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Li J, Jiang Z, Duan S, Zhu X. Multiple Early Biomarkers to Predict Cognitive Decline in Dementia-Free Older Adults. J Geriatr Psychiatry Neurol 2024; 37:395-402. [PMID: 38335267 DOI: 10.1177/08919887241232650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Baseline olfactory impairment, poor performance on cognitive test, and medial temporal lobe atrophy are considered biomarkers for predicting future cognitive decline in dementia-free older adults. However, the combined effect of these predictors has not been fully investigated. METHODS A group of 110 participants without dementia were continuously recruited into this study, and underwent olfactory, cognitive tests and MRI scanning at baseline and 5-year follow-up. Olfactory function was assessed using the University of Pennsylvania Smell Identification Test (UPSIT). Participants were divided into the cognitive decliners and non-decliners. RESULTS Among 87 participants who completed the 5-year follow-up, cognitive decline was present in 32 cases and 55 remained stable. Compared with non-decliners, cognitive decliners presented lower scores on both the UPSIT and the Montreal Cognitive Assessment (MoCA), and smaller hippocampal volume at baseline (all P < .001). The logistic regression analysis revealed that lower scores on UPSIT and MoCA, and smaller hippocampal volume were strongly associated with subsequent cognitive decline, respectively (all P < .001). For the prediction of cognitive decline, lower score on UPSIT performed the sensitivity of 63.6% and specificity of 81.2%, lower score on MoCA with the sensitivity of 74.5% and specificity of 65.6%, smaller hippocampal volume with the sensitivity of 70.9% and specificity of 78.1%, respectively. Combining three predictors resulted in the sensitivity of 83.6% and specificity of 93.7%. CONCLUSIONS The combination of olfactory test, cognitive test with structural MRI may enhance the predictive ability for future cognitive decline for dementia-free older adults.
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Affiliation(s)
- Juan Li
- Department of Radiology, Heji Hospital Affiliated to Changzhi Medical University, Changzhi, China
| | - Zhiying Jiang
- Department of Radiology, Heji Hospital Affiliated to Changzhi Medical University, Changzhi, China
| | - Shengjie Duan
- Department of Neurology, Heji Hospital Affiliated to Changzhi Medical University, Changzhi, China
| | - Xingxing Zhu
- Department of Radiology, Honghe Hani and Yi Autonomous Prefecture Third People's Hospital, Gejiu, China
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Teng Z. Novel Development and Prospects in Pathogenesis, Diagnosis, and Therapy of Alzheimer's Disease. J Alzheimers Dis Rep 2024; 8:345-354. [PMID: 38405339 PMCID: PMC10894614 DOI: 10.3233/adr-230130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/29/2023] [Indexed: 02/27/2024] Open
Abstract
Alzheimer's disease (AD) is the most prevalent neurodegenerative disease with cognitive decline and behavioral dysfunction. AD will become a global public health concern due to its increasing prevalence brought on by the severity of global aging. It is critical to understand the pathogenic mechanisms of AD and investigate or pursue a viable therapy strategy in clinic. Amyloid-β (Aβ) accumulation and abnormally hyperphosphorylated tau protein are the main regulating variables in the pathological phase of AD. And neuroinflammation brought on by activated microglia was found to be one risk factor contributing to changes in Aβ and tau pathology. It is important to investigate the unique biomarkers of early diagnosis and advanced stage, which may help to elucidate the specific pathological process of AD and provide potential novel therapeutic targets or preventative measures.
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Affiliation(s)
- Zenghui Teng
- Medical Faculty, Institute of Neuro- and Sensory Physiology, Heinrich-Heine-University Düsseldorf, Germany
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Labrador-Espinosa MA, Silva-Rodríguez J, Reina-Castillo MI, Mir P, Grothe MJ. Basal Forebrain Atrophy, Cortical Thinning, and Amyloid-β Status in Parkinson's disease-Related Cognitive Decline. Mov Disord 2023; 38:1871-1880. [PMID: 37492892 DOI: 10.1002/mds.29564] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 06/16/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Degeneration of the cortically-projecting cholinergic basal forebrain (cBF) is a well-established pathologic correlate of cognitive decline in Parkinson's disease (PD). In Alzheimer's disease (AD) the effect of cBF degeneration on cognitive decline was found to be mediated by parallel atrophy of denervated cortical areas. OBJECTIVES To examine whether the association between cBF degeneration and cognitive decline in PD is mediated by parallel atrophy of cortical areas and whether these associations depend on the presence of comorbid AD pathology. METHODS We studied 162 de novo PD patients who underwent serial 3 T magnetic resonance imaging scanning (follow-up: 2.33 ± 1.46 years) within the Parkinson's Progression Markers Initiative. cBF volume and regional cortical thickness were automatically calculated using established procedures. Individual slopes of structural brain changes and cognitive decline were estimated using linear-mixed models. Associations between longitudinal cBF degeneration, regional cortical thinning, and cognitive decline were assessed using regression analyses and mediation effects were assessed using nonparametric bootstrap. Complementary analyses assessed the effect of amyloid-β biomarker positivity on these associations. RESULTS After controlling for global brain atrophy, longitudinal cBF degeneration was highly correlated with faster cortical thinning (PFDR < 0.05), and thinning in cBF-associated cortical areas mediated the association between cBF degeneration and cognitive decline (rcBF-MoCA = 0.30, P < 0.001). Interestingly, both longitudinal cBF degeneration and its association with cortical thinning were largely independent of amyloid-β status. CONCLUSIONS cBF degeneration in PD is linked to parallel thinning of cortical target areas, which mediate the effect on cognitive decline. These associations are independent of amyloid-β status, indicating that they reflect proper features of PD pathophysiology. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Miguel A Labrador-Espinosa
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Seville, Spain
| | - Jesús Silva-Rodríguez
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - María Isabel Reina-Castillo
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Pablo Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Seville, Spain
| | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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Schumacher J, Ray NJ, Hamilton CA, Bergamino M, Donaghy PC, Firbank M, Watson R, Roberts G, Allan L, Barnett N, O'Brien JT, Thomas AJ, Taylor JP. Free water imaging of the cholinergic system in dementia with Lewy bodies and Alzheimer's disease. Alzheimers Dement 2023; 19:4549-4563. [PMID: 36919460 DOI: 10.1002/alz.13034] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 03/16/2023]
Abstract
INTRODUCTION Degeneration of cortical cholinergic projections from the nucleus basalis of Meynert (NBM) is characteristic of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD), whereas involvement of cholinergic projections from the pedunculopontine nucleus (PPN) to the thalamus is less clear. METHODS We studied both cholinergic projection systems using a free water-corrected diffusion tensor imaging (DTI) model in the following cases: 46 AD, 48 DLB, 35 mild cognitive impairment (MCI) with AD, 38 MCI with Lewy bodies, and 71 controls. RESULTS Free water in the NBM-cortical pathway was increased in both dementia and MCI groups compared to controls and associated with cognition. Free water along the PPN-thalamus tract was increased only in DLB and related to visual hallucinations. Results were largely replicated in an independent cohort. DISCUSSION While NBM-cortical projections degenerate early in AD and DLB, the thalamic cholinergic input from the PPN appears to be more selectively affected in DLB and might associate with visual hallucinations. HIGHLIGHTS Free water in the NBM-cortical cholinergic pathways is increased in AD and DLB. NBM-cortical pathway integrity is related to overall cognitive performance. Free water in the PPN-thalamus cholinergic pathway is only increased in DLB, not AD. PPN-thalamus pathway integrity might be related to visual hallucinations in DLB.
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Affiliation(s)
- Julia Schumacher
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
- Department of Neurology, University Medical Center Rostock, Rostock, Germany
- German Center for Neurodegenerative Diseases (DZNE) Rostock-Greifswald, Rostock, Germany
| | - Nicola J Ray
- Health, Psychology and Communities Research Centre, Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Calum A Hamilton
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
| | - Maurizio Bergamino
- Barrow Neurological Institute, Neuroimaging Research, Phoenix, Arizona, USA
| | - Paul C Donaghy
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
| | - Michael Firbank
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
| | - Rosie Watson
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Gemma Roberts
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
| | - Louise Allan
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
- University of Exeter Medical School, Exeter, UK
| | - Nicola Barnett
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge School of Medicine, Cambridge, UK
| | - Alan J Thomas
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL , UK
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Diaz-Galvan P, Lorenzon G, Mohanty R, Mårtensson G, Cavedo E, Lista S, Vergallo A, Kantarci K, Hampel H, Dubois B, Grothe MJ, Ferreira D, Westman E. Differential response to donepezil in MRI subtypes of mild cognitive impairment. Alzheimers Res Ther 2023; 15:117. [PMID: 37353809 PMCID: PMC10288762 DOI: 10.1186/s13195-023-01253-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 06/01/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Donepezil is an approved therapy for the treatment of Alzheimer's disease (AD). Results across clinical trials have been inconsistent, which may be explained by design-methodological issues, the pathophysiological heterogeneity of AD, and diversity of included study participants. We investigated whether response to donepezil differs in mild cognitive impaired (MCI) individuals demonstrating different magnetic resonance imaging (MRI) subtypes. METHODS From the Hippocampus Study double-blind, randomized clinical trial, we included 173 MCI individuals (donepezil = 83; placebo = 90) with structural MRI data, at baseline and at clinical follow-up assessments (6-12-month). Efficacy outcomes were the annualized percentage change (APC) in hippocampal, ventricular, and total grey matter volumes, as well as in the AD cortical thickness signature. Participants were classified into MRI subtypes as typical AD, limbic-predominant, hippocampal-sparing, or minimal atrophy at baseline. We primarily applied a subtyping approach based on continuous scale of two subtyping dimensions. We also used the conventional categorical subtyping approach for comparison. RESULTS Donepezil-treated MCI individuals showed slower atrophy rates compared to the placebo group, but only if they belonged to the minimal atrophy or hippocampal-sparing subtypes. Importantly, only the continuous subtyping approach, but not the conventional categorical approach, captured this differential response. CONCLUSIONS Our data suggest that individuals with MCI, with hippocampal-sparing or minimal atrophy subtype, may have improved benefit from donepezil, as compared with MCI individuals with typical or limbic-predominant patterns of atrophy. The newly proposed continuous subtyping approach may have advantages compared to the conventional categorical approach. Future research is warranted to demonstrate the potential of subtype stratification for disease prognosis and response to treatment. TRIAL REGISTRATION ClinicalTrial.gov NCT00403520. Submission Date: November 21, 2006.
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Affiliation(s)
| | - Giulia Lorenzon
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Rosaleena Mohanty
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Gustav Mårtensson
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Enrica Cavedo
- Alzheimer Precision Medicine (APM), Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Boulevard de L'hôpital, Paris, France
| | - Simone Lista
- Alzheimer Precision Medicine (APM), Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Boulevard de L'hôpital, Paris, France
| | - Andrea Vergallo
- Alzheimer Precision Medicine (APM), Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Boulevard de L'hôpital, Paris, France
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Harald Hampel
- Alzheimer Precision Medicine (APM), Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Boulevard de L'hôpital, Paris, France
| | - Bruno Dubois
- Alzheimer Precision Medicine (APM), Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Boulevard de L'hôpital, Paris, France
| | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, CSIC, Sevilla, Spain
- Wallenberg Center for Molecular and Translational Medicine, Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Daniel Ferreira
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
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Lee LH, Wu SC, Ho CF, Liang WL, Liu YC, Chou CJ. White matter hyperintensities in cholinergic pathways may predict poorer responsiveness to acetylcholinesterase inhibitor treatment for Alzheimer's disease. PLoS One 2023; 18:e0283790. [PMID: 37000849 PMCID: PMC10065432 DOI: 10.1371/journal.pone.0283790] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/19/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Acetylcholinesterase inhibitor (AChEI) drug regimens are the mainstay treatment options for patients with Alzheimer's disease (AD). Herein, We examined the association between clinical response to AChEI and white matter hyperintensities on magnetic resonance imaging (MRI) scan at baseline. METHODS Between 2020 and 2021, we recruited 101 individuals with a clinical diagnosis of probable AD. Each participant underwent complete neuropsychological testing and 3T (Telsa) brain magnetic resonance imaging. Responsiveness to AChEI, as assessed after 12 months, was designated as less than two points of regression in Mini-Mental State Examination scores (MMSE) and stable clinical dementia rating scale. We also evaluated MRI images by examining scores on the Cholinergic Pathways Hyperintensities Scale (CHIPS), Fazekas scale, and medial temporal atrophy (MTA) scale. RESULTS In our cohort, 52 patients (51.4%) were classified as responders. We observed significantly higher CHIPS scores in the nonresponder group (21.1 ± 12.9 vs. 14.9 ± 9.2, P = 0.007). Age at baseline, education level, sex, Clinical Dementia Rating sum of boxes scores, and three neuroimaging parameters were tested in regression models. Only CHIPS scores predicted clinical response to AChEI treatment. CONCLUSION WMHs in the cholinergic pathways, not diffuse white matter lesions or hippocampal atrophy, correlated with poorer responsiveness to AChEI treatment. Therefore, further investigation into the role of the cholinergic pathway in AD is warranted.
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Affiliation(s)
- Li-Hua Lee
- Department of Neurology, Cardinal Tien Hospital, New Taipei City, Taipei, Taiwan
| | - Shu-Ching Wu
- Department of Neurology, Cardinal Tien Hospital, New Taipei City, Taipei, Taiwan
| | - Cheng-Feng Ho
- Department of Radiology, Cardinal Tien Hospital, New Taipei City, Taipei, Taiwan
| | - Wan-Lin Liang
- Department of Medical Research, Far Eastern Hospital, New Taipei City, Taipei, Taiwan
| | - Yi-Chien Liu
- Department of Neurology, Cardinal Tien Hospital, New Taipei City, Taipei, Taiwan
- Department of Education and Research, Medical school of Fu-Jen University, New Taipei City, Taipei, Taiwan
- Geriatric Behavioral Neurology Project, Tohoku University New Industry Hatchery Center (NICHe), Sendai, Japan
- * E-mail:
| | - Chia-Ju Chou
- Department of Neurology, Cardinal Tien Hospital, New Taipei City, Taipei, Taiwan
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Wang Y, Zhan M, Roebroeck A, De Weerd P, Kashyap S, Roberts MJ. Inconsistencies in atlas-based volumetric measures of the human nucleus basalis of Meynert: A need for high-resolution alternatives. Neuroimage 2022; 259:119421. [PMID: 35779763 DOI: 10.1016/j.neuroimage.2022.119421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 06/10/2022] [Accepted: 06/28/2022] [Indexed: 10/17/2022] Open
Abstract
The nucleus basalis of Meynert (nbM) is the major source of cortical acetylcholine (ACh) and has been related to cognitive processes and to neurological disorders. However, spatially delineating the human nbM in MRI studies remains challenging. Due to the absence of a functional localiser for the human nbM, studies to date have localised it using nearby neuroanatomical landmarks or using probabilistic atlases. To understand the feasibility of MRI of the nbM we set our four goals; our first goal was to review current human nbM region-of-interest (ROI) selection protocols used in MRI studies, which we found have reported highly variable nbM volume estimates. Our next goal was to quantify and discuss the limitations of existing atlas-based volumetry of nbM. We found that the identified ROI volume depends heavily on the atlas used and on the probabilistic threshold set. In addition, we found large disparities even for data/studies using the same atlas and threshold. To test whether spatial resolution contributes to volume variability, as our third goal, we developed a novel nbM mask based on the normalized BigBrain dataset. We found that as long as the spatial resolution of the target data was 1.3 mm isotropic or above, our novel nbM mask offered realistic and stable volume estimates. Finally, as our last goal we tried to discern nbM using publicly available and novel high resolution structural MRI ex vivo MRI datasets. We find that, using an optimised 9.4T quantitative T2⁎ ex vivo dataset, the nbM can be visualised using MRI. We conclude caution is needed when applying the current methods of mapping nbM, especially for high resolution MRI data. Direct imaging of the nbM appears feasible and would eliminate the problems we identify, although further development is required to allow such imaging using standard (f)MRI scanning.
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Affiliation(s)
- Yawen Wang
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.
| | - Minye Zhan
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands; U992 (Cognitive neuroimaging unit), NeuroSpin, INSERM-CEA, Gif sur Yvette, France
| | - Alard Roebroeck
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Peter De Weerd
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Sriranga Kashyap
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands; Techna Institute, University Health Network, Toronto, ON, Canada
| | - Mark J Roberts
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.
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Preclinical and randomized clinical evaluation of the p38α kinase inhibitor neflamapimod for basal forebrain cholinergic degeneration. Nat Commun 2022; 13:5308. [PMID: 36130946 PMCID: PMC9492778 DOI: 10.1038/s41467-022-32944-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/23/2022] [Indexed: 12/14/2022] Open
Abstract
The endosome-associated GTPase Rab5 is a central player in the molecular mechanisms leading to degeneration of basal forebrain cholinergic neurons (BFCN), a long-standing target for drug development. As p38α is a Rab5 activator, we hypothesized that inhibition of this kinase holds potential as an approach to treat diseases associated with BFCN loss. Herein, we report that neflamapimod (oral small molecule p38α inhibitor) reduces Rab5 activity, reverses endosomal pathology, and restores the numbers and morphology of BFCNs in a mouse model that develops BFCN degeneration. We also report on the results of an exploratory (hypothesis-generating) phase 2a randomized double-blind 16-week placebo-controlled clinical trial (Clinical trial registration: NCT04001517/EudraCT #2019-001566-15) of neflamapimod in mild-to-moderate dementia with Lewy bodies (DLB), a disease in which BFCN degeneration is an important driver of disease expression. A total of 91 participants, all receiving background cholinesterase inhibitor therapy, were randomized 1:1 between neflamapimod 40 mg or matching placebo capsules (taken orally twice-daily if weight <80 kg or thrice-daily if weight >80 kg). Neflamapimod does not show an effect in the clinical study on the primary endpoint, a cognitive-test battery. On two secondary endpoints, a measure of functional mobility and a dementia rating-scale, improvements were seen that are consistent with an effect on BFCN function. Neflamapimod treatment is well-tolerated with no study drug associated treatment discontinuations. The combined preclinical and clinical observations inform on the validity of the Rab5-based pathogenic model of cholinergic degeneration and provide a foundation for confirmatory (hypothesis-testing) clinical evaluation of neflamapimod in DLB.
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Pozzi FE, Conti E, Appollonio I, Ferrarese C, Tremolizzo L. Predictors of response to acetylcholinesterase inhibitors in dementia: A systematic review. Front Neurosci 2022; 16:998224. [PMID: 36203811 PMCID: PMC9530658 DOI: 10.3389/fnins.2022.998224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background The mainstay of therapy for many neurodegenerative dementias still relies on acetylcholinesterase inhibitors (AChEI); however, there is debate on various aspects of such treatment. A huge body of literature exists on possible predictors of response, but a comprehensive review is lacking. Therefore, our aim is to perform a systematic review of the predictors of response to AChEI in neurodegenerative dementias, providing a categorization and interpretation of the results. Methods We conducted a systematic review of the literature up to December 31st, 2021, searching five different databases and registers, including studies on rivastigmine, donepezil, and galantamine, with clearly defined criteria for the diagnosis of dementia and the response to AChEI therapy. Records were identified through the string: predict * AND respon * AND (acetylcholinesterase inhibitors OR donepezil OR rivastigmine OR galantamine). The results were presented narratively. Results We identified 1,994 records in five different databases; after exclusion of duplicates, title and abstract screening, and full-text retrieval, 122 studies were finally included. Discussion The studies show high heterogeneity in duration, response definition, drug dosage, and diagnostic criteria. Response to AChEI seems associated with correlates of cholinergic deficit (hallucinations, fluctuating cognition, substantia innominate atrophy) and preserved cholinergic neurons (faster alpha on REM sleep EEG, increased anterior frontal and parietal lobe perfusion after donepezil); white matter hyperintensities in the cholinergic pathways have shown inconsistent results. The K-variant of butyrylcholinesterase may correlate with better response in late stages of disease, while the role of polymorphisms in other genes involved in the cholinergic system is controversial. Factors related to drug availability may influence response; in particular, low serum albumin (for donepezil), CYP2D6 variants associated with reduced enzymatic activity and higher drug doses are the most consistent predictors, while AChEI concentration influence on clinical outcomes is debatable. Other predictors of response include faster disease progression, lower serum cholesterol, preserved medial temporal lobes, apathy, absence of concomitant diseases, and absence of antipsychotics. Short-term response may predict subsequent cognitive response, while higher education might correlate with short-term good response (months), and long-term poor response (years). Age, gender, baseline cognitive and functional levels, and APOE relationship with treatment outcome is controversial.
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Affiliation(s)
| | - Elisa Conti
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Milan Center for Neuroscience (NeuroMi), University of Milano-Bicocca, Milan, Italy
| | - Ildebrando Appollonio
- Neurology Department, San Gerardo Hospital, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Milan Center for Neuroscience (NeuroMi), University of Milano-Bicocca, Milan, Italy
| | - Carlo Ferrarese
- Neurology Department, San Gerardo Hospital, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Milan Center for Neuroscience (NeuroMi), University of Milano-Bicocca, Milan, Italy
| | - Lucio Tremolizzo
- Neurology Department, San Gerardo Hospital, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Milan Center for Neuroscience (NeuroMi), University of Milano-Bicocca, Milan, Italy
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Richter N, David LS, Grothe MJ, Teipel S, Dietlein M, Tittgemeyer M, Neumaier B, Fink GR, Onur OA, Kukolja J. Age and Anterior Basal Forebrain Volume Predict the Cholinergic Deficit in Patients with Mild Cognitive Impairment due to Alzheimer’s Disease. J Alzheimers Dis 2022; 86:425-440. [DOI: 10.3233/jad-210261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background: Early and severe neuronal loss in the cholinergic basal forebrain is observed in Alzheimer’s disease (AD). To date, cholinomimetics play a central role in the symptomatic treatment of AD dementia. Although basic research indicates that a cholinergic deficit is present in AD before dementia, the efficacy of cholinomimetics in mild cognitive impairment (MCI) remains controversial. Predictors of cholinergic impairment could guide individualized therapy. Objective: To investigate if the extent of the cholinergic deficit, measured using positron emission tomography (PET) and the tracer 11C-N-methyl-4-piperidyl acetate (MP4A), could be predicted from the volume of cholinergic basal forebrain nuclei in non-demented AD patients. Methods: Seventeen patients with a high likelihood of MCI due to AD and 18 age-matched cognitively healthy adults underwent MRI-scanning. Basal forebrain volume was assessed using voxel-based morphometry and a cytoarchitectonic atlas of cholinergic nuclei. Cortical acetylcholinesterase (AChE) activity was measured using MP4A-PET. Results: Cortical AChE activity and nucleus basalis of Meynert (Ch4 area) volume were significantly decreased in MCI. The extent of the cholinergic deficit varied considerably across patients. Greater volumes of anterior basal forebrain nuclei (Ch1/2 area) and younger age (Spearman’s rho (17) = –0.596, 95% -CI [–0.905, –0.119] and 0.593, 95% -CI [0.092, 0.863])) were associated with a greater cholinergic deficit. Conclusion: Data suggest that less atrophy of the Ch1/2 area and younger age are associated with a more significant cholinergic deficit in MCI due to AD. Further investigations are warranted to determine if the individual response to cholinomimetics can be inferred from these measures.
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Affiliation(s)
- Nils Richter
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, Medical Faculty and University Hospital of Cologne, Cologne, Germany
- Max-Planck-Institute for Metabolism Research, Cologne, Cologne, Germany
| | - Lara-Sophia David
- Department of Neurology, Medical Faculty and University Hospital of Cologne, Cologne, Germany
| | - Michel J. Grothe
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Movement Disorders Group, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| | - Markus Dietlein
- Department of Nuclear Medicine, Medical Faculty and University Hospital of Cologne, Cologne, Germany
| | - Marc Tittgemeyer
- Max-Planck-Institute for Metabolism Research, Cologne, Cologne, Germany
| | - Bernd Neumaier
- Max-Planck-Institute for Metabolism Research, Cologne, Cologne, Germany
- Nuclear Chemistry, Institute of Neuroscience and Medicine (INM-5), Research Center Jülich, Jülich, Germany
- Institute for Radiochemistry and Experimental Molecular Imaging, Medical Faculty and University Hospital of Cologne, Cologne, Germany
| | - Gereon R. Fink
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, Medical Faculty and University Hospital of Cologne, Cologne, Germany
| | - Oezguer A. Onur
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, Medical Faculty and University Hospital of Cologne, Cologne, Germany
| | - Juraj Kukolja
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany
- Department of Neurology, Medical Faculty and University Hospital of Cologne, Cologne, Germany
- Department of Neurology and Clinical Neurophysiology, Helios University Hospital Wuppertal, Wuppertal, Germany
- Faculty of Health, Witten/Herdecke University, Witten, Germany
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Electrical stimulation of the nucleus basalis of meynert: a systematic review of preclinical and clinical data. Sci Rep 2021; 11:11751. [PMID: 34083732 PMCID: PMC8175342 DOI: 10.1038/s41598-021-91391-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 05/24/2021] [Indexed: 12/09/2022] Open
Abstract
Deep brain stimulation (DBS) of the nucleus basalis of Meynert (NBM) has been clinically investigated in Alzheimer’s disease (AD) and Lewy body dementia (LBD). However, the clinical effects are highly variable, which questions the suggested basic principles underlying these clinical trials. Therefore, preclinical and clinical data on the design of NBM stimulation experiments and its effects on behavioral and neurophysiological aspects are systematically reviewed here. Animal studies have shown that electrical stimulation of the NBM enhanced cognition, increased the release of acetylcholine, enhanced cerebral blood flow, released several neuroprotective factors, and facilitates plasticity of cortical and subcortical receptive fields. However, the translation of these outcomes to current clinical practice is hampered by the fact that mainly animals with an intact NBM were used, whereas most animals were stimulated unilaterally, with different stimulation paradigms for only restricted timeframes. Future animal research has to refine the NBM stimulation methods, using partially lesioned NBM nuclei, to better resemble the clinical situation in AD, and LBD. More preclinical data on the effect of stimulation of lesioned NBM should be present, before DBS of the NBM in human is explored further.
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Müller P, Vellage A, Schmicker M, Menze I, Grothe MJ, Teipel SJ, Müller NG. Structural MRI of the basal forebrain as predictor of cognitive response to galantamine in healthy older adults-A randomized controlled double-blinded crossover study. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12153. [PMID: 33842683 PMCID: PMC8020325 DOI: 10.1002/trc2.12153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/19/2020] [Accepted: 01/22/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Cholinesterase inhibitors can enhance cognitive functions in healthy elderly and delay cognitive decline in patients with Alzheimer`s disease (AD). However, not everyone benefits from this treatment (non-responders). Current studies show clinical meaningful improvements only in one third of AD patients treated with cholinesterase inhibitors. METHODS Here we investigate structural magnetic resonance imaging of the basal forebrain cholinergic system volume (BFvol) as a potential predictor of cognitive response to a single dose of galantamine in healthy adults (n = 18; 59 to 75 years). RESULTS We observed that the cognitive response to galantamine, more specifically the attention-dependent filtering performance in a delayed match-to-sample working memory task, correlated with BFvol: Only participants with high BFvol showed a significant positive effect of galantamine on the ability to filter out distracting information during the working memory encoding process. DISCUSSION Future studies need to assess whether BFvol may serve as a predictor of the galantamine response in AD patients, too.
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Affiliation(s)
- Patrick Müller
- German Centre for Neurodegenerative DiseasesMagdeburgGermany
- Department of NeurologyOtto von Guericke UniversityMagdeburgGermany
| | - Anne‐Katrin Vellage
- German Centre for Neurodegenerative DiseasesMagdeburgGermany
- Berlin School of Mind and BrainHumboldt‐UniversityBerlinGermany
| | | | - Inga Menze
- German Centre for Neurodegenerative DiseasesMagdeburgGermany
| | - Michel J. Grothe
- German Centre for Neurodegenerative DiseasesRostockGermany
- Unidad de Trastornos del MovimientoServicio de Neurología y Neurofisiología ClínicaInstituto de Biomedicina de SevillaHospital Universitario Virgen del Rocío/CSIC/Universidad de SevillaSevilleSpain
| | | | - Notger G. Müller
- German Centre for Neurodegenerative DiseasesMagdeburgGermany
- Department of NeurologyOtto von Guericke UniversityMagdeburgGermany
- Center for Behavioral Brain Science (CBBS)MagdeburgGermany
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13
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Kauppi K, Rönnlund M, Nordin Adolfsson A, Pudas S, Adolfsson R. Effects of polygenic risk for Alzheimer's disease on rate of cognitive decline in normal aging. Transl Psychiatry 2020; 10:250. [PMID: 32709845 PMCID: PMC7381667 DOI: 10.1038/s41398-020-00934-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/24/2020] [Accepted: 07/09/2020] [Indexed: 12/11/2022] Open
Abstract
Most people's cognitive abilities decline with age, with significant and partly genetically driven, individual differences in rate of change. Although APOE ɛ4 and genetic scores for late-onset Alzheimer's disease (LOAD) have been related to cognitive decline during preclinical stages of dementia, there is limited knowledge concerning genetic factors implied in normal cognitive aging. In the present study, we examined three potential genetic predictors of age-related cognitive decline as follows: (1) the APOE ɛ4 allele, (2) a polygenic score for general cognitive ability (PGS-cog), and (3) a polygenic risk score for late-onset AD (PRS-LOAD). We examined up to six time points of cognitive measurements in the longitudinal population-based Betula study, covering a 25-year follow-up period. Only participants that remained alive and non-demented until the most recent dementia screening (1-3 years after the last test occasion) were included (n = 1087). Individual differences in rate of cognitive change (composite score) were predicted by the PRS-LOAD and APOE ɛ4, but not by PGS-cog. To control for the possibility that the results reflected a preclinical state of Alzheimer's disease in some participants, we re-ran the analyses excluding cognitive data from the last test occasion to model cognitive change up-until a minimum of 6 years before potential onset of clinical Alzheimers. Strikingly, the association of PRS-LOAD, but not APOE ɛ4, with cognitive change remained. The results indicate that PRS-LOAD predicts individual difference in rate of cognitive decline in normal aging, but it remains to be determined to what extent this reflects preclinical Alzheimer's disease brain pathophysiology and subsequent risk to develop the disease.
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Affiliation(s)
- Karolina Kauppi
- Department of Integrative Medical Biologi, Umeå University, Umeå, Sweden. .,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Michael Rönnlund
- grid.12650.300000 0001 1034 3451Department of Psychology, Umeå University, Umeå, Sweden
| | | | - Sara Pudas
- grid.12650.300000 0001 1034 3451Department of Integrative Medical Biologi, Umeå University, Umeå, Sweden
| | - Rolf Adolfsson
- grid.12650.300000 0001 1034 3451Department of Clinical Sciences, Umeå University, Umeå, Sweden
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Hampel H, Vergallo A, Perry G, Lista S. The Alzheimer Precision Medicine Initiative. J Alzheimers Dis 2019; 68:1-24. [DOI: 10.3233/jad-181121] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Harald Hampel
- AXA Research Fund & Sorbonne University Chair, Paris, France
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l’hôpital, Paris, France
- Brain & Spine Institute (ICM), INSERM U 1127, CNRS UMR 7225, Paris, France
- Institute of Memory and Alzheimer’s Disease (IM2A), Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l’hôpital, Paris, France
| | - Andrea Vergallo
- AXA Research Fund & Sorbonne University Chair, Paris, France
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l’hôpital, Paris, France
- Brain & Spine Institute (ICM), INSERM U 1127, CNRS UMR 7225, Paris, France
- Institute of Memory and Alzheimer’s Disease (IM2A), Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l’hôpital, Paris, France
| | - George Perry
- College of Sciences, One UTSA Circle, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Simone Lista
- AXA Research Fund & Sorbonne University Chair, Paris, France
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l’hôpital, Paris, France
- Brain & Spine Institute (ICM), INSERM U 1127, CNRS UMR 7225, Paris, France
- Institute of Memory and Alzheimer’s Disease (IM2A), Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l’hôpital, Paris, France
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15
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Chiesa PA, Cavedo E, Grothe MJ, Houot M, Teipel SJ, Potier MC, Habert MO, Lista S, Dubois B, Hampel H. Relationship between Basal Forebrain Resting-State Functional Connectivity and Brain Amyloid-β Deposition in Cognitively Intact Older Adults with Subjective Memory Complaints. Radiology 2018; 290:167-176. [PMID: 30351255 DOI: 10.1148/radiol.2018180268] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Purpose To evaluate the association between the global fibrillary amyloid-β pathology and the basal forebrain connectivity at rest in cognitively intact older adults at risk for Alzheimer disease. Materials and Methods This retrospective study was approved by the local ethics committee and written informed consent was obtained from all participants. Resting-state functional connectivity (RSFC) of anterior and posterior basal forebrain seeds was investigated, as well as PET-measured global amyloid-β load by using standardized uptake value ratio (SUVR) in 267 older cognitively intact individuals with subjective memory complaints (age range, 70-85 years; overall mean age, 75.8 years; 167 women [mean age, 75.9 years] and 100 men [mean age, 75.8 years]). The participants were from the Investigation of Alzheimer's Predictors in Subjective Memory Complainers (INSIGHT-preAD) cohort (date range, 2013-present). The relationship between SUVR and the basal forebrain RSFC was assessed, followed by the effects of apolipoprotein E (APOE) genotype and sex on the basal forebrain RSFC. Results Higher SUVR values correlated with lower posterior basal forebrain RSFC in the hippocampus and the thalamus (Pearson r =-0.23; P <.001 corrected for familywise error [FWE]). Both sex and APOE genotype impacted the associations between basal forebrain RSFC and the global amyloid deposition (t values >3.59; P <.05 corrected for FWE). Conclusion Data indicate a distinct in vivo association between posterior basal forebrain dynamics and global fibrillary amyloid-β pathology in cognitively intact older adults with subjective memory complaints; both apolipoprotein E and sex moderate such association. © RSNA, 2018 Online supplemental material is available for this article. See also the editorial by Caspers in this issue.
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Affiliation(s)
- Patrizia A Chiesa
- From the AXA Research Fund & UPMC Chair, Paris, France (P.A.C., E.C., S.L., H.H.); Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine, AP-HP, Hôpital de la Pitié-Salpêtrière, Boulevard de l'hôpital, F-75013, Paris, France (P.A.C., E.C., M.H., S.L., B.D., H.H.); Institut du Cerveau et de la Moelle Épinière (ICM), INSERM U 1127, CNRS UMR 7225 (P.A.C., E.C., S.L., B.D., H.H.); Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Department of Neurology, Hôpital de la Pitié-Salpêtrière (P.A.C., E.C., M.H., S.L., B.D., H.H.); Istituto Centro San Giovanni di Dio-Fatebenefratelli, Italy (E.C.); German Center for Neurodegenerative Diseases - Rostock/Greifswald, Rostock, Germany (M.J.G., S.J.T.); Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany (S.J.T.); ICM, CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière, Paris, France (M.C.P.); Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (M.O.H.); Centre pour l'Acquisition et le Traitement des Images, Paris, France (M.O.H.); AP-HP, Hôpital Pitié-Salpêtrière, Department of Nuclear Medicine, Paris, France (M.O.H.). Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital de la Pitié-Salpêtrière (M.H., B.D.); Center for Clinical Investigation Neurosciences, ICM (M.H.)
| | - Enrica Cavedo
- From the AXA Research Fund & UPMC Chair, Paris, France (P.A.C., E.C., S.L., H.H.); Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine, AP-HP, Hôpital de la Pitié-Salpêtrière, Boulevard de l'hôpital, F-75013, Paris, France (P.A.C., E.C., M.H., S.L., B.D., H.H.); Institut du Cerveau et de la Moelle Épinière (ICM), INSERM U 1127, CNRS UMR 7225 (P.A.C., E.C., S.L., B.D., H.H.); Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Department of Neurology, Hôpital de la Pitié-Salpêtrière (P.A.C., E.C., M.H., S.L., B.D., H.H.); Istituto Centro San Giovanni di Dio-Fatebenefratelli, Italy (E.C.); German Center for Neurodegenerative Diseases - Rostock/Greifswald, Rostock, Germany (M.J.G., S.J.T.); Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany (S.J.T.); ICM, CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière, Paris, France (M.C.P.); Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (M.O.H.); Centre pour l'Acquisition et le Traitement des Images, Paris, France (M.O.H.); AP-HP, Hôpital Pitié-Salpêtrière, Department of Nuclear Medicine, Paris, France (M.O.H.). Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital de la Pitié-Salpêtrière (M.H., B.D.); Center for Clinical Investigation Neurosciences, ICM (M.H.)
| | - Michel J Grothe
- From the AXA Research Fund & UPMC Chair, Paris, France (P.A.C., E.C., S.L., H.H.); Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine, AP-HP, Hôpital de la Pitié-Salpêtrière, Boulevard de l'hôpital, F-75013, Paris, France (P.A.C., E.C., M.H., S.L., B.D., H.H.); Institut du Cerveau et de la Moelle Épinière (ICM), INSERM U 1127, CNRS UMR 7225 (P.A.C., E.C., S.L., B.D., H.H.); Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Department of Neurology, Hôpital de la Pitié-Salpêtrière (P.A.C., E.C., M.H., S.L., B.D., H.H.); Istituto Centro San Giovanni di Dio-Fatebenefratelli, Italy (E.C.); German Center for Neurodegenerative Diseases - Rostock/Greifswald, Rostock, Germany (M.J.G., S.J.T.); Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany (S.J.T.); ICM, CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière, Paris, France (M.C.P.); Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (M.O.H.); Centre pour l'Acquisition et le Traitement des Images, Paris, France (M.O.H.); AP-HP, Hôpital Pitié-Salpêtrière, Department of Nuclear Medicine, Paris, France (M.O.H.). Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital de la Pitié-Salpêtrière (M.H., B.D.); Center for Clinical Investigation Neurosciences, ICM (M.H.)
| | - Marion Houot
- From the AXA Research Fund & UPMC Chair, Paris, France (P.A.C., E.C., S.L., H.H.); Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine, AP-HP, Hôpital de la Pitié-Salpêtrière, Boulevard de l'hôpital, F-75013, Paris, France (P.A.C., E.C., M.H., S.L., B.D., H.H.); Institut du Cerveau et de la Moelle Épinière (ICM), INSERM U 1127, CNRS UMR 7225 (P.A.C., E.C., S.L., B.D., H.H.); Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Department of Neurology, Hôpital de la Pitié-Salpêtrière (P.A.C., E.C., M.H., S.L., B.D., H.H.); Istituto Centro San Giovanni di Dio-Fatebenefratelli, Italy (E.C.); German Center for Neurodegenerative Diseases - Rostock/Greifswald, Rostock, Germany (M.J.G., S.J.T.); Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany (S.J.T.); ICM, CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière, Paris, France (M.C.P.); Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (M.O.H.); Centre pour l'Acquisition et le Traitement des Images, Paris, France (M.O.H.); AP-HP, Hôpital Pitié-Salpêtrière, Department of Nuclear Medicine, Paris, France (M.O.H.). Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital de la Pitié-Salpêtrière (M.H., B.D.); Center for Clinical Investigation Neurosciences, ICM (M.H.)
| | - Stefan J Teipel
- From the AXA Research Fund & UPMC Chair, Paris, France (P.A.C., E.C., S.L., H.H.); Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine, AP-HP, Hôpital de la Pitié-Salpêtrière, Boulevard de l'hôpital, F-75013, Paris, France (P.A.C., E.C., M.H., S.L., B.D., H.H.); Institut du Cerveau et de la Moelle Épinière (ICM), INSERM U 1127, CNRS UMR 7225 (P.A.C., E.C., S.L., B.D., H.H.); Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Department of Neurology, Hôpital de la Pitié-Salpêtrière (P.A.C., E.C., M.H., S.L., B.D., H.H.); Istituto Centro San Giovanni di Dio-Fatebenefratelli, Italy (E.C.); German Center for Neurodegenerative Diseases - Rostock/Greifswald, Rostock, Germany (M.J.G., S.J.T.); Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany (S.J.T.); ICM, CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière, Paris, France (M.C.P.); Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (M.O.H.); Centre pour l'Acquisition et le Traitement des Images, Paris, France (M.O.H.); AP-HP, Hôpital Pitié-Salpêtrière, Department of Nuclear Medicine, Paris, France (M.O.H.). Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital de la Pitié-Salpêtrière (M.H., B.D.); Center for Clinical Investigation Neurosciences, ICM (M.H.)
| | - Marie-Claude Potier
- From the AXA Research Fund & UPMC Chair, Paris, France (P.A.C., E.C., S.L., H.H.); Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine, AP-HP, Hôpital de la Pitié-Salpêtrière, Boulevard de l'hôpital, F-75013, Paris, France (P.A.C., E.C., M.H., S.L., B.D., H.H.); Institut du Cerveau et de la Moelle Épinière (ICM), INSERM U 1127, CNRS UMR 7225 (P.A.C., E.C., S.L., B.D., H.H.); Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Department of Neurology, Hôpital de la Pitié-Salpêtrière (P.A.C., E.C., M.H., S.L., B.D., H.H.); Istituto Centro San Giovanni di Dio-Fatebenefratelli, Italy (E.C.); German Center for Neurodegenerative Diseases - Rostock/Greifswald, Rostock, Germany (M.J.G., S.J.T.); Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany (S.J.T.); ICM, CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière, Paris, France (M.C.P.); Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (M.O.H.); Centre pour l'Acquisition et le Traitement des Images, Paris, France (M.O.H.); AP-HP, Hôpital Pitié-Salpêtrière, Department of Nuclear Medicine, Paris, France (M.O.H.). Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital de la Pitié-Salpêtrière (M.H., B.D.); Center for Clinical Investigation Neurosciences, ICM (M.H.)
| | - Marie-Odile Habert
- From the AXA Research Fund & UPMC Chair, Paris, France (P.A.C., E.C., S.L., H.H.); Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine, AP-HP, Hôpital de la Pitié-Salpêtrière, Boulevard de l'hôpital, F-75013, Paris, France (P.A.C., E.C., M.H., S.L., B.D., H.H.); Institut du Cerveau et de la Moelle Épinière (ICM), INSERM U 1127, CNRS UMR 7225 (P.A.C., E.C., S.L., B.D., H.H.); Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Department of Neurology, Hôpital de la Pitié-Salpêtrière (P.A.C., E.C., M.H., S.L., B.D., H.H.); Istituto Centro San Giovanni di Dio-Fatebenefratelli, Italy (E.C.); German Center for Neurodegenerative Diseases - Rostock/Greifswald, Rostock, Germany (M.J.G., S.J.T.); Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany (S.J.T.); ICM, CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière, Paris, France (M.C.P.); Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (M.O.H.); Centre pour l'Acquisition et le Traitement des Images, Paris, France (M.O.H.); AP-HP, Hôpital Pitié-Salpêtrière, Department of Nuclear Medicine, Paris, France (M.O.H.). Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital de la Pitié-Salpêtrière (M.H., B.D.); Center for Clinical Investigation Neurosciences, ICM (M.H.)
| | - Simone Lista
- From the AXA Research Fund & UPMC Chair, Paris, France (P.A.C., E.C., S.L., H.H.); Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine, AP-HP, Hôpital de la Pitié-Salpêtrière, Boulevard de l'hôpital, F-75013, Paris, France (P.A.C., E.C., M.H., S.L., B.D., H.H.); Institut du Cerveau et de la Moelle Épinière (ICM), INSERM U 1127, CNRS UMR 7225 (P.A.C., E.C., S.L., B.D., H.H.); Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Department of Neurology, Hôpital de la Pitié-Salpêtrière (P.A.C., E.C., M.H., S.L., B.D., H.H.); Istituto Centro San Giovanni di Dio-Fatebenefratelli, Italy (E.C.); German Center for Neurodegenerative Diseases - Rostock/Greifswald, Rostock, Germany (M.J.G., S.J.T.); Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany (S.J.T.); ICM, CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière, Paris, France (M.C.P.); Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (M.O.H.); Centre pour l'Acquisition et le Traitement des Images, Paris, France (M.O.H.); AP-HP, Hôpital Pitié-Salpêtrière, Department of Nuclear Medicine, Paris, France (M.O.H.). Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital de la Pitié-Salpêtrière (M.H., B.D.); Center for Clinical Investigation Neurosciences, ICM (M.H.)
| | - Bruno Dubois
- From the AXA Research Fund & UPMC Chair, Paris, France (P.A.C., E.C., S.L., H.H.); Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine, AP-HP, Hôpital de la Pitié-Salpêtrière, Boulevard de l'hôpital, F-75013, Paris, France (P.A.C., E.C., M.H., S.L., B.D., H.H.); Institut du Cerveau et de la Moelle Épinière (ICM), INSERM U 1127, CNRS UMR 7225 (P.A.C., E.C., S.L., B.D., H.H.); Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Department of Neurology, Hôpital de la Pitié-Salpêtrière (P.A.C., E.C., M.H., S.L., B.D., H.H.); Istituto Centro San Giovanni di Dio-Fatebenefratelli, Italy (E.C.); German Center for Neurodegenerative Diseases - Rostock/Greifswald, Rostock, Germany (M.J.G., S.J.T.); Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany (S.J.T.); ICM, CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière, Paris, France (M.C.P.); Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (M.O.H.); Centre pour l'Acquisition et le Traitement des Images, Paris, France (M.O.H.); AP-HP, Hôpital Pitié-Salpêtrière, Department of Nuclear Medicine, Paris, France (M.O.H.). Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital de la Pitié-Salpêtrière (M.H., B.D.); Center for Clinical Investigation Neurosciences, ICM (M.H.)
| | - Harald Hampel
- From the AXA Research Fund & UPMC Chair, Paris, France (P.A.C., E.C., S.L., H.H.); Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine, AP-HP, Hôpital de la Pitié-Salpêtrière, Boulevard de l'hôpital, F-75013, Paris, France (P.A.C., E.C., M.H., S.L., B.D., H.H.); Institut du Cerveau et de la Moelle Épinière (ICM), INSERM U 1127, CNRS UMR 7225 (P.A.C., E.C., S.L., B.D., H.H.); Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Department of Neurology, Hôpital de la Pitié-Salpêtrière (P.A.C., E.C., M.H., S.L., B.D., H.H.); Istituto Centro San Giovanni di Dio-Fatebenefratelli, Italy (E.C.); German Center for Neurodegenerative Diseases - Rostock/Greifswald, Rostock, Germany (M.J.G., S.J.T.); Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany (S.J.T.); ICM, CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière, Paris, France (M.C.P.); Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (M.O.H.); Centre pour l'Acquisition et le Traitement des Images, Paris, France (M.O.H.); AP-HP, Hôpital Pitié-Salpêtrière, Department of Nuclear Medicine, Paris, France (M.O.H.). Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital de la Pitié-Salpêtrière (M.H., B.D.); Center for Clinical Investigation Neurosciences, ICM (M.H.)
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- From the AXA Research Fund & UPMC Chair, Paris, France (P.A.C., E.C., S.L., H.H.); Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine, AP-HP, Hôpital de la Pitié-Salpêtrière, Boulevard de l'hôpital, F-75013, Paris, France (P.A.C., E.C., M.H., S.L., B.D., H.H.); Institut du Cerveau et de la Moelle Épinière (ICM), INSERM U 1127, CNRS UMR 7225 (P.A.C., E.C., S.L., B.D., H.H.); Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Department of Neurology, Hôpital de la Pitié-Salpêtrière (P.A.C., E.C., M.H., S.L., B.D., H.H.); Istituto Centro San Giovanni di Dio-Fatebenefratelli, Italy (E.C.); German Center for Neurodegenerative Diseases - Rostock/Greifswald, Rostock, Germany (M.J.G., S.J.T.); Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany (S.J.T.); ICM, CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière, Paris, France (M.C.P.); Sorbonne Universités, UPMC Univ Paris 06, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale, Paris, France (M.O.H.); Centre pour l'Acquisition et le Traitement des Images, Paris, France (M.O.H.); AP-HP, Hôpital Pitié-Salpêtrière, Department of Nuclear Medicine, Paris, France (M.O.H.). Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital de la Pitié-Salpêtrière (M.H., B.D.); Center for Clinical Investigation Neurosciences, ICM (M.H.)
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16
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Teipel SJ, Cavedo E, Hampel H, Grothe MJ. Basal Forebrain Volume, but Not Hippocampal Volume, Is a Predictor of Global Cognitive Decline in Patients With Alzheimer's Disease Treated With Cholinesterase Inhibitors. Front Neurol 2018; 9:642. [PMID: 30158893 PMCID: PMC6104491 DOI: 10.3389/fneur.2018.00642] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 07/17/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Predicting the progression of cognitive decline in Alzheimer's disease (AD) is important for treatment selection and patient counseling. Structural MRI markers such as hippocampus or basal forebrain volumes might represent useful instruments for the prediction of cognitive decline. The primary objective was to determine the predictive value of hippocampus and basal forebrain volumes for global and domain specific cognitive decline in AD dementia during cholinergic treatment. Methods: We used MRI and cognitive data from 124 patients with the clinical diagnosis of AD dementia, derived from the ADNI-1 cohort, who were on standard of care cholinesterase inhibitor treatment during a follow-up period between 0.4 and 3.1 years. We used linear mixed effects models with cognitive function as outcome to assess the main effects as well as two-way interactions between baseline volumes and time controlling for age, sex, and total intracranial volume. This model accounts for individual variation in follow-up times. Results: Basal forebrain volume, but not hippocampus volume, was a significant predictor of rates of global cognitive decline. Larger volumes were associated with smaller rates of cognitive decline. Left hippocampus volume had a modest association with rates of episodic memory decline. Baseline performance in global cognition and memory was significantly associated with hippocampus and basal forebrain volumes; in addition, basal forebrain volume was associated with baseline performance in executive function. Conclusions: Our findings indicate that in AD dementia patients, basal forebrain volume may be a useful marker to predict subsequent cognitive decline during cholinergic treatment.
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Affiliation(s)
- Stefan J Teipel
- German Center for Neurodegenerative Diseases-Rostock/Greifswald, Rostock, Germany.,Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| | - Enrica Cavedo
- AXA Research Fund and Sorbonne University Chair, Paris, France.,Sorbonne University, GRC n° 21, Alzheimer Precision Medicine, AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'Hôpital, Paris, France.,Brain and Spine Institute (ICM), INSERM U 1127, CNRS UMR 7225, Boulevard de l'Hôpital, Paris, France.,Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l'Hôpital, Paris, France.,IRCCS Istituto Centro San Giovanni di Dio-Fatebenefratelli, Brescia, Italy
| | - Harald Hampel
- AXA Research Fund and Sorbonne University Chair, Paris, France.,Sorbonne University, GRC n° 21, Alzheimer Precision Medicine, AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'Hôpital, Paris, France.,Brain and Spine Institute (ICM), INSERM U 1127, CNRS UMR 7225, Boulevard de l'Hôpital, Paris, France.,Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l'Hôpital, Paris, France
| | - Michel J Grothe
- German Center for Neurodegenerative Diseases-Rostock/Greifswald, Rostock, Germany
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17
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Peter J, Schumacher LV, Landerer V, Abdulkadir A, Kaller CP, Lahr J, Klöppel S. Biological Factors Contributing to the Response to Cognitive Training in Mild Cognitive Impairment. J Alzheimers Dis 2018; 61:333-345. [PMID: 29154279 PMCID: PMC5734129 DOI: 10.3233/jad-170580] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In mild cognitive impairment (MCI), small benefits from cognitive training were observed for memory functions but there appears to be great variability in the response to treatment. Our study aimed to improve the characterization and selection of those participants who will benefit from cognitive intervention. We evaluated the predictive value of disease-specific biological factors for the outcome after cognitive training in MCI (n = 25) and also considered motivation of the participants. We compared the results of the cognitive intervention group with two independent control groups of MCI patients (local memory clinic, n = 20; ADNI cohort, n = 302). The primary outcome measure was episodic memory as measured by verbal delayed recall of a 10-word list. Episodic memory remained stable after treatment and slightly increased 6 months after the intervention. In contrast, in MCI patients who did not receive an intervention, episodic memory significantly decreased during the same time interval. A larger left entorhinal cortex predicted more improvement in episodic memory after treatment and so did higher levels of motivation. Adding disease-specific biological factors significantly improved the prediction of training-related change compared to a model based simply on age and baseline performance. Bootstrapping with resampling (n = 1000) verified the stability of our finding. Cognitive training might be particularly helpful in individuals with a bigger left entorhinal cortex as individuals who did not benefit from intervention showed 17% less volume in this area. When extended to alternative treatment options, stratification based on disease-specific biological factors is a useful step towards individualized medicine.
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Affiliation(s)
- Jessica Peter
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland.,Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Germany
| | - Lena V Schumacher
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Germany
| | - Verena Landerer
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Germany
| | - Ahmed Abdulkadir
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland.,Department of Computer Science, University of Freiburg, Germany
| | - Christoph P Kaller
- Department of Neurology, Faculty of Medicine, University of Freiburg, Germany.,BrainLinks-BrainTools Cluster of Excellence, University of Freiburg, Freiburg, Germany
| | - Jacob Lahr
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Germany
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland.,Centre for Geriatric Medicine and Gerontology, Faculty of Medicine, University of Freiburg, Germany
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18
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Teipel SJ, Cavedo E, Lista S, Habert MO, Potier MC, Grothe MJ, Epelbaum S, Sambati L, Gagliardi G, Toschi N, Greicius MD, Dubois B, Hampel H. Effect of Alzheimer's disease risk and protective factors on cognitive trajectories in subjective memory complainers: An INSIGHT-preAD study. Alzheimers Dement 2018; 14:1126-1136. [PMID: 29792873 DOI: 10.1016/j.jalz.2018.04.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 01/16/2018] [Accepted: 04/09/2018] [Indexed: 10/16/2022]
Abstract
INTRODUCTION Cognitive change in people at risk of Alzheimer's disease (AD) such as subjective memory complainers is highly variable across individuals. METHODS We used latent class growth modeling to identify distinct classes of nonlinear trajectories of cognitive change over 2 years follow-up from 265 subjective memory complainers individuals (age 70 years and older) of the INSIGHT-preAD cohort. We determined the effect of cortical amyloid load, hippocampus and basal forebrain volumes, and education on the cognitive trajectory classes. RESULTS Latent class growth modeling identified distinct nonlinear cognitive trajectories. Education was associated with higher performing trajectories, whereas global amyloid load and basal forebrain atrophy were associated with lower performing trajectories. DISCUSSION Distinct classes of cognitive trajectories were associated with risk and protective factors of AD. These associations support the notion that the identified cognitive trajectories reflect different risk for AD that may be useful for selecting high-risk individuals for intervention trials.
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Affiliation(s)
- Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE)-Rostock/Greifswald, Rostock, Germany; Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany.
| | - Enrica Cavedo
- AXA Research Fund & Sorbonne Université Chair, Paris, France; Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France; Institut du Cerveau et de la Moelle Épiniére (ICM), INSERM U 1127, CNRS UMR 7225, Paris, France; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Département de Neurologie, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France; IRCCS Centro San Giovanni di Dio-Fatebenefratelli, Brescia, Italy
| | - Simone Lista
- AXA Research Fund & Sorbonne Université Chair, Paris, France; Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France; Institut du Cerveau et de la Moelle Épiniére (ICM), INSERM U 1127, CNRS UMR 7225, Paris, France; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Département de Neurologie, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France
| | - Marie-Odile Habert
- Département de Médecine Nucléaire, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Universités, UPMC Univ Paris 06, Inserm U 1146, CNRS UMR 7371, Paris, France
| | - Marie-Claude Potier
- ICM Institut du Cerveau et de la Moelle épinière, CNRS UMR7225, INSERM U1127, UPMC, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Michel J Grothe
- German Center for Neurodegenerative Diseases (DZNE)-Rostock/Greifswald, Rostock, Germany; Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| | - Stephane Epelbaum
- Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Luisa Sambati
- Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Geoffroy Gagliardi
- Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Michael D Greicius
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Bruno Dubois
- Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Harald Hampel
- AXA Research Fund & Sorbonne Université Chair, Paris, France; Sorbonne Université, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France; Institut du Cerveau et de la Moelle Épiniére (ICM), INSERM U 1127, CNRS UMR 7225, Paris, France; Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Département de Neurologie, Hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France
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19
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Reduced basal forebrain atrophy progression in a randomized Donepezil trial in prodromal Alzheimer's disease. Sci Rep 2017; 7:11706. [PMID: 28916821 PMCID: PMC5601919 DOI: 10.1038/s41598-017-09780-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/31/2017] [Indexed: 01/20/2023] Open
Abstract
Acetylcholinesterase inhibitors are approved drugs currently used for the treatment of Alzheimer's disease (AD) dementia. Basal forebrain cholinergic system (BFCS) atrophy is reported to precede both entorhinal cortex atrophy and memory impairment in AD, challenging the traditional model of the temporal sequence of topographical pathology associated with AD. We studied the effect of one-year Donepezil treatment on the rate of BFCS atrophy in prodromal AD patients using a double-blind, randomized, placebo-controlled trial of Donepezil (10 mg/day). Reduced annual BFCS rates of atrophy were found in the Donepezil group compared to the Placebo treated arm. Secondary analyses on BFCS subregions demonstrated the largest treatment effects in the Nucleus Basalis of Meynert (NbM) and the medial septum/diagonal band (Ch1/2). Donepezil administered at a prodromal stage of AD seems to substantially reduce the rate of atrophy of the BFCS nuclei with highest concentration of cholinergic neurons projecting to the cortex (NbM), hippocampus and entorhinal cortex (Ch1/2).
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20
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Peter J, Lahr J, Minkova L, Lauer E, Grothe MJ, Teipel S, Köstering L, Kaller CP, Heimbach B, Hüll M, Normann C, Nissen C, Reis J, Klöppel S. Contribution of the Cholinergic System to Verbal Memory Performance in Mild Cognitive Impairment. J Alzheimers Dis 2016; 53:991-1001. [PMID: 27340852 PMCID: PMC5008225 DOI: 10.3233/jad-160273] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2016] [Indexed: 01/25/2023]
Abstract
Acetylcholine is critically involved in modulating learning and memory function, which both decline in neurodegeneration. It remains unclear to what extent structural and functional changes in the cholinergic system contribute to episodic memory dysfunction in mild cognitive impairment (MCI), in addition to hippocampal degeneration. A better understanding is critical, given that the cholinergic system is the main target of current symptomatic treatment in mild to moderate Alzheimer's disease. We simultaneously assessed the structural and functional integrity of the cholinergic system in 20 patients with MCI and 20 matched healthy controls and examined their effect on verbal episodic memory via multivariate regression analyses. Mediating effects of either cholinergic function or hippocampal volume on the relationship between cholinergic structure and episodic memory were computed. In MCI, a less intact structure and function of the cholinergic system was found. A smaller cholinergic structure was significantly correlated with a functionally more active cholinergic system in patients, but not in controls. This association was not modulated by age or disease severity, arguing against compensational processes. Further analyses indicated that neither functional nor structural changes in the cholinergic system influence verbal episodic memory at the MCI stage. In fact, those associations were fully mediated by hippocampal volume. Although the cholinergic system is structurally and functionally altered in MCI, episodic memory dysfunction results primarily from hippocampal neurodegeneration, which may explain the inefficiency of cholinergic treatment at this disease stage.
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Affiliation(s)
- Jessica Peter
- Freiburg Brain Imaging, Faculty of Medicine, University of Freiburg, Germany
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Germany
- Department of Neurology, Faculty of Medicine, University of Freiburg, Germany
| | - Jacob Lahr
- Freiburg Brain Imaging, Faculty of Medicine, University of Freiburg, Germany
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Germany
| | - Lora Minkova
- Freiburg Brain Imaging, Faculty of Medicine, University of Freiburg, Germany
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Germany
- Department of Psychology, Laboratory for Biological and Personality Psychology, University of Freiburg, Germany
| | - Eliza Lauer
- Freiburg Brain Imaging, Faculty of Medicine, University of Freiburg, Germany
| | - Michel J. Grothe
- German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - Stefan Teipel
- German Centre for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - Lena Köstering
- Freiburg Brain Imaging, Faculty of Medicine, University of Freiburg, Germany
- Department of Neurology, Faculty of Medicine, University of Freiburg, Germany
- Department of Neuroradiology, Faculty of Medicine, University of Freiburg, Germany
| | - Christoph P. Kaller
- Freiburg Brain Imaging, Faculty of Medicine, University of Freiburg, Germany
- Department of Neurology, Faculty of Medicine, University of Freiburg, Germany
- BrainLinks-BrainTools Cluster of Excellence, University of Freiburg, Germany
| | - Bernhard Heimbach
- Department of Neurology, Faculty of Medicine, University of Freiburg, Germany
- Centre for Geriatric Medicine and Gerontology, Faculty of Medicine, University of Freiburg, Germany
| | - Michael Hüll
- Centre for Geriatric Medicine and Gerontology, Faculty of Medicine, University of Freiburg, Germany
- Centre for Psychiatry Emmendingen, Germany
| | - Claus Normann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Germany
| | - Christoph Nissen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Germany
| | - Janine Reis
- Department of Neurology, Faculty of Medicine, University of Freiburg, Germany
| | - Stefan Klöppel
- Freiburg Brain Imaging, Faculty of Medicine, University of Freiburg, Germany
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Germany
- Centre for Geriatric Medicine and Gerontology, Faculty of Medicine, University of Freiburg, Germany
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