinical Research Center for Ageing and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.,Krembil Institute, Toronto Western Hospital, University Health Network, Toronto, ON, M5T 2S8, Canada
| | - Jian Wang
- Department of Neurology and National Clinical Research Center for Ageing and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
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23
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Lee SH, Cho H, Choi JY, Lee JH, Ryu YH, Lee MS, Lyoo CH. Distinct patterns of amyloid-dependent tau accumulation in Lewy body diseases. Mov Disord 2017; 33:262-272. [DOI: 10.1002/mds.27252] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 09/25/2017] [Accepted: 10/02/2017] [Indexed: 01/06/2023] Open
Affiliation(s)
- Seung Ha Lee
- Department of Neurology, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Jae Yong Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
- Division of RI-Convergence Research; Korea Institute Radiological and Medical Sciences; Seoul Republic of Korea
| | - Jae Hoon Lee
- Department of Nuclear Medicine, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Myung Sik Lee
- Department of Neurology, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital; Yonsei University College of Medicine; Seoul Republic of Korea
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24
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Brockmann K, Lerche S, Dilger SS, Stirnkorb JG, Apel A, Hauser AK, Liepelt-Scarfone I, Berg D, Gasser T, Schulte C, Maetzler W. SNPs in Aβ clearance proteins: Lower CSF Aβ 1-42 levels and earlier onset of dementia in PD. Neurology 2017; 89:2335-2340. [PMID: 29117956 DOI: 10.1212/wnl.0000000000004705] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 08/30/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate whether genetic variants in β-amyloid (Aβ) clearance proteins are associated with CSF levels of Aβ1-42 on a biological level and the onset of dementia on a clinical level in Parkinson disease (PD). METHODS We analyzed genetic variants known to be involved in Aβ clearance in a PD group comprising 456 patients, 103 of them with dementia. Single nucleotide polymorphisms in the genes APOE, cystatin C (CST), and membrane metalloendopeptidase (MME) were evaluated in relation to demographic variables, clinical phenotypes, and CSF Aβ1-42 levels using a cross-sectional approach. RESULTS Risk variants in the genes APOE and CST were associated with lower CSF Aβ1-42 levels. Clinically, patients with 2 risk alleles in CST tended to show a shorter interval from age at onset of PD to age at onset of dementia. CONCLUSIONS This study suggests that genetic variants associated with Aβ clearance are involved in the pathogenesis of dementia in PD and possibly influence the onset of dementia.
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Affiliation(s)
- Kathrin Brockmann
- From the Center of Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research (K.B., S.L., S.S.D., J.G.S., A.A., A.-K.H., I.L.-S., D.B., T.G., C.S., W.M.), and German Center for Neurodegenerative Diseases (DZNE) (K.B., S.L., A.A., A.-K.H., I.L.-S., T.G., C.S.), University of Tübingen; and Department of Neurology (D.B., W.M.), Christian-Albrechts University, Kiel, Germany
| | - Stefanie Lerche
- From the Center of Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research (K.B., S.L., S.S.D., J.G.S., A.A., A.-K.H., I.L.-S., D.B., T.G., C.S., W.M.), and German Center for Neurodegenerative Diseases (DZNE) (K.B., S.L., A.A., A.-K.H., I.L.-S., T.G., C.S.), University of Tübingen; and Department of Neurology (D.B., W.M.), Christian-Albrechts University, Kiel, Germany
| | - Sarah Selina Dilger
- From the Center of Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research (K.B., S.L., S.S.D., J.G.S., A.A., A.-K.H., I.L.-S., D.B., T.G., C.S., W.M.), and German Center for Neurodegenerative Diseases (DZNE) (K.B., S.L., A.A., A.-K.H., I.L.-S., T.G., C.S.), University of Tübingen; and Department of Neurology (D.B., W.M.), Christian-Albrechts University, Kiel, Germany
| | - Johannes Georg Stirnkorb
- From the Center of Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research (K.B., S.L., S.S.D., J.G.S., A.A., A.-K.H., I.L.-S., D.B., T.G., C.S., W.M.), and German Center for Neurodegenerative Diseases (DZNE) (K.B., S.L., A.A., A.-K.H., I.L.-S., T.G., C.S.), University of Tübingen; and Department of Neurology (D.B., W.M.), Christian-Albrechts University, Kiel, Germany
| | - Anja Apel
- From the Center of Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research (K.B., S.L., S.S.D., J.G.S., A.A., A.-K.H., I.L.-S., D.B., T.G., C.S., W.M.), and German Center for Neurodegenerative Diseases (DZNE) (K.B., S.L., A.A., A.-K.H., I.L.-S., T.G., C.S.), University of Tübingen; and Department of Neurology (D.B., W.M.), Christian-Albrechts University, Kiel, Germany
| | - Ann-Kathrin Hauser
- From the Center of Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research (K.B., S.L., S.S.D., J.G.S., A.A., A.-K.H., I.L.-S., D.B., T.G., C.S., W.M.), and German Center for Neurodegenerative Diseases (DZNE) (K.B., S.L., A.A., A.-K.H., I.L.-S., T.G., C.S.), University of Tübingen; and Department of Neurology (D.B., W.M.), Christian-Albrechts University, Kiel, Germany
| | - Inga Liepelt-Scarfone
- From the Center of Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research (K.B., S.L., S.S.D., J.G.S., A.A., A.-K.H., I.L.-S., D.B., T.G., C.S., W.M.), and German Center for Neurodegenerative Diseases (DZNE) (K.B., S.L., A.A., A.-K.H., I.L.-S., T.G., C.S.), University of Tübingen; and Department of Neurology (D.B., W.M.), Christian-Albrechts University, Kiel, Germany
| | - Daniela Berg
- From the Center of Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research (K.B., S.L., S.S.D., J.G.S., A.A., A.-K.H., I.L.-S., D.B., T.G., C.S., W.M.), and German Center for Neurodegenerative Diseases (DZNE) (K.B., S.L., A.A., A.-K.H., I.L.-S., T.G., C.S.), University of Tübingen; and Department of Neurology (D.B., W.M.), Christian-Albrechts University, Kiel, Germany
| | - Thomas Gasser
- From the Center of Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research (K.B., S.L., S.S.D., J.G.S., A.A., A.-K.H., I.L.-S., D.B., T.G., C.S., W.M.), and German Center for Neurodegenerative Diseases (DZNE) (K.B., S.L., A.A., A.-K.H., I.L.-S., T.G., C.S.), University of Tübingen; and Department of Neurology (D.B., W.M.), Christian-Albrechts University, Kiel, Germany
| | - Claudia Schulte
- From the Center of Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research (K.B., S.L., S.S.D., J.G.S., A.A., A.-K.H., I.L.-S., D.B., T.G., C.S., W.M.), and German Center for Neurodegenerative Diseases (DZNE) (K.B., S.L., A.A., A.-K.H., I.L.-S., T.G., C.S.), University of Tübingen; and Department of Neurology (D.B., W.M.), Christian-Albrechts University, Kiel, Germany
| | - Walter Maetzler
- From the Center of Neurology, Department of Neurodegenerative Diseases, and Hertie Institute for Clinical Brain Research (K.B., S.L., S.S.D., J.G.S., A.A., A.-K.H., I.L.-S., D.B., T.G., C.S., W.M.), and German Center for Neurodegenerative Diseases (DZNE) (K.B., S.L., A.A., A.-K.H., I.L.-S., T.G., C.S.), University of Tübingen; and Department of Neurology (D.B., W.M.), Christian-Albrechts University, Kiel, Germany.
