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Zhang R, Liu S, Mousavi SM. Cognitive Dysfunction and Exercise: From Epigenetic to Genetic Molecular Mechanisms. Mol Neurobiol 2024; 61:6279-6299. [PMID: 38286967 DOI: 10.1007/s12035-024-03970-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/19/2024] [Indexed: 01/31/2024]
Abstract
Maintaining good health is crucial, and exercise plays a vital role in achieving this goal. It offers a range of positive benefits for cognitive function, regardless of age. However, as our population ages and life expectancy increases, cognitive impairment has become a prevalent issue, often coexisting with age-related neurodegenerative conditions. This can result in devastating consequences such as memory loss, difficulty speaking, and confusion, greatly hindering one's ability to lead an ordinary life. In addition, the decrease in mental capacity has a significant effect on an individual's physical and emotional well-being, greatly reducing their overall level of contentment and causing a significant financial burden for communities. While most current approaches aim to slow the decline of cognition, exercise offers a non-pharmacological, safe, and accessible solution. Its effects on cognition are intricate and involve changes in the brain's neural plasticity, mitochondrial stability, and energy metabolism. Moreover, exercise triggers the release of cytokines, playing a significant role in the body-brain connection and its impact on cognition. Additionally, exercise can influence gene expression through epigenetic mechanisms, leading to lasting improvements in brain function and behavior. Herein, we summarized various genetic and epigenetic mechanisms that can be modulated by exercise in cognitive dysfunction.
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Affiliation(s)
- Runhong Zhang
- Department of Physical Education, Luliang University, Lishi, 033000, Shanxi, China.
| | - Shangwu Liu
- Department of Physical Education, Luliang University, Lishi, 033000, Shanxi, China
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Youn C, Caillaud ML, Li Y, Gallagher I, Strasser B, Tanaka H, Haley AP. Interplay of Large Neutral Amino Acids, Metabolic Syndrome, and Apolipoprotein E ε4 on Brain Integrity at Midlife. Lifestyle Genom 2024; 17:113-121. [PMID: 39102798 PMCID: PMC11385466 DOI: 10.1159/000540336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/05/2024] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Large neutral amino acids (LNAAs) tryptophan and phenylalanine have been implicated in the pathogenesis of neurodegenerative diseases. Given limited research on the effects of LNAA on brain health across different life stages, vascular risk, and genetic backgrounds, our study aimed to explore the interaction of LNAA levels, metabolic syndrome (MetS), and the presence of the apolipoprotein E ε4 (ApoE ε4) allele brain integrity at midlife. METHODS Sixty-eight adults aged 40-61 underwent a health assessment to calculate the number of MetS components, quantify LNAA, measure white matter hyperintensity (WMH) volume, and genotype ApoE ε4. Multivariate linear regression analyses were performed to test the joint effect of LNAA, MetS, and ApoE ε4 on WMH while adjusting for sex, age, and education. RESULTS Significant 3-way interactions were observed between serum tryptophan (β = 0.042, SE = 0.018, p < 0.05) and phenylalanine (β = 0.044, SE = 0.013, p < 0.01) levels, number of MetS components, and ApoE ε4 alleles status on WMH volume. Neither individual LNAA levels nor MetS components alone predicted WMH volume. CONCLUSIONS The study highlights significant 3-way interactions between LNAA, MetS, and genetic risk factors in the pathology of WMH, particularly in individuals genetically predisposed to Alzheimer's disease. These interactions suggest differential impacts of LNAA on WMH volume dependent on both genetic and metabolic factors. Results emphasize the need for personalized metabolic and genetic profile assessments in neurodegenerative disease management.
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Affiliation(s)
- Cherry Youn
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Marie L Caillaud
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Yanrong Li
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Isabelle Gallagher
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Barbara Strasser
- Faculty of Medicine, Sigmund Freud Private University Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - Andreana P Haley
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
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Wefel JS, Deshmukh S, Brown PD, Grosshans DR, Sulman EP, Cerhan JH, Mehta MP, Khuntia D, Shi W, Mishra MV, Suh JH, Laack NN, Chen Y, Curtis AA, Laba JM, Elsayed A, Thakrar A, Pugh SL, Bruner DW. Impact of Apolipoprotein E Genotype on Neurocognitive Function in Patients With Brain Metastases: An Analysis of NRG Oncology's RTOG 0614. Int J Radiat Oncol Biol Phys 2024; 119:846-857. [PMID: 38101486 PMCID: PMC11162903 DOI: 10.1016/j.ijrobp.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 11/28/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Whole-brain radiation therapy (WBRT) is a common treatment for brain metastases and is frequently associated with decline in neurocognitive functioning (NCF). The e4 allele of the apolipoprotein E (APOE) gene is associated with increased risk of Alzheimer disease and NCF decline associated with a variety of neurologic diseases and insults. APOE carrier status has not been evaluated as a risk factor for onset time or extent of NCF impairment in patients with brain metastases treated with WBRT. METHODS AND MATERIALS NRG/Radiation Therapy Oncology Group 0614 treated adult patients with brain metastases with 37.5 Gy of WBRT (+/- memantine), performed longitudinal NCF testing, and included an optional blood draw for APOE analysis. NCF test results were compared at baseline and over time with mixed-effects models. A cause-specific Cox model for time to NCF failure was performed to assess the effects of treatment arm and APOE carrier status. RESULTS APOE results were available for 45% of patients (n = 227/508). NCF did not differ by APOE e4 carrier status at baseline. Mixed-effects modeling showed that APOE e4 carriers had worse memory after WBRT compared with APOE e4 noncarriers (Hopkins Verbal Learning Test-Revised total recall [least square mean difference, 0.63; P = .0074], delayed recognition [least square mean difference, 0.75; P = .023]). However, APOE e4 carrier status was not associated with time to NCF failure (hazard ratio, 0.86; 95% CI, 0.60-1.23; P = .40). Memantine delayed the time to NCF failure, regardless of carrier status (hazard ratio, 0.72; 95% CI, 0.52-1.01; P = .054). CONCLUSIONS APOE e4 carriers with brain metastases exhibited greater decline in learning and memory, executive function, and the Clinical Trial Battery Composite score after treatment with WBRT (+/- memantine), without acceleration of onset of difference in time to NCF failure.
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Affiliation(s)
- Jeffrey S Wefel
- University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Snehal Deshmukh
- NRG Oncology Statistics and Data Management Center/American College of Radiology, Philadelphia, Pennsylvania
| | | | | | - Erik P Sulman
- Laura and Isaac Perlmutter Cancer Center, New York University Langone, New York, New York
| | | | - Minesh P Mehta
- Baptist Hospital of Miami and Florida International University, Miami, Florida
| | | | - Wenyin Shi
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Mark V Mishra
- University of Maryland Medical Systems, Baltimore, Maryland
| | - John H Suh
- Cleveland Clinic Foundation, Cleveland, Ohio
| | | | | | - Amarinthia Amy Curtis
- Spartanburg Medical Center, Accruals for Upstate Carolina NCORP-Gibbs Regional Cancer Center, Spartanburg, South Carolina
| | - Joanna M Laba
- London Regional Cancer Program, Accruals for University of Western Ontario, London, Ontario, Canada
| | - Ahmed Elsayed
- Toledo Community Hospital Oncology Program CCOP, Toledo, Ohio
| | - Anu Thakrar
- John H. Stroger Jr Hospital of Cook County MBCCOP, Chicago, Illinois
| | - Stephanie L Pugh
- NRG Oncology Statistics and Data Management Center/American College of Radiology, Philadelphia, Pennsylvania
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Rahman MS, Harrison E, Biggs H, Seikus C, Elliott P, Breen G, Kingston N, Bradley JR, Hill SM, Tom BDM, Chinnery PF. Dynamics of cognitive variability with age and its genetic underpinning in NIHR BioResource Genes and Cognition cohort participants. Nat Med 2024; 30:1739-1748. [PMID: 38745010 PMCID: PMC11186791 DOI: 10.1038/s41591-024-02960-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/28/2024] [Indexed: 05/16/2024]
Abstract
A leading explanation for translational failure in neurodegenerative disease is that new drugs are evaluated late in the disease course when clinical features have become irreversible. Here, to address this gap, we cognitively profiled 21,051 people aged 17-85 years as part of the Genes and Cognition cohort within the National Institute for Health and Care Research BioResource across England. We describe the cohort, present cognitive trajectories and show the potential utility. Surprisingly, when studied at scale, the APOE genotype had negligible impact on cognitive performance. Different cognitive domains had distinct genetic architectures, with one indicating brain region-specific activation of microglia and another with glycogen metabolism. Thus, the molecular and cellular mechanisms underpinning cognition are distinct from dementia risk loci, presenting different targets to slow down age-related cognitive decline. Participants can now be recalled stratified by genotype and cognitive phenotype for natural history and interventional studies of neurodegenerative and other disorders.
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Affiliation(s)
- Md Shafiqur Rahman
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Emma Harrison
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- National Institute for Health and Care Research BioResource, Cambridge, UK
| | - Heather Biggs
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- National Institute for Health and Care Research BioResource, Cambridge, UK
| | - Chloe Seikus
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- National Institute for Health and Care Research BioResource, Cambridge, UK
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, Imperial College London School of Public Health, London, UK
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- UK National Institute for Health Research Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK
| | - Nathalie Kingston
- National Institute for Health and Care Research BioResource, Cambridge, UK
- Dept of Haematology, Cambridge University, Cambridge, UK
| | - John R Bradley
- National Institute for Health and Care Research BioResource, Cambridge, UK
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Steven M Hill
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
- Cancer Research UK National Biomarker Centre, University of Manchester, Manchester, UK
| | - Brian D M Tom
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK.
| | - Patrick F Chinnery
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
- National Institute for Health and Care Research BioResource, Cambridge, UK.
- MRC Mitochondrial Biology Unit, University of Cambridge, Cambridge, UK.
