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Bagg MK, Hicks AJ, Hellewell SC, Ponsford JL, Lannin NA, O'Brien TJ, Cameron PA, Cooper DJ, Rushworth N, Gabbe BJ, Fitzgerald M. The Australian Traumatic Brain Injury Initiative: Statement of Working Principles and Rapid Review of Methods to Define Data Dictionaries for Neurological Conditions. Neurotrauma Rep 2024; 5:424-447. [PMID: 38660461 PMCID: PMC11040195 DOI: 10.1089/neur.2023.0116] [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] [Indexed: 04/26/2024] Open
Abstract
The Australian Traumatic Brain Injury Initiative (AUS-TBI) aims to develop a health informatics approach to collect data predictive of outcomes for persons with moderate-severe TBI across Australia. Central to this approach is a data dictionary; however, no systematic reviews of methods to define and develop data dictionaries exist to-date. This rapid systematic review aimed to identify and characterize methods for designing data dictionaries to collect outcomes or variables in persons with neurological conditions. Database searches were conducted from inception through October 2021. Records were screened in two stages against set criteria to identify methods to define data dictionaries for neurological conditions (International Classification of Diseases, 11th Revision: 08, 22, and 23). Standardized data were extracted. Processes were checked at each stage by independent review of a random 25% of records. Consensus was reached through discussion where necessary. Thirty-nine initiatives were identified across 29 neurological conditions. No single established or recommended method for defining a data dictionary was identified. Nine initiatives conducted systematic reviews to collate information before implementing a consensus process. Thirty-seven initiatives consulted with end-users. Methods of consultation were "roundtable" discussion (n = 30); with facilitation (n = 16); that was iterative (n = 27); and frequently conducted in-person (n = 27). Researcher stakeholders were involved in all initiatives and clinicians in 25. Importantly, only six initiatives involved persons with lived experience of TBI and four involved carers. Methods for defining data dictionaries were variable and reporting is sparse. Our findings are instructive for AUS-TBI and can be used to further development of methods for defining data dictionaries.
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Affiliation(s)
- Matthew K. Bagg
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Health Sciences, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Amelia J. Hicks
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Victoria, Australia
| | - Sarah C. Hellewell
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Jennie L. Ponsford
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Victoria, Australia
| | - Natasha A. Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Terence J. O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Peter A. Cameron
- National Trauma Research Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - D. Jamie Cooper
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Nick Rushworth
- Brain Injury Australia, Sydney, New South Wales, Australia
| | - Belinda J. Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Health Data Research UK, Swansea University Medical School, Swansea University, Singleton Park, United Kingdom
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
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Bae JB, Lee S, Oh H, Sung J, Lee D, Han JW, Kim JS, Kim JH, Kim SE, Kim KW. A Case-Control Clinical Trial on a Deep Learning-Based Classification System for Diagnosis of Amyloid-Positive Alzheimer's Disease. Psychiatry Investig 2023; 20:1195-1203. [PMID: 38163659 PMCID: PMC10758320 DOI: 10.30773/pi.2023.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/13/2023] [Accepted: 09/12/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE A deep learning-based classification system (DLCS) which uses structural brain magnetic resonance imaging (MRI) to diagnose Alzheimer's disease (AD) was developed in a previous recent study. Here, we evaluate its performance by conducting a single-center, case-control clinical trial. METHODS We retrospectively collected T1-weighted brain MRI scans of subjects who had an accompanying measure of amyloid-beta (Aβ) positivity based on a 18F-florbetaben positron emission tomography scan. The dataset included 188 Aβ-positive patients with mild cognitive impairment or dementia due to AD, and 162 Aβ-negative controls with normal cognition. We calculated the sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC) of the DLCS in the classification of Aβ-positive AD patients from Aβ-negative controls. RESULTS The DLCS showed excellent performance, with sensitivity, specificity, positive predictive value, negative predictive value, and AUC of 85.6% (95% confidence interval [CI], 79.8-90.0), 90.1% (95% CI, 84.5-94.2), 91.0% (95% CI, 86.3-94.1), 84.4% (95% CI, 79.2-88.5), and 0.937 (95% CI, 0.911-0.963), respectively. CONCLUSION The DLCS shows promise in clinical settings where it could be routinely applied to MRI scans regardless of original scan purpose to improve the early detection of AD.
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Affiliation(s)
- Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Republic of Korea
| | - Subin Lee
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | | | | | | | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Republic of Korea
| | - Jun Sung Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sang Eun Kim
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Center for Nanomolecular Imaging and Innovative Drug Development, Advanced Institutes of Convergence Technology, Suwon, Republic of Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Republic of Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
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Chen S, Chen G, Li Y, Yue Y, Zhu Z, Li L, Jiang W, Shen Z, Wang T, Hou Z, Xu Z, Shen X, Yuan Y. Predicting the diagnosis of various mental disorders in a mixed cohort using blood-based multi-protein model: a machine learning approach. Eur Arch Psychiatry Clin Neurosci 2023; 273:1267-1277. [PMID: 36567366 DOI: 10.1007/s00406-022-01540-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 12/16/2022] [Indexed: 12/26/2022]
Abstract
The lack of objective diagnostic methods for mental disorders challenges the reliability of diagnosis. The study aimed to develop an easily accessible and useable objective method for diagnosing major depressive disorder (MDD), schizophrenia (SZ), bipolar disorder (BPD), and panic disorder (PD) using serum multi-protein. Serum levels of brain-derived neurotrophic factor (BDNF), VGF (non-acronymic), bicaudal C homolog 1 (BICC1), C-reactive protein (CRP), and cortisol, which are generally recognized to be involved in different pathogenesis of various mental disorders, were measured in patients with MDD (n = 50), SZ (n = 50), BPD (n = 55), and PD along with 50 healthy controls (HC). Linear discriminant analysis (LDA) was employed to construct a multi-classification model to classify these mental disorders. Both leave-one-out cross-validation (LOOCV) and fivefold cross-validation were applied to validate the accuracy and stability of the LDA model. All five serum proteins were included in the LDA model, and it was found to display a high overall accuracy of 96.9% when classifying MDD, SZ, BPD, PD, and HC groups. Multi-classification accuracy of the LDA model for LOOCV and fivefold cross-validation (within-study replication) reached 96.9 and 96.5%, respectively, demonstrating the feasibility of the blood-based multi-protein LDA model for classifying common mental disorders in a mixed cohort. The results suggest that combining multiple proteins associated with different pathogeneses of mental disorders using LDA may be a novel and relatively objective method for classifying mental disorders. Clinicians should consider combining multiple serum proteins to diagnose mental disorders objectively.
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Affiliation(s)
- Suzhen Chen
- Department of Psychosomatics and Psychiatry, School of Medicine, ZhongDa Hospital, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009, China
| | - Gang Chen
- School of Medicine, Southeast University, Nanjing, 210009, China
| | - Yinghui Li
- Department of Psychosomatics and Psychiatry, School of Medicine, ZhongDa Hospital, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009, China
- Nanjing Medical University, Nanjing, 210009, China
| | - Yingying Yue
- Department of Psychosomatics and Psychiatry, School of Medicine, ZhongDa Hospital, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009, China
| | - Zixin Zhu
- School of Medicine, Southeast University, Nanjing, 210009, China
| | - Lei Li
- School of Medicine, Southeast University, Nanjing, 210009, China
- Department of Sleep Medicine, The Fourth People's Hospital of Lianyungang, Lianyungang, 222000, China
| | - Wenhao Jiang
- Department of Psychosomatics and Psychiatry, School of Medicine, ZhongDa Hospital, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009, China
| | - Zhongxia Shen
- School of Medicine, Southeast University, Nanjing, 210009, China
- Department of Psychiatry, The Third People's Hospital of Huzhou, Huzhou, 313000, China
| | - Tianyu Wang
- Department of Psychosomatics and Psychiatry, School of Medicine, ZhongDa Hospital, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009, China
| | - Zhenghua Hou
- Department of Psychosomatics and Psychiatry, School of Medicine, ZhongDa Hospital, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009, China
| | - Zhi Xu
- Department of Psychosomatics and Psychiatry, School of Medicine, ZhongDa Hospital, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009, China
| | - Xinhua Shen
- Department of Psychiatry, The Third People's Hospital of Huzhou, Huzhou, 313000, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, School of Medicine, ZhongDa Hospital, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009, China.
- School of Medicine, Southeast University, Nanjing, 210009, China.
- Nanjing Medical University, Nanjing, 210009, China.
- Jiangsu Provincial Key Laboratory of Critical Care Medicine, Southeast University, Nanjing, 210009, China.
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Mollenhauer B. Status of Current Biofluid Biomarkers in Parkinson's Disease. Mov Disord Clin Pract 2023; 10:S18-S20. [PMID: 37637982 PMCID: PMC10448129 DOI: 10.1002/mdc3.13753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Brit Mollenhauer
- Department of NeurologyUniversity Medical Center GöttingenGöttingenGermany
- Paracelsus‐Elena‐KlinikKasselGermany
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5
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Babić M, Banović M, Berečić I, Banić T, Babić Leko M, Ulamec M, Junaković A, Kopić J, Sertić J, Barišić N, Šimić G. Molecular Biomarkers for the Diagnosis, Prognosis, and Pharmacodynamics of Spinal Muscular Atrophy. J Clin Med 2023; 12:5060. [PMID: 37568462 PMCID: PMC10419842 DOI: 10.3390/jcm12155060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/24/2023] [Accepted: 07/30/2023] [Indexed: 08/13/2023] Open
Abstract
Spinal muscular atrophy (SMA) is a progressive degenerative illness that affects 1 in every 6 to 11,000 live births. This autosomal recessive disorder is caused by homozygous deletion or mutation of the SMN1 gene (survival motor neuron). As a backup, the SMN1 gene has the SMN2 gene, which produces only 10% of the functional SMN protein. Nusinersen and risdiplam, the first FDA-approved medications, act as SMN2 pre-mRNA splicing modifiers and enhance the quantity of SMN protein produced by this gene. The emergence of new therapies for SMA has increased the demand for good prognostic and pharmacodynamic (response) biomarkers in SMA. This article discusses current molecular diagnostic, prognostic, and pharmacodynamic biomarkers that could be assessed in SMA patients' body fluids. Although various proteomic, genetic, and epigenetic biomarkers have been explored in SMA patients, more research is needed to uncover new prognostic and pharmacodynamic biomarkers (or a combination of biomarkers).
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Affiliation(s)
- Marija Babić
- Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
| | - Maria Banović
- Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
| | - Ivana Berečić
- Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
| | - Tea Banić
- Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
| | - Mirjana Babić Leko
- Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
| | - Monika Ulamec
- Department of Pathology, University Clinical Hospital Sestre Milosrdnice Zagreb, 10000 Zagreb, Croatia
- Department of Pathology, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
| | - Alisa Junaković
- Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
| | - Janja Kopić
- Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
| | - Jadranka Sertić
- Department of Medical Chemistry and Biochemistry, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Nina Barišić
- Department of Pediatrics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Goran Šimić
- Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb School of Medicine, 10000 Zagreb, Croatia
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Peña-Bautista C, Kumar R, Baquero M, Johansson J, Cháfer-Pericás C, Abelein A, Ferreira D. Misfolded alpha-synuclein detection by RT-QuIC in dementia with lewy bodies: a systematic review and meta-analysis. Front Mol Biosci 2023; 10:1193458. [PMID: 37266333 PMCID: PMC10229818 DOI: 10.3389/fmolb.2023.1193458] [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: 03/24/2023] [Accepted: 05/02/2023] [Indexed: 06/03/2023] Open
Abstract
Introduction: Dementia with Lewy Bodies (DLB) is the second most common cause of neurodegenerative dementia after Alzheimer's disease (AD), but the field is still lacking a specific biomarker for its core pathology: alpha synuclein (α-syn). Realtime quaking induced conversion (RT-QuIC) has recently emerged as a strong biomarker candidate to detect misfolded α-syn in DLB. However, the variability in the parameters of the technique and the heterogeneity of DLB patients make the reproducibility of the results difficult. Here, we provide an overview of the state-of-the-art research of α-syn RT-QuIC in DLB focused on: (1) the capacity of α-syn RT-QuIC to discriminate DLB from controls, Parkinson's disease (PD) and AD; (2) the capacity of α-syn RT-QuIC to identify prodromal stages of DLB; and (3) the influence of co-pathologies on α-syn RT-QuIC's performance. We also assessed the influence of different factors, such as technical conditions (e.g., temperature, pH, shaking-rest cycles), sample type, and clinical diagnosis versus autopsy confirmation. Methods: We conducted a systematic review following the PRISMA guidelines in August 2022, without any limits in publication dates. Search terms were combinations of "RT-QuIC" and "Lewy Bodies," "DLB" or "LBD". Results: Our meta-analysis shows that α-syn RT-QuIC reaches very high diagnostic performance in discriminating DLB from both controls (pooled sensitivity and specificity of 0.94 and 0.96, respectively) and AD (pooled sensitivity and specificity of 0.95 and 0.88) and is promising for prodromal phases of DLB. However, the performance of α-syn RT-QuIC to discriminate DLB from PD is currently low due to low specificity (pooled sensitivity and specificity of 0.94 and 0.11). Our analysis showed that α-syn RT-QuIC's performance is not substantially influenced by sample type or clinical diagnosis versus autopsy confirmation. Co-pathologies did not influence the performance of α-syn RT-QuIC, but the number of such studies is currently limited. We observed technical variability across published articles. However, we could not find a clear effect of technical variability on the reported results. Conclusion: There is currently enough evidence to test misfolded α-syn by RT-QuIC for clinical use. We anticipate that harmonization of protocols across centres and advances in standardization will facilitate the clinical establishment of misfolded α-syn detection by RT-QuIC.
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Affiliation(s)
- Carmen Peña-Bautista
- Alzheimer’s Disease Research Group, Health Research Institute La Fe, Avda de Fernando Abril Martorell, Valencia, Spain
| | - Rakesh Kumar
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Miguel Baquero
- Alzheimer’s Disease Research Group, Health Research Institute La Fe, Avda de Fernando Abril Martorell, Valencia, Spain
- Neurology Unit, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Jan Johansson
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Consuelo Cháfer-Pericás
- Alzheimer’s Disease Research Group, Health Research Institute La Fe, Avda de Fernando Abril Martorell, Valencia, Spain
| | - Axel Abelein
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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7
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Tsamou M, Kalligerou F, Ntanasi E, Scarmeas N, Skalicky S, Hackl M, Roggen EL. A Candidate microRNA Profile for Early Diagnosis of Sporadic Alzheimer’s Disease. J Alzheimers Dis Rep 2023; 7:235-248. [PMID: 37090956 PMCID: PMC10116165 DOI: 10.3233/adr-230001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/07/2023] [Indexed: 04/07/2023] Open
Abstract
Background: Late-onset or sporadic Alzheimer’s disease (sAD) is a neurodegenerative disease leading to cognitive impairment and memory loss. The underlying pathological changes take place several years prior to the appearance of the first clinical symptoms, however, the early diagnosis of sAD remains obscure. Objective: To identify changes in circulating microRNA (miR) expression in an effort to detect early biomarkers of underlying sAD pathology. Methods: A set of candidate miRs, earlier detected in biofluids from subjects at early stage of sAD, was linked to the proposed tau-driven adverse outcome pathway for memory loss. The relative expression of the selected miRs in serum of 12 cases (mild cognitive impairment, MCI) and 27 cognitively normal subjects, recruited within the ongoing Aiginition Longitudinal Biomarker Investigation Of Neurodegeneration (ALBION) study, was measured by RT-qPCR. Data on the protein levels of amyloid-β (Aβ42) and total/phosphorylated tau (t-tau/p-tau), in cerebrospinal fluid (CSF), and the cognitive z-scores of the participants were also retrieved. Results: Each doubling in relative expression of 13 miRs in serum changed the odds of either having MCI (versus control), or having pathological Aβ42 or pathological Aβ42 and tau (versus normal) proteins in their CSF, or was associated with the global composite z-score. Conclusion: These candidate human circulating miRs may be of great importance in early diagnosis of sAD. There is an urgent need for confirming these proposed early predictive biomarkers for sAD, contributing not only to societal but also to economic benefits.
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Affiliation(s)
- Maria Tsamou
- ToxGenSolutions (TGS), Maastricht, The Netherlands
| | - Faidra Kalligerou
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Eva Ntanasi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Department of Neurology, Columbia University, New York, NY, USA
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Abstract
Alzheimer's disease (AD) was described in 1906 as a dementing disease marked by the presence of two types of fibrillar aggregates in the brain: neurofibrillary tangles and senile plaques. The process of aggregation and formation of the aggregates has been a major focus of investigation ever since the discoveries that the tau protein is the predominant protein in tangles and amyloid β is the predominant protein in plaques. The idea that smaller, oligomeric species of amyloid may also be bioactive has now been clearly established. This review examines the possibility that soluble, nonfibrillar, bioactive forms of tau-the "tau we cannot see"-comprise a dominant driver of neurodegeneration in AD.
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Affiliation(s)
- Bradley Hyman
- Department of Neurology, Massachusetts General Hospital, Charlestown, Massachusetts, USA;
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9
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Foko LPK, Narang G, Tamang S, Hawadak J, Jakhan J, Sharma A, Singh V. The spectrum of clinical biomarkers in severe malaria and new avenues for exploration. Virulence 2022; 13:634-653. [PMID: 36036460 PMCID: PMC9427047 DOI: 10.1080/21505594.2022.2056966] [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] [Indexed: 11/28/2022] Open
Abstract
Globally, malaria is a public health concern, with severe malaria (SM) contributing a major share of the disease burden in malaria endemic countries. In this context, identification and validation of SM biomarkers are essential in clinical practice. Some biomarkers (C-reactive protein, angiopoietin 2, angiopoietin-2/1 ratio, platelet count, histidine-rich protein 2) have yielded interesting results in the prognosis of Plasmodium falciparum severe malaria, but for severe P. vivax and P. knowlesi malaria, similar evidence is missing. The validation of these biomarkers is hindered by several factors such as low sample size, paucity of evidence-evaluating studies, suboptimal values of sensitivity/specificity, poor clinical practicality of measurement methods, mixed Plasmodium infections, and good clinical value of the biomarkers for concurrent infections (pneumonia and current COVID-19 pandemic). Most of these biomarkers are non-specific to pathogens as they are related to host response and hence should be regarded as prognostic/predictive biomarkers that complement but do not replace pathogen biomarkers for clinical evaluation of SM patients. This review highlights the importance of research on diagnostic/predictive/therapeutic biomarkers, neglected malaria species, and clinical practicality of measurement methods in future studies. Finally, the importance of omics technologies for faster identification/validation of SM biomarkers is also included.
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Affiliation(s)
- Loick Pradel Kojom Foko
- Parasite and Host Biology Group, ICMR-National Institute of Malaria Research, New Delhi, India
| | - Geetika Narang
- Parasite and Host Biology Group, ICMR-National Institute of Malaria Research, New Delhi, India
| | - Suman Tamang
- Parasite and Host Biology Group, ICMR-National Institute of Malaria Research, New Delhi, India
| | - Joseph Hawadak
- Parasite and Host Biology Group, ICMR-National Institute of Malaria Research, New Delhi, India
| | - Jahnvi Jakhan
- Parasite and Host Biology Group, ICMR-National Institute of Malaria Research, New Delhi, India
| | - Amit Sharma
- Parasite and Host Biology Group, ICMR-National Institute of Malaria Research, New Delhi, India.,Molecular Medicine Group, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Vineeta Singh
- Parasite and Host Biology Group, ICMR-National Institute of Malaria Research, New Delhi, India
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Cerebrospinal Fluid Biomarker Profile in TDP-43-Related Genetic Frontotemporal Dementia. J Pers Med 2022; 12:jpm12101747. [PMID: 36294886 PMCID: PMC9605286 DOI: 10.3390/jpm12101747] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/06/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
Cerebrospinal fluid (CSF) biomarkers, namely total tau, phospho-tau and amyloid beta peptides, have received much attention specifically regarding Alzheimer’s disease (AD), since they can detect the biochemical fingerprint of AD and serve as a diagnostic tool for accurate and early diagnosis during life. In the same way, biomarkers for other neurodegenerative disease pathologies are also needed. We present a case series of six patients with genetic frontotemporal dementia (FTD), with TDP-43 underlying proteinopathy, in an attempt to assess TDP-43 as a novel biomarker alone and in combination with established AD biomarkers for this specific patient group, based on the principles of personalized and precision medicine. Our results indicate that genetic TDP-43-FTD is characterized by increased CSF TPD-43 and increased TDP-43 × τΤ/τP-181 combination. Hence, TDP-43 combined with tau proteins could be a useful tool for the diagnosis of genetic FTD with TDP-43 underling histopathology, supplementing clinical, neuropsychological and imaging data.
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Benussi A, Cantoni V, Rivolta J, Archetti S, Micheli A, Ashton N, Zetterberg H, Blennow K, Borroni B. Classification accuracy of blood-based and neurophysiological markers in the differential diagnosis of Alzheimer's disease and frontotemporal lobar degeneration. Alzheimers Res Ther 2022; 14:155. [PMID: 36229847 PMCID: PMC9558959 DOI: 10.1186/s13195-022-01094-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 09/22/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND In the last decade, non-invasive blood-based and neurophysiological biomarkers have shown great potential for the discrimination of several neurodegenerative disorders. However, in the clinical workup of patients with cognitive impairment, it will be highly unlikely that any biomarker will achieve the highest potential predictive accuracy on its own, owing to the multifactorial nature of Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD). METHODS In this retrospective study, performed on 202 participants, we analysed plasma neurofilament light (NfL), glial fibrillary acidic protein (GFAP), and tau phosphorylated at amino acid 181 (p-Tau181) concentrations, as well as amyloid β42 to 40 ratio (Aβ1-42/1-40) ratio, using the ultrasensitive single-molecule array (Simoa) technique, and neurophysiological measures obtained by transcranial magnetic stimulation (TMS), including short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), long-interval intracortical inhibition (LICI), and short-latency afferent inhibition (SAI). We assessed the diagnostic accuracy of combinations of both plasma and neurophysiological biomarkers in the differential diagnosis between healthy ageing, AD, and FTLD. RESULTS We observed significant differences in plasma NfL, GFAP, and p-Tau181 levels between the groups, but not for the Aβ1-42/Aβ1-40 ratio. For the evaluation of diagnostic accuracy, we adopted a two-step process which reflects the clinical judgement on clinical grounds. In the first step, the best single biomarker to classify "cases" vs "controls" was NfL (AUC 0.94, p < 0.001), whilst in the second step, the best single biomarker to classify AD vs FTLD was SAI (AUC 0.96, p < 0.001). The combination of multiple biomarkers significantly increased diagnostic accuracy. The best model for classifying "cases" vs "controls" included the predictors p-Tau181, GFAP, NfL, SICI, ICF, and SAI, resulting in an AUC of 0.99 (p < 0.001). For the second step, classifying AD from FTD, the best model included the combination of Aβ1-42/Aβ1-40 ratio, p-Tau181, SICI, ICF, and SAI, resulting in an AUC of 0.98 (p < 0.001). CONCLUSIONS The combined assessment of plasma and neurophysiological measures may greatly improve the differential diagnosis of AD and FTLD.
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Affiliation(s)
- Alberto Benussi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy
- Neurology Unit, ASST Spedali Civili Brescia, Brescia, Italy
| | - Valentina Cantoni
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Jasmine Rivolta
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy
| | - Silvana Archetti
- Biotechnology Laboratory and Department of Diagnostics, Civic Hospital of Brescia, Brescia, Italy
| | | | - Nicholas Ashton
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Mölndal, Sweden
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, London, UK
- NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Barbara Borroni
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy.
- Neurology Unit, ASST Spedali Civili Brescia, Brescia, Italy.
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Lin J, Yang S, Wang C, Yu E, Zhu Z, Shi J, Li X, Xin J, Chen X, Pan X. Prediction of Alzheimer’s Disease Using Patterns of Methylation Levels in Key Immunologic-Related Genes. J Alzheimers Dis 2022; 90:783-794. [DOI: 10.3233/jad-220701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: DNA methylation is expected to become a kind of new diagnosis and treatment method of Alzheimer’s disease (AD). Neuroinflammation- and immune-related pathways represent one of the major genetic risk factors for AD. Objective: We aimed to investigate DNA methylation levels of 7 key immunologic-related genes in peripheral blood and appraise their applicability in the diagnosis of AD. Methods: Methylation levels were obtained from 222 participants (101 AD, 72 MC, 49 non-cognitively impaired controls). Logistic regression models for diagnosing AD were established after least absolute shrinkage and selection operator (LASSO) and best subset selection (BSS), evaluated by respondent working curve and decision curve analysis for sensitivity. Results: Six differentially methylated positions (DMPs) in the MCI group and 64 in the AD group were found, respectively. Among them, there were 2 DMPs in the MCI group and 30 DMPs in the AD group independent of age, gender, and APOE4 carriers (p < 0.05). AD diagnostic prediction models differentiated AD from normal controls both in a training dataset (LASSO: 8 markers, including methylation levels at ABCA7_1040077, CNR1_88166293, CX3CR1_39322324, LRRK2_40618505, LRRK2_40618493, NGFR_49496745, TARDBP_11070956, TARDBP_11070840, area under the curve [AUC] = 0.81; BSS: 2 markers, including methylation levels at ABCA7_1040077 and CX3CR1_39322324, AUC = 0.80) and a testing dataset (AUC = 0.84, AUC = 0.82, respectively). Conclusion: Our work indicated that methylation levels of 7 key immunologic-related genes (ABCA7, CNR1, CX3CR1, CSF1 R, LRRK2, NGFR, and TARDBP) in peripheral blood was altered in AD and the models including methylation of immunologic-related genes biomarkers improved prediction of AD.
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Affiliation(s)
- Junhan Lin
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Siyu Yang
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Chao Wang
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Erhan Yu
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Zhibao Zhu
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Jinying Shi
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Xiang Li
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Jiawei Xin
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Xiaochun Chen
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
| | - Xiaodong Pan
- Department of Neurology, Center for Cognitive Neurology, Institute of Clinical Neurology, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China
- Key Laboratory of Brain Aging and Neurodegenerative Diseases, Fujian Medical University, Fuzhou, China
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Plasma P-Tau181 for the Discrimination of Alzheimer’s Disease from Other Primary Dementing and/or Movement Disorders. Biomolecules 2022; 12:biom12081099. [PMID: 36008993 PMCID: PMC9405977 DOI: 10.3390/biom12081099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/23/2022] Open
Abstract
Blood phospho-tau181 may offer a useful biomarker for Alzheimer’s disease. However, the use of either serum or plasma phospho-tau181 and their diagnostic value are currently under intense investigation. In a pilot study, we measured both serum and plasma phospho-tau181 (pT181-Tau) by single molecule array (Simoa) in a group of patients with Alzheimer’s disease and a mixed group of patients with other primary dementing and/or movement disorders. Classical cerebrospinal fluid biomarkers were also measured. Plasma (but not serum) pT181-Tau showed a significant increase in Alzheimer’s disease and correlated significantly with cerebrospinal fluid amyloid and pT181-Tau. Receiver operating curve analysis revealed a significant discrimination of Alzheimer’s from non-Alzheimer’s disease patients, with an area under the curve of 0.83 and an excellent sensitivity but a moderate specificity. Plasma pT181-Tau is not an established diagnostic biomarker for Alzheimer’s disease, but it could become one in the future, or it may serve as a screening tool for specific cases of patients or presymptomatic subjects.
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Tau as a Biomarker of Neurodegeneration. Int J Mol Sci 2022; 23:ijms23137307. [PMID: 35806324 PMCID: PMC9266883 DOI: 10.3390/ijms23137307] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 06/29/2022] [Accepted: 06/29/2022] [Indexed: 12/13/2022] Open
Abstract
Less than 50 years since tau was first isolated from a porcine brain, its detection in femtolitre concentrations in biological fluids is revolutionizing the diagnosis of neurodegenerative diseases. This review highlights the molecular and technological advances that have catapulted tau from obscurity to the forefront of biomarker diagnostics. Comprehensive updates are provided describing the burgeoning clinical applications of tau as a biomarker of neurodegeneration. For the clinician, tau not only enhances diagnostic accuracy, but holds promise as a predictor of clinical progression, phenotype, and response to drug therapy. For patients living with neurodegenerative disorders, characterization of tau dysregulation could provide much-needed clarity to a notoriously murky diagnostic landscape.
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Neuronal and Neuroaxonal Damage Cerebrospinal Fluid Biomarkers in Autoimmune Encephalitis Associated or Not with the Presence of Tumor. Biomedicines 2022; 10:biomedicines10061262. [PMID: 35740284 PMCID: PMC9220160 DOI: 10.3390/biomedicines10061262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to evaluate the association of neuronal damage biomarkers (neurofilament light chain (NFL) and total tau protein (T-tau)) in the CSF of patients with autoimmune encephalitis (AE) with the presence of an underlying malignancy and to determine correlations with patient characteristics. The study comprised 21 patients with encephalitis associated with antibodies against intracellular (n = 11) and surface/synaptic antigens (extracellular, n = 10) and non-inflammatory disease controls (n = 10). Patients with AE associated with intracellular antigens had increased CSF-NFL (p = 0.003) but not T-tau levels compared to controls. When adjusted for age, CSF-NFL but not CSF-T-tau was higher in patients with encephalitis associated with intracellular antigens as compared to those with encephalitis associated with extracellular antigens (p = 0.032). Total tau and NFL levels were not significantly altered in patients with encephalitis associated with extracellular antigens compared to controls. NFL in the total cohort correlated with neurological signs of cerebellar dysfunction, peripheral neuropathy, presence of CV2 positivity, presence of an underlying tumor and a more detrimental clinical outcome. AE patients with abnormal MRI findings displayed higher NFL levels compared to those without, albeit with no statistical significance (p = 0.07). Using receiver operating characteristic curve analysis, CSF-NFL levels with a cut-off value of 969 pg/mL had a sensitivity and specificity of 100% and 76.19%, respectively, regarding the detection of underlying malignancies. Our findings suggest that neuronal integrity is preserved in autoimmune encephalitis associated with extracellular antigens and without the presence of tumor. However, highly increased NFL is observed in AE associated with intracellular antigens and presence of an underlying tumor. CSF-NFL could potentially be used as a diagnostic biomarker of underlying malignancies in the clinical setting of AE.
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Said HM, Kaya D, Yavuz I, Dost FS, Altun ZS, Isik AT. A Comparison of Cerebrospinal Fluid Beta-Amyloid and Tau in Idiopathic Normal Pressure Hydrocephalus and Neurodegenerative Dementias. Clin Interv Aging 2022; 17:467-477. [PMID: 35431542 PMCID: PMC9012339 DOI: 10.2147/cia.s360736] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/02/2022] [Indexed: 01/17/2023] Open
Abstract
Purpose Idiopathic normal pressure hydrocephalus (iNPH) is the leading reversible cause of cognitive impairment and gait disturbance that has similar clinical manifestations and accompanies to major neurodegenerative disorders in older adults. We aimed to investigate whether cerebrospinal fluid (CSF) biomarker for Alzheimer’s disease (AD) may be useful in the differential diagnosis of iNPH. Patients and Methods Amyloid-beta (Aß) 42 and 40, total tau (t-tau), phosphorylated tau (p-tau) were measured via ELISA in 192 consecutive CSF samples of patients with iNPH (n=80), AD (n=48), frontotemporal dementia (FTD) (n=34), Lewy body diseases (LBDs) (n=30) consisting of Parkinson’s disease dementia and dementia with Lewy bodies. Results The mean age of the study population was 75.6±7.7 years, and 54.2% were female. CSF Aβ42 levels were significantly higher, and p-tau and t-tau levels were lower in iNPH patients than in those with AD and LBDs patients. Additionally, iNPH patients had significantly higher levels of t-tau than those with FTD. Age and sex-adjusted multi-nominal regression analysis revealed that the odds of having AD relative to iNPH decreased by 37% when the Aβ42 level increased by one standard deviation (SD), and the odds of having LBDs relative to iNPH decreased by 47%. The odds of having LBDs relative to iNPH increased 76% when the p-tau level increased 1SD. It is 2.5 times more likely for a patient to have LBD relative to NPH and 2.1 times more likely to have AD relative to iNPH when the t-tau value increased 1SD. Conclusion Our results suggest that levels of CSF Aβ42, p-tau, and t-tau, in particularly decreased t-tau, are of potential value in differentiating iNPH from LBDs and also confirm previous studies reporting t-tau level is lower and Aβ42 level is higher in iNPH than in AD.
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Affiliation(s)
- Harun Muayad Said
- Department of Molecular Medicine, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Derya Kaya
- Unit for Brain Aging and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
- Geriatric Science Association, Izmir, Turkey
| | - Idil Yavuz
- Department of Statistics, Dokuz Eylul University, Faculty of Science, Izmir, Turkey
| | - Fatma Sena Dost
- Unit for Brain Aging and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
- Geriatric Science Association, Izmir, Turkey
| | - Zekiye Sultan Altun
- Department of Basic Oncology, Oncology Institute, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ahmet Turan Isik
- Unit for Brain Aging and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
- Geriatric Science Association, Izmir, Turkey
- Correspondence: Ahmet Turan Isik, Unit for Brain Aging and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey, Tel +90 232 412 43 41, Fax +90 232 412 43 49, Email
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Shippy DC, Watters JJ, Ulland TK. Transcriptional response of murine microglia in Alzheimer’s disease and inflammation. BMC Genomics 2022; 23:183. [PMID: 35247975 PMCID: PMC8898509 DOI: 10.1186/s12864-022-08417-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/21/2022] [Indexed: 01/09/2023] Open
Abstract
Background Alzheimer’s disease (AD) is a neurodegenerative disorder and is the most common cause of late-onset dementia. Microglia, the primary innate immune cells of the central nervous system (CNS), have a complex role in AD neuropathology. In the initial stages of AD, microglia play a role in limiting pathology by removing amyloid-β (Aβ) by phagocytosis. In contrast, microglia also release pro-inflammatory cytokines and chemokines to promote neuroinflammation and exacerbate AD neuropathology. Therefore, investigating microglial gene networks could identify new targets for therapeutic strategies for AD. Results We identified 465 differentially expressed genes (DEG) in 5XFAD versus wild-type mice by microarray, 354 DEG in lipopolysaccharide (LPS)-stimulated N9 microglia versus unstimulated control cells using RNA-sequencing (RNA-seq), with 32 DEG common between both datasets. Analyses of the 32 common DEG uncovered numerous molecular functions and pathways involved in Aβ phagocytosis and neuroinflammation associated with AD. Furthermore, multiplex ELISA confirmed the induction of several cytokines and chemokines in LPS-stimulated microglia. Conclusions In summary, AD triggered multiple signaling pathways that regulate numerous genes in microglia, contributing to Aβ phagocytosis and neuroinflammation. Overall, these data identified several regulatory factors and biomarkers in microglia that could be useful in further understanding AD neuropathology. Supplementary Information The online version contains supplementary material available at 10.1186/s12864-022-08417-8.
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Longobardi A, Nicsanu R, Bellini S, Squitti R, Catania M, Tiraboschi P, Saraceno C, Ferrari C, Zanardini R, Binetti G, Di Fede G, Benussi L, Ghidoni R. Cerebrospinal Fluid EV Concentration and Size Are Altered in Alzheimer’s Disease and Dementia with Lewy Bodies. Cells 2022; 11:cells11030462. [PMID: 35159272 PMCID: PMC8834088 DOI: 10.3390/cells11030462] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/21/2022] [Accepted: 01/28/2022] [Indexed: 02/06/2023] Open
Abstract
Alzheimer’s disease (AD), dementia with Lewy bodies (DLB) and frontotemporal dementia (FTD) represent the three major neurodegenerative dementias characterized by abnormal brain protein accumulation. In this study, we investigated extracellular vesicles (EVs) and neurotrophic factors in the cerebrospinal fluid (CSF) of 120 subjects: 36 with AD, 30 with DLB, 34 with FTD and 20 controls. Specifically, CSF EVs were analyzed by Nanoparticle Tracking Analysis and neurotrophic factors were measured with ELISA. We found higher EV concentration and lower EV size in AD and DLB groups compared to the controls. Classification tree analysis demonstrated EV size as the best parameter able to discriminate the patients from the controls (96.7% vs. 3.3%, respectively). The diagnostic performance of the EV concentration/size ratio resulted in a fair discrimination level with an area under the curve of 0.74. Moreover, the EV concentration/size ratio was associated with the p-Tau181/Aβ42 ratio in AD patients. In addition, we described altered levels of cystatin C and progranulin in the DLB and AD groups. We did not find any correlation between neurotrophic factors and EV parameters. In conclusion, the results of this study suggest a common involvement of the endosomal pathway in neurodegenerative dementias, giving important insight into the molecular mechanisms underlying these pathologies.
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Affiliation(s)
- Antonio Longobardi
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy; (A.L.); (R.N.); (S.B.); (R.S.); (C.S.); (R.Z.); (L.B.)
| | - Roland Nicsanu
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy; (A.L.); (R.N.); (S.B.); (R.S.); (C.S.); (R.Z.); (L.B.)
| | - Sonia Bellini
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy; (A.L.); (R.N.); (S.B.); (R.S.); (C.S.); (R.Z.); (L.B.)
| | - Rosanna Squitti
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy; (A.L.); (R.N.); (S.B.); (R.S.); (C.S.); (R.Z.); (L.B.)
| | - Marcella Catania
- Neurology 5 and Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (M.C.); (P.T.); (G.D.F.)
| | - Pietro Tiraboschi
- Neurology 5 and Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (M.C.); (P.T.); (G.D.F.)
| | - Claudia Saraceno
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy; (A.L.); (R.N.); (S.B.); (R.S.); (C.S.); (R.Z.); (L.B.)
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy;
| | - Roberta Zanardini
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy; (A.L.); (R.N.); (S.B.); (R.S.); (C.S.); (R.Z.); (L.B.)
| | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy;
| | - Giuseppe Di Fede
- Neurology 5 and Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy; (M.C.); (P.T.); (G.D.F.)
| | - Luisa Benussi
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy; (A.L.); (R.N.); (S.B.); (R.S.); (C.S.); (R.Z.); (L.B.)
| | - Roberta Ghidoni
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125 Brescia, Italy; (A.L.); (R.N.); (S.B.); (R.S.); (C.S.); (R.Z.); (L.B.)
- Correspondence: ; Tel.: +39-030-3501725
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Kulichikhin KY, Fedotov SA, Rubel MS, Zalutskaya NM, Zobnina AE, Malikova OA, Neznanov NG, Chernoff YO, Rubel AA. Development of molecular tools for diagnosis of Alzheimer's disease that are based on detection of amyloidogenic proteins. Prion 2021; 15:56-69. [PMID: 33910450 PMCID: PMC8096329 DOI: 10.1080/19336896.2021.1917289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 12/12/2022] Open
Abstract
Alzheimer's disease (AD) is the most common form of dementia that usually occurs among older people. AD results from neuronal degeneration that leads to the cognitive impairment and death. AD is incurable, typically develops over the course of many years and is accompanied by a loss of functional autonomy, making a patient completely dependent on family members and/or healthcare workers. Critical features of AD are pathological polymerization of Aβ peptide and microtubule-associated protein tau, accompanied by alterations of their conformations and resulting in accumulation of cross-β fibrils (amyloids) in human brains. AD apparently progresses asymptomatically for years or even decades before the appearance of symptoms. Therefore, development of the early AD diagnosis at a pre-symptomatic stage is essential for potential therapies. This review is focused on current and potential molecular tools (including non-invasive methods) that are based on detection of amyloidogenic proteins and can be applicable to early diagnosis of AD.Abbreviations: Aβ - amyloid-β peptide; AβO - amyloid-β oligomers; AD - Alzheimer's disease; ADRDA - Alzheimer's Disease and Related Disorders Association; APH1 - anterior pharynx defective 1; APP - amyloid precursor protein; BACE1 - β-site APP-cleaving enzyme 1; BBB - brain blood barrier; CJD - Creutzfeldt-Jakob disease; CRM - certified reference material; CSF - cerebrospinal fluid; ELISA - enzyme-linked immunosorbent assay; FGD - 18F-fluorodesoxyglucose (2-deoxy-2-[18F]fluoro-D-glucose); IP-MS - immunoprecipitation-mass spectrometry assay; MCI - mild cognitive impairment; MDS - multimer detection system; MRI - magnetic resonance imaging; NIA-AA - National Institute on Ageing and Alzheimer's Association; NINCDS - National Institute of Neurological and Communicative Disorders and Stroke; PEN2 - presenilin enhancer 2; PET - positron emission tomography; PiB - Pittsburgh Compound B; PiB-SUVR - PIB standardized uptake value ratio; PMCA - Protein Misfolding Cycling Amplification; PrP - Prion Protein; P-tau - hyperphosphorylated tau protein; RMP - reference measurement procedure; RT-QuIC - real-time quaking-induced conversion; SiMoA - single-molecule array; ThT - thioflavin T; TSEs - Transmissible Spongiform Encephslopathies; T-tau - total tau protein.
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Affiliation(s)
| | - Sergei A. Fedotov
- Laboratory of Amyloid Biology, St. Petersburg State University, St. Petersburg, Russia
- I.P Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russia
| | - Maria S. Rubel
- SCAMT Institute, ITMO University, St. Petersburg, Russia
| | - Natalia M. Zalutskaya
- V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - Anastasia E. Zobnina
- Laboratory of Amyloid Biology, St. Petersburg State University, St. Petersburg, Russia
- Sirius University of Science and Technology, Sochi, Russia
| | - Oksana A. Malikova
- Laboratory of Amyloid Biology, St. Petersburg State University, St. Petersburg, Russia
- Sirius University of Science and Technology, Sochi, Russia
| | - Nikolay G. Neznanov
- V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - Yury O. Chernoff
- Laboratory of Amyloid Biology, St. Petersburg State University, St. Petersburg, Russia
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Aleksandr A. Rubel
- Laboratory of Amyloid Biology, St. Petersburg State University, St. Petersburg, Russia
- Sirius University of Science and Technology, Sochi, Russia
- Department of Genetics and Biotechnology, St. Petersburg State University, St. Petersburg, Russia
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Rehiman SH, Lim SM, Lim FT, Chin AV, Tan MP, Kamaruzzaman SB, Ramasamy K, Abdul Majeed AB. Fibrinogen isoforms as potential blood-based biomarkers of Alzheimer's disease using a proteomics approach. Int J Neurosci 2020; 132:1014-1025. [PMID: 33280461 DOI: 10.1080/00207454.2020.1860038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: Alzheimer's disease (AD), the commonest form of dementia which is characterized by progressive decline in cognitive function, can only be definitively diagnosed after death. Although biomarkers may aid diagnosis, currently available AD biomarkers, which are predominantly based on cerebrospinal fluid and neuroimaging facilities, are either invasive or costly. Blood-based biomarkers for AD diagnosis are highly sought after due to its practicality at the clinic. This study was undertaken to determine the differential protein expression in plasma amongst Malaysian AD, mild cognitive impairment (MCI) and non-AD individuals. Methods: A proteomic approach which utilized two-dimensional differential in gel electrophoresis (2 D DIGE) was performed for blood samples from 15 AD, 14 MCI and 15 non-AD individuals. Results: Mass spectrometry (MS)-based protein identification via MALDI ToF/ToF showed that fibrinogen-β-chain (spot 64) and fibrinogen-γ-chain (spot 91) with differential expression ratio >1.5 were significantly upregulated (p < 0.05) in AD patients when compared to non-AD individuals. Further data analysis using Pearson correlation found that the upregulated fibrinogen-γ-chain was weakly but significantly (p < 0.05) and inversely correlated with cognitive decline. Conclusion: Fibrinogen isoforms may play important roles in the vascular pathology of AD as well as neuroinflammation. As such, fibrinogen appears to be a promising blood-based biomarker for AD. Further validation of the present findings in larger population is now warranted.
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Affiliation(s)
- Siti Hajar Rehiman
- Collaborative Drug Discovery Research (CDDR) and Brain Degeneration and Therapeutics Research Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Siong Meng Lim
- Collaborative Drug Discovery Research (CDDR) and Brain Degeneration and Therapeutics Research Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Fei Tieng Lim
- Collaborative Drug Discovery Research (CDDR) and Brain Degeneration and Therapeutics Research Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Ai-Vyrn Chin
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shahrul Bahyah Kamaruzzaman
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kalavathy Ramasamy
- Collaborative Drug Discovery Research (CDDR) and Brain Degeneration and Therapeutics Research Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Abu Bakar Abdul Majeed
- Collaborative Drug Discovery Research (CDDR) and Brain Degeneration and Therapeutics Research Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
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Alashwal H, Diallo TMO, Tindle R, Moustafa AA. Latent Class and Transition Analysis of Alzheimer's Disease Data. FRONTIERS IN COMPUTER SCIENCE 2020. [DOI: 10.3389/fcomp.2020.551481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study uses independent latent class analysis (LCA) and latent transition analysis (LTA) to explore accurate diagnosis and disease status change of a big Alzheimer's disease Neuroimaging Initiative (ADNI) data of 2,132 individuals over a 3-year period. The data includes clinical and neural measures of controls (CN), individuals with subjective memory complains (SMC), early-onset mild cognitive impairment (EMCI), late-onset mild cognitive impairment (LMCI), and Alzheimer's disease (AD). LCA at each time point yielded 3 classes: Class 1 is mostly composed of individuals from CN, SMC, and EMCI groups; Class 2 represents individuals from LMCI and AD groups with improved scores on memory, clinical, and neural measures; in contrast, Class 3 represents LMCI and from AD individuals with deteriorated scores on memory, clinical, and neural measures. However, 63 individuals from Class 1 were diagnosed as AD patients. This could be misdiagnosis, as their conditional probability of belonging to Class 1 (0.65) was higher than that of Class 2 (0.27) and Class 3 (0.08). LTA results showed that individuals had a higher probability of staying in the same class over time with probability >0.90 for Class 1 and 3 and probability >0.85 for Class 2. Individuals from Class 2, however, transitioned to Class 1 from time 2 to time 3 with a probability of 0.10. Other transition probabilities were not significant. Lastly, further analysis showed that individuals in Class 2 who moved to Class 1 have different memory, clinical, and neural measures to other individuals in the same class. We acknowledge that the proposed framework is sophisticated and time-consuming. However, given the severe neurodegenerative nature of AD, we argue that clinicians should prioritize an accurate diagnosis. Our findings show that LCA can provide a more accurate prediction for classifying and identifying the progression of AD compared to traditional clinical cut-off measures on neuropsychological assessments.
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Bjorkli C, Sandvig A, Sandvig I. Bridging the Gap Between Fluid Biomarkers for Alzheimer's Disease, Model Systems, and Patients. Front Aging Neurosci 2020; 12:272. [PMID: 32982716 PMCID: PMC7492751 DOI: 10.3389/fnagi.2020.00272] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 08/06/2020] [Indexed: 12/12/2022] Open
Abstract
Alzheimer’s disease (AD) is a debilitating neurodegenerative disease characterized by the accumulation of two proteins in fibrillar form: amyloid-β (Aβ) and tau. Despite decades of intensive research, we cannot yet pinpoint the exact cause of the disease or unequivocally determine the exact mechanism(s) underlying its progression. This confounds early diagnosis and treatment of the disease. Cerebrospinal fluid (CSF) biomarkers, which can reveal ongoing biochemical changes in the brain, can help monitor developing AD pathology prior to clinical diagnosis. Here we review preclinical and clinical investigations of commonly used biomarkers in animals and patients with AD, which can bridge translation from model systems into the clinic. The core AD biomarkers have been found to translate well across species, whereas biomarkers of neuroinflammation translate to a lesser extent. Nevertheless, there is no absolute equivalence between biomarkers in human AD patients and those examined in preclinical models in terms of revealing key pathological hallmarks of the disease. In this review, we provide an overview of current but also novel AD biomarkers and how they relate to key constituents of the pathological cascade, highlighting confounding factors and pitfalls in interpretation, and also provide recommendations for standardized procedures during sample collection to enhance the translational validity of preclinical AD models.
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Affiliation(s)
- Christiana Bjorkli
- Sandvig Group, Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Axel Sandvig
- Sandvig Group, Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Institute of Neuromedicine and Movement Science, Department of Neurology, St. Olavs Hospital, Trondheim, Norway.,Department of Pharmacology and Clinical Neurosciences, Division of Neuro, Head, and Neck, University Hospital of Umeå, Umeå, Sweden
| | - Ioanna Sandvig
- Sandvig Group, Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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23
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Teitsdottir UD, Jonsdottir MK, Lund SH, Darreh-Shori T, Snaedal J, Petersen PH. Association of glial and neuronal degeneration markers with Alzheimer's disease cerebrospinal fluid profile and cognitive functions. ALZHEIMERS RESEARCH & THERAPY 2020; 12:92. [PMID: 32753068 PMCID: PMC7404927 DOI: 10.1186/s13195-020-00657-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 07/21/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Neuroinflammation has gained increasing attention as a potential contributing factor in the onset and progression of Alzheimer's disease (AD). The objective of this study was to examine the association of selected cerebrospinal fluid (CSF) inflammatory and neuronal degeneration markers with signature CSF AD profile and cognitive functions among subjects at the symptomatic pre- and early dementia stages. METHODS In this cross-sectional study, 52 subjects were selected from an Icelandic memory clinic cohort. Subjects were classified as having AD (n = 28, age = 70, 39% female, Mini-Mental State Examination [MMSE] = 27) or non-AD (n = 24, age = 67, 33% female, MMSE = 28) profile based on the ratio between CSF total-tau (T-tau) and amyloid-β1-42 (Aβ42) values (cut-off point chosen as 0.52). Novel CSF biomarkers included neurofilament light (NFL), YKL-40, S100 calcium-binding protein B (S100B) and glial fibrillary acidic protein (GFAP), measured with enzyme-linked immunosorbent assays (ELISAs). Subjects underwent neuropsychological assessment for evaluation of different cognitive domains, including verbal episodic memory, non-verbal episodic memory, language, processing speed, and executive functions. RESULTS Accuracy coefficient for distinguishing between the two CSF profiles was calculated for each CSF marker and test. Novel CSF markers performed poorly (area under curve [AUC] coefficients ranging from 0.61 to 0.64) compared to tests reflecting verbal episodic memory, which all performed fair (AUC > 70). LASSO regression with a stability approach was applied for the selection of CSF markers and demographic variables predicting performance on each cognitive domain, both among all subjects and only those with a CSF AD profile. Relationships between CSF markers and cognitive domains, where the CSF marker reached stability selection criteria of > 75%, were visualized with scatter plots. Before calculations of corresponding Pearson's correlations coefficients, composite scores for cognitive domains were adjusted for age and education. GFAP correlated with executive functions (r = - 0.37, p = 0.01) overall, while GFAP correlated with processing speed (r = - 0.68, p < 0.001) and NFL with verbal episodic memory (r = - 0.43, p = 0.02) among subjects with a CSF AD profile. CONCLUSIONS The novel CSF markers NFL and GFAP show potential as markers for cognitive decline among individuals with core AD pathology at the symptomatic pre- and early stages of dementia.
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Affiliation(s)
- Unnur D Teitsdottir
- Faculty of Medicine, Department of Anatomy, Biomedical Center, University of Iceland, Reykjavik, Iceland.
| | - Maria K Jonsdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland.,Department of Psychiatry, Landspitali - National University Hospital, Reykjavik, Iceland
| | | | - Taher Darreh-Shori
- Division of Clinical Geriatrics, Center for Alzheimer Research, NVS Department, Karolinska Institutet, Huddinge, Sweden
| | - Jon Snaedal
- Memory clinic, Department of Geriatric Medicine, Landspitali - National University Hospital, Reykjavik, Iceland
| | - Petur H Petersen
- Faculty of Medicine, Department of Anatomy, Biomedical Center, University of Iceland, Reykjavik, Iceland
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Alves L, Cardoso S, Silva D, Mendes T, Marôco J, Nogueira J, Lima M, Tábuas-Pereira M, Baldeiras I, Santana I, de Mendonça A, Guerreiro M. Neuropsychological profile of amyloid-positive versus amyloid-negative amnestic Mild Cognitive Impairment. J Neuropsychol 2020; 15 Suppl 1:41-52. [PMID: 32588984 DOI: 10.1111/jnp.12218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/19/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Patients diagnosed with amnestic mild cognitive impairment (aMCI) are at high risk of progressing to dementia. It became possible, through the use of biomarkers, to diagnose those patients with aMCI who have Alzheimer's disease. However, it is presently unfeasible that all patients undergo biomarker testing. Since neuropsychological testing is required to make a formal diagnosis of aMCI, it would be interesting if it could be used to predict the amyloid status of patients with aMCI. METHODS Participants with aMCI, known amyloid status (Aβ+ or Aβ-) and a comprehensive neuropsychological evaluation, were selected from the Cognitive Complaints Cohort database for this study. Neuropsychological tests were compared in Aβ+ and Aβ- aMCI patients. A binary logistic regression analysis was conducted to model the probability of being amyloid positive. RESULTS Of the 216 aMCI patients studied, 117 were Aβ+ and 99 were Aβ-. Aβ+ aMCI patients performed worse on several memory tests, namely Word Total Recall, Logical Memory Immediate and Delayed Free Recall, and Verbal Paired Associate Learning, as well as on Trail Making Test B, an executive function test. In a binary logistic regression model, only Logical Memory Delayed Free Recall retained significance, so that for each additional score point in this test, the probability of being amyloid positive decreased by 30.6%. The resulting model correctly classified 64.6% of the aMCI cases regarding their amyloid status. CONCLUSIONS The neuropsychological assessment remains an essential step to diagnose and characterize patients with aMCI; however, neuropsychological tests have limited value to distinguish the aMCI patients who have amyloid pathology from those who might suffer from other clinical conditions.
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Affiliation(s)
- Luísa Alves
- Chronic Diseases Research Centre, NOVA Medical School, NOVA University of Lisbon, Portugal
| | | | - Dina Silva
- Faculty of Medicine, University of Lisbon, Portugal.,Cognitive Neuroscience Research Group, Department of Psychology and Educational Sciences and Center for Biomedical Research (CBMR), Universidade do Algarve, Faro, Portugal
| | - Tiago Mendes
- Faculty of Medicine, University of Lisbon, Portugal.,Psychiatry and Mental Health Department, Santa Maria Hospital, Lisbon, Portugal
| | - João Marôco
- Instituto Superior de Psicologia Aplicada, Lisbon, Portugal
| | - Joana Nogueira
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Portugal.,Faculdade de Medicina da Universidade de Coimbra, Portugal
| | - Marisa Lima
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Portugal.,Faculdade de Medicina da Universidade de Coimbra, Portugal
| | - Miguel Tábuas-Pereira
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Portugal.,Faculdade de Medicina da Universidade de Coimbra, Portugal
| | - Inês Baldeiras
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Portugal.,Faculdade de Medicina da Universidade de Coimbra, Portugal
| | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Portugal.,Faculdade de Medicina da Universidade de Coimbra, Portugal
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25
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Santangelo R, Masserini F, Agosta F, Sala A, Caminiti SP, Cecchetti G, Caso F, Martinelli V, Pinto P, Passerini G, Perani D, Magnani G, Filippi M. CSF p-tau/Aβ42 ratio and brain FDG-PET may reliably detect MCI “imminent” converters to AD. Eur J Nucl Med Mol Imaging 2020; 47:3152-3164. [DOI: 10.1007/s00259-020-04853-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/01/2020] [Indexed: 12/11/2022]
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26
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Alzheimer's Disease Diagnosis Using Misfolding Proteins in Blood. Dement Neurocogn Disord 2020; 19:1-18. [PMID: 32174051 PMCID: PMC7105719 DOI: 10.12779/dnd.2020.19.1.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 12/02/2019] [Accepted: 12/09/2019] [Indexed: 01/06/2023] Open
Abstract
Alzheimer's disease (AD) is pathologically characterized by a long progressive phase of neuronal changes, including accumulation of extracellular amyloid-β (Aβ) and intracellular neurofibrillary tangles, before the onset of observable symptoms. Many efforts have been made to develop a blood-based diagnostic method for AD by incorporating Aβ and tau as plasma biomarkers. As blood tests have the advantages of being highly accessible and low cost, clinical implementation of AD blood tests would provide preventative screening to presymptomatic individuals, facilitating early identification of AD patients and, thus, treatment development in clinical research. However, the low concentration of AD biomarkers in the plasma has posed difficulties for accurate detection, hindering the development of a reliable blood test. In this review, we introduce three AD blood test technologies emerging in South Korea, which have distinctive methods of heightening detection sensitivity of specific plasma biomarkers. We discuss in detail the multimer detection system, the self-standard analysis of Aβ biomarkers quantified by interdigitated microelectrodes, and a biomarker ratio analysis comprising Aβ and tau.