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25
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Abstract
A compelling need in the field of neurodegenerative diseases is the development and validation of biomarkers for early identification and differential diagnosis. The availability of positron emission tomography (PET) neuroimaging tools for the assessment of molecular biology and neuropathology has opened new venues in the diagnostic design and the conduction of new clinical trials. PET techniques, allowing the in vivo assessment of brain function and pathology changes, are increasingly showing great potential in supporting clinical diagnosis also in the early and even preclinical phases of dementia. This review will summarize the most recent evidence on fluorine-18 fluorodeoxyglucose-, amyloid -, tau -, and neuroinflammation - PET tools, highlighting strengths and limitations and possible new perspectives in research and clinical applications. Appropriate use of PET tools is crucial for a prompt diagnosis and target evaluation of new developed drugs aimed at slowing or preventing dementia.
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Affiliation(s)
- Leonardo Iaccarino
- Vita-Salute San Raffaele University, Milan, Italy.,In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Arianna Sala
- Vita-Salute San Raffaele University, Milan, Italy.,In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Paola Caminiti
- Vita-Salute San Raffaele University, Milan, Italy.,In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Daniela Perani
- Vita-Salute San Raffaele University, Milan, Italy.,In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Nuclear Medicine Unit, IRCCS San Raffaele Hospital, Milan, Italy
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26
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Akhtar RS, Xie SX, Chen YJ, Rick J, Gross RG, Nasrallah IM, Van Deerlin VM, Trojanowski JQ, Chen-Plotkin AS, Hurtig HI, Siderowf AD, Dubroff JG, Weintraub D. Regional brain amyloid-β accumulation associates with domain-specific cognitive performance in Parkinson disease without dementia. PLoS One 2017; 12:e0177924. [PMID: 28542444 PMCID: PMC5444629 DOI: 10.1371/journal.pone.0177924] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 05/05/2017] [Indexed: 01/31/2023] Open
Abstract
Parkinson disease patients develop clinically significant cognitive impairment at variable times over their disease course, which is often preceded by milder deficits in memory, visuo-spatial, and executive domains. The significance of amyloid-β accumulation to these problems is unclear. We hypothesized that amyloid-β PET imaging by 18F-florbetapir, a radiotracer that detects fibrillar amyloid-β plaque deposits, would identify subjects with global cognitive impairment or poor performance in individual cognitive domains in non-demented Parkinson disease patients. We assessed 61 non-demented Parkinson disease patients with detailed cognitive assessments and 18F-florbetapir PET brain imaging. Scans were interpreted qualitatively (positive or negative) by two independent nuclear medicine physicians blinded to clinical data, and quantitatively by a novel volume-weighted method. The presence of mild cognitive impairment was determined through an expert consensus process using Level 1 criteria from the Movement Disorder Society. Nineteen participants (31.2%) were diagnosed with mild cognitive impairment and the remainder had normal cognition. Qualitative 18F-florbetapir PET imaging was positive in 15 participants (24.6%). Increasing age and presence of an APOE ε4 allele were associated with higher composite 18F-florbetapir binding. In multivariable models, an abnormal 18F-florbetapir scan by expert rating was not associated with a diagnosis of mild cognitive impairment. However, 18F-florbetapir retention values in the posterior cingulate gyrus inversely correlated with verbal memory performance. Retention values in the frontal cortex, precuneus, and anterior cingulate gyrus retention values inversely correlated with naming performance. Regional cortical amyloid-β amyloid, as measured by 18F-florbetapir PET, may be a biomarker of specific cognitive deficits in non-demented Parkinson disease patients.
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Affiliation(s)
- Rizwan S. Akhtar
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Center for Neurodegenerative Disease Research and Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| | - Sharon X. Xie
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Yin J. Chen
- Department of Radiology, Division of Nuclear Medicine and Clinical Molecular Imaging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Jacqueline Rick
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Rachel G. Gross
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Ilya M. Nasrallah
- Department of Radiology, Division of Nuclear Medicine and Clinical Molecular Imaging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Vivianna M. Van Deerlin
- Center for Neurodegenerative Disease Research and Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - John Q. Trojanowski
- Center for Neurodegenerative Disease Research and Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Alice S. Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Howard I. Hurtig
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Andrew D. Siderowf
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- AVID Radiopharmaceuticals, Philadelphia, Pennsylvania, United States of America
| | - Jacob G. Dubroff
- Department of Radiology, Division of Nuclear Medicine and Clinical Molecular Imaging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Daniel Weintraub
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Department of Psychiatry, Perelman School of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Parkinson’s Disease and Mental Health Research, Education, and Clinical Centers (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, United States of America
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27
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Mashima K, Ito D, Kameyama M, Osada T, Tabuchi H, Nihei Y, Yoshizaki T, Noguchi E, Tanikawa M, Iizuka T, Date Y, Ogata Y, Nakahara T, Iwabuchi Y, Jinzaki M, Murakami K, Suzuki N. Extremely Low Prevalence of Amyloid Positron Emission Tomography Positivity in Parkinson's Disease without Dementia. Eur Neurol 2017; 77:231-237. [PMID: 28285306 DOI: 10.1159/000464322] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 02/16/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Most cases of dementia with Lewy bodies (DLB) show Alzheimer's disease pathology-like senile plaques and neurofibrillary tangles. Several studies have also revealed a high prevalence of positive amyloid imaging with positron emission tomography (PET) in DLB and moderate prevalence in Parkinson's disease (PD) with dementia. However, it remains unclear in PD without dementia as to when the brain β amyloid (Aβ) burden begins and progresses. Our study aimed to determine the prevalence of Aβ deposition in PD without dementia using amyloid PET. METHODS This was a cross-sectional study on 33 patients with PD without dementia, of whom 21 had normal cognition and 12 met the criteria for PD-mild cognitive impairment. All subjects underwent neuropsychological assessment and [18F] florbetaben (FBB) PET. RESULTS All subjects had Lewy body-related disorders, displaying a significantly reduced myocardial [123I] metaiodobenzylguanidine uptake. The cortical FBB-binding pattern in all subjects, including APOE e4 carriers, suggested negative Aβ deposition. CONCLUSION Patients with PD without dementia exhibit an extremely low prevalence of Aβ positivity compared with those reported in cognitively normal elderly controls. Further longitudinal imaging studies and long-term follow-up are needed; however, our findings provide novel insights for understanding Aβ metabolism in PD.
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Affiliation(s)
- Kyoko Mashima
- Department of Neurology, Keio University School of Medicine, Tokyo, Germany
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28
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Villemagne VL, Doré V, Bourgeat P, Burnham SC, Laws S, Salvado O, Masters CL, Rowe CC. Aβ-amyloid and Tau Imaging in Dementia. Semin Nucl Med 2017; 47:75-88. [DOI: 10.1053/j.semnuclmed.2016.09.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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29
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Politis M, Pagano G, Niccolini F. Imaging in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 132:233-274. [DOI: 10.1016/bs.irn.2017.02.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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30
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Buongiorno M, Antonelli F, Compta Y, Fernandez Y, Pavia J, Lomeña F, Ríos J, Ramírez I, García JR, Soler M, Cámara A, Fernández M, Basora M, Salazar F, Sanchez-Etayo G, Valldeoriola F, Barrio JR, Marti MJ. Cross-Sectional and Longitudinal Cognitive Correlates of FDDNP PET and CSF Amyloid-β and Tau in Parkinson’s Disease1. J Alzheimers Dis 2016; 55:1261-1272. [DOI: 10.3233/jad-160698] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Mariateresa Buongiorno
- Parkinson’s Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Spain Instituto de Investigaciones Biomédicas August Pi i Sunyer IDIBAPS, Barcelona, Catalonia, Spain CIBER
| | - Francesca Antonelli
- Parkinson’s Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Spain Instituto de Investigaciones Biomédicas August Pi i Sunyer IDIBAPS, Barcelona, Catalonia, Spain CIBER
| | - Yaroslau Compta
- Parkinson’s Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Spain Instituto de Investigaciones Biomédicas August Pi i Sunyer IDIBAPS, Barcelona, Catalonia, Spain CIBER
| | | | - Javier Pavia
- Nuclear Medicine Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Centre on Bioengineering, Biomaterials and. Nanomedicine (CIBER-BBN), Barcelona, Catalonia, Spain
| | - Francisco Lomeña
- Nuclear Medicine Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
- Biomedical Research Networking Centre for Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - José Ríos
- Medical Statistics Core Facility, IDIBAPS, (Hospital Clinic), Barcelona, Spain. Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona. Catalonia, Spain
| | | | | | - Marina Soler
- CETIR Nuclear Medicine Esplugues de Llobregat, Catalonia, Spain
| | - Ana Cámara
- Parkinson’s Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Spain Instituto de Investigaciones Biomédicas August Pi i Sunyer IDIBAPS, Barcelona, Catalonia, Spain CIBER
| | - Manel Fernández
- Parkinson’s Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Spain Instituto de Investigaciones Biomédicas August Pi i Sunyer IDIBAPS, Barcelona, Catalonia, Spain CIBER
| | - Misericòrdia Basora
- Anaesthesiology Service, Hospital Clínic, IDIBAPS, Barcelona, Catalonia, Spain
| | - Fàtima Salazar
- Anaesthesiology Service, Hospital Clínic, IDIBAPS, Barcelona, Catalonia, Spain
| | | | - Francesc Valldeoriola
- Parkinson’s Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Spain Instituto de Investigaciones Biomédicas August Pi i Sunyer IDIBAPS, Barcelona, Catalonia, Spain CIBER
| | - Jorge Raúl Barrio
- Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, California, USA
| | - Maria Jose Marti
- Parkinson’s Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, Spain Instituto de Investigaciones Biomédicas August Pi i Sunyer IDIBAPS, Barcelona, Catalonia, Spain CIBER
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31
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Sarro L, Senjem ML, Lundt ES, Przybelski SA, Lesnick TG, Graff-Radford J, Boeve BF, Lowe VJ, Ferman TJ, Knopman DS, Comi G, Filippi M, Petersen RC, Jack CR, Kantarci K. Amyloid-β deposition and regional grey matter atrophy rates in dementia with Lewy bodies. Brain 2016; 139:2740-2750. [PMID: 27452602 PMCID: PMC5035818 DOI: 10.1093/brain/aww193] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/15/2016] [Accepted: 06/20/2016] [Indexed: 12/17/2022] Open
Abstract
Alzheimer's disease pathology frequently coexists with Lewy body disease at autopsy in patients with probable dementia with Lewy bodies. More than half of patients with probable dementia with Lewy bodies have high amyloid-β deposition as measured with 11C-Pittsburgh compound B binding on positron emission tomography. Biomarkers of amyloid-β deposition precede neurodegeneration on magnetic resonance imaging during the progression of Alzheimer's disease, but little is known about how amyloid-β deposition relates to longitudinal progression of atrophy in patients with probable dementia with Lewy bodies. We investigated the associations between baseline 11C-Pittsburgh compound B binding on positron emission tomography and the longitudinal rates of grey matter atrophy in a cohort of clinically diagnosed patients with dementia with Lewy bodies (n = 20), who were consecutively recruited to the Mayo Clinic Alzheimer's Disease Research Centre. All patients underwent 11C-Pittsburgh compound B positron emission tomography and magnetic resonance imaging examinations at baseline. Follow-up magnetic resonance imaging was performed after a mean (standard deviation) interval of 2.5 (1.1) years. Regional grey matter loss was determined on three-dimensional T1-weighted magnetic resonance imaging with the tensor-based morphometry-symmetric normalization technique. Linear regression was performed between baseline 11C-Pittsburgh compound B standard unit value ratio and longitudinal change in regional grey matter volumes from an in-house modified atlas. We identified significant associations between greater baseline 11C-Pittsburgh compound B standard unit value ratio and greater grey matter loss over time in the posterior cingulate gyrus, lateral and medial temporal lobe, and occipital lobe as well as caudate and putamen nuclei, after adjusting for age (P < 0.05). Greater baseline 11C-Pittsburgh compound B standard unit value ratio was also associated with greater ventricular expansion rates (P < 0.01) and greater worsening over time in Clinical Dementia Rating Scale, sum of boxes (P = 0.02). In conclusion, in patients with probable dementia with Lewy bodies, higher amyloid-β deposition at baseline is predictive of faster neurodegeneration in the cortex and also in the striatum. This distribution is suggestive of possible interactions among amyloid-β, tau and α-synuclein aggregates, which needs further investigation. Furthermore, higher amyloid-β deposition at baseline predicts a faster clinical decline over time in patients with probable dementia with Lewy bodies.
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Affiliation(s)
- Lidia Sarro
- 1 Department of Radiology, Mayo Clinic, Rochester, MN, USA 2 Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy 3 Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Matthew L Senjem
- 1 Department of Radiology, Mayo Clinic, Rochester, MN, USA 4 Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Emily S Lundt
- 5 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Scott A Przybelski
- 5 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Timothy G Lesnick
- 5 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | | | - Val J Lowe
- 1 Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Tanis J Ferman
- 7 Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Giancarlo Comi
- 3 Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- 2 Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy 3 Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Ronald C Petersen
- 5 Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA 6 Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Kejal Kantarci
- 1 Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Amyloid imaging: Past, present and future perspectives. Ageing Res Rev 2016; 30:95-106. [PMID: 26827784 DOI: 10.1016/j.arr.2016.01.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 11/23/2022]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterised by the gradual onset of dementia. The pathological hallmarks of the disease are Aβ amyloid plaques, and tau neurofibrillary tangles, along dendritic and synaptic loss and reactive gliosis. Functional and molecular neuroimaging techniques such as positron emission tomography (PET) using functional and molecular tracers, in conjuction with other Aβ and tau biomarkers in CSF, are proving valuable in the differential diagnosis of AD, as well as in establishing disease prognosis. With the advent of new therapeutic strategies, there has been an increasing application of these techniques for the determination of Aβ burden in vivo in the patient selection, evaluation of target engagement and assessment of the efficacy of therapeutic approaches aimed at reducing Aβ in the brain.
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Villemagne VL, Chételat G. Neuroimaging biomarkers in Alzheimer's disease and other dementias. Ageing Res Rev 2016; 30:4-16. [PMID: 26827785 DOI: 10.1016/j.arr.2016.01.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 12/16/2022]
Abstract
In vivo imaging of β-amyloid (Aβ) has transformed the assessment of Aβ pathology and its changes over time, extending our insight into Aβ deposition in the brain by providing highly accurate, reliable, and reproducible quantitative statements of regional or global Aβ burden in the brain. This knowledge is essential for therapeutic trial recruitment and for the evaluation of anti-Aβ treatments. Although cross sectional evaluation of Aβ burden does not strongly correlate with cognitive impairment, it does correlate with cognitive (especially memory) decline and with a higher risk for conversion to AD in the aging population and MCI subjects. This suggests that Aβ deposition is a protracted pathological process starting well before the onset of symptoms. Longitudinal observations, coupled with different disease-specific biomarkers to assess potential downstream effects of Aβ are required to confirm this hypothesis and further elucidate the role of Aβ deposition in the course of Alzheimer's disease.
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Affiliation(s)
- Victor L Villemagne
- Department of Molecular Imaging & Therapy, Centre for PET, Austin Health, Victoria 3084, Australia; Department of Medicine, University of Melbourne, Austin Health, Victoria 3084, Australia; The Florey Institute of Neuroscience and Mental Health, Victoria 3052, Australia; Institut National de la Santé et de la Recherche Médicale (Inserm), Unité, 1077 Caen, France.
| | - Gaël Chételat
- The Florey Institute of Neuroscience and Mental Health, Victoria 3052, Australia; Institut National de la Santé et de la Recherche Médicale (Inserm), Unité, 1077 Caen, France; Université de Caen Basse-Normandie, Unité Mixte de Recherche (UMR), S1077 Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, 14000 Caen, France; Unité 1077, Centre Hospitalier Universitaire de Caen, 14000 Caen, France
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Graff-Radford J, Lesnick TG, Boeve BF, Przybelski SA, Jones DT, Senjem ML, Gunter JL, Ferman TJ, Knopman DS, Murray ME, Dickson DW, Sarro L, Jack CR, Petersen RC, Kantarci K. Predicting Survival in Dementia With Lewy Bodies With Hippocampal Volumetry. Mov Disord 2016; 31:989-94. [PMID: 27214825 DOI: 10.1002/mds.26666] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 04/04/2016] [Accepted: 04/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The clinical course of dementia with Lewy bodies patients is heterogeneous. The ability to more accurately prognosticate survival is important. OBJECTIVE The objective of this study was to investigate hippocampal volume as a predictor of survival in dementia with Lewy bodies patients. METHODS Survival analysis for time from onset of cognitive symptoms to death was carried out using Cox proportional hazards models. Given their age and total intracranial volume, patients were dichotomized into low/medium (0%-66.7%) and high (66. 7%-100%) hippocampal volume categories. The models using these categories to predict survival were adjusted for field strength, APOE ε4 status, and estimated onset age of cognitive problems. RESULTS We investigated 167 consecutive patients with dementia with Lewy bodies. The median age at MRI was 72 years (interquartile range 67-76), and 80% were male. The median time from estimated first cognitive symptom to death was 7.4 years (interquartile range:5.7-10.2). Lower hippocampal volumes were significantly associated with higher risk of death (hazard ratio 1.28; 95% confidence interval 1.04-1.58; P = .024). The predicted median survival for participants with onset of cognitive symptoms at age 68 was 10.63 years (95% confidence interval 8.66-14.54) for APOE ε4 negative, high hippocampal volume participants; 8.89 years (95% confidence interval 7.56-12.36) for APOE ε4 positive, high hippocampal volume participants; 8.10 years (95% confidence interval 7.34-11.08) for APOE ε4 negative, low/medium hippocampal volume participants; and 7.38 (95% confidence interval 6.74-9.29) years for APOE ε4 positive, low/medium hippocampal volume participants. CONCLUSIONS Among patients with clinically diagnosed dementia with Lewy bodies, those with neuroimaging evidence of hippocampal atrophy have shorter survival times. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
| | - Timothy G Lesnick
- Department of Health Sciences Research, Division of Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Scott A Przybelski
- Department of Health Sciences Research, Division of Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Tanis J Ferman
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA
| | - David S Knopman
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Melissa E Murray
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Dennis W Dickson
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Lidia Sarro
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.,Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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Delgado-Alvarado M, Gago B, Navalpotro-Gomez I, Jiménez-Urbieta H, Rodriguez-Oroz MC. Biomarkers for dementia and mild cognitive impairment in Parkinson's disease. Mov Disord 2016; 31:861-81. [PMID: 27193487 DOI: 10.1002/mds.26662] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 04/15/2016] [Accepted: 04/18/2016] [Indexed: 12/27/2022] Open
Abstract
Cognitive decline is one of the most frequent and disabling nonmotor features of Parkinson's disease. Around 30% of patients with Parkinson's disease experience mild cognitive impairment, a well-established risk factor for the development of dementia. However, mild cognitive impairment in patients with Parkinson's disease is a heterogeneous entity that involves different types and extents of cognitive deficits. Because it is not currently known which type of mild cognitive impairment confers a higher risk of progression to dementia, it would be useful to define biomarkers that could identify these patients to better study disease progression and possible interventions. In this sense, the identification among patients with Parkinson's disease and mild cognitive impairment of biomarkers associated with dementia would allow the early detection of this process. This review summarizes studies from the past 25 years that have assessed the potential biomarkers of dementia and mild cognitive impairment in Parkinson's disease patients. Despite the potential importance, no biomarker has as yet been validated. However, features such as low levels of epidermal and insulin-like growth factors or uric acid in plasma/serum and of Aß in CSF, reduction of cerebral cholinergic innervation and metabolism measured by PET mainly in posterior areas, and hippocampal atrophy in MRI might be indicative of distinct deficits with a distinct risk of dementia in subgroups of patients. Longitudinal studies combining the existing techniques and new approaches are needed to identify patients at higher risk of dementia. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Manuel Delgado-Alvarado
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Belén Gago
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Irene Navalpotro-Gomez
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Haritz Jiménez-Urbieta
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - María C Rodriguez-Oroz
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Neurology Department, University Hospital Donostia, San Sebastián, Spain.,Ikerbasque (Basque Foundation for Science), Bilbao, Spain.,Basque Center on Cognition, Brain and Language (BCBL), San Sebastián, Spain.,Physiology Department, Medical School University of Navarra, Pamplona, Spain
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36
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Canadian Consensus Guidelines on Use of Amyloid Imaging in Canada: Update and Future Directions from the Specialized Task Force on Amyloid imaging in Canada. Can J Neurol Sci 2016; 43:503-12. [DOI: 10.1017/cjn.2015.401] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AbstractPositron emission tomography (PET) imaging of brain amyloid beta is now clinically available in several countries including the United States and the United Kingdom, but not Canada. It has become an established technique in the field of neuroimaging of aging and dementia, with data incorporated in the new consensus guidelines for the diagnosis of Alzheimer disease and predementia Alzheimer’s disease–related conditions. At this point, there are three US Food and Drug Administration– and European Union–approved tracers. Guided by appropriate use criteria developed in 2013 by the Alzheimer’s Association and the Society of Nuclear Medicine and Molecular Imaging, the utility of amyloid imaging in medical practice is now supported by a growing body of research. In this paper, we aimed to provide an update on the 2012 Canadian consensus guidelines to dementia care practitioners on proper use of amyloid imaging. We also wished to generate momentum for the industry to submit a new drug proposal to Health Canada. A group of local, national, and international dementia experts and imaging specialists met to discuss scenarios in which amyloid PET could be used appropriately. Peer-reviewed and published literature between January 2004 and May 2015 was searched. Technical and regulatory considerations pertaining to Canada were considered. The results of a survey of current practices in Canadian dementia centers were considered. A set of specific clinical and research guidelines was agreed on that defines the types of patients and clinical circumstances in which amyloid PET could be used in Canada. Future research directions were also outlined, notably the importance of studies that would assess the pharmaco-economics of amyloid imaging.