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Nasri A, Sghaier I, Neji A, Gharbi A, Abida Y, Mrabet S, Gargouri A, Djebara MB, Kacem I, Gouider R. Phenotypic Spectrum of Progressive Supranuclear Palsy: Clinical Study and Apolipoprotein E Effect. J Mov Disord 2024; 17:158-170. [PMID: 38290492 PMCID: PMC11082606 DOI: 10.14802/jmd.23178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/08/2023] [Accepted: 01/30/2024] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVE Progressive supranuclear palsy (PSP) is a rare neurodegenerative disorder encompassing several phenotypes with various motor and cognitive deficits. We aimed to study motor and cognitive characteristics across PSP phenotypes and to assess the influence of apolipoprotein E (APOE) gene variants on PSP phenotypic expression. METHODS In this 20-year cross-sectional study, we retrospectively reviewed the charts of all patients classified as PSP patients and recategorized them according to phenotype using the Movement Disorder Society criteria (2017). Phenotypes were divided into three subgroups, Richardson's syndrome (PSP-RS), PSP-cortical (PSP with predominant frontal presentation [PSP-F] + PSP with predominant speech/language disorder [PSP-SL] + PSP with predominant corticobasal syndrome [PSP-CBS]) and PSP-subcortical (PSP with predominant parkinsonism [PSP-P] + PSP with progressive gait freezing [PSP-PGF] + PSP with predominant postural instability [PSP-PI] + PSP with predominant ocular motor dysfunction [PSP-OM] + PSP with cerebellar ataxia [PSP-C] + PSP with primary lateral sclerosis [PSP-PLS]), based on clinical presentation during the first 3 years after symptom onset, which defines the early disease stage. Clinical and neuropsychological assessment data were collected. Genotyping of APOE was performed using restriction fragment length polymorphism polymerase chain reaction and verified by Sanger sequencing. RESULTS We included 112 PSP patients comprising 10 phenotypes classified into 48 PSP-RS, 34 PSP-cortical (PSP-CBS, 17.6%; PSP-F, 9.4%; PSP-SL, 8.2%) and 30 PSP-subcortical (PSP-P, 11.6%; PSP-PI, 8%; PSP-OM, 2.7%; PSP-PGF, 1.8%; PSP-C, 1.8%; PSP-PLS, 0.9%) subgroups. PSP-RS patients were older at disease onset (p = 0.009) and had more akinetic-rigid and levodopa-resistant parkinsonism (p = 0.006), while PSP-cortical patients had more tremors and asymmetric and/or levodopa-responsive parkinsonism (p = 0.025). Cognitive domains were significantly less altered in the PSP-subcortical subgroup. Overall, PSP-APOEε4 carriers developed parkinsonism earlier (p = 0.038), had earlier oculomotor dysfunction (p = 0.052) and had more altered cognitive profiles. The APOEε4 allele was also associated with a younger age of parkinsonism onset in the PSP-RS phenotype group (p = 0.026). CONCLUSION This study demonstrated the wide phenotypic spectrum of PSP among Tunisians. Disease onset and akinetic-rigid and levodopa-resistant parkinsonism were the hallmarks of the PSP-RS phenotype, while milder cognitive impairment was characteristic of the PSP-subcortical subgroup. The APOEε4 allele was associated with earlier parkinsonism and oculomotor dysfunction and seemed to play a role in defining a more altered cognitive profile in PSP patients.
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Affiliation(s)
- Amina Nasri
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Ikram Sghaier
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Anis Neji
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
| | - Alya Gharbi
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Youssef Abida
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Saloua Mrabet
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Amina Gargouri
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Mouna Ben Djebara
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Imen Kacem
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
| | - Riadh Gouider
- Department of Neurology, LR18SP03, Razi University Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
- Clinical Investigation Center (CIC) “Neurosciences and Mental Health”, Razi University Hospital, Tunis, Tunisia
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Gogniat MA, Khan OA, Bown CW, Liu D, Pechman KR, Taylor Davis L, Gifford KA, Landman BA, Hohman TJ, Jefferson AL. Perivascular space burden interacts with APOE-ε4 status on cognition in older adults. Neurobiol Aging 2024; 136:1-8. [PMID: 38280312 PMCID: PMC11384903 DOI: 10.1016/j.neurobiolaging.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 12/19/2023] [Accepted: 01/04/2024] [Indexed: 01/29/2024]
Abstract
Enlarged perivascular spaces (ePVS) may adversely affect cognition. Little is known about how basal ganglia ePVS interact with apolipoprotein (APOE)-ε4 status. Vanderbilt Memory and Aging Project participants (n = 326, 73 ± 7, 59% male) underwent 3 T brain MRI at baseline to assess ePVS and longitudinal neuropsychological assessments. The interaction between ePVS volume and APOE-ε4 carrier status was related to baseline outcomes using ordinary least squares regressions and longitudinal cognition using linear mixed-effects regressions. ePVS volume interacted with APOE-ε4 status on cross-sectional naming performance (β = -0.002, p = 0.002), and executive function excluding outliers (β = 0.001, p = 0.009). There were no significant longitudinal interactions (p-values>0.10) except for Coding excluding outliers (β = 0.002, p = 0.05). While cross-sectional models stratified by APOE-ε4 status indicated greater ePVS related to worse cognition mostly in APOE-ε4 carriers, longitudinal models stratified by APOE-ε4 status showed greater ePVS volume related to worse cognition among APOE-ε4 non-carriers only. Results indicated that greater ePVS volume interacts with APOE-ε4 status on cognition cross-sectionally. Longitudinally, the association of greater ePVS volume and worse cognition appears stronger in APOE-ε4 non-carriers, possibly due to the deleterious effects of APOE-ε4 on cognition across the lifespan.
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Affiliation(s)
- Marissa A Gogniat
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Omair A Khan
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Corey W Bown
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dandan Liu
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kimberly R Pechman
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - L Taylor Davis
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Katherine A Gifford
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bennett A Landman
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA
| | - Timothy J Hohman
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Angela L Jefferson
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
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7
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Topriceanu CC, Shah M, Webber M, Chan F, Shiwani H, Richards M, Schott J, Chaturvedi N, Moon JC, Hughes AD, Hingorani AD, O'Regan DP, Captur G. APOE ε4 carriage associates with improved myocardial performance from adolescence to older age. BMC Cardiovasc Disord 2024; 24:172. [PMID: 38509472 PMCID: PMC10956279 DOI: 10.1186/s12872-024-03808-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 02/21/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Although APOE ε4 allele carriage confers a risk for coronary artery disease, its persistence in humans might be explained by certain survival advantages (antagonistic pleiotropy). METHODS Combining data from ~ 37,000 persons from three older age British cohorts (1946 National Survey of Health and Development [NSHD], Southall and Brent Revised [SABRE], and UK Biobank) and one younger age cohort (Avon Longitudinal Study of Parents and Children [ALSPAC]), we explored whether APOE ε4 carriage associates with beneficial or unfavorable left ventricular (LV) structural and functional metrics by echocardiography and cardiovascular magnetic resonance (CMR). RESULTS Compared to the non-APOE ε4 group, APOE ε4 carriers had similar cardiac phenotypes in terms of LV ejection fraction, E/e', posterior wall and interventricular septal thickness, and LV mass. However, they had improved myocardial performance resulting in greater LV stroke volume generation per 1 mL of myocardium (higher myocardial contraction fraction). In NSHD (n = 1467) and SABRE (n = 1187), ε4 carriers had a 4% higher MCF (95% CI 1-7%, p = 0.016) using echocardiography. Using CMR data, in UK Biobank (n = 32,972), ε4 carriers had a 1% higher MCF 95% (CI 0-1%, p = 0.020) with a dose-response relationship based on the number of ε4 alleles. In addition, UK Biobank ε4 carriers also had more favorable radial and longitudinal strain rates compared to non APOE ε4 carriers. In ALSPAC (n = 1397), APOE ε4 carriers aged < 24 years had a 2% higher MCF (95% CI 0-5%, p = 0.059). CONCLUSIONS By triangulating results in four independent cohorts, across imaging modalities (echocardiography and CMR), and in ~ 37,000 individuals, our results point towards an association between ε4 carriage and improved cardiac performance in terms of LV MCF. This potentially favorable cardiac phenotype adds to the growing number of reported survival advantages attributed to the pleiotropic effects APOE ε4 carriage that might collectively explain its persistence in human populations.
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Affiliation(s)
- Constantin-Cristian Topriceanu
- UCL MRC Unit for Lifelong Health and Ageing, University College London, London, UK
- UCL Institute of Cardiovascular Science, University College London, London, UK
- Cardiac MRI Unit, Barts Heart Centre, London, UK
- Cardiology Department, Centre for Inherited Heart Muscle Conditions, The Royal Free Hospital, Pond Street, Hampstead, London, UK
| | - Mit Shah
- Imperial Centre for Translational and Experimental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
- MRC London Institute of Medical Science, Imperial College London, London, UK
| | - Matthew Webber
- UCL MRC Unit for Lifelong Health and Ageing, University College London, London, UK
- UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Fiona Chan
- UCL MRC Unit for Lifelong Health and Ageing, University College London, London, UK
- UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Hunain Shiwani
- UCL Institute of Cardiovascular Science, University College London, London, UK
- Cardiac MRI Unit, Barts Heart Centre, London, UK
| | - Marcus Richards
- UCL MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Jonathan Schott
- UCL MRC Unit for Lifelong Health and Ageing, University College London, London, UK
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Nishi Chaturvedi
- UCL MRC Unit for Lifelong Health and Ageing, University College London, London, UK
- UCL Institute of Cardiovascular Science, University College London, London, UK
| | - James C Moon
- UCL Institute of Cardiovascular Science, University College London, London, UK
- Cardiac MRI Unit, Barts Heart Centre, London, UK
| | - Alun D Hughes
- UCL MRC Unit for Lifelong Health and Ageing, University College London, London, UK
- UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Aroon D Hingorani
- UCL Institute of Cardiovascular Science, University College London, London, UK
- BHF Research Accelerator, University College London, London, UK
- Health Data Research, University College London, London, UK
| | - Declan P O'Regan
- Imperial Centre for Translational and Experimental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
- MRC London Institute of Medical Science, Imperial College London, London, UK
| | - Gabriella Captur
- UCL MRC Unit for Lifelong Health and Ageing, University College London, London, UK.
- UCL Institute of Cardiovascular Science, University College London, London, UK.
- Cardiac MRI Unit, Barts Heart Centre, London, UK.
- Imperial Centre for Translational and Experimental Medicine, National Heart and Lung Institute, Imperial College London, London, UK.
- Cardiology Department, Centre for Inherited Heart Muscle Conditions, The Royal Free Hospital, Pond Street, Hampstead, London, UK.
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Mak E, Dounavi ME, Operto G, Ziukelis ET, Jones PS, Low A, Swann P, Newton C, Muniz Terrera G, Malhotra P, Koychev I, Falcon C, Mackay C, Lawlor B, Naci L, Wells K, Ritchie C, Ritchie K, Su L, Gispert JD, O’Brien JT. APOE ɛ4 exacerbates age-dependent deficits in cortical microstructure. Brain Commun 2024; 6:fcad351. [PMID: 38384997 PMCID: PMC10881196 DOI: 10.1093/braincomms/fcad351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/20/2023] [Accepted: 02/09/2024] [Indexed: 02/23/2024] Open
Abstract
The apolipoprotein E ɛ4 allele is the primary genetic risk factor for the sporadic type of Alzheimer's disease. However, the mechanisms by which apolipoprotein E ɛ4 are associated with neurodegeneration are still poorly understood. We applied the Neurite Orientation Dispersion Model to characterize the effects of apolipoprotein ɛ4 and its interactions with age and education on cortical microstructure in cognitively normal individuals. Data from 1954 participants were included from the PREVENT-Dementia and ALFA (ALzheimer and FAmilies) studies (mean age = 57, 1197 non-carriers and 757 apolipoprotein E ɛ4 carriers). Structural MRI datasets were processed with FreeSurfer v7.2. The Microstructure Diffusion Toolbox was used to derive Orientation Dispersion Index maps from diffusion MRI datasets. Primary analyses were focused on (i) the main effects of apolipoprotein E ɛ4, and (ii) the interactions of apolipoprotein E ɛ4 with age and education on lobar and vertex-wise Orientation Dispersion Index and implemented using Permutation Analysis of Linear Models. There were apolipoprotein E ɛ4 × age interactions in the temporo-parietal and frontal lobes, indicating steeper age-dependent Orientation Dispersion Index changes in apolipoprotein E ɛ4 carriers. Steeper age-related Orientation Dispersion Index declines were observed among apolipoprotein E ɛ4 carriers with lower years of education. We demonstrated that apolipoprotein E ɛ4 worsened age-related Orientation Dispersion Index decreases in brain regions typically associated with atrophy patterns of Alzheimer's disease. This finding also suggests that apolipoprotein E ɛ4 may hasten the onset age of dementia by accelerating age-dependent reductions in cortical Orientation Dispersion Index.