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27
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Ye LQ, Li XY, Zhang YB, Cheng HR, Ma Y, Chen DF, Tao QQ, Li HL, Wu ZY. The discriminative capacity of CSF β-amyloid 42 and Tau in neurodegenerative diseases in the Chinese population. J Neurol Sci 2020; 412:116756. [PMID: 32142967 DOI: 10.1016/j.jns.2020.116756] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/09/2020] [Accepted: 02/21/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION In the past few years, the β-amyloid 42 peptide and tau protein in cerebrospinal fluid (CSF) have become primary diagnostic biomarkers in differentiating Alzheimer's disease (AD) and cognitive normal controls. As we know, several neurodegenerative diseases have been reported to overlap with AD in neuropathology and clinical symptoms. To examine the discriminative utility of these biomarkers in AD and other neurodegenerative diseases, we measured them in a cohort of Chinese population. METHODS We measured CSF Aβ42, t-tau and p-tau181 by ELISA tests and calculated the ratios of t-tau/Aβ42 and p-tau181/Aβ42 in 240 Chinese Han patients with AD (n = 82), frontotemporal dementia (FTD, n = 20), Huntington's disease (HD, n = 27), multiple system atrophy (MSA, n = 24), spinocerebellar ataxia type-3 (SCA3, n = 27), amyotrophic lateral sclerosis (ALS, n = 36) and controls (n = 24). RESULTS As expected, all biomarkers showed high discriminative capacity between AD and non-AD groups (p < .05) except for the elevated CSF t-tau in FTD (p > .05). Comparing with the controls, tau related biomarkers significantly elevated in the FTD (p < .001) and MSA (p < .05) groups. Surprisingly, comparing with controls, we found that CSF Aβ42 increased remarkably in the SCA3 (p < .05), HD and ALS groups (p < .001), achieving a high specificity, respectively. CONCLUSION To our best knowledge, this is the first comprehensive study in the Han Chinese population that confirmed the discriminative utility of CSF Aβ42 and tau biomarkers between AD and other neurodegenerative diseases.
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Affiliation(s)
- Ling-Qi Ye
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao-Yan Li
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan-Bin Zhang
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China; Department of Neurology and Institute of Neurology, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Hong-Rong Cheng
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Yin Ma
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Dian-Fu Chen
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Qing-Qing Tao
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China
| | - Hong-Lei Li
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China.
| | - Zhi-Ying Wu
- Department of Neurology and Research Center of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China.
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28
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Cressatti M, Juwara L, Galindez JM, Velly AM, Nkurunziza ES, Marier S, Canie O, Gornistky M, Schipper HM. Salivary microR‐153 and microR‐223 Levels as Potential Diagnostic Biomarkers of Idiopathic Parkinson's Disease. Mov Disord 2019; 35:468-477. [DOI: 10.1002/mds.27935] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/18/2019] [Accepted: 11/11/2019] [Indexed: 01/04/2023] Open
Affiliation(s)
- Marisa Cressatti
- Lady Davis Institute for Medical ResearchJewish General Hospital Montreal Quebec Canada
- Department of Neurology and NeurosurgeryMcGill University Montreal Quebec Canada
| | - Lamin Juwara
- Lady Davis Institute for Medical ResearchJewish General Hospital Montreal Quebec Canada
- Department of Quantitative Life SciencesMcGill University Montreal Quebec Canada
| | - Julia M. Galindez
- Lady Davis Institute for Medical ResearchJewish General Hospital Montreal Quebec Canada
- Department of Neurology and NeurosurgeryMcGill University Montreal Quebec Canada
| | - Ana M. Velly
- Lady Davis Institute for Medical ResearchJewish General Hospital Montreal Quebec Canada
- Department of DentistryJewish General Hospital Montreal Quebec Canada
- Faculty of DentistryMcGill University Montreal Quebec Canada
| | - Eva S. Nkurunziza
- Lady Davis Institute for Medical ResearchJewish General Hospital Montreal Quebec Canada
| | - Sara Marier
- Lady Davis Institute for Medical ResearchJewish General Hospital Montreal Quebec Canada
- Department of Neurology and NeurosurgeryMcGill University Montreal Quebec Canada
| | - Olivia Canie
- Lady Davis Institute for Medical ResearchJewish General Hospital Montreal Quebec Canada
| | - Mervyn Gornistky
- Lady Davis Institute for Medical ResearchJewish General Hospital Montreal Quebec Canada
- Department of DentistryJewish General Hospital Montreal Quebec Canada
- Faculty of DentistryMcGill University Montreal Quebec Canada
| | - Hyman M. Schipper
- Lady Davis Institute for Medical ResearchJewish General Hospital Montreal Quebec Canada
- Department of Neurology and NeurosurgeryMcGill University Montreal Quebec Canada
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30
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Kang MJ, Kim SY, Na DL, Kim BC, Yang DW, Kim EJ, Na HR, Han HJ, Lee JH, Kim JH, Park KH, Park KW, Han SH, Kim SY, Yoon SJ, Yoon B, Seo SW, Moon SY, Yang Y, Shim YS, Baek MJ, Jeong JH, Choi SH, Youn YC. Prediction of cognitive impairment via deep learning trained with multi-center neuropsychological test data. BMC Med Inform Decis Mak 2019; 19:231. [PMID: 31752864 PMCID: PMC6873409 DOI: 10.1186/s12911-019-0974-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/08/2019] [Indexed: 12/16/2022] Open
Abstract
Background Neuropsychological tests (NPTs) are important tools for informing diagnoses of cognitive impairment (CI). However, interpreting NPTs requires specialists and is thus time-consuming. To streamline the application of NPTs in clinical settings, we developed and evaluated the accuracy of a machine learning algorithm using multi-center NPT data. Methods Multi-center data were obtained from 14,926 formal neuropsychological assessments (Seoul Neuropsychological Screening Battery), which were classified into normal cognition (NC), mild cognitive impairment (MCI) and Alzheimer’s disease dementia (ADD). We trained a machine learning model with artificial neural network algorithm using TensorFlow (https://www.tensorflow.org) to distinguish cognitive state with the 46-variable data and measured prediction accuracies from 10 randomly selected datasets. The features of the NPT were listed in order of their contribution to the outcome using Recursive Feature Elimination. Results The ten times mean accuracies of identifying CI (MCI and ADD) achieved by 96.66 ± 0.52% of the balanced dataset and 97.23 ± 0.32% of the clinic-based dataset, and the accuracies for predicting cognitive states (NC, MCI or ADD) were 95.49 ± 0.53 and 96.34 ± 1.03%. The sensitivity to the detection CI and MCI in the balanced dataset were 96.0 and 96.0%, and the specificity were 96.8 and 97.4%, respectively. The ‘time orientation’ and ‘3-word recall’ score of MMSE were highly ranked features in predicting CI and cognitive state. The twelve features reduced from 46 variable of NPTs with age and education had contributed to more than 90% accuracy in predicting cognitive impairment. Conclusions The machine learning algorithm for NPTs has suggested potential use as a reference in differentiating cognitive impairment in the clinical setting.
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Affiliation(s)
- Min Ju Kang
- Department of Neurology, Seoul National University College of Medicine & Seoul National University Bundang Hospital, Seoul, South Korea.,Department of Neurology, Veterans Health Service Medical Center, Seoul, South Korea
| | - Sang Yun Kim
- Department of Neurology, Seoul National University College of Medicine & Seoul National University Bundang Hospital, Seoul, South Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Byeong C Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju, South Korea
| | - Dong Won Yang
- Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, South Korea
| | - Hae Ri Na
- The Brain Fitness Center, Bobath Memorial Hospital, Seongnam, South Korea
| | - Hyun Jeong Han
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea
| | - Jae-Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Jong Hun Kim
- Department of Neurology, Dementia Center, Ilsan Hospital, National Health Insurance Service, Goyang, South Korea
| | - Kee Hyung Park
- Department of Neurology, College of Medicine, Gachon University Gil Hospital, Incheon, South Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A University College of Medicine and Institute of Convergence Bio-Health, Busan, South Korea
| | - Seol-Heui Han
- Department of Neurology, Konkuk University Medical Center, Seoul, South Korea
| | - Seong Yoon Kim
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Soo Jin Yoon
- Department of Neurology, Eulji University College of Medicine, Daejeon, South Korea
| | - Bora Yoon
- Department of Neurology, Konyang University Hospital, College of Medicine, Konyang University, Daejeon, South Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, South Korea
| | - YoungSoon Yang
- Department of Neurology, Veterans Health Service Medical Center, Seoul, South Korea
| | - Yong S Shim
- Department of Neurology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Min Jae Baek
- Department of Neurology, Seoul National University College of Medicine & Seoul National University Bundang Hospital, Seoul, South Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, South Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University School of Medicine, Incheon, South Korea
| | - Young Chul Youn
- Department of Neurology, College of Medicine, Chung-Ang University, Seoul, South Korea.
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Chehrehnegar N, Nejati V, Shati M, Esmaeili M, Rezvani Z, Haghi M, Foroughan M. Behavioral and cognitive markers of mild cognitive impairment: diagnostic value of saccadic eye movements and Simon task. Aging Clin Exp Res 2019; 31:1591-1600. [PMID: 30659514 DOI: 10.1007/s40520-019-01121-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 01/03/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mild Cognitive Impairment (MCI) has been considered as a prodromal stage of Alzheimer disease (AD). Subtle changes in specific aspects of executive function like inhibitory control have been found in MCI. AIMS We examined attentional and inhibitory control with the aim to distinguish between amnestic MCI patients and healthy controls. METHOD Using neuropsychological, behavioral, and oculomotor function experiments, we examined executive function in 59 normal control, 49, multiple domain amnestic MCI (a-MCI) subjects, and 21 early stage AD patients using eye tracking and Simon task as measures of attentional control, to determine which saccade and behavioral tasks were sensitive enough to identify a-MCI. Saccades were investigated in gap and overlap pro-saccade and anti-saccade tasks. RESULTS Scores on the Simon task were inversely correlated with general cognitive status and can distinguish a-MCI from controls with excellent specificity (AUC = 0.65 for reaction time and 0.59 for false responses). More importantly, our results showed that saccadic gains were affected in a-MCI and were the most sensitive measures to distinguish a-MCI from normal participants AST gap task AUC = 0.7, PST gap task AUC = 0.63, AST overlap task (AUC = 0.73). Moreover, these parameters were strongly correlated with neuropsychological measures. Using tests in parallel model, improved sensitivity up to 0.97. CONCLUSION The present results enable us to suggest eye tracking along with behavioral data as a possible sensitive tools to detect a-MCI in preclinical stage.
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Affiliation(s)
- Negin Chehrehnegar
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Occupational Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Nejati
- Department of Psychology and Educational Sciences, Shahid Behehsti University Tehran, Tehran, Iran
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Mohsen Shati
- Mental health, Research center, School of behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdieh Esmaeili
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Zahra Rezvani
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Marjan Haghi
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mahshid Foroughan
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Mavroudis I, Petridis F, Kazis D. Cerebrospinal Fluid, Imaging, and Physiological Biomarkers in Dementia With Lewy Bodies. Am J Alzheimers Dis Other Demen 2019; 34:421-432. [PMID: 31422676 PMCID: PMC10653361 DOI: 10.1177/1533317519869700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Dementia with Lewy bodies is a progressive neurodegenerative disorder, clinically characterized by gradual cognitive impairment and fluctuating cognition, behavioral changes and recurrent visual hallucinations, and autonomic function and movement symptoms in the type of parkinsonism. It is the second most common type of dementia in the Western world after Alzheimer disease. Over the last 20 years, many neurophysiological, neuroimaging, and cerebrospinal fluid (CSF) biomarkers have been described toward a better discrimination between dementia with Lewy bodies, Alzheimer disease, and other neurodegenerative conditions.In the present review, we aim to describe the neurophysiological, imaging, and CSF biomarkers in dementia with Lewy bodies and to question whether they could be reliable tools for the clinical practice.
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Affiliation(s)
- Ioannis Mavroudis
- Department of Neurology, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Foivos Petridis
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Kazis
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Casoli T, Paolini S, Fabbietti P, Fattoretti P, Paciaroni L, Fabi K, Gobbi B, Galeazzi R, Rossi R, Lattanzio F, Pelliccioni G. Cerebrospinal fluid biomarkers and cognitive status in differential diagnosis of frontotemporal dementia and Alzheimer's disease. J Int Med Res 2019; 47:4968-4980. [PMID: 31524025 PMCID: PMC6833432 DOI: 10.1177/0300060519860951] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective This study aimed to determine the most appropriate cognitive and cerebrospinal fluid (CSF) biomarker setting to distinguish frontotemporal dementia (FTD) from Alzheimer’s disease (AD). Method Patients with FTD, those with AD, and those without dementia were enrolled in this study. CSF amyloid-ß 42 (Aß42), total (t)-tau, and phosphorylated (p)-tau concentrations were determined by enzyme-linked immunosorbent assays. Cognition was evaluated by the Mini-Mental State Examination (MMSE) and its domain scores. The associations of CSF biomarkers with cognitive measures were examined using regression models and the diagnostic value of CSF biomarkers was determined by receiver operating characteristics curves. Results CSF Aß42 levels were lower, whereas t-tau/Aß42 and p-tau/Aß42 ratios were higher in patients with AD compared with those with FTD. Some MMSE domain scores were different in FTD and AD, but they did not improve the ability to distinguish between the two pathologies. Poor temporal orientation scores were associated with low Aß42 levels only in patients with FTD. The p-tau/Aß42 ratio reached sufficient levels of sensitivity and specificity to discriminate FTD with primary progressive aphasia from AD. Conclusions The ratio of CSF p-tau/Aß42 is a sensitive and specific biomarker for discriminating patients with primary progressive aphasia from those with AD.
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Affiliation(s)
- Tiziana Casoli
- Center for Neurobiology of Aging, IRCCS INRCA, Ancona, Italy
| | - Susy Paolini
- Neurology Unit, Geriatric Hospital, IRCCS INRCA, Ancona, Italy
| | - Paolo Fabbietti
- Diagnostic Unit of Geriatric Pharmacoepidemiology, IRCCS INRCA, Cosenza, Italy
| | | | - Lucia Paciaroni
- Neurology Unit, Geriatric Hospital, IRCCS INRCA, Ancona, Italy
| | - Katia Fabi
- Neurology Unit, Geriatric Hospital, IRCCS INRCA, Ancona, Italy
| | - Beatrice Gobbi
- Neurology Unit, Geriatric Hospital, IRCCS INRCA, Ancona, Italy
| | - Roberta Galeazzi
- Clinical Laboratory & Molecular Diagnostics, IRCCS INRCA, Ancona, Italy
| | - Roberto Rossi
- Diagnostic and Interventional Radiology Unit, IRCCS INRCA, Ancona, Italy
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Alhajraf F, Ness D, Hye A, Strydom A. Plasma amyloid and tau as dementia biomarkers in Down syndrome: Systematic review and meta-analyses. Dev Neurobiol 2019; 79:684-698. [PMID: 31389176 PMCID: PMC6790908 DOI: 10.1002/dneu.22715] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/02/2019] [Accepted: 08/02/2019] [Indexed: 12/18/2022]
Abstract
Individuals with Down syndrome (DS) are at high risk of developing Alzheimer's disease (AD). Discovering reliable biomarkers which could facilitate early AD diagnosis and be used to predict/monitor disease course would be extremely valuable. To examine if analytes in blood related to amyloid plaques may constitute such biomarkers, we conducted meta‐analyses of studies comparing plasma amyloid beta (Aβ) levels between DS individuals and controls, and between DS individuals with and without dementia. PubMed, Embase, and Google Scholar were searched for studies investigating the relationship between Aβ plasma concentrations and dementia in DS and 10 studies collectively comprising >1,600 adults, including >1,400 individuals with DS, were included. RevMan 5.3 was used to perform meta‐analyses. Meta‐analyses showed higher plasma Aβ40 (SMD = 1.79, 95% CI [1.14, 2.44], Z = 5.40, p < .00001) and plasma Aβ42 levels (SMD = 1.41, 95% CI [1.15, 1.68], Z = 10.46, p < .00001) in DS individuals than controls, and revealed that DS individuals with dementia had higher plasma Aβ40 levels (SMD = 0.23, 95% CI [0.05, 0.41], Z = 2.54, p = .01) and lower Aβ42/Aβ40 ratios (SMD = −0.33, 95% CI [−0.63, −0.03], Z = 2.15, p = .03) than DS individuals without dementia. Our results indicate that plasma Aβ40 levels may constitute a promising biomarker for predicting dementia status in individuals with DS. Further investigations using new ultra‐sensitive assays are required to obtain more reliable results and to investigate to what extent these results may be generalizable beyond the DS population.
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Affiliation(s)
- Falah Alhajraf
- UCL Queen Square Institute of Neurology, University College London, London, UK.,Al Amiri Hospital, Kuwait City, State of Kuwait
| | - Deborah Ness
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,The LonDownS Consortium (London Down Syndrome Consortium), London, UK
| | - Abdul Hye
- The Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andre Strydom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,The LonDownS Consortium (London Down Syndrome Consortium), London, UK
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Santangelo R, Dell'Edera A, Sala A, Cecchetti G, Masserini F, Caso F, Pinto P, Leocani L, Falautano M, Passerini G, Martinelli V, Comi G, Perani D, Magnani G. The CSF p-tau181/Aβ42 Ratio Offers a Good Accuracy “In Vivo” in the Differential Diagnosis of Alzheimer’s Dementia. Curr Alzheimer Res 2019; 16:587-595. [DOI: 10.2174/1567205016666190725150836] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/06/2019] [Accepted: 07/04/2019] [Indexed: 11/22/2022]
Abstract
Background:
The incoming disease-modifying therapies against Alzheimer’s disease (AD)
require reliable diagnostic markers to correctly enroll patients all over the world. CSF AD biomarkers,
namely amyloid-β 42 (Aβ42), total tau (t-tau), and tau phosphorylated at threonine 181 (p-tau181),
showed good diagnostic accuracy in detecting AD pathology, but their real usefulness in daily clinical
practice is still a matter of debate. Therefore, further validation in complex clinical settings, that is patients
with different types of dementia, is needed to uphold their future worldwide adoption.
Methods:
We measured CSF AD biomarkers’ concentrations in a sample of 526 patients with a clinical
diagnosis of dementia (277 with AD and 249 with Other Type of Dementia, OTD). Brain FDG-PET was
also considered in a subsample of 54 patients with a mismatch between the clinical diagnosis and the
CSF findings.
Results:
A p-tau181/Aβ42 ratio higher than 0.13 showed the best diagnostic performance in differentiating
AD from OTD (86% accuracy index, 74% sensitivity, 81% specificity). In cases with a mismatch
between clinical diagnosis and CSF findings, brain FDG-PET partially agreed with the p-tau181/Aβ42
ratio, thus determining an increase in CSF accuracy.
Conclusions:
The p-tau181/Aβ42 ratio alone might reliably detect AD pathology in heterogeneous samples
of patients suffering from different types of dementia. It might constitute a simple, cost-effective
and reproducible in vivo proxy of AD suitable to be adopted worldwide not only in daily clinical practice
but also in future experimental trials, to avoid the enrolment of misdiagnosed AD patients.
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Affiliation(s)
- Roberto Santangelo
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Alessandro Dell'Edera
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Arianna Sala
- Nuclear Medicine Unit, IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giordano Cecchetti
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Federico Masserini
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Francesca Caso
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Patrizia Pinto
- Department of Neurology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Letizia Leocani
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | | | - Gabriella Passerini
- Department of Laboratory Medicine, IRCCS-San Raffaele Hospital, Milan, Italy
| | - Vittorio Martinelli
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
| | - Daniela Perani
- Nuclear Medicine Unit, IRCCS-San Raffaele Hospital, Milan, Italy
| | - Giuseppe Magnani
- Department of Neurology, INSPE, Vita-Salute University and IRCCS-San Raffaele Hospital, Milan, Italy
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Goldhardt O, Warnhoff I, Yakushev I, Begcevic I, Förstl H, Magdolen V, Soosaipillai A, Diamandis E, Alexopoulos P, Grimmer T. Kallikrein-related peptidases 6 and 10 are elevated in cerebrospinal fluid of patients with Alzheimer's disease and associated with CSF-TAU and FDG-PET. Transl Neurodegener 2019; 8:25. [PMID: 31467673 PMCID: PMC6712703 DOI: 10.1186/s40035-019-0168-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 08/13/2019] [Indexed: 12/20/2022] Open
Abstract
Background Alterations in the expression of human kallikrein-related peptidases (KLKs) have been described in patients with Alzheimer’s disease (AD). We elucidated the suitability of KLK6, KLK8 and KLK10 to distinguish AD from NC and explored associations with established AD biomarkers. Methods KLK levels in cerebrospinal fluid (CSF), as determined by ELISA, were compared between 32 AD patients stratified to A/T/(N) system with evidence for amyloid pathology and of 23 normal controls with normal AD biomarkers. Associations between KLK levels and clinical severity, CSF and positron emission tomography (PET) based AD biomarkers were tested for. Results Levels of KLK6 and KLK10 were significantly increased in AD. KLK6 differed significantly between AD A+/T+/N+ and AD A+/T−/N+ or NC with an AUC of 0.922. CSF pTau and tTau levels were significantly associated with KLK6 in AD. Conclusions KLK6 deserves further investigations as a potential biomarker of Tau pathology in AD. Electronic supplementary material The online version of this article (10.1186/s40035-019-0168-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Oliver Goldhardt
- 1Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Ismaninger Str. 22, 81675 Munich, Germany
| | - Inanna Warnhoff
- 1Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Ismaninger Str. 22, 81675 Munich, Germany
| | - Igor Yakushev
- 2Department of Nuclear Medicine, TUM-NIC, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Ismaninger Str. 22, 81675 Munich, Germany
| | - Ilijana Begcevic
- 5Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Medical Science Building, 1 King's College Circle, Toronto, Ontario M5S 1A8 Canada
| | - Hans Förstl
- 1Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Ismaninger Str. 22, 81675 Munich, Germany
| | - Viktor Magdolen
- 3Department of Obstetrics & Gynecology, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Ismaninger Str. 22, 81675 Munich, Germany
| | - Antoninus Soosaipillai
- 4Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, 60 Murray St., Toronto, Ontario M5T 3L9 Canada
| | - Eleftherios Diamandis
- 4Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, 60 Murray St., Toronto, Ontario M5T 3L9 Canada.,5Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Medical Science Building, 1 King's College Circle, Toronto, Ontario M5S 1A8 Canada
| | - Panagiotis Alexopoulos
- 1Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Ismaninger Str. 22, 81675 Munich, Germany.,6Department of Psychiatry, University hospital of Rion, University of Patras, 26500 Rion Patras, Patras, Greece
| | - Timo Grimmer
- 1Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Ismaninger Str. 22, 81675 Munich, Germany
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The Association Between Circulating Inflammatory Markers and the Progression of Alzheimer Disease in Norwegian Memory Clinic Patients With Mild Cognitive Impairment or Dementia. Alzheimer Dis Assoc Disord 2019; 34:47-53. [PMID: 31414991 DOI: 10.1097/wad.0000000000000342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Neuroinflammation may play an important role in the pathogenesis and progression of Alzheimer disease (AD). The aim of the present study was to detect whether increased inflammatory activity at baseline could predict cognitive and functional decline in patients with amnestic mild cognitive impairment (aMCI) or AD dementia after 2 years. METHODS Serum samples from 242 memory clinic patients with an aMCI (n=88) or AD dementia (n=154) were analyzed for C-reactive protein and for 14 other inflammatory markers [interleukin (IL)-1β, interleukin-1 receptor antagonist, IL-6, IL-10, IL-12p40, IL-17a, IL-18, IL-22, IL-33, tumor necrosis factor, cluster of differentiation 40 ligand, interferon-γ, chemokine ligand (CCL) 2, and CCL4] by bead-based multiplex immunoassay. Disease progression was measured by the annual increase in the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) and annual decrease in the score on the Mini-Mental State Examination (MMSE). RESULTS No association between increased levels of the inflammatory markers and change on the CDR-SB or MMSE score was found, but there was a significant difference in baseline IL-6 and interleukin-1 receptor antagonist levels between aMCI and AD dementia groups. CONCLUSION Increased levels of inflammatory markers were not associated with faster progression as measured by the annual change on the CDR-SB or MMSE score.
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Abstract
Neurodegenerative diseases are sporadic and rare hereditary disorders of the central nervous system, which cause a slowly progressive loss of function of specific neuron populations and their connections. Severe impairments and care dependency can be the sequelae. Neurodegenerative disorders are diseases of older people; therefore, the demographic shift leads to an increase in the number of affected patients. Radiologists will also become more involved. For this reason important neurodegenerative diseases are presented in this article. In addition to Alzheimer's and Parkinson's diseases these also include frontotemporal lobar degeneration, Lewy body dementia, vascular dementia, Creutzfeldt-Jakob disease and Huntington's chorea. The clinical symptoms and diagnostics are described, whereby the focus lies on typical results of morphological imaging.
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Manole E, E. Bastian A, D. Popescu I, Constantin C, Mihai S, F. Gaina G, Codrici E, T. Neagu M. Immunoassay Techniques Highlighting Biomarkers in Immunogenetic Diseases. Immunogenetics 2019. [DOI: 10.5772/intechopen.75951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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40
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Bouts MJRJ, van der Grond J, Vernooij MW, Koini M, Schouten TM, de Vos F, Feis RA, Cremers LGM, Lechner A, Schmidt R, de Rooij M, Niessen WJ, Ikram MA, Rombouts SARB. Detection of mild cognitive impairment in a community-dwelling population using quantitative, multiparametric MRI-based classification. Hum Brain Mapp 2019; 40:2711-2722. [PMID: 30803110 PMCID: PMC6563478 DOI: 10.1002/hbm.24554] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/30/2019] [Accepted: 02/09/2019] [Indexed: 01/18/2023] Open
Abstract
Early and accurate mild cognitive impairment (MCI) detection within a heterogeneous, nonclinical population is needed to improve care for persons at risk of developing dementia. Magnetic resonance imaging (MRI)-based classification may aid early diagnosis of MCI, but has only been applied within clinical cohorts. We aimed to determine the generalizability of MRI-based classification probability scores to detect MCI on an individual basis within a general population. To determine classification probability scores, an AD, mild-AD, and moderate-AD detection model were created with anatomical and diffusion MRI measures calculated from a clinical Alzheimer's Disease (AD) cohort and subsequently applied to a population-based cohort with 48 MCI and 617 normal aging subjects. Each model's ability to detect MCI was quantified using area under the receiver operating characteristic curve (AUC) and compared with an MCI detection model trained and applied to the population-based cohort. The AD-model and mild-AD identified MCI from controls better than chance level (AUC = 0.600, p = 0.025; AUC = 0.619, p = 0.008). In contrast, the moderate-AD-model was not able to separate MCI from normal aging (AUC = 0.567, p = 0.147). The MCI-model was able to separate MCI from controls better than chance (p = 0.014) with mean AUC values comparable with the AD-model (AUC = 0.611, p = 1.0). Within our population-based cohort, classification models detected MCI better than chance. Nevertheless, classification performance rates were moderate and may be insufficient to facilitate robust MRI-based MCI detection on an individual basis. Our data indicate that multiparametric MRI-based classification algorithms, that are effective in clinical cohorts, may not straightforwardly translate to applications in a general population.
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Affiliation(s)
- Mark J. R. J. Bouts
- Institute of PsychologyLeiden UniversityLeidenthe Netherlands
- Department of RadiologyLeiden University Medical CenterLeidenthe Netherlands
- Leiden Institute for Brain and CognitionLeiden UniversityLeidenthe Netherlands
| | | | - Meike W. Vernooij
- Department of EpidemiologyErasmus MC University Medical CenterRotterdamthe Netherlands
- Department of Radiology and Nuclear MedicineErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Marisa Koini
- Department of NeurologyMedical University of GrazAustria
| | - Tijn M. Schouten
- Institute of PsychologyLeiden UniversityLeidenthe Netherlands
- Department of RadiologyLeiden University Medical CenterLeidenthe Netherlands
- Leiden Institute for Brain and CognitionLeiden UniversityLeidenthe Netherlands
| | - Frank de Vos
- Institute of PsychologyLeiden UniversityLeidenthe Netherlands
- Department of RadiologyLeiden University Medical CenterLeidenthe Netherlands
- Leiden Institute for Brain and CognitionLeiden UniversityLeidenthe Netherlands
| | - Rogier A. Feis
- Department of RadiologyLeiden University Medical CenterLeidenthe Netherlands
- Leiden Institute for Brain and CognitionLeiden UniversityLeidenthe Netherlands
| | - Lotte G. M. Cremers
- Department of EpidemiologyErasmus MC University Medical CenterRotterdamthe Netherlands
- Department of Radiology and Nuclear MedicineErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Anita Lechner
- Department of NeurologyMedical University of GrazAustria
| | | | - Mark de Rooij
- Institute of PsychologyLeiden UniversityLeidenthe Netherlands
- Leiden Institute for Brain and CognitionLeiden UniversityLeidenthe Netherlands
| | - Wiro J. Niessen
- Department of Radiology and Nuclear MedicineErasmus MC University Medical CenterRotterdamthe Netherlands
- Department of Medical InformaticsErasmus MC University Medical CenterRotterdamthe Netherlands
- Faculty of Applied SciencesDelft University of TechnologyDelftthe Netherlands
| | - M. Arfan Ikram
- Department of EpidemiologyErasmus MC University Medical CenterRotterdamthe Netherlands
- Department of Radiology and Nuclear MedicineErasmus MC University Medical CenterRotterdamthe Netherlands
- Department of NeurologyErasmus MC University Medical CenterRotterdamthe Netherlands
| | - Serge A. R. B. Rombouts
- Institute of PsychologyLeiden UniversityLeidenthe Netherlands
- Department of RadiologyLeiden University Medical CenterLeidenthe Netherlands
- Leiden Institute for Brain and CognitionLeiden UniversityLeidenthe Netherlands
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O'Bryant SE, Edwards M, Zhang F, Johnson LA, Hall J, Kuras Y, Scherzer CR. Potential two-step proteomic signature for Parkinson's disease: Pilot analysis in the Harvard Biomarkers Study. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2019; 11:374-382. [PMID: 31080873 PMCID: PMC6502745 DOI: 10.1016/j.dadm.2019.03.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction We sought to determine if our previously validated proteomic profile for detecting Alzheimer's disease would detect Parkinson's disease (PD) and distinguish PD from other neurodegenerative diseases. Methods Plasma samples were assayed from 150 patients of the Harvard Biomarkers Study (PD, n = 50; other neurodegenerative diseases, n = 50; healthy controls, n = 50) using electrochemiluminescence and Simoa platforms. Results The first step proteomic profile distinguished neurodegenerative diseases from controls with a diagnostic accuracy of 0.94. The second step profile distinguished PD cases from other neurodegenerative diseases with a diagnostic accuracy of 0.98. The proteomic profile differed in step 1 versus step 2, suggesting that a multistep proteomic profile algorithm to detecting and distinguishing between neurodegenerative diseases may be optimal. Discussion These data provide evidence of the potential use of a multitiered blood-based proteomic screening method for detecting individuals with neurodegenerative disease and then distinguishing PD from other neurodegenerative diseases.
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Affiliation(s)
- Sid E O'Bryant
- Institute for Translational Research, Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Melissa Edwards
- Department of Neuro-Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Fan Zhang
- Vermont Genetics Network, University of Vermont, Burlington, VT, USA
| | - Leigh A Johnson
- Institute for Translational Research, Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - James Hall
- Institute for Translational Research, Department of Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Yuliya Kuras
- Advanced Center for Parkinson's Disease Research of Brigham & Women's Hospital, and Harvard Medical School, Boston, MA, USA.,Precision Neurology Program, Harvard Medical School, Brigham & Women's Hospital, Boston, MA, USA
| | - Clemens R Scherzer
- Advanced Center for Parkinson's Disease Research of Brigham & Women's Hospital, and Harvard Medical School, Boston, MA, USA.,Precision Neurology Program, Harvard Medical School, Brigham & Women's Hospital, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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42
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Prediction of Alzheimer's disease dementia with MRI beyond the short-term: Implications for the design of predictive models. NEUROIMAGE-CLINICAL 2019; 23:101837. [PMID: 31078938 PMCID: PMC6515129 DOI: 10.1016/j.nicl.2019.101837] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 02/12/2019] [Accepted: 04/24/2019] [Indexed: 11/22/2022]
Abstract
Magnetic resonance imaging (MRI) volumetric measures have become a standard tool for the detection of incipient Alzheimer's Disease (AD) dementia in mild cognitive impairment (MCI). Focused on providing an earlier and more accurate diagnosis, sophisticated MRI machine learning algorithms have been developed over the recent years, most of them learning their non-disease patterns from MCI that remained stable over 2–3 years. In this work, we analyzed whether these stable MCI over short-term periods are actually appropriate training examples of non-disease patterns. To this aim, we compared the diagnosis of MCI patients at 2 and 5 years of follow-up and investigated its impact on the predictive performance of baseline volumetric MRI measures primarily involved in AD, i.e., hippocampal and entorhinal cortex volumes. Predictive power was evaluated in terms of the area under the ROC curve (AUC), sensitivity, and specificity in a trial sample of 248 MCI patients followed-up over 5 years. We further compared the sensitivity in those MCI that converted before 2 years and those that converted after 2 years. Our results indicate that 23% of the stable MCI at 2 years progressed in the next three years and that MRI volumetric measures are good predictors of conversion to AD dementia even at the mid-term, showing a better specificity and AUC as follow-up time increases. The combination of hippocampus and entorhinal cortex yielded an AUC that was significantly higher for the 5-year follow-up (AUC = 73% at 2 years vs. AUC = 84% at 5 years), as well as for specificity (56% vs. 71%). Sensitivity showed a non-significant slight decrease (81% vs. 78%). Remarkably, the performance of this model was comparable to machine learning models at the same follow-up times. MRI correctly identified most of the patients that converted after 2 years (with sensitivity >60%), and these patients showed a similar degree of abnormalities to those that converted before 2 years. This implies that most of the MCI patients that remained stable over short periods and subsequently progressed to AD dementia had evident atrophies at baseline. Therefore, machine learning models that use these patients to learn non-disease patterns are including an important fraction of patients with evident pathological changes related to the disease, something that might result in reduced performance and lack of biological interpretability. MRI predicted AD dementia significantly better when extending follow-up from 2 to 5 years. MRI was similarly able to detect AD in short and mid-term converters. Predictive models should not learn non-disease patterns from stable MCI over short periods.
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Falgàs N, Tort-Merino A, Balasa M, Borrego-Écija S, Castellví M, Olives J, Bosch B, Férnandez-Villullas G, Antonell A, Augé JM, Lomeña F, Perissinotti A, Bargalló N, Sánchez-Valle R, Lladó A. Clinical applicability of diagnostic biomarkers in early-onset cognitive impairment. Eur J Neurol 2019; 26:1098-1104. [PMID: 30793432 DOI: 10.1111/ene.13945] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/19/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Several diagnostic biomarkers are currently available for clinical use in early-onset cognitive impairment. The decision on which biomarker is used in each patient depends on several factors such as its predictive value or tolerability. METHODS There were a total of 40 subjects with early-onset cognitive complaints (<65 years of age): 26 with Alzheimer's disease (AD), five with frontotemporal dementia and nine with diagnostic suspicion of non-neurodegenerative disorder. Clinical and neuropsychological evaluation, lumbar puncture for cerebrospinal fluid (CSF) AD core biochemical marker determination, medial temporal atrophy evaluation on magnetic resonance imaging, amyloid-positron emission tomography (PET) and 18 F-fluorodeoxyglucose-PET were performed. Neurologists provided pre- and post-biomarker diagnosis, together with diagnostic confidence and clinical/therapeutic management. Patients scored the tolerability of each procedure. RESULTS Cerebrospinal fluid biomarkers and amyloid-PET increased diagnostic confidence in AD (77.4%-86.2% after CSF, 92.4% after amyloid-PET, P < 0.01) and non-neurodegenerative conditions (53.6%-75% after CSF, 95% after amyloid-PET, P < 0.05). Biomarker results led to diagnostic (32.5%) and treatment (32.5%) changes. All tests were well tolerated. CONCLUSIONS Biomarker procedures are well tolerated and have an important diagnostic/therapeutic impact on early-onset cognitive impairment.
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Affiliation(s)
- N Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Tort-Merino
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - M Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain.,Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - S Borrego-Écija
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - M Castellví
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - J Olives
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - B Bosch
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - G Férnandez-Villullas
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Antonell
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - J M Augé
- Biochemistry and Molecular Genetics Department, Hospital Clínic de Barcelona, Barcelona
| | - F Lomeña
- Nuclear Medicine Department, Hospital Clínic de Barcelona, Barcelona
| | - A Perissinotti
- Nuclear Medicine Department, Hospital Clínic de Barcelona, Barcelona
| | - N Bargalló
- Image Diagnostic Centre, IDIBAPS, Hospital Clínic de Barcelona, Barcelona, Spain
| | - R Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
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Cid-Fernández S, Lindín M, Díaz F. The importance of age in the search for ERP biomarkers of aMCI. Biol Psychol 2019; 142:108-115. [PMID: 30721717 DOI: 10.1016/j.biopsycho.2019.01.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 02/07/2023]
Abstract
Alzheimer's Disease (AD) has become a major health issue in recent decades, and there is now growing interest in amnestic mild cognitive impairment (aMCI), an intermediate stage between healthy aging and dementia, usually AD. Event-related brain potential (ERP) studies have sometimes failed to detect differences between aMCI and control participants in the Go-P3 (or P3b, related to target classification processes in a variety of tasks) and NoGo-P3 (related to response inhibition processes, mainly in Go/NoGo tasks) ERP components. The aim of the present study was to evaluate whether the age factor, which is not usually taken into account in ERP studies, modulates group differences in these components. With this aim, we divided two groups of volunteer participants, 34 subjects with aMCI (51-87 years) and 31 controls (52-86 years), into two age subgroups: 69 years or less and 70 years or more. We recorded brain activity while the participants performed a distraction-attention auditory-visual (AV) task. Task performance was poorer in the older than in the younger group, and aMCI participants produced fewer correct responses than the matched controls; but no interactions of the age and group factors on performance were found. On the other hand, Go-P3 and NoGo-N2 latencies were longer in aMCI participants than in controls only in the younger subgroup. Thus, the younger aMCI participants categorized the Go stimuli in working memory and processed the NoGo stimuli (which required response inhibition) slower than the corresponding controls. Finally, the combination of the number of hits, Go-P3 latency and NoGo-N2 latency yielded acceptable sensitivity and specificity scores (0.70 and 0.92, respectively) as regards distinguishing aMCI participants aged 69 years or less from the age-matched controls. The findings indicate age should be taken into account in the search for aMCI biomarkers.
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Affiliation(s)
- Susana Cid-Fernández
- Laboratorio de Neurociencia Cognitiva, Departamento de Psicoloxía Clínica e Psicobioloxía, Universidade de Santiago de Compostela, Galicia, Spain.
| | - Mónica Lindín
- Laboratorio de Neurociencia Cognitiva, Departamento de Psicoloxía Clínica e Psicobioloxía, Universidade de Santiago de Compostela, Galicia, Spain
| | - Fernando Díaz
- Laboratorio de Neurociencia Cognitiva, Departamento de Psicoloxía Clínica e Psicobioloxía, Universidade de Santiago de Compostela, Galicia, Spain
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Pathological, imaging and genetic characteristics support the existence of distinct TDP-43 types in non-FTLD brains. Acta Neuropathol 2019; 137:227-238. [PMID: 30604226 DOI: 10.1007/s00401-018-1951-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/13/2018] [Accepted: 12/16/2018] [Indexed: 12/13/2022]
Abstract
TDP-43 is present in a high proportion of aged brains that do not meet criteria for frontotemporal lobar degeneration (FTLD). We determined whether there are distinct TDP-43 types in non-FTLD brains. From a cohort of 553 brains (Braak neurofibrillary tangle (NFT) stage 0-VI), excluding cases meeting criteria for FTLD, we identified those that had screened positive for TDP-43. We reviewed 14 different brain regions in these TDP-43 positive cases and classified them into those with "typical" TDP-43 immunoreactive inclusions (TDP type-α), and those in which TDP-43 immunoreactivity was adjacent to/associated with NFTs in the same neuron (TDP type-β). We compared pathological, genetic (APOE4, TMEM106B and GRN variants), neuroimaging and clinical data between types, as well as compared neuroimaging between types and a group of TDP-43 negative cases (n = 309). Two-hundred forty-one cases were classified as TDP type-α (n = 131, 54%) or TDP type-β (n = 110, 46%). Type-α cases were older than type-β at death (median 89 years vs. 87 years; p = 0.02). Hippocampal sclerosis was present in 78 (60%) type-α cases and 16 (15%) type-β cases (p < 0.001). Type-α cases showed a pattern of widespread TDP-43 deposition commonly extending into temporal, frontal and brainstem regions (84% TDP-43 stage 4-6) while in type-β cases deposition was predominantly limbic, located in amygdala, entorhinal cortex and subiculum of the hippocampus (84% TDP-43 stages 1-3) (p < 0.001). There was a difference in the frequency of TMEM106B protective (GG) and risk (CC) haplotypes (SNP rs3173615 encoding p.T185S) in type-α cases compared to type-β cases (GG/CG/CC: 8%/42%/50% vs. 24%/49%/27%; p = 0.01). Type-α cases had smaller amygdala (- 10.6% [- 17.6%, - 3.5%]; p = 0.003) and hippocampal (- 14.4% [- 21.6%, - 7.3%]; p < 0.001) volumes on MRI at death compared to type-β cases, although both types had smaller amygdala and hippocampal volumes compared to TDP-43 negative cases (- 7.77%, - 21.6%; p < 0.001). These findings demonstrate that there is distinct heterogeneity of TDP-43 deposition in non-FTLD brains.
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Yang MH, Chen SC, Lin YF, Lee YC, Huang MY, Chen KC, Wu HY, Lin PC, Gozes I, Tyan YC. Reduction of aluminum ion neurotoxicity through a small peptide application - NAP treatment of Alzheimer's disease. J Food Drug Anal 2019; 27:551-564. [PMID: 30987727 PMCID: PMC9296191 DOI: 10.1016/j.jfda.2018.11.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 11/16/2018] [Accepted: 11/20/2018] [Indexed: 12/15/2022] Open
Abstract
Alzheimer's disease (AD) is the most common cause of dementia in late life. It is difficult to precisely diagnose AD at early stages, making biomarker search essential for further developments. The objective of this study was to identify protein biomarkers associated with aluminum ions toxicity (AD-like toxicity) in a human neuroblastoma cell model, SH-SY5Y and assess potential prevention by NAP (NAPVSIPQ). Complete proteomic techniques were implemented. Four proteins were identified as up-regulated with aluminum ion treatment, CBP80/20-dependent translation initiation factor (CTIF), Early endosome antigen 1 (EEA1), Leucine-rich repeat neuronal protein 4 (LRRN4) and Phosphatidylinositol 3-kinase regulatory subunit beta (PI3KR2). Of these four proteins, EEA1 and PI3KR2 were down-regulated after NAP-induced neuroprotective activity in neuroblastoma cells. Thus, aluminum ions may increase the risk for neurotoxicity in AD, and the use of NAP is suggested as a treatment to provide additional protection against the effects of aluminum ions, via EEA1 and PI3KR2, associated with sorting and processing of the AD amyloid precursor protein (APP) through the endosomal system.
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Affiliation(s)
- Ming-Hui Yang
- Institute of Biological Chemistry, Academia Sinica, Taipei, 115, Taiwan; Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Shih-Cheng Chen
- Office of Research and Development, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Yu-Fen Lin
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Yi-Chia Lee
- Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Ming-Yii Huang
- Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; Department of Radiation Oncology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Ko-Chin Chen
- Department of Pathology, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Hsin-Yi Wu
- Instrumentation Center, National Taiwan University, Taipei 106, Taiwan
| | - Po-Chiao Lin
- Department of Chemistry, National Sun Yat-sen University, Kaohsiung 804, Taiwan
| | - Illana Gozes
- Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Adams Super Center for Brain Studies and Sagol School for Neuroscience, Tel Aviv University, Tel Aviv 69978, Israel.
| | - Yu-Chang Tyan
- Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 804, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
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The sinister face of heme oxygenase-1 in brain aging and disease. Prog Neurobiol 2019; 172:40-70. [DOI: 10.1016/j.pneurobio.2018.06.008] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/19/2018] [Accepted: 06/30/2018] [Indexed: 11/23/2022]
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Cheng Z, Yin J, Yuan H, Jin C, Zhang F, Wang Z, Liu X, Wu Y, Wang T, Xiao S. Blood-Derived Plasma Protein Biomarkers for Alzheimer's Disease in Han Chinese. Front Aging Neurosci 2018; 10:414. [PMID: 30618720 PMCID: PMC6305130 DOI: 10.3389/fnagi.2018.00414] [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: 04/04/2018] [Accepted: 11/30/2018] [Indexed: 11/13/2022] Open
Abstract
It is well known that Alzheimer's disease (AD) is one of the most common progressive neurodegenerative diseases; it begins gradually, and therefore no effective medicine is administered in the beginning. Thus, early diagnosis and prevention of AD are crucial. The present study focused on comparing the plasma protein changes between patients with AD and their healthy counterparts, aiming to explore a specific protein panel as a potential biomarker for AD patients in Han Chinese. Hence, we recruited and collected plasma samples from 98 AD patients and 101 elderly healthy controls from Wuxi and Shanghai Mental Health Centers. Using a Luminex assay, we investigated the expression levels of fifty plasma proteins in these samples. Thirty-two out of 50 proteins were found to be significantly different between AD patients and healthy controls (P < 0.05). Furthermore, an eight-protein panel that included brain-derived neurotrophic factor (BDNF), angiotensinogen (AGT), insulin-like growth factor binding protein 2 (IGFBP-2), osteopontin (OPN), cathepsin D, serum amyloid P component (SAP), complement C4, and prealbumin (transthyretin, TTR) showed the highest determinative score for AD and healthy controls (all P = 0.00). In conclusion, these findings suggest that a combination of eight plasma proteins can serve as a promising diagnostic biomarker for AD with high sensitivity and specificity in Han Chinese populations; the eight plasma proteins were proven important for AD diagnosis by further cross-validation studies within the AD cohort.
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Affiliation(s)
- Zaohuo Cheng
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Jiajun Yin
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Hongwei Yuan
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Chunhui Jin
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Fuquan Zhang
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Zhiqiang Wang
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Xiaowei Liu
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Yue Wu
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Tao Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shifu Xiao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Molinuevo JL, Ayton S, Batrla R, Bednar MM, Bittner T, Cummings J, Fagan AM, Hampel H, Mielke MM, Mikulskis A, O'Bryant S, Scheltens P, Sevigny J, Shaw LM, Soares HD, Tong G, Trojanowski JQ, Zetterberg H, Blennow K. Current state of Alzheimer's fluid biomarkers. Acta Neuropathol 2018; 136:821-853. [PMID: 30488277 PMCID: PMC6280827 DOI: 10.1007/s00401-018-1932-x] [Citation(s) in RCA: 331] [Impact Index Per Article: 55.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 12/12/2022]
Abstract
Alzheimer’s disease (AD) is a progressive neurodegenerative disease with a complex and heterogeneous pathophysiology. The number of people living with AD is predicted to increase; however, there are no disease-modifying therapies currently available and none have been successful in late-stage clinical trials. Fluid biomarkers measured in cerebrospinal fluid (CSF) or blood hold promise for enabling more effective drug development and establishing a more personalized medicine approach for AD diagnosis and treatment. Biomarkers used in drug development programmes should be qualified for a specific context of use (COU). These COUs include, but are not limited to, subject/patient selection, assessment of disease state and/or prognosis, assessment of mechanism of action, dose optimization, drug response monitoring, efficacy maximization, and toxicity/adverse reactions identification and minimization. The core AD CSF biomarkers Aβ42, t-tau, and p-tau are recognized by research guidelines for their diagnostic utility and are being considered for qualification for subject selection in clinical trials. However, there is a need to better understand their potential for other COUs, as well as identify additional fluid biomarkers reflecting other aspects of AD pathophysiology. Several novel fluid biomarkers have been proposed, but their role in AD pathology and their use as AD biomarkers have yet to be validated. In this review, we summarize some of the pathological mechanisms implicated in the sporadic AD and highlight the data for several established and novel fluid biomarkers (including BACE1, TREM2, YKL-40, IP-10, neurogranin, SNAP-25, synaptotagmin, α-synuclein, TDP-43, ferritin, VILIP-1, and NF-L) associated with each mechanism. We discuss the potential COUs for each biomarker.
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Affiliation(s)
- José Luis Molinuevo
- BarcelonaBeta Brain Research Center, Fundació Pasqual Maragall, Universitat Pompeu Fabra, Barcelona, Spain
- Unidad de Alzheimer y otros trastornos cognitivos, Hospital Clinic-IDIBAPS, Barcelona, Spain
| | - Scott Ayton
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Richard Batrla
- Roche Centralised and Point of Care Solutions, Roche Diagnostics International, Rotkreuz, Switzerland
| | - Martin M Bednar
- Neuroscience Therapeutic Area Unit, Takeda Development Centre Americas Ltd, Cambridge, MA, USA
| | - Tobias Bittner
- Genentech, A Member of the Roche Group, Basel, Switzerland
| | - Jeffrey Cummings
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Anne M Fagan
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Harald Hampel
- AXA Research Fund and Sorbonne University Chair, Paris, France
- Sorbonne University, GRC No 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
- Brain and Spine Institute (ICM), INSERM U 1127, CNRS UMR 7225, Paris, France
- Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Michelle M Mielke
- Departments of Epidemiology and Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Sid O'Bryant
- Department of Pharmacology and Neuroscience; Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Philip Scheltens
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Jeffrey Sevigny
- Roche Innovation Center Basel, F. Hoffmann-La Roche, Basel, Switzerland
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, and Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Holly D Soares
- Clinical Development Neurology, AbbVie, North Chicago, IL, USA
| | | | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal Campus, Sahlgrenska University Hospital, 431 80, Mölndal, Sweden
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal Campus, Sahlgrenska University Hospital, 431 80, Mölndal, Sweden.
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Del Campo M, Galimberti D, Elias N, Boonkamp L, Pijnenburg YA, van Swieten JC, Watts K, Paciotti S, Beccari T, Hu W, Teunissen CE. Novel CSF biomarkers to discriminate FTLD and its pathological subtypes. Ann Clin Transl Neurol 2018; 5:1163-1175. [PMID: 30349851 PMCID: PMC6186934 DOI: 10.1002/acn3.629] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 06/19/2018] [Accepted: 07/05/2018] [Indexed: 12/12/2022] Open
Abstract
Objective Frontotemporal lobar degeneration (FTLD) is the second most prevalent dementia in young patients and is characterized by the presence of two main protein aggregates in the brain, tau (FTLD‐Tau) or TDP43 (FTLD‐TDP), which likely require distinct pharmacological therapy. However, specific diagnosis of FTLD and its subtypes remains challenging due to largely overlapping clinical phenotypes. Here, we aimed to assess the clinical performance of novel cerebrospinal fluid (CSF) biomarkers for discrimination of FTLD and its pathological subtypes. Methods YKL40, FABP4, MFG‐E8, and the activities of catalase and specific lysosomal enzymes were analyzed in patients with FTLD‐TDP (n = 30), FTLD‐Tau (n = 20), AD (n = 30), DLB (n = 29), and nondemented controls (n = 29) obtained from two different centers. Models were validated in an independent CSF cohort (n = 188). Results YKL40 and catalase activity were increased in FTLD‐TDP cases compared to controls. YKL40 levels were also higher in FTLD‐TDP compared to FTLD‐Tau. We identified biomarker models able to discriminate FTLD from nondemented controls (MFG‐E8, tTau, and Aβ42; 78% sensitivity and 83% specificity) and non‐FTLD dementia (YKL40, pTau, p/tTau ratio, and age; 90% sensitivity, 78% specificity), which were validated in an independent cohort. In addition, we identified a biomarker model differentiating FTLD‐TDP from FTLD‐Tau (YKL40, MFGE‐8, βHexA together with βHexA/tHex and p/tTau ratios and age) with 80% sensitivity and 82% specificity. Interpretation This study identifies CSF protein signatures distinguishing FTLD and the two main pathological subtypes with optimal accuracy (specificity/sensitivity > 80%). Validation of these models may allow appropriate selection of cases for clinical trials targeting the accumulation of Tau or TDP43, thereby increasing their efficiency and facilitating the development of successful therapies.
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Affiliation(s)
- Marta Del Campo
- Neurochemistry Laboratory and Biobank Department of Clinical Chemistry Neuroscience Campus Amsterdam VU University Medical Center Amsterdam The Netherlands
| | - Daniela Galimberti
- Department of Neurological Sciences, Pathophysiology and Transplantation "Dino Ferrari" Center University of Milan Fondazione Ca' Granda IRCCS Ospedale Policlinico Milan Italy
| | - Naura Elias
- Neurochemistry Laboratory and Biobank Department of Clinical Chemistry Neuroscience Campus Amsterdam VU University Medical Center Amsterdam The Netherlands
| | - Lynn Boonkamp
- Neurochemistry Laboratory and Biobank Department of Clinical Chemistry Neuroscience Campus Amsterdam VU University Medical Center Amsterdam The Netherlands
| | - Yolande A Pijnenburg
- Alzheimer Centre and Department of Neurology Neuroscience Campus Amsterdam VU University Medical Centre Amsterdam The Netherlands
| | - John C van Swieten
- Alzheimer Centre and Department of Neurology Neuroscience Campus Amsterdam VU University Medical Centre Amsterdam The Netherlands.,Department of Neurology Erasmus Medical Center Rotterdam The Netherlands
| | - Kelly Watts
- Department of Neurology Center for Neurodegenerative Diseases Research Alzheimer's Disease Research Center Emory University School of Medicine Atlanta Georgia
| | - Silvia Paciotti
- Department of Pharmaceutical Sciences University of Perugia Perugia Italy
| | - Tommaso Beccari
- Department of Pharmaceutical Sciences University of Perugia Perugia Italy
| | - William Hu
- Department of Neurology Center for Neurodegenerative Diseases Research Alzheimer's Disease Research Center Emory University School of Medicine Atlanta Georgia
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank Department of Clinical Chemistry Neuroscience Campus Amsterdam VU University Medical Center Amsterdam The Netherlands
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