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Abstract
Movement disorders can be hypokinetic (e.g., parkinsonism), hyperkinetic, or dystonic in nature and commonly arise from altered function in nuclei of the basal ganglia or their connections. As obvious structural changes are often limited, standard imaging plays less of a role than in other neurologic disorders. However, structural imaging is indicated where clinical presentation is atypical, particularly if the disorder is abrupt in onset or remains strictly unilateral. More recent advances in magnetic resonance imaging (MRI) may allow for differentiation between Parkinson's disease and atypical forms of parkinsonism. Functional imaging can assess regional cerebral blood flow (functional MRI (fMRI), positron emission tomography (PET), or single-photon emission computed tomography (SPECT)), cerebral glucose metabolism (PET), neurochemical and neuroreceptor status (PET and SPECT), and pathologic processes such as inflammation or abnormal protein deposition (PET) (Table 49.1). Cerebral blood flow can be assessed at rest, during the performance of motor or cognitive tasks, or in response to a variety of stimuli. In appropriate situations, the correct imaging modality and/or combination of modalities can be used to detect early disease or even preclinical disease, and to monitor disease progression and the effects of disease-modifying interventions. Various approaches are reviewed here.
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Affiliation(s)
- A Jon Stoessl
- Pacific Parkinson's Research Centre and Division of Neurology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia and Vancouver Coastal Health, Vancouver, BC, Canada.
| | - Martin J Mckeown
- Pacific Parkinson's Research Centre and Division of Neurology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia and Vancouver Coastal Health, Vancouver, BC, Canada
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Lin CL, Cheng YS, Li HH, Chiu PY, Chang YT, Ho YJ, Lai TJ. Amyloid-β suppresses AMP-activated protein kinase (AMPK) signaling and contributes to α-synuclein-induced cytotoxicity. Exp Neurol 2016; 275 Pt 1:84-98. [DOI: 10.1016/j.expneurol.2015.10.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 10/11/2015] [Accepted: 10/24/2015] [Indexed: 12/01/2022]
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Shimada H, Hirano S, Sinotoh H, Ota T, Tanaka N, Sato K, Yamada M, Fukushi K, Irie T, Zhang MR, Higuchi M, Kuwabara S, Suhara T. Dementia with Lewy bodies can be well-differentiated from Alzheimer's disease by measurement of brain acetylcholinesterase activity-a [11C]MP4A PET study. Int J Geriatr Psychiatry 2015; 30:1105-13. [PMID: 26280153 DOI: 10.1002/gps.4338] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 07/07/2015] [Accepted: 07/08/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To investigate the diagnostic performance of brain acetylcholinesterase (AChE) activity measurement using N-[(11) C]-methyl-4-piperidyl acetate (MP4A) and PET in patients with dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). METHODS Participants were 14 DLB patients, 25 AD patients and 18 age-matched healthy controls (HC). All subjects underwent PET scans and MP4A to measure regional brain AChE activity. We performed anatomical standardization of each brain image, and k3 values, an index of AChE activity, in each voxel were estimated by nonlinear least squares analysis. Volumes of interest (VOIs) were identified on parametric k3 images in frontal, temporal, parietal and occipital cortices, and in anterior and posterior cingulate gyri (ACG and PCG). In each VOI, the differential diagnostic performance between AD and DLB of k3 values was assessed by area under the curve (AUC) of the receiver-operating characteristic. Voxel-based statistical analyses were also performed. RESULTS Mean cortical AChE activities in AD patients (-8.2% compared with normal mean) and DLB patients (-27.8%) were lower than HCs (p < 0.05, p < 0.001, respectively). There was a significant difference in mean cortical AChE activities between AD and DLB patients (p < 0.001). All regional brain AChE activities of defined VOIs except ACG were able to well discriminate DLB from AD, and notably performance was the most significant in PCG (AUC = 0.989, 95% CI: 0.965-1.000). CONCLUSIONS Brain cholinergic deficit is consistently prominent in DLB compared with AD. PET measurement of brain AChE activity may be useful for the differential diagnosis between DLB and AD.
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Affiliation(s)
- H Shimada
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
| | - S Hirano
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan.,Department of Neurology, Graduate School of Medicine, Chiba University, Chiba-shi, Chiba, Japan
| | - H Sinotoh
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan.,Neurology Chiba Clinic, Chiba-shi, Chiba, Japan
| | - T Ota
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan.,Department of Psychiatry, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - N Tanaka
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
| | - K Sato
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan.,Department of Psychiatry, Teikyo University Chiba Medical Center, Ichihara-shi, Chiba, Japan
| | - M Yamada
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan.,Precursory Research for Embryonic Science and Technology, Japan Science and Technology Agency, Chiyoda-ku, Tokyo, Japan
| | - K Fukushi
- Molecular Probe Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
| | - T Irie
- Molecular Probe Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
| | - M R Zhang
- Molecular Probe Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
| | - M Higuchi
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
| | - S Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba-shi, Chiba, Japan
| | - T Suhara
- Molecular Neuroimaging Program, Molecular Imaging Center, National Institute of Radiological Sciences, Chiba-shi, Chiba, Japan
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Petrou M, Dwamena BA, Foerster BR, MacEachern MP, Bohnen NI, Müller ML, Albin RL, Frey KA. Amyloid deposition in Parkinson's disease and cognitive impairment: a systematic review. Mov Disord 2015; 30:928-35. [PMID: 25879534 DOI: 10.1002/mds.26191] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 01/22/2015] [Accepted: 01/26/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Varying degrees of cortical amyloid deposition are reported in the setting of Parkinsonism with cognitive impairment. We performed a systematic review to estimate the prevalence of Alzheimer disease (AD) range cortical amyloid deposition among patients with Parkinson's disease with dementia (PDD), Parkinson's disease with mild cognitive impairment (PD-MCI) and dementia with Lewy bodies (DLB). We included amyloid positron emission tomography (PET) imaging studies using Pittsburgh Compound B (PiB). METHODS We searched the databases Ovid MEDLINE, PubMed, Embase, Scopus, and Web of Science for articles pertaining to amyloid imaging in Parkinsonism and impaired cognition. We identified 11 articles using PiB imaging to quantify cortical amyloid. We used the metan module in Stata, version 11.0, to calculate point prevalence estimates of patients with "PiB-positive" studies, that is, patients showing AD range cortical Aβ-amyloid deposition. Heterogeneity was assessed. A scatterplot was used to assess publication bias. RESULTS Overall pooled prevalence of "PiB-positive" studies across all three entities along the spectrum of Parkinson's disease and impaired cognition (specifically PDD, PD-MCI, and DLB) was 0.41 (95% confidence interval [CI], 0.24-0.57). Prevalence of "PiB-positive" studies was 0.68 (95% CI, 0.55-0.82) in the DLB group, 0.34 (95% CI, 0.13-0.56) in the PDD group, and 0.05 (95% CI, -0.07-0.17) in the PD-MCI group. CONCLUSIONS Substantial variability occurs in the prevalence of "PiB-positive" studies in subjects with Parkinsonism and cognitive impairment. Higher prevalence of PiB-positive studies was encountered among subjects with DLB as opposed to subjects with PDD. The PD-MCI subjects showed overall lower prevalence of PiB-positive studies than reported findings in non-PD-related MCI. © 2015 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Myria Petrou
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ben A Dwamena
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Veterans Administration Healthcare System, Ann Arbor, Michigan, USA
| | - Bradley R Foerster
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Veterans Administration Healthcare System, Ann Arbor, Michigan, USA
| | - Mark P MacEachern
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicolaas I Bohnen
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Veterans Administration Healthcare System, Ann Arbor, Michigan, USA.,Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.,Univerity of Michigan Morris K. Udall Center for Excellence in Parkinson's Disease Research, Ann Arbor, Michigan, USA
| | - Martijn Ltm Müller
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Roger L Albin
- Veterans Administration Healthcare System, Ann Arbor, Michigan, USA.,Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA.,Univerity of Michigan Morris K. Udall Center for Excellence in Parkinson's Disease Research, Ann Arbor, Michigan, USA
| | - Kirk A Frey
- Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.,Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan, USA
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Blennow K, Mattsson N, Schöll M, Hansson O, Zetterberg H. Amyloid biomarkers in Alzheimer's disease. Trends Pharmacol Sci 2015; 36:297-309. [PMID: 25840462 DOI: 10.1016/j.tips.2015.03.002] [Citation(s) in RCA: 335] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 03/02/2015] [Accepted: 03/05/2015] [Indexed: 02/06/2023]
Abstract
Aggregation of amyloid-β (Aβ) into oligomers, fibrils, and plaques is central in the molecular pathogenesis of Alzheimer's disease (AD), and is the main focus of AD drug development. Biomarkers to monitor Aβ metabolism and aggregation directly in patients are important for further detailed study of the involvement of Aβ in disease pathogenesis and to monitor the biochemical effect of drugs targeting Aβ in clinical trials. Furthermore, if anti-Aβ disease-modifying drugs prove to be effective clinically, amyloid biomarkers will be of special value in the clinic to identify patients with brain amyloid deposition at risk for progression to AD dementia, to enable initiation of treatment before neurodegeneration is too severe, and to monitor drug effects on Aβ metabolism or pathology to guide dosage. Two types of amyloid biomarker have been developed: Aβ-binding ligands for use in positron emission tomography (PET) and assays to measure Aβ42 in cerebrospinal fluid (CSF). In this review, we present the rationales behind these biomarkers and compare their ability to measure Aβ plaque load in the brain. We also review possible shortcomings and the need of standardization of both biomarkers, as well as their implementation in the clinic.
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Affiliation(s)
- Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; The Torsten Söderberg Professorship at the Royal Swedish Academy of Sciences.
| | - Niklas Mattsson
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Michael Schöll
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA; Department of Clinical Neuroscience and Rehabilitation, University of Gothenburg, Gothenburg, Sweden
| | - Oskar Hansson
- Department of Clinical Sciences, Lund University, Lund, Sweden; Clinical Memory Research unit, Clinical Sciences, Lund University, Lund, Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; UCL Institute of Neurology, Queen Square, London, UK
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Lin CH, Wu RM. Biomarkers of cognitive decline in Parkinson's disease. Parkinsonism Relat Disord 2015; 21:431-43. [PMID: 25737398 DOI: 10.1016/j.parkreldis.2015.02.010] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 02/10/2015] [Accepted: 02/12/2015] [Indexed: 10/24/2022]
Abstract
Cognitive impairment is a frequent and devastating non-motor symptom of Parkinson's disease (PD). Impaired cognition has a major impact on either quality of life or mortality in patients with PD. Notably, the rate of cognitive decline and pattern of early cognitive deficits in PD are highly variable between individuals. Given that the underlying mechanisms of cognitive decline or dementia associated with PD remain unclear, there is currently no mechanism-based treatment available. Identification of biological markers, including neuroimaging, biofluids and common genetic variants, that account for the heterogeneity of PD related cognitive decline could provide important insights into the pathological processes that underlie cognitive impairment in PD. These combined biomarker approaches will enable early diagnosis and provide indicators of cognitive progression in PD patients. This review summarizes recent advances in the development of biomarkers for cognitive impairments in PD.
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Affiliation(s)
- Chin-Hsien Lin
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Ruey-Meei Wu
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 100, Taiwan.
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Frey KA, Petrou M. Imaging Amyloidopathy in Parkinson Disease and Parkinsonian Dementia Syndromes. Clin Transl Imaging 2015; 3:57-64. [PMID: 25745616 DOI: 10.1007/s40336-015-0104-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Dementia arising in patients with Parkinson disease or parkinsonian neurodegeneration comprises a heterogeneous neuropathology. Clinical labeling of patients with both dementia and Parkinson disease is dichotomous, depending on the temporal development of cognitive impairment and motor parkinsonism. Patients with dementia arising first (or within the first year of PD) are classified as dementia with Lewy bodies; patients with PD for more than one year before cognitive decline are classified as Parkinson disease with dementia. Despite this differential clinical classification, autopsy studies demonstrate variable admixtures of cortical synuicleinopathy, Aβ-amyloidopathy and tau neurofibrillary tangle deposition. There are no routine clinical diagnostic measures that accurately distinguish the underlying neuropathologies in individual patients. In the present paper, we review the published literature describing characteristics of fibrillary Aβ-amyloid deposition on the basis of PET radiotracer imaging in patients with Parkinson disease and in parkinsonian dementia syndromes. Although individual reports often include only small-to-modest subject numbers, there is overall suggestion that PD patients have a lower incidence of Aβ-amyloid deposition than seen amongst elderly normal subjects, and that Parkinson disease with dementia patients have a lower incidence of Aβ-amyloid deposition than do patients with dementia with Lewy bodies. These apparent features contrast the findings of Aβ-amyloid-PET imaging in normal aging and the development of Alzheimer disease, where Aβ-amyloid deposition arises asymptomatically and apparently many years before development of signs or symptoms of dementia. It is proposed that focused, prospective studies are needed to further address and understand the complex role(s) of Aβ-amyloid pathology in Parkinson disease, and that this understanding will be critical to the development of targeted disease-modifying therapy for dementia in PD.
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Affiliation(s)
- Kirk A Frey
- Departments of Radiology and Neurology and the Molecular and Behavioral Neuroscience Institute, The University of Michigan, Ann Arbor, MI USA
| | - Myria Petrou
- Departments of Radiology and Neurology and the Molecular and Behavioral Neuroscience Institute, The University of Michigan, Ann Arbor, MI USA
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Evaluation of selective positron emission tomography template method for spatial normalization of amyloid imaging with 11C-Pittsburgh Compound B. J Comput Assist Tomogr 2015; 38:924-9. [PMID: 24979265 DOI: 10.1097/rct.0000000000000123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Spatial normalization of C-Pittsburgh Compound B (PiB) images is challenging for an automatic quantitative analysis without magnetic resonance imaging (MRI) because of different distribution patterns between amyloid positive and negative images. To overcome this issue, we evaluated a selective positron emission tomography template (SPT) method. MATERIALS AND METHODS Three sets of single positron emission tomography templates were created: PiB negative template, PiB positive template, and mixed template. Sixty-one patients with dementia were enrolled as the validation cohort. Magnetic resonance imaging-aided normalization method was used as a reference. The SPT method was based on visual classification (positive, negative, and equivocal). The optimal templates for each visual group were determined by correlation values and average percent errors (APEs) with MRI-aided normalization. The results of the SPT and the single template methods were compared with those of MRI-aided normalization in terms of correlation values, APEs, and concordance rates. RESULTS The SPT (PiB negative template for the negative and equivocal groups and PiB positive template for the positive group) showed higher correlations and concordance rate and lower APEs with MRI-aided normalization than did the single template. CONCLUSIONS Use of the SPT provides accurate normalization of amyloid images without MRI.
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Amyloid PET imaging: applications beyond Alzheimer's disease. Clin Transl Imaging 2015; 3:39-55. [PMID: 25741489 PMCID: PMC4339781 DOI: 10.1007/s40336-014-0098-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 12/22/2014] [Indexed: 12/14/2022]
Abstract
As a biomarker of beta-amyloid, positron emission tomography (PET) amyloid imaging offers a unique opportunity to detect the presence of this protein in the human body during life. Besides Alzheimer's disease (AD), deposits of beta-amyloid in the brain are also present in other neurodegenerative diseases associated to dementia, such as Parkinson's disease and dementia with Lewy bodies, as well as in other processes affecting brain function, such as cerebral amyloid angiopathy, brain trauma, Down's syndrome and meningiomas, as shown by post-mortem pathology studies. Furthermore, in systemic amyloidosis other organs besides the brain are affected, and amyloid PET imaging may be suitable for the identification of these extra-cerebral amyloid depositions. Finally, the potential use of amyloid PET tracer accumulation in cerebral white matter (WM) as a marker of myelin is being investigated, leading to some promising results in patients with WM lesions and multiple sclerosis. In this article, a review of the ongoing research pointing to a broader application of amyloid PET imaging in clinical practice beyond AD is provided.
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Donaghy P, Thomas AJ, O'Brien JT. Amyloid PET Imaging in Lewy body disorders. Am J Geriatr Psychiatry 2015; 23:23-37. [PMID: 23831180 DOI: 10.1016/j.jagp.2013.03.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 02/19/2013] [Accepted: 03/01/2013] [Indexed: 11/25/2022]
Abstract
Lewy body (LB) disorders, including Parkinson disease (PD), Parkinson disease dementia (PDD), and dementia with Lewy bodies (DLB), are the second most common type of neurodegenerative dementia. Although the pathological hallmarks of LB disorders are Lewy bodies and Lewy neurites, cortical amyloid-beta (Aβ) deposition is also often seen. The relationship between Aβ pathology and dementia in LB disorders is unclear. Recently, positron emission tomography Aβ ligands have been developed that enable in vivo imaging of Aβ. In this paper we review amyloid imaging studies in LB disorders. LB disorders are associated with lower mean cortical Aβ ligand binding compared with Alzheimer disease. In DLB and PDD many subjects have normal levels of cortical Aβ, though a subset show increased Aβ ligand binding. Those with DLB show greater ligand binding than PDD; binding does not appear to be increased in PD without dementia. Cortical Aβ deposition may be a factor in the development of cognitive impairment in some cases of dementia in LB disorders. Amyloid imaging is of limited use in the diagnosis of LB disorders but Aβ deposition may predict the future development of dementia in PD. Reports of correlation between Aβ deposition and symptom profile, severity, and progression have been inconsistent. Some results suggest a synergistic interaction between Aβ and α-synuclein. Interpretation of the current evidence is hampered by differing methodologies across studies and small sample sizes. Large, prospective longitudinal studies are needed to clarify the association of Aβ with symptom development, progression, severity, and treatment response in LB disorders.
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Affiliation(s)
- Paul Donaghy
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom.
| | - Alan J Thomas
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, United Kingdom
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
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Buddhala C, Campbell MC, Perlmutter JS, Kotzbauer PT. Correlation between decreased CSF α-synuclein and Aβ₁₋₄₂ in Parkinson disease. Neurobiol Aging 2015; 36:476-84. [PMID: 25212463 PMCID: PMC4268043 DOI: 10.1016/j.neurobiolaging.2014.07.043] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 07/14/2014] [Accepted: 07/30/2014] [Indexed: 02/07/2023]
Abstract
Accumulation of misfolded α-synuclein (α-syn) protein in Lewy bodies and neurites is the cardinal pathologic feature of Parkinson disease (PD), but abnormal deposition of other proteins may also play a role. Cerebrospinal fluid (CSF) levels of proteins known to accumulate in PD may provide insight into disease-associated changes in protein metabolism and their relationship to disease progression. We measured CSF α-syn, amyloid β₁₋₄₂ (Aβ₁₋₄₂), and tau from 77 nondemented PD and 30 control participants. CSF α-syn and Aβ₁₋₄₂ were significantly lower in PD compared with controls. In contrast with increased CSF tau in Alzheimer disease, CSF tau did not significantly differ between PD and controls. CSF protein levels did not significantly correlate with ratings of motor function or performance on neuropsychological testing. As expected, CSF Aβ₁₋₄₂ inversely correlated with [(11)C]-Pittsburgh compound B (PiB) mean cortical binding potential, with PiB(+) PD participants having lower CSF Aβ₁₋₄₂ compared with PiB(-) PD participants. Furthermore, CSF α-syn positively correlated with Aβ₁₋₄₂ in PD participants but not in controls, suggesting a pathophysiologic connection between the metabolisms of these proteins in PD.
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Affiliation(s)
- Chandana Buddhala
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA; Department of Developmental Biology, Washington University School of Medicine, St Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St Louis, MO, USA
| | - Meghan C Campbell
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA; Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Joel S Perlmutter
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St Louis, MO, USA; Department of Radiology, Washington University School of Medicine, St Louis, MO, USA; Department of Anatomy and Neurobiology, Washington University School of Medicine, St Louis, MO, USA; Program in Occupational Therapy, Washington University School of Medicine, St Louis, MO, USA; Program in Physical Therapy, Washington University School of Medicine, St Louis, MO, USA
| | - Paul T Kotzbauer
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA; Department of Developmental Biology, Washington University School of Medicine, St Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St Louis, MO, USA.
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Perlmutter JS, Norris SA. Neuroimaging biomarkers for Parkinson disease: facts and fantasy. Ann Neurol 2014; 76:769-83. [PMID: 25363872 PMCID: PMC4245400 DOI: 10.1002/ana.24291] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/30/2014] [Accepted: 10/05/2014] [Indexed: 11/12/2022]
Abstract
In this grand rounds, we focus on development, validation, and application of neuroimaging biomarkers for Parkinson disease (PD). We cover whether such biomarkers can be used to identify presymptomatic individuals (probably yes), provide a measure of PD severity (in a limited fashion, but frequently done poorly), investigate pathophysiology of parkinsonian disorders (yes, if done carefully), play a role in differential diagnosis of parkinsonism (not well), and investigate pathology underlying cognitive impairment (yes, in conjunction with postmortem data). Along the way, we clarify several issues about definitions of biomarkers and surrogate endpoints. The goal of this lecture is to provide a basis for interpreting current literature and newly proposed clinical tools in PD. In the end, one should be able to critically distinguish fact from fantasy.
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Affiliation(s)
- Joel S. Perlmutter
- Neurology, Washington University, St. Louis, MO, USA
- Radiology, Washington University, St. Louis, MO, USA
- Anatomy & Neurobiology, Washington University, St. Louis, MO, USA
- Occupational Therapy, Washington University, St. Louis, MO, USA
- Physical Therapy, Washington University, St. Louis, MO, USA
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Hall S, Surova Y, Öhrfelt A, Zetterberg H, Lindqvist D, Hansson O. CSF biomarkers and clinical progression of Parkinson disease. Neurology 2014; 84:57-63. [PMID: 25411441 DOI: 10.1212/wnl.0000000000001098] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To investigate whether certain CSF biomarkers at baseline can predict future progression of motor symptoms and cognitive decline in patients with Parkinson disease (PD). METHODS Patients and controls were recruited from hospitals in southern Sweden as part of the prospective and longitudinal Swedish BioFinder Study. In the present study, we included 42 patients with PD and 69 controls who had clinical assessment and lumbar puncture at baseline. Baseline CSF samples were analyzed for α-synuclein (αSyn), β-amyloid 1-42 (Aβ42), tau, phosphorylated tau, and neurofilament light. Associations between CSF markers at baseline and change in clinical characteristics after 2 years of follow-up were investigated using multivariate models adjusting for age, sex, disease duration, and levodopa-equivalent daily dose. RESULTS Higher levels of αSyn within the PD group were associated with progression of motor symptoms and cognitive decline over 2 years, indicated by significant relationships between αSyn and change in Hoehn and Yahr (β = 0.394, p = 0.043), Unified Parkinson's Disease Rating Scale, Part III (UPDRS-III) (β = 0.449, p = 0.013), Timed Up and Go (β = 0.406, p = 0.023), and A Quick Test of Cognitive Speed (β = 0.423, p = 0.018). Lower levels of Aβ42 were associated with worsening of performance on delayed memory recall (F = 5.834, p = 0.022). Finally, high levels of phosphorylated tau were associated with worsening in motor symptoms (UPDRS-III, β = 0.350, p = 0.045; Hoehn and Yahr, β = 0.366, p = 0.038). CONCLUSION We found evidence of a link between higher levels of αSyn at baseline and worsening of motor symptoms and cognitive speed over 2 years in PD. Increased αSyn might be a marker of more intense synaptic degeneration in PD. The results indicate that cortical amyloid pathology (low CSF Aβ42) is associated with memory decline.
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Affiliation(s)
- Sara Hall
- From the Department of Neurology (S.H., Y.S.) and Memory Clinic (O.H.), Skåne University Hospital; Department of Clinical Sciences (S.H., Y.S., D.L., O.H.), Lund University; Department of Psychiatry and Neurochemistry (A.O., H.Z.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg and Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; and Psychiatry Skåne (D.L.), Lund, Sweden.
| | - Yulia Surova
- From the Department of Neurology (S.H., Y.S.) and Memory Clinic (O.H.), Skåne University Hospital; Department of Clinical Sciences (S.H., Y.S., D.L., O.H.), Lund University; Department of Psychiatry and Neurochemistry (A.O., H.Z.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg and Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; and Psychiatry Skåne (D.L.), Lund, Sweden
| | - Annika Öhrfelt
- From the Department of Neurology (S.H., Y.S.) and Memory Clinic (O.H.), Skåne University Hospital; Department of Clinical Sciences (S.H., Y.S., D.L., O.H.), Lund University; Department of Psychiatry and Neurochemistry (A.O., H.Z.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg and Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; and Psychiatry Skåne (D.L.), Lund, Sweden
| | - Henrik Zetterberg
- From the Department of Neurology (S.H., Y.S.) and Memory Clinic (O.H.), Skåne University Hospital; Department of Clinical Sciences (S.H., Y.S., D.L., O.H.), Lund University; Department of Psychiatry and Neurochemistry (A.O., H.Z.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg and Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; and Psychiatry Skåne (D.L.), Lund, Sweden
| | - Daniel Lindqvist
- From the Department of Neurology (S.H., Y.S.) and Memory Clinic (O.H.), Skåne University Hospital; Department of Clinical Sciences (S.H., Y.S., D.L., O.H.), Lund University; Department of Psychiatry and Neurochemistry (A.O., H.Z.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg and Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; and Psychiatry Skåne (D.L.), Lund, Sweden
| | - Oskar Hansson
- From the Department of Neurology (S.H., Y.S.) and Memory Clinic (O.H.), Skåne University Hospital; Department of Clinical Sciences (S.H., Y.S., D.L., O.H.), Lund University; Department of Psychiatry and Neurochemistry (A.O., H.Z.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg and Mölndal, Sweden; UCL Institute of Neurology (H.Z.), Queen Square, London, UK; and Psychiatry Skåne (D.L.), Lund, Sweden
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Ishii K, Hosokawa C, Hyodo T, Sakaguchi K, Usami K, Shimamoto K, Hosono M, Yamazoe Y, Murakami T. Regional glucose metabolic reduction in dementia with Lewy bodies is independent of amyloid deposition. Ann Nucl Med 2014; 29:78-83. [PMID: 25270712 PMCID: PMC4835511 DOI: 10.1007/s12149-014-0911-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 09/21/2014] [Indexed: 11/29/2022]
Abstract
Purpose There is evidence that some cases of patients with dementia with Lewy bodies (DLB) can demonstrate Alzheimer disease (AD) like reduced glucose metabolism without amyloid deposition. The aim of this study was to clarify whether regional hypometabolism is related to amyloid deposits in the DLB brain and measure the degree of regional hypometabolism. Methods Ten consecutive subjects with DLB and 10 AD patients who underwent both Pittsburgh compound B (PiB)-PET and 18F-fluoro-2-deoxyglucose (FDG)-PET were included in this study. Regional standardized uptake value ratio (SUVR)s normalised to cerebellar cortices were calculated in the FDG- and PiB-PET images. Results All AD patients and five DLB patients showed amyloid deposits (PiB positive). In the DLB group the parietotemporal and occipital metabolism were significantly lower than those in the AD group but there was no difference between the posterior cingulate hypometabolism between DLB and AD groups. There were no differences in regional glucose metabolism between PiB positive and negative DLB patients. Conclusions In the DLB brain, it is suggested that decreased regional glucose metabolism is unrelated to amyloid deposits, although the hypometabolic area overlaps with the AD hypometabolic area and the degree of parietotemporal and occipital hypometabolism in DLB brain is much larger than that in AD brain.
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Affiliation(s)
- Kazunari Ishii
- Neurocognitive Disorders Center, Kinki University Hospital, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan,
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