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Affiliation(s)
- Elijah Mak
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Maria-Eleni Dounavi
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Grégory Operto
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona 08005, Spain
| | - Elina T Ziukelis
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Peter Simon Jones
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Audrey Low
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Peter Swann
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Coco Newton
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | | | - Paresh Malhotra
- Department of Brain Sciences, Imperial College, London W12 0NN, UK
| | - Ivan Koychev
- Department of Psychiatry, Oxford University, Oxford OX3 7JX, UK
| | - Carles Falcon
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona 08005, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid 28029, Spain
| | - Clare Mackay
- Department of Psychiatry, Oxford University, Oxford OX3 7JX, UK
| | - Brian Lawlor
- Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin D02 PX31, Ireland
| | - Lorina Naci
- Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin D02 PX31, Ireland
| | - Katie Wells
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Craig Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Karen Ritchie
- Institut National de la Santé et de la Recherche Médicale, U1061 Neuropsychiatrie, Montpellier 34093, France
- Faculty of Medicine, University of Montpellier, Montpellier 34093, France
| | - Li Su
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona 08005, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid 28029, Spain
| | - John T O’Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK
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Shah SN, Dounavi ME, Malhotra PA, Lawlor B, Naci L, Koychev I, Ritchie CW, Ritchie K, O’Brien JT. Dementia risk and thalamic nuclei volumetry in healthy midlife adults: the PREVENT Dementia study. Brain Commun 2024; 6:fcae046. [PMID: 38444908 PMCID: PMC10914447 DOI: 10.1093/braincomms/fcae046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/31/2023] [Accepted: 02/13/2024] [Indexed: 03/07/2024] Open
Abstract
A reduction in the volume of the thalamus and its nuclei has been reported in Alzheimer's disease, mild cognitive impairment and asymptomatic individuals with risk factors for early-onset Alzheimer's disease. Some studies have reported thalamic atrophy to occur prior to hippocampal atrophy, suggesting thalamic pathology may be an early sign of cognitive decline. We aimed to investigate volumetric differences in thalamic nuclei in middle-aged, cognitively unimpaired people with respect to dementia family history and apolipoprotein ε4 allele carriership and the relationship with cognition. Seven hundred participants aged 40-59 years were recruited into the PREVENT Dementia study. Individuals were stratified according to dementia risk (approximately half with and without parental dementia history). The subnuclei of the thalamus of 645 participants were segmented on T1-weighted 3 T MRI scans using FreeSurfer 7.1.0. Thalamic nuclei were grouped into six regions: (i) anterior, (ii) lateral, (iii) ventral, (iv) intralaminar, (v) medial and (vi) posterior. Cognitive performance was evaluated using the computerized assessment of the information-processing battery. Robust linear regression was used to analyse differences in thalamic nuclei volumes and their association with cognitive performance, with age, sex, total intracranial volume and years of education as covariates and false discovery rate correction for multiple comparisons. We did not find significant volumetric differences in the thalamus or its subregions, which survived false discovery rate correction, with respect to first-degree family history of dementia or apolipoprotein ε4 allele status. Greater age was associated with smaller volumes of thalamic subregions, except for the medial thalamus, but only in those without a dementia family history. A larger volume of the mediodorsal medial nucleus (Pfalse discovery rate = 0.019) was associated with a faster processing speed in those without a dementia family history. Larger volumes of the thalamus (P = 0.016) and posterior thalamus (Pfalse discovery rate = 0.022) were associated with significantly worse performance in the immediate recall test in apolipoprotein ε4 allele carriers. We did not find significant volumetric differences in thalamic subregions in relation to dementia risk but did identify an interaction between dementia family history and age. Larger medial thalamic nuclei may exert a protective effect on cognitive performance in individuals without a dementia family history but have little effect on those with a dementia family history. Larger volumes of posterior thalamic nuclei were associated with worse recall in apolipoprotein ε4 carriers. Our results could represent initial dysregulation in the disease process; further study is needed with functional imaging and longitudinal analysis.
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Affiliation(s)
- Sita N Shah
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge CB2 0QQ, UK
| | - Maria-Eleni Dounavi
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge CB2 0QQ, UK
| | - Paresh A Malhotra
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK
- UK Dementia Research Institute Care Research and Technology Centre, Imperial College London and the University of Surrey, London SW7 2AZ, UK
| | - Brian Lawlor
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin D02 PX31, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin D02 X9W9, Ireland
| | - Lorina Naci
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin D02 PX31, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin D02 X9W9, Ireland
| | - Ivan Koychev
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
| | - Craig W Ritchie
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Karen Ritchie
- Institute de Neurosciences de Montpellier, INSERM, Montpellier 34093, France
| | - John T O’Brien
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge CB2 0QQ, UK
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Murray-Smith H, Barker S, Barkhof F, Barnes J, Brown TM, Captur G, R E Cartlidge M, Cash DM, Coath W, Davis D, Dickson JC, Groves J, Hughes AD, James SN, Keshavan A, Keuss SE, King-Robson J, Lu K, Malone IB, Nicholas JM, Rapala A, Scott CJ, Street R, Sudre CH, Thomas DL, Wong A, Wray S, Zetterberg H, Chaturvedi N, Fox NC, Crutch SJ, Richards M, Schott JM. Updating the study protocol: Insight 46 - a longitudinal neuroscience sub-study of the MRC National Survey of Health and Development - phases 2 and 3. BMC Neurol 2024; 24:40. [PMID: 38263061 PMCID: PMC10804658 DOI: 10.1186/s12883-023-03465-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/13/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Although age is the biggest known risk factor for dementia, there remains uncertainty about other factors over the life course that contribute to a person's risk for cognitive decline later in life. Furthermore, the pathological processes leading to dementia are not fully understood. The main goals of Insight 46-a multi-phase longitudinal observational study-are to collect detailed cognitive, neurological, physical, cardiovascular, and sensory data; to combine those data with genetic and life-course information collected from the MRC National Survey of Health and Development (NSHD; 1946 British birth cohort); and thereby contribute to a better understanding of healthy ageing and dementia. METHODS/DESIGN Phase 1 of Insight 46 (2015-2018) involved the recruitment of 502 members of the NSHD (median age = 70.7 years; 49% female) and has been described in detail by Lane and Parker et al. 2017. The present paper describes phase 2 (2018-2021) and phase 3 (2021-ongoing). Of the 502 phase 1 study members who were invited to a phase 2 research visit, 413 were willing to return for a clinic visit in London and 29 participated in a remote research assessment due to COVID-19 restrictions. Phase 3 aims to recruit 250 study members who previously participated in both phases 1 and 2 of Insight 46 (providing a third data time point) and 500 additional members of the NSHD who have not previously participated in Insight 46. DISCUSSION The NSHD is the oldest and longest continuously running British birth cohort. Members of the NSHD are now at a critical point in their lives for us to investigate successful ageing and key age-related brain morbidities. Data collected from Insight 46 have the potential to greatly contribute to and impact the field of healthy ageing and dementia by combining unique life course data with longitudinal multiparametric clinical, imaging, and biomarker measurements. Further protocol enhancements are planned, including in-home sleep measurements and the engagement of participants through remote online cognitive testing. Data collected are and will continue to be made available to the scientific community.
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Affiliation(s)
- Heidi Murray-Smith
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK.
| | - Suzie Barker
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Centre for Medical Image Computing, University College London, London, UK
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Josephine Barnes
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - Thomas M Brown
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - Gabriella Captur
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Molly R E Cartlidge
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - David M Cash
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - William Coath
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - Daniel Davis
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - John C Dickson
- Institute of Nuclear Medicine, University College London Hospitals, London, UK
| | - James Groves
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - Alun D Hughes
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Sarah-Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Ashvini Keshavan
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - Sarah E Keuss
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - Josh King-Robson
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - Kirsty Lu
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - Ian B Malone
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - Jennifer M Nicholas
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Alicja Rapala
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Catherine J Scott
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
- Institute of Nuclear Medicine, University College London Hospitals, London, UK
| | - Rebecca Street
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - Carole H Sudre
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
- Centre for Medical Image Computing, University College London, London, UK
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - David L Thomas
- Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Selina Wray
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute, University College London, London, UK
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Hong, Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Nishi Chaturvedi
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science & Experimental Medicine, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Jonathan M Schott
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, 1St Floor, 8-11 Queen Square, London, UK
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Lan G, Du J, Chen X, Wang Q, Han Y, Guo T. Association of APOE-ε4 and GAP-43-related presynaptic loss with β-amyloid, tau, neurodegeneration, and cognitive decline. Neurobiol Aging 2023; 132:209-219. [PMID: 37852045 DOI: 10.1016/j.neurobiolaging.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
Apolipoprotein E-ε4 (APOE-ε4) carriers had elevated cerebrospinal fluid (CSF) presynaptic protein growth-associated protein-43 (GAP-43), but the underlying mechanism is not fully understood. We investigated how the APOE-ε4 genotype affects the baseline and longitudinal changes in CSF GAP-43 and their associations with β-amyloid positron emission tomography (Aβ PET), CSF phosphorylated tau 181 (p-Tau181), neurodegeneration, and cognitive decline. Compared to APOE-ε4 non-carriers, APOE-ε4 carriers had higher baseline levels and faster rates of increases in Aβ PET, CSF p-Tau181, and CSF GAP-43. Both higher baseline levels and faster rates of increase in CSF GAP-43 were associated with greater baseline Aβ PET and CSF p-Tau181, which fully mediated the APOE-ε4 effect on CSF GAP-43 elevations. Independent of Aβ PET and CSF p-Tau181, APOE-ε4 carriage was associated with exacerbated GAP-43-related longitudinal hippocampal atrophy and cognitive decline, especially in Aβ+ participants (GAP-43 × time × APOE-ε4). These findings suggest that the APOE-ε4 effect on GAP-43-related presynaptic dysfunction is mediated by primary Alzheimer's pathologies and independently correlates to hippocampal atrophy and cognitive decline in the future.
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Affiliation(s)
- Guoyu Lan
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, China
| | - Jing Du
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, China
| | - Xuhui Chen
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Qingyong Wang
- Department of Neurology, University of Chinese Academy of Sciences-Shenzhen Hospital, Shenzhen, China
| | - Ying Han
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, China; Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Tengfei Guo
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, China; Institute of Biomedical Engineering, Peking University Shenzhen Graduate School, Shenzhen, China.
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Bolton CJ, Steinbach M, Khan OA, Liu D, O'Malley J, Dumitrescu L, Peterson A, Jefferson AL, Hohman TJ, Zetterberg H, Gifford KA. Clinical and demographic factors modify the association between plasma phosphorylated tau-181 and cognition. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.03.23298051. [PMID: 37961576 PMCID: PMC10635266 DOI: 10.1101/2023.11.03.23298051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
INTRODUCTION Plasma phosphorylated tau181 (p-tau181) associations with global cognition and memory are clear, but the link between p-tau181 with other cognitive domains and subjective cognitive decline (SCD) across the clinical spectrum of Alzheimer's disease (AD) and how this association changes based on genetic and demographic factors is poorly understood. METHODS Participants were drawn from the Alzheimer's Disease Neuroimaging Initiative and included 1185 adults aged >55 years with plasma p-tau181 and neuropsychological test data. Linear regression models related plasma p-tau181 to neuropsychological composite and SCD scores with follow-up models examining plasma p-tau181 interactions with cognitive diagnosis, APOE ε4 carrier status, age, and sex on cognitive outcomes. RESULTS Higher plasma p-tau181 was associated with worse memory, executive functioning, and language abilities, and greater informant-reported SCD. Visuospatial abilities and self-report SCD were not associated with plasma p-tau181. Associations were generally stronger in MCI or dementia, APOE ε4 carriers, women, and younger participants. DISCUSSION Higher levels of plasma p-tau181 are associated with worse neuropsychological test performance across multiple cognitive domains; however, these associations vary based on disease stage, genetic risk status, age, and sex.
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Lee H, Cho S, Kim MJ, Park YJ, Cho E, Jo YS, Kim YS, Lee JY, Thoudam T, Woo SH, Lee SI, Jeon J, Lee YS, Suh BC, Yoon JH, Go Y, Lee IK, Seo J. ApoE4-dependent lysosomal cholesterol accumulation impairs mitochondrial homeostasis and oxidative phosphorylation in human astrocytes. Cell Rep 2023; 42:113183. [PMID: 37777962 DOI: 10.1016/j.celrep.2023.113183] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 08/07/2023] [Accepted: 09/13/2023] [Indexed: 10/03/2023] Open
Abstract
Recent developments in genome sequencing have expanded the knowledge of genetic factors associated with late-onset Alzheimer's disease (AD). Among them, genetic variant ε4 of the APOE gene (APOE4) confers the greatest disease risk. Dysregulated glucose metabolism is an early pathological feature of AD. Using isogenic ApoE3 and ApoE4 astrocytes derived from human induced pluripotent stem cells, we find that ApoE4 increases glycolytic activity but impairs mitochondrial respiration in astrocytes. Ultrastructural and autophagy flux analyses show that ApoE4-induced cholesterol accumulation impairs lysosome-dependent removal of damaged mitochondria. Acute treatment with cholesterol-depleting agents restores autophagic activity, mitochondrial dynamics, and associated proteomes, and extended treatment rescues mitochondrial respiration in ApoE4 astrocytes. Taken together, our study provides a direct link between ApoE4-induced lysosomal cholesterol accumulation and abnormal oxidative phosphorylation.
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Affiliation(s)
- Hyein Lee
- Department of Brain Sciences, Daegu Gyeongbuk Institute of Science & Technology, Daegu 42988, South Korea
| | - Sukhee Cho
- Department of Brain Sciences, Daegu Gyeongbuk Institute of Science & Technology, Daegu 42988, South Korea
| | - Mi-Jin Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu 41944, South Korea
| | - Yeo Jin Park
- Korean Medicine Life Science, University of Science and Technology, Daejeon 34054, South Korea; Korean Medicine-Application Center, Korea Institute of Oriental Medicine, Daegu 41062, South Korea
| | - Eunji Cho
- Neurodegenerative Disease Research Group, Korea Brain Research Institute, Daegu 41062, South Korea
| | - Yeon Suk Jo
- Department of Brain Sciences, Daegu Gyeongbuk Institute of Science & Technology, Daegu 42988, South Korea; Neurodegenerative Disease Research Group, Korea Brain Research Institute, Daegu 41062, South Korea
| | - Yong-Seok Kim
- Department of Brain Sciences, Daegu Gyeongbuk Institute of Science & Technology, Daegu 42988, South Korea
| | - Jung Yi Lee
- Leading-Edge Research Center for Drug Discovery and Development for Diabetes and Metabolic Disease, Kyungpook National University School of Medicine, Daegu 41944, South Korea
| | - Themis Thoudam
- Research Institute of Aging and Metabolism, Kyungpook National University School of Medicine, Daegu 41944, South Korea
| | - Seung-Hwa Woo
- Department of New Biology, Daegu Gyeongbuk Institute of Science & Technology, Daegu 42988, South Korea
| | - Se-In Lee
- Department of Brain Sciences, Daegu Gyeongbuk Institute of Science & Technology, Daegu 42988, South Korea
| | - Juyeong Jeon
- Department of Brain Sciences, Daegu Gyeongbuk Institute of Science & Technology, Daegu 42988, South Korea
| | - Young-Sam Lee
- Department of New Biology, Daegu Gyeongbuk Institute of Science & Technology, Daegu 42988, South Korea
| | - Byung-Chang Suh
- Department of Brain Sciences, Daegu Gyeongbuk Institute of Science & Technology, Daegu 42988, South Korea
| | - Jong Hyuk Yoon
- Neurodegenerative Disease Research Group, Korea Brain Research Institute, Daegu 41062, South Korea
| | - Younghoon Go
- Korean Medicine-Application Center, Korea Institute of Oriental Medicine, Daegu 41062, South Korea.
| | - In-Kyu Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu 41944, South Korea; Leading-Edge Research Center for Drug Discovery and Development for Diabetes and Metabolic Disease, Kyungpook National University School of Medicine, Daegu 41944, South Korea; Research Institute of Aging and Metabolism, Kyungpook National University School of Medicine, Daegu 41944, South Korea.
| | - Jinsoo Seo
- Department of Brain Sciences, Daegu Gyeongbuk Institute of Science & Technology, Daegu 42988, South Korea.
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Polsinelli AJ, Logan PE, Lane KA, Manchella MK, Nemes S, Sanjay AB, Gao S, Apostolova LG. APOE ε4 carrier status and sex differentiate rates of cognitive decline in early- and late-onset Alzheimer's disease. Alzheimers Dement 2023; 19:1983-1993. [PMID: 36394443 PMCID: PMC10182251 DOI: 10.1002/alz.12831] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/19/2022] [Accepted: 09/19/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND We studied the effect of apolipoprotein E (APOE) ε4 status and sex on rates of cognitive decline in early- (EO) and late- (LO) onset Alzheimer's disease (AD). METHOD We ran mixed-effects models with longitudinal cognitive measures as dependent variables, and sex, APOE ε4 carrier status, and interaction terms as predictor variables in 998 EOAD and 2562 LOAD participants from the National Alzheimer's Coordinating Center. RESULTS APOE ε4 carriers showed accelerated cognitive decline relative to non-carriers in both EOAD and LOAD, although the patterns of specific cognitive domains that were affected differed. Female participants showed accelerated cognitive decline relative to male participants in EOAD only. The effect of APOE ε4 was greater in EOAD for executive functioning (p < 0.0001) and greater in LOAD for language (p < 0.0001). CONCLUSION We found APOE ε4 effects on cognitive decline in both EOAD and LOAD and female sex in EOAD only. The specific patterns and magnitude of decline are distinct between the two disease variants. HIGHLIGHTS Apolipoprotein E (APOE) ε4 carrier status and sex differentiate rates of cognitive decline in early-onset (EO) and late-onset (LO) Alzheimer's disease (AD). APOE ε4 in EOAD accelerated decline in memory, executive, and processing speed domains. Female sex in EOAD accelerated decline in language, memory, and global cognition. The effect of APOE ε4 was stronger for language in LOAD and for executive function in EOAD. Sex effects on language and executive function decline differed between EOAD and LOAD.
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Affiliation(s)
- Angelina J. Polsinelli
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Indiana Alzheimer’s Disease Research Center, Indianapolis, Indiana, USA
| | - Paige E. Logan
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Indiana Alzheimer’s Disease Research Center, Indianapolis, Indiana, USA
| | - Kathleen A. Lane
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Mohit K. Manchella
- Department of Chemistry, University of Southern Indiana Evansville, Indiana, USA
| | - Sára Nemes
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - Sujuan Gao
- Indiana Alzheimer’s Disease Research Center, Indianapolis, Indiana, USA
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Liana G. Apostolova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Indiana Alzheimer’s Disease Research Center, Indianapolis, Indiana, USA
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15
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Corley J, Conte F, Harris SE, Taylor AM, Redmond P, Russ TC, Deary IJ, Cox SR. Predictors of longitudinal cognitive ageing from age 70 to 82 including APOE e4 status, early-life and lifestyle factors: the Lothian Birth Cohort 1936. Mol Psychiatry 2023; 28:1256-1271. [PMID: 36481934 PMCID: PMC10005946 DOI: 10.1038/s41380-022-01900-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022]
Abstract
Discovering why some people's cognitive abilities decline more than others is a key challenge for cognitive ageing research. The most effective strategy may be to address multiple risk factors from across the life-course simultaneously in relation to robust longitudinal cognitive data. We conducted a 12-year follow-up of 1091 (at age 70) men and women from the longitudinal Lothian Birth Cohort 1936 study. Comprehensive repeated cognitive measures of visuospatial ability, processing speed, memory, verbal ability, and a general cognitive factor were collected over five assessments (age 70, 73, 76, 79, and 82 years) and analysed using multivariate latent growth curve modelling. Fifteen life-course variables were used to predict variation in cognitive ability levels at age 70 and cognitive slopes from age 70 to 82. Only APOE e4 carrier status was found to be reliably informative of general- and domain-specific cognitive decline, despite there being many life-course correlates of cognitive level at age 70. APOE e4 carriers had significantly steeper slopes across all three fluid cognitive domains compared with non-carriers, especially for memory (β = -0.234, p < 0.001) and general cognitive function (β = -0.246, p < 0.001), denoting a widening gap in cognitive functioning with increasing age. Our findings suggest that when many other candidate predictors of cognitive ageing slope are entered en masse, their unique contributions account for relatively small proportions of variance, beyond variation in APOE e4 status. We conclude that APOE e4 status is important for identifying those at greater risk for accelerated cognitive ageing, even among ostensibly healthy individuals.
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Affiliation(s)
- Janie Corley
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK.
| | - Federica Conte
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Sarah E Harris
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Adele M Taylor
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Paul Redmond
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Tom C Russ
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Ian J Deary
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Simon R Cox
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
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16
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Liu JY, Ma LZ, Wang J, Cui XJ, Sheng ZH, Fu Y, Li M, Ou YN, Yu JT, Tan L, Lian Y. Age-Related Association Between APOE ɛ4 and Cognitive Progression in de novo Parkinson's Disease. J Alzheimers Dis 2023; 91:1121-1132. [PMID: 36565124 DOI: 10.3233/jad-220976] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND APOE ɛ4 genotype was correlated with exacerbation of pathology and higher risk of dementia in Parkinson's disease (PD). Meanwhile, the differential influence of APOE ɛ4 on cognition in young and old individuals interpreted as antagonistic pleiotropy. OBJECTIVE To examine whether the effect of APOE ɛ4 on cognitive progression in de novo PD is age dependent. METHODS In this study, 613 de novo PD patients were recruited from Parkinson's Progression Markers Initiative (PPMI). To examine the age-dependent relationship between APOE ɛ4 and cognitive changes, we added 3-way interaction of APOE ɛ4*baseline age*time to the linear mixed-effect (LME) models and evaluated the specific roles of APOE ɛ4 in the middle age group and elderly group separately. Cox regression was utilized to examine the progression of cognition in age-stratified PD participants. RESULTS Age significantly modified relationship between APOE ɛ4 and cognitive changes in most cognitive domains (pinteraction <0.05). In the elderly group, APOE ɛ4 carriers showed steeper decline in global cognition (p = 0.001) as well as in most cognitive domains, and they had a greater risk of cognitive progression (adjusted HR 1.625, 95% CI 1.143-2.310, p = 0.007), compared with non-carriers. However, in the middle age group, no significant relationships between APOE ɛ4 and cognitive decline can be detected. CONCLUSION Our results indicated that the APOE ɛ4 allele has an age-dependent effect on cognitive decline in PD patients. The underlying mechanisms need to be investigated in the future.
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Affiliation(s)
- Jia-Yao Liu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ling-Zhi Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Jun Wang
- Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China.,Department of Neurology and Center for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Xin-Jing Cui
- Department of Outpatient, Qingdao Municipal Hospital, Qingdao, China
| | - Ze-Hu Sheng
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yan Fu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Meng Li
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Ya-Nan Ou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yan Lian
- Chongqing Key Laboratory of Ageing and Brain Diseases, Chongqing, China.,Department of Prevention and Health Care, Daping Hospital, Third Military Medical University, Chongqing, China
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17
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Dang M, Yang C, Chen K, Lu P, Li H, Zhang Z. Hippocampus-centred grey matter covariance networks predict the development and reversion of mild cognitive impairment. Alzheimers Res Ther 2023; 15:27. [PMID: 36732782 PMCID: PMC9893696 DOI: 10.1186/s13195-023-01167-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/09/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Mild cognitive impairment (MCI) has been thought of as the transitional stage between normal ageing and Alzheimer's disease, involving substantial changes in brain grey matter structures. As most previous studies have focused on single regions (e.g. the hippocampus) and their changes during MCI development and reversion, the relationship between grey matter covariance among distributed brain regions and clinical development and reversion of MCI remains unclear. METHODS With samples from two independent studies (155 from the Beijing Aging Brain Rejuvenation Initiative and 286 from the Alzheimer's Disease Neuroimaging Initiative), grey matter covariance of default, frontoparietal, and hippocampal networks were identified by seed-based partial least square analyses, and random forest models were applied to predict the progression from normal cognition to MCI (N-t-M) and the reversion from MCI to normal cognition (M-t-N). RESULTS With varying degrees, the grey matter covariance in the three networks could predict N-t-M progression (AUC = 0.692-0.792) and M-t-N reversion (AUC = 0.701-0.809). Further analyses indicated that the hippocampus has emerged as an important region in reversion prediction within all three brain networks, and even though the hippocampus itself could predict the clinical reversion of M-t-N, the grey matter covariance showed higher prediction accuracy for early progression of N-t-M. CONCLUSIONS Our findings are the first to report grey matter covariance changes in MCI development and reversion and highlight the necessity of including grey matter covariance changes along with hippocampal degeneration in the early detection of MCI and Alzheimer's disease.
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Affiliation(s)
- Mingxi Dang
- grid.20513.350000 0004 1789 9964State Key Laboratory of Cognitive Neuroscience and Learning, Faculty of Psychology, Beijing Normal University, Beijing, 100875 China
| | - Caishui Yang
- grid.20513.350000 0004 1789 9964State Key Laboratory of Cognitive Neuroscience and Learning, Faculty of Psychology, Beijing Normal University, Beijing, 100875 China ,grid.20513.350000 0004 1789 9964School of Systems Science, Beijing Normal University, Beijing, 100875 China
| | - Kewei Chen
- grid.418204.b0000 0004 0406 4925Banner Alzheimer’s Institute, Phoenix, AZ 85006 USA
| | - Peng Lu
- grid.20513.350000 0004 1789 9964State Key Laboratory of Cognitive Neuroscience and Learning, Faculty of Psychology, Beijing Normal University, Beijing, 100875 China
| | - He Li
- grid.410318.f0000 0004 0632 3409Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700 China
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Faculty of Psychology, Beijing Normal University, Beijing, 100875, China.
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18
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James SN, Nicholas JM, Lu K, Keshavan A, Lane CA, Parker T, Buchanan SM, Keuss SE, Murray-Smith H, Wong A, Cash DM, Malone IB, Barnes J, Sudre CH, Coath W, Modat M, Ourselin S, Crutch SJ, Kuh D, Fox NC, Schott JM, Richards M. Adulthood cognitive trajectories over 26 years and brain health at 70 years of age: findings from the 1946 British Birth Cohort. Neurobiol Aging 2023; 122:22-32. [PMID: 36470133 PMCID: PMC10564626 DOI: 10.1016/j.neurobiolaging.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
Few studies can address how adulthood cognitive trajectories relate to brain health in 70-year-olds. Participants (n = 468, 49% female) from the 1946 British birth cohort underwent 18F-Florbetapir PET/MRI. Cognitive function was measured in childhood (age 8 years) and across adulthood (ages 43, 53, 60-64 and 69 years) and was examined in relation to brain health markers of β-amyloid (Aβ) status, whole brain and hippocampal volume, and white matter hyperintensity volume (WMHV). Taking into account key contributors of adult cognitive decline including childhood cognition, those with greater Aβ and WMHV at age 70 years had greater decline in word-list learning memory in the preceding 26 years, particularly after age 60. In contrast, those with smaller whole brain and hippocampal volume at age 70 years had greater decline in processing search speed, subtly manifest from age 50 years. Subtle changes in memory and processing speed spanning 26 years of adulthood were associated with markers of brain health at 70 years of age, consistent with detectable prodromal cognitive effects in early older age.
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Affiliation(s)
- Sarah-Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK.
| | - Jennifer M Nicholas
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Kirsty Lu
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Ashvini Keshavan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Christopher A Lane
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Thomas Parker
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, UK; Department of Medicine, Division of Brain Sciences, Imperial College London
| | - Sarah M Buchanan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah E Keuss
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Heidi Murray-Smith
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - David M Cash
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; UK Dementia Research Institute at UCL, University College London, London, UK
| | - Ian B Malone
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Josephine Barnes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Carole H Sudre
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - William Coath
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Marc Modat
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Sebastien Ourselin
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; UK Dementia Research Institute at UCL, University College London, London, UK
| | - Jonathan M Schott
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK; Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; UK Dementia Research Institute at UCL, University College London, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
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19
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Dunn PJ, Lea RA, Maksemous N, Smith RA, Sutherland HG, Haupt LM, Griffiths LR. Investigating a Genetic Link Between Alzheimer's Disease and CADASIL-Related Cerebral Small Vessel Disease. Mol Neurobiol 2022; 59:7293-7302. [PMID: 36175824 PMCID: PMC9616771 DOI: 10.1007/s12035-022-03039-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/19/2022] [Indexed: 10/14/2022]
Abstract
Monogenic forms of Alzheimer's disease (AD) have been identified through mutations in genes such as APP, PSEN1, and PSEN2, whilst other genetic markers such as the APOE ε carrier allele status have been shown to increase the likelihood of having the disease. Mutations in these genes are not limited to AD, as APP mutations can also cause an amyloid form of cerebral small vessel disease (CSVD) known as cerebral amyloid angiopathy, whilst PSEN1 and PSEN2 are involved in NOTCH3 signalling, a process known to be dysregulated in the monogenic CSVD, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). The overlap between AD genes and causes of CSVD led to the hypothesis that mutations in other genes within the PANTHER AD-presenilin pathway may be novel causes of CSVD in a cohort of clinically suspicious CADASIL patients without a pathogenic NOTCH3 mutation. To investigate this, whole exome sequencing was performed on 50 suspected CADASIL patients with no NOTCH3 mutations, and a targeted gene analysis was completed on the PANTHER. ERN1 was identified as a novel candidate CSVD gene following predicted pathogenic gene mutation analysis. Rare variant burden testing failed to identify an association with any gene; however, it did show a nominally significant link with ERN1 and TRPC3. This study provides evidence to support a genetic overlap between CSVD and Alzheimer's disease.
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Affiliation(s)
- Paul J Dunn
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia.,Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia
| | - Rodney A Lea
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
| | - Neven Maksemous
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
| | - Robert A Smith
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
| | - Heidi G Sutherland
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
| | - Larisa M Haupt
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia
| | - Lyn R Griffiths
- Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology (QUT), 60 Musk Ave, Kelvin Grove, QLD, 4059, Australia.
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20
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Richards M. The Power of Birth Cohorts to Study Risk Factors for Cognitive Impairment. Curr Neurol Neurosci Rep 2022; 22:847-854. [PMID: 36350423 PMCID: PMC9643995 DOI: 10.1007/s11910-022-01244-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE OF REVIEW Birth cohorts are studies of people the same time; some of which have continuously followed participants across the life course. These are powerful designs for studying predictors of age-related outcomes, especially when information on predictors is collected before these outcomes are known. This article reviews recent findings from these cohorts for the outcomes of cognitive function, cognitive impairment, and risk of dementia, in relation to prior cognitive function, and social and biological predictors. RECENT FINDINGS Cognitive function and impairment are predicted by a wide range of factors, including childhood cognition, education, occupational status and complexity, and biological factors, including genetic and epigenetic. The particular importance of high and rising blood pressure in midlife is highlighted, with some insight into brain mechanisms involved. Some limitations are noted, including sources of bias in the data. Despite these limitations, birth cohorts have provided valuable insights into factors across the life course associated with cognitive impairment.
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Affiliation(s)
- Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
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21
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Cardiorespiratory fitness decreases the odds for subclinical carotid plaques in apolipoprotein e4 homozygotes. Sci Rep 2022; 12:19196. [PMID: 36357490 PMCID: PMC9649711 DOI: 10.1038/s41598-022-23075-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
Some studies suggest that being an apolipoprotein e4 (APOE e4) carrier increases the risk of atherosclerosis, and others suggest that cardiorespiratory fitness (CRF) could play a key role in atherosclerotic prevention. Our aim was to analyze the association of APOE e4 with carotid atherosclerosis and the association of CRF with atherosclerosis in APOE e4 carriers. A cross-sectional analysis based on a subsample of 90 participants in the Aragon Workers' Health Study was carried out. Ultrasonography was used to assess the presence of plaques in carotid territory; the submaximal Chester Step Test was used to assess CRF; and behavioral, demographic, anthropometric, and clinical data were obtained by trained personnel during annual medical examinations. APOE e4e4 participants were categorized into Low-CRF (VO2max < 35 mL/kg/min) and High-CRF (VO2max ≥ 35 mL/kg/min) groups. After adjusting for several confounders, compared with APOE e3e3, those participants genotyped as APOE e3e4 and APOE e4e4 showed an OR = 1.60 (95% CI 0.45, 5.71) and OR = 4.29 (95% CI 1.16, 15.91), respectively, for carotid atherosclerosis. Compared to Low-CRF APOE e4e4 carriers, the odds of carotid plaque detection were 0.09 (95% CI 0.008, 0.98) times lower among High-CRF APOE e4e4 carriers. The APOE e4e4 genotype was associated with increased carotid atherosclerosis. However, CRF is a modifiable factor that may be targeted by APOE e4e4 to decrease the elevation of atherosclerotic risk due to this genetic condition.
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22
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Ebright B, Assante I, Poblete RA, Wang S, Duro MV, Bennett DA, Arvanitakis Z, Louie SG, Yassine HN. Eicosanoid lipidome activation in post-mortem brain tissues of individuals with APOE4 and Alzheimer's dementia. Alzheimers Res Ther 2022; 14:152. [PMID: 36217192 PMCID: PMC9552454 DOI: 10.1186/s13195-022-01084-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 09/16/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Chronic neuroinflammation is one of the hallmarks of late-onset Alzheimer's disease (AD) dementia pathogenesis. Carrying the apolipoprotein ε4 (APOE4) allele has been associated with an accentuated response to brain inflammation and increases the risk of AD dementia progression. Among inflammation signaling pathways, aberrant eicosanoid activation plays a prominent role in neurodegeneration. METHODS Using brains from the Religious Order Study (ROS), this study compared measures of brain eicosanoid lipidome in older persons with AD dementia to age-matched controls with no cognitive impairment (NCI), stratified by APOE genotype. RESULTS Lipidomic analysis of the dorsolateral prefrontal cortex demonstrated lower levels of omega-3 fatty acids eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and DHA-derived neuroprotectin D1 (NPD-1) in persons with AD dementia, all of which associated with lower measures of cognitive function. A significant interaction was observed between carrying the APOE4 allele and higher levels of both pro-inflammatory lipids and pro-resolving eicosanoid lipids on measures of cognitive performance and on neuritic plaque burden. Furthermore, analysis of lipid metabolism pathways implicated activation of calcium-dependent phospholipase A2 (cPLA2), 5-lipoxygenase (5-LOX), and soluble epoxide hydrolase (sEH) enzymes. CONCLUSION These findings implicate activation of the eicosanoid lipidome in the chronic unresolved state of inflammation in AD dementia, which is increased in carriers of the APOE4 allele, and identify potential therapeutic targets for resolving this chronic inflammatory state.
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Affiliation(s)
- Brandon Ebright
- School of Pharmacy, University of Southern California, Los Angeles, USA
| | - Isaac Assante
- School of Pharmacy, University of Southern California, Los Angeles, USA
- Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Roy A Poblete
- Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Shaowei Wang
- Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Marlon V Duro
- Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Zoe Arvanitakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Stan G Louie
- School of Pharmacy, University of Southern California, Los Angeles, USA.
- Keck School of Medicine, University of Southern California, Los Angeles, USA.
| | - Hussein N Yassine
- Keck School of Medicine, University of Southern California, Los Angeles, USA.
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23
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Almeida-Meza P, Richards M, Cadar D. Moderating Role of Cognitive Reserve Markers Between Childhood Cognition and Cognitive Aging: Evidence From the 1946 British Birth Cohort. Neurology 2022; 99:e1239-e1250. [PMID: 35922143 PMCID: PMC9576292 DOI: 10.1212/wnl.0000000000200928] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 05/19/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES As the population ages, differences in cognitive abilities become more evident. We investigated key genetic and life course influences on cognitive state at age 69 years, building on previous work using the longitudinal Medical Research Council National Survey of Health and Development (the British 1946 birth cohort). METHODS Multivariable regressions investigated the association between 4 factors: (1) childhood cognition at age 8 years; (2) a Cognitive Reserve Index (CRI) composed of 3 markers: (i) educational attainment by age 26 years, (ii) engagement in leisure activities at age 43 years, and (iii) occupation up to age 53 years; (3) reading ability assessed by the National Adult Reading Test (NART) at age 53 years; and (4) APOE genotype in relation to cognitive state measured at age 69 years with Addenbrooke's Cognitive Examination, third edition (ACE-III). We then investigated the modifying role of the CRI, NART, and APOE in the association between childhood cognition and the ACE-III. RESULTS The analytical sample comprised 1,184 participants. Higher scores in childhood cognition, CRI, and NART were associated with higher scores in the ACE-III. We found that the CRI and NART modified the association between childhood cognition and the ACE-III: for 30 additional points in the CRI or 20 additional points in the NART, the simple slope of childhood cognition decreased by approximately 0.10 points (CRI = 70: marginal effects (MEs) 0.22, 95% CI 0.12-0.32, p < 0.001 vs CRI = 100: MEs 0.12, 95% CI 0.06-0.17, p < 0.001; NART = 15: MEs 0.22, 95% CI 0.09-0.35, p = 0.001, vs NART = 35: MEs 0.11, 95% CI 0.05-0.17, p < 0.001). The association between childhood cognition and the ACE-III was nonsignificant at high levels of the CRI or NART. Furthermore, the e4 allele of the APOE gene was associated with lower scores in the ACE-III (β = -0.71, 95% CI -1.36 to -0.06, p = 0.03) but did not modify the association between childhood cognition and cognitive state in later life. DISCUSSION The CRI and NART are independent measures of cognitive reserve because both modify the association between childhood cognition and cognitive state.
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Affiliation(s)
- Pamela Almeida-Meza
- From the Department of Behavioural Science and Health (P.A.-M., D.C.), University College London; MRC Unit for Lifelong Health and Ageing, University College London; and Centre for Dementia Studies (D.C.), Department of Neuroscience, Brighton and Sussex Medical School, UK.
| | - Marcus Richards
- From the Department of Behavioural Science and Health (P.A.-M., D.C.), University College London; MRC Unit for Lifelong Health and Ageing, University College London; and Centre for Dementia Studies (D.C.), Department of Neuroscience, Brighton and Sussex Medical School, UK
| | - Dorina Cadar
- From the Department of Behavioural Science and Health (P.A.-M., D.C.), University College London; MRC Unit for Lifelong Health and Ageing, University College London; and Centre for Dementia Studies (D.C.), Department of Neuroscience, Brighton and Sussex Medical School, UK
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Hostettler IC, Seiffge D, Wong A, Ambler G, Wilson D, Shakeshaft C, Banerjee G, Sharma N, Jäger HR, Cohen H, Yousry TA, Al-Shahi Salman R, Lip GYH, Brown MM, Muir K, Houlden H, Werring DJ. APOE and Cerebral Small Vessel Disease Markers in Patients With Intracerebral Hemorrhage. Neurology 2022; 99:e1290-e1298. [PMID: 36123141 PMCID: PMC9576291 DOI: 10.1212/wnl.0000000000200851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/28/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVE We investigated the associations between the APOE genotype, intracerebral hemorrhage (ICH), and neuroimaging markers of cerebral amyloid angiopathy (CAA). METHODS We included patients from a prospective, multicenter UK observational cohort study of patients with ICH and representative UK population controls. First, we assessed the association of the APOE genotype with ICH (compared with controls without ICH). Second, among patients with ICH, we assessed the association of APOE status with the hematoma location (lobar or deep) and brain CT markers of CAA (finger-like projections [FLP] and subarachnoid extension [SAE]). RESULTS We included 907 patients with ICH and 2,636 controls. The mean age was 73.2 (12.4 SD) years for ICH cases vs 69.6 (0.2 SD) for population controls; 50.3% of cases and 42.1% of controls were female. Compared with controls, any APOE ε2 allele was associated with all ICH (lobar and nonlobar) and lobar ICH on its own in the dominant model (OR 1.38, 95% CI 1.13-1.7, p = 0.002 and OR 1.50, 95% CI 1.1-2.04, p = 0.01, respectively) but not deep ICH in an age-adjusted analyses (OR 1.26, 95% CI 0.97-1.63, p = 0.08). In the cases-only analysis, the APOE ε4 allele was associated with lobar compared with deep ICH in an age-adjusted analyses (OR 1.56, 95% CI 1.1-2.2, p = 0.01). When assessing CAA markers, APOE alleles were independently associated with FLP (ε4: OR 1.74, 95% CI 1.04-2.93, p = 0.04 and ε2/ε4: 2.56, 95% CI 0.99-6.61, p = 0.05). We did not find an association between APOE alleles and SAE. DISCUSSION We confirmed associations between APOE alleles and ICH including lobar ICH. Our analysis shows selective associations between APOE ε2 and ε4 alleles with FLP, a CT marker of CAA. Our findings suggest that different APOE alleles might have diverging influences on individual neuroimaging biomarkers of CAA-associated ICH.
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Affiliation(s)
- Isabel Charlotte Hostettler
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - David Seiffge
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Andrew Wong
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Gareth Ambler
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Duncan Wilson
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Clare Shakeshaft
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Gargi Banerjee
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Nikhil Sharma
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Hans Rolf Jäger
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Hannah Cohen
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Tarek A Yousry
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Rustam Al-Shahi Salman
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Gregory Y H Lip
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Martin M Brown
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Keith Muir
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - Henry Houlden
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK
| | - David J Werring
- From the Stroke Research Centre (I.C.H., D.S., Duncan Wilson, C.S., G.B., M.M.B., David Werring), University College London, Institute of Neurology; Neurogenetics Laboratory (I.C.H., H.H.), The National Hospital of Neurology and Neurosurgery, London, UK; Department of Neurosurgery (I.C.H.), Cantonal Hospital St. Gallen, Switzerland; Stroke Centre (D.S.), Department of Neurology and Department of Clinical Research, University of Basel and University Hospital Basel; Department of Neurology and Stroke Centre (D.S.), University Hospital Berne; MRC Unit for Lifelong Health and Ageing at UCL (A.W.), London; Department of Statistical Science (G.A.), UCL, London; Department of Clinical and Movement Neuroscience (N.S.), Institute of Neurology, London; Neuroradiological Academic Unit (H.R.J., T.A.Y.), Department of Brain Repair & Rehabilitation, University College London, Institute of Neurology; Haemostasis Research Unit (H.C.), Department of Haematology, University College London; Centre for Clinical Brain Sciences (R.A.-S.S.), School of Clinical Sciences, University of Edinburgh; Liverpool Centre for Cardiovascular Science (G.Y.H.L.), University of Liverpool and Liverpool Heart & Chest Hospital; Department of Clinical Medicine (G.Y.H.L.), Aalborg University, Denmark; and Institute of Neuroscience & Psychology (K.M.), University of Glasgow, Queen Elizabeth University Hospital, UK.
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Keuss SE, Coath W, Nicholas JM, Poole T, Barnes J, Cash DM, Lane CA, Parker TD, Keshavan A, Buchanan SM, Wagen AZ, Storey M, Harris M, Malone IB, Sudre CH, Lu K, James SN, Street R, Thomas DL, Dickson JC, Murray-Smith H, Wong A, Freiberger T, Crutch S, Richards M, Fox NC, Schott JM. Associations of β-Amyloid and Vascular Burden With Rates of Neurodegeneration in Cognitively Normal Members of the 1946 British Birth Cohort. Neurology 2022; 99:e129-e141. [PMID: 35410910 PMCID: PMC9280996 DOI: 10.1212/wnl.0000000000200524] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 03/01/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The goals of this work were to quantify the independent and interactive associations of β-amyloid (Aβ) and white matter hyperintensity volume (WMHV), a marker of presumed cerebrovascular disease (CVD), with rates of neurodegeneration and to examine the contributions of APOE ε4 and vascular risk measured at different stages of adulthood in cognitively normal members of the 1946 British Birth Cohort. METHODS Participants underwent brain MRI and florbetapir-Aβ PET as part of Insight 46, an observational population-based study. Changes in whole-brain, ventricular, and hippocampal volume were directly measured from baseline and repeat volumetric T1 MRI with the boundary shift integral. Linear regression was used to test associations with baseline Aβ deposition, baseline WMHV, APOE ε4, and office-based Framingham Heart Study Cardiovascular Risk Score (FHS-CVS) and systolic blood pressure (BP) at ages 36, 53, and 69 years. RESULTS Three hundred forty-six cognitively normal participants (mean [SD] age at baseline scan 70.5 [0.6] years; 48% female) had high-quality T1 MRI data from both time points (mean [SD] scan interval 2.4 [0.2] years). Being Aβ positive at baseline was associated with 0.87-mL/y faster whole-brain atrophy (95% CI 0.03, 1.72), 0.39-mL/y greater ventricular expansion (95% CI 0.16, 0.64), and 0.016-mL/y faster hippocampal atrophy (95% CI 0.004, 0.027), while each 10-mL additional WMHV at baseline was associated with 1.07-mL/y faster whole-brain atrophy (95% CI 0.47, 1.67), 0.31-mL/y greater ventricular expansion (95% CI 0.13, 0.60), and 0.014-mL/y faster hippocampal atrophy (95% CI 0.006, 0.022). These contributions were independent, and there was no evidence that Aβ and WMHV interacted in their effects. There were no independent associations of APOE ε4 with rates of neurodegeneration after adjustment for Aβ status and WMHV, no clear relationships between FHS-CVS or systolic BP and rates of neurodegeneration when assessed across the whole sample, and no evidence that FHS-CVS or systolic BP acted synergistically with Aβ. DISCUSSION Aβ and presumed CVD have distinct and additive effects on rates of neurodegeneration in cognitively normal elderly. These findings have implications for the use of MRI measures as biomarkers of neurodegeneration and emphasize the importance of risk management and early intervention targeting both pathways.
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Affiliation(s)
- Sarah E Keuss
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - William Coath
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Jennifer M Nicholas
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Teresa Poole
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Josephine Barnes
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - David M Cash
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Christopher A Lane
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Thomas D Parker
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Ashvini Keshavan
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Sarah M Buchanan
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Aaron Z Wagen
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Mathew Storey
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Matthew Harris
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Ian B Malone
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Carole H Sudre
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Kirsty Lu
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Sarah-Naomi James
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Rebecca Street
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - David L Thomas
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - John C Dickson
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Heidi Murray-Smith
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Andrew Wong
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Tamar Freiberger
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Sebastian Crutch
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Marcus Richards
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Nick C Fox
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK
| | - Jonathan M Schott
- From the Dementia Research Centre (S.E.K., W.C., J.M.N., T.P., J.B., D.M.C., C.A.L., A.K. S.M.B., A.Z.W., M.S., M.H., I.B.M., C.H.S., K.L., R.S., H.M.-S, T.F., S.C., N.C.F., J.M.S.), Dementia Research Institute (D.M.C., N.C.F.), Leonard Wolfson Experimental Neurology Centre (D.L.T.), and Department of Brain Repair and Neurorehabilitation (D.L.T.), UCL Queen Square Institute of Neurology; Department of Medical Statistics (J.M.N., T.P.), London School of Hygiene and Tropical Medicine; 4. Department of Medicine (T.D.P.), Division of Brain Sciences, Imperial College London; MRC Unit for Lifelong Health and Ageing at UCL (C.H.S., S.-N.J., A.W., M.R.); Centre for Medical Image Computing (C.H.S.), University College London; School of Biomedical Engineering & Imaging Sciences (C.H.S.), King's College London; and Institute of Nuclear Medicine (J.C.D.), University College London Hospitals, UK.
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Mai Y, Cao Z, Xu J, Yu Q, Yang S, Tang J, Zhao L, Fang W, Luo Y, Lei M, Mok VCT, Shi L, Liao W, Liu J. AD Resemblance Atrophy Index of Brain Magnetic Resonance Imaging in Predicting the Progression of Mild Cognitive Impairment Carrying Apolipoprotein E-ε4 Allele. Front Aging Neurosci 2022; 14:859492. [PMID: 35572149 PMCID: PMC9097868 DOI: 10.3389/fnagi.2022.859492] [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: 01/21/2022] [Accepted: 03/23/2022] [Indexed: 01/03/2023] Open
Abstract
Background and Objective Early identification is important for timely Alzheimer’s disease (AD) treatment. Apolipoprotein E ε4 allele (APOE-ε4) is an important genetic risk factor for sporadic AD. The AD-Resemblance Atrophy Index (RAI)—a structural magnetic resonance imaging-derived composite index—was found to predict the risk of progression from mild cognitive impairment (MCI) to AD. Therefore, we investigated whether the AD-RAI can predict cognitive decline and progression to AD in patients with MCI carrying APOE ε4. Methods We included 733 participants with MCI from the Alzheimer’s Disease Neuroimaging Initiative Database (ADNI). Their APOE genotypes, cognitive performance, and levels of AD-RAI were assessed at baseline and follow-up. Linear regression models were used to test the correlations between the AD-RAI and baseline cognitive measures, and linear mixed models with random intercepts and slopes were applied to investigate whether AD-RAI and APOE-ε4 can predict the level of cognitive decline. Cox proportional risk regression models were used to test the association of AD-RAI and APOE status with the progression from MCI to AD. Results The baseline AD-RAI was higher in the MCI converted to AD group than in the MCI stable group (P < 0.001). The AD-RAI was significantly correlated with cognition, and had a synergistic effect with APOE-ε4 to predict the rate of cognitive decline. The AD-RAI predicted the risk and timing of MCI progression to AD. Based on the MCI population carrying APOE-ε4, the median time to progression from MCI to AD was 24 months if the AD-RAI > 0.5, while the median time to progression from MCI to AD was 96 months for patients with an AD-RAI ≤ 0.5. Conclusion The AD-RAI can predict the risk of progression to AD in people with MCI carrying APOE ε4, is strongly correlated with cognition, and can predict cognitive decline.
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Affiliation(s)
- Yingren Mai
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhiyu Cao
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiaxin Xu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qun Yu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shaoqing Yang
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jingyi Tang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lei Zhao
- BrainNow Research Institute, Shenzhen, China
- BrainNow Medical Technology Limited, Shenzhen, China
| | - Wenli Fang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yishan Luo
- BrainNow Research Institute, Shenzhen, China
- BrainNow Medical Technology Limited, Shenzhen, China
| | - Ming Lei
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Vincent C. T. Mok
- BrainNow Research Institute, Shenzhen, China
- BrainNow Medical Technology Limited, Shenzhen, China
- Division of Neurology, Department of Medicine and Therapeutics, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Lin Shi
- BrainNow Research Institute, Shenzhen, China
- BrainNow Medical Technology Limited, Shenzhen, China
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Wang Liao
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- *Correspondence: Wang Liao,
| | - Jun Liu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- *Correspondence: Wang Liao,
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27
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Zimmerman SC, Brenowitz WD, Calmasini C, Ackley SF, Graff RE, Asiimwe SB, Staffaroni AM, Hoffmann TJ, Glymour MM. Association of Genetic Variants Linked to Late-Onset Alzheimer Disease With Cognitive Test Performance by Midlife. JAMA Netw Open 2022; 5:e225491. [PMID: 35377426 PMCID: PMC8980909 DOI: 10.1001/jamanetworkopen.2022.5491] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
IMPORTANCE Identifying the youngest age when Alzheimer disease (AD) influences cognition and the earliest affected cognitive domains will improve understanding of the natural history of AD and approaches to early diagnosis. OBJECTIVE To evaluate the age at which cognitive differences between individuals with higher compared with lower genetic risk of AD are first apparent and which cognitive assessments show the earliest difference. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from UK Biobank participants of European genetic ancestry, aged 40 years or older, who contributed genotypic and cognitive test data from January 1, 2006, to December 31, 2015. Data analysis was performed from March 10, 2020, to January 4, 2022. EXPOSURE The AD genetic risk score (GRS), which is a weighted sum of 23 single-nucleotide variations. MAIN OUTCOMES AND MEASURES Seven cognitive tests were administered via touchscreen at in-person visits or online. Cognitive domains assessed included fluid intelligence, episodic memory, processing speed, executive functioning, and prospective memory. Multiple cognitive measures were derived from some tests, yielding 32 separate measures. Interactions between age and AD-GRS for each of the 32 cognitive measures were tested with linear regression using a Bonferroni-corrected P value threshold. For cognitive measures with significant evidence of age by AD-GRS interaction, the youngest age of interaction was assessed with new regression models, with nonlinear specification of age terms. Models with youngest age of interaction from 40 to 70 years, in 1-year increments, were compared, and the best-fitting model for each cognitive measure was chosen. Results across cognitive measures were compared to determine which cognitive indicators showed earliest AD-related change. RESULTS A total of 405 050 participants (mean [SD] age, 57.1 [7.9] years; 54.1% female) were included. Sample sizes differed across cognitive tests (from 12 455 to 404 682 participants). The AD-GRS significantly modified the association with age on 13 measures derived from the pairs matching (range in difference in mean cognition per decade increase in age for 1-SD higher AD-GRS, 2.5%-11.5%), symbol digit substitution (range in difference in mean cognition per decade increase in age for 1-SD higher AD-GRS, 2.0%-5.8%), and numeric memory tests (difference in mean cognition per decade increase in age for 1-SD higher AD-GRS, 8.8%) (P = 1.56 × 10-3). Best-fitting models suggested that cognitive scores of individuals with a high vs low AD-GRS began to diverge by 56 years of age for all 13 measures and by 47 years of age for 9 measures. CONCLUSIONS AND RELEVANCE In this cross-sectional study, by early midlife, subtle differences in memory and attention were detectable among individuals with higher genetic risk of AD.
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Affiliation(s)
- Scott C. Zimmerman
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Willa D. Brenowitz
- Department of Epidemiology and Biostatistics, University of California, San Francisco
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | - Camilla Calmasini
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Sarah F. Ackley
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Rebecca E. Graff
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Stephen B. Asiimwe
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Adam M. Staffaroni
- Weill Institute for Neurosciences, Department of Neurology, Memory and Aging Center, University of California, San Francisco
| | - Thomas J. Hoffmann
- Department of Epidemiology and Biostatistics, University of California, San Francisco
- Institute for Human Genetics, University of California, San Francisco
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco
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28
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Regy M, Dugravot A, Sabia S, Fayosse A, Mangin JF, Chupin M, Fischer C, Bouteloup V, Dufouil C, Chêne G, Paquet C, Hanseeuw B, Singh-Manoux A, Dumurgier J. Association of APOE ε4 with cerebral gray matter volumes in non-demented older adults: the MEMENTO cohort study. Neuroimage 2022; 250:118966. [PMID: 35122970 DOI: 10.1016/j.neuroimage.2022.118966] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/24/2022] [Accepted: 02/01/2022] [Indexed: 10/19/2022] Open
Abstract
Data on 2,045 non-demented individuals with memory complaints were drawn from the Memento cohort study to examine the association between Apolipoprotein E ε4 allele (APOE4) and regional brain gray matter volumes. Linear regression was used to examine the association of APOE4 and measures of regional gray matter volumes in cross-sectional analysis and change therein using longitudinal analyses based on two brain MRI performed at baseline and at two-year follow-up. Overall, in analyses adjusted for age, sex, and intracranial volume, the presence of APOE4 was associated with lower total gray matter volume at baseline and with a higher atrophy rate over the follow-up. The hippocampus and entorhinal cortex were the two gray matter regions most associated with APOE4. Further adjustment for cardiovascular risk factors had little impact on these associations. There was an interaction between age, APOE4 status and total brain volume atrophy rate, with evidence of an earlier age at onset of atrophy in hippocampal volume in APOE4 carriers compared to non-carriers. Those results are in accordance with the role of medial temporal structures in the greater risk of dementia observed in people carrying the APOE4 allele.
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Affiliation(s)
- Melina Regy
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France; Université catholique de Louvain, Louvain, Belgium.
| | - Aline Dugravot
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Séverine Sabia
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France; University College London, Department of Epidemiology and Public Health, London, United Kingdom
| | - Aurore Fayosse
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France
| | - Jean-Francois Mangin
- Université Paris-Saclay, CEA, CNRS, CATI, NeuroSpin, Baobab, Gif sur Yvette, France
| | - Marie Chupin
- Université Paris-Saclay, CEA, CNRS, CATI, NeuroSpin, Baobab, Gif sur Yvette, France
| | - Clara Fischer
- Université Paris-Saclay, CEA, CNRS, CATI, NeuroSpin, Baobab, Gif sur Yvette, France
| | - Vincent Bouteloup
- Université de Bordeaux, Bordeaux, France; Pôle de Santé publique Centre Hospitalier Universitaire de Bordeaux, Inserm, UMR 1219, Inserm, CIC1401-EC, Bordeaux, France
| | - Carole Dufouil
- Université de Bordeaux, Bordeaux, France; Pôle de Santé publique Centre Hospitalier Universitaire de Bordeaux, Inserm, UMR 1219, Inserm, CIC1401-EC, Bordeaux, France
| | - Geneviève Chêne
- Université de Bordeaux, Bordeaux, France; Pôle de Santé publique Centre Hospitalier Universitaire de Bordeaux, Inserm, UMR 1219, Inserm, CIC1401-EC, Bordeaux, France
| | - Claire Paquet
- GHU APHP Nord Université de Paris Lariboisiere - Fernand Widal Paris, France; Université de Paris, INSERMU1144, Paris France
| | - Bernard Hanseeuw
- Université catholique de Louvain, Louvain, Belgium; Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Archana Singh-Manoux
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France; University College London, Department of Epidemiology and Public Health, London, United Kingdom
| | - Julien Dumurgier
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseases, Paris, France; GHU APHP Nord Université de Paris Lariboisiere - Fernand Widal Paris, France
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29
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Clouston SAP, Hall CB, Kritikos M, Bennett DA, DeKosky S, Edwards J, Finch C, Kreisl WC, Mielke M, Peskind ER, Raskind M, Richards M, Sloan RP, Spiro A, Vasdev N, Brackbill R, Farfel M, Horton M, Lowe S, Lucchini RG, Prezant D, Reibman J, Rosen R, Seil K, Zeig-Owens R, Deri Y, Diminich ED, Fausto BA, Gandy S, Sano M, Bromet EJ, Luft BJ. Cognitive impairment and World Trade Centre-related exposures. Nat Rev Neurol 2022; 18:103-116. [PMID: 34795448 PMCID: PMC8938977 DOI: 10.1038/s41582-021-00576-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 02/03/2023]
Abstract
On 11 September 2001 the World Trade Center (WTC) in New York was attacked by terrorists, causing the collapse of multiple buildings including the iconic 110-story 'Twin Towers'. Thousands of people died that day from the collapse of the buildings, fires, falling from the buildings, falling debris, or other related accidents. Survivors of the attacks, those who worked in search and rescue during and after the buildings collapsed, and those working in recovery and clean-up operations were exposed to severe psychological stressors. Concurrently, these 'WTC-affected' individuals breathed and ingested a mixture of organic and particulate neurotoxins and pro-inflammogens generated as a result of the attack and building collapse. Twenty years later, researchers have documented neurocognitive and motor dysfunctions that resemble the typical features of neurodegenerative disease in some WTC responders at midlife. Cortical atrophy, which usually manifests later in life, has also been observed in this population. Evidence indicates that neurocognitive symptoms and corresponding brain atrophy are associated with both physical exposures at the WTC and chronic post-traumatic stress disorder, including regularly re-experiencing traumatic memories of the events while awake or during sleep. Despite these findings, little is understood about the long-term effects of these physical and mental exposures on the brain health of WTC-affected individuals, and the potential for neurocognitive disorders. Here, we review the existing evidence concerning neurological outcomes in WTC-affected individuals, with the aim of contextualizing this research for policymakers, researchers and clinicians and educating WTC-affected individuals and their friends and families. We conclude by providing a rationale and recommendations for monitoring the neurological health of WTC-affected individuals.
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Affiliation(s)
- Sean A P Clouston
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
| | - Charles B Hall
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Minos Kritikos
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Department of Neurological Sciences, Rush Medical College, Rush University, Chicago, IL, USA
| | - Steven DeKosky
- Evelyn F. and William L. McKnight Brain Institute and Florida Alzheimer's Disease Research Center, Department of Neurology and Neuroscience, University of Florida, Gainesville, FL, USA
| | - Jerri Edwards
- Department of Psychiatry and Behavioral Neuroscience, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Caleb Finch
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - William C Kreisl
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University, New York, NY, USA
| | - Michelle Mielke
- Specialized Center of Research Excellence on Sex Differences, Department of Neurology, Department of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Elaine R Peskind
- Veteran's Association VISN 20 Northwest Mental Illness Research, Education, and Clinical Center, Veteran's Affairs Puget Sound Health Care System, Seattle, WA, USA
- Alzheimer's Disease Research Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Murray Raskind
- Veteran's Association VISN 20 Northwest Mental Illness Research, Education, and Clinical Center, Veteran's Affairs Puget Sound Health Care System, Seattle, WA, USA
- Alzheimer's Disease Research Center, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Marcus Richards
- Medical Research Council Unit for Lifelong Health and Ageing, Population Health Sciences, University College London, London, UK
| | - Richard P Sloan
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Avron Spiro
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Department of Veterans Affairs Boston Healthcare System, Boston, MA, USA
| | - Neil Vasdev
- Azrieli Centre for Neuro-Radiochemistry, Brain Health Imaging Center, Center for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Robert Brackbill
- World Trade Center Health Registry, New York Department of Health and Mental Hygiene, New York, NY, USA
| | - Mark Farfel
- World Trade Center Health Registry, New York Department of Health and Mental Hygiene, New York, NY, USA
| | - Megan Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sandra Lowe
- The World Trade Center Mental Health Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Roberto G Lucchini
- Department of Environmental Health Sciences, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - David Prezant
- World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Joan Reibman
- Department of Environmental Medicine, New York University Langone Health, New York, NY, USA
| | - Rebecca Rosen
- World Trade Center Environmental Health Center, Department of Psychiatry, New York University, New York, NY, USA
| | - Kacie Seil
- World Trade Center Health Registry, New York Department of Health and Mental Hygiene, New York, NY, USA
| | - Rachel Zeig-Owens
- World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yael Deri
- Department of Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
- Department of Psychiatry, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Erica D Diminich
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Bernadette A Fausto
- Center for Molecular & Behavioral Neuroscience, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Sam Gandy
- Research and Development Service, James J. Peters Department of Veterans Affairs Medical Center, Bronx, NY, USA
- Mount Sinai Alzheimer's Disease Research Center and Ronald M. Loeb Center for Alzheimer's Disease, Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Mary Sano
- Research and Development Service, James J. Peters Department of Veterans Affairs Medical Center, Bronx, NY, USA
- Mount Sinai Alzheimer's Disease Research Center and Ronald M. Loeb Center for Alzheimer's Disease, Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Evelyn J Bromet
- Department of Psychiatry, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Benjamin J Luft
- Department of Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
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30
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Richards M, James SN, Lu K, Livingston G, Schott JM, Lane CA, Barnes J, Parker TD, Sudre CH, Cash DM, Coath W, Fox N, Davis DHJ. Straight and Divergent Pathways to Cognitive State: Seven Decades of Follow-Up in the British 1946 Birth Cohort. J Alzheimers Dis 2022; 89:659-667. [PMID: 35964185 DOI: 10.3233/jad-220296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Using the British 1946 birth cohort we previously estimated life course paths to the Addenbrooke's Cognitive Examination (ACE-III). OBJECTIVE We now compared those whose ACE-III scores were expected, worse and better than predicted from the path model on a range of independent variables including clinical ratings of cognitive impairment and neuroimaging measures. METHODS Predicted ACE-III scores were categorized into three groups: those with Expected (between -1.5 and 1.5 standard deviation; SD); Worse (&lt; -1.5 SD); and Better (&gt;1.5 SD) scores. Differences in the independent variables were then tested between these three groups. RESULTS Compared with the Expected group, those in the Worse group showed independent evidence of progressive cognitive impairment: faster memory decline, more self-reported memory difficulties, more functional difficulties, greater likelihood of being independently rated by experienced specialist clinicians as having a progressive cognitive impairment, and a cortical thinning pattern suggestive of preclinical Alzheimer's disease. Those in the Better group showed slower verbal memory decline and absence of independently rated progressive cognitive impairment compared to the Expected group, but no differences in any of the other independent variables including the neuroimaging variables. CONCLUSION The residual approach shows that life course features can map directly to clinical diagnoses. One future challenge is to translate this into a readily usable algorithm to identify high-risk individuals in preclinical state, when preventive strategies and therapeutic interventions may be most effective.
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Affiliation(s)
- Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Sarah N James
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Kirsty Lu
- Dementia Research Centre, University College London, London, UK
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
| | | | | | | | - Thomas D Parker
- Dementia Research Centre, University College London, London, UK
| | - Carole H Sudre
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK.,Dementia Research Centre, University College London, London, UK.,Centre for Medical Image Computing, University College London, London, UK.,School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - David M Cash
- Dementia Research Centre, University College London, London, UK
| | - William Coath
- Dementia Research Centre, University College London, London, UK
| | - Nicholas Fox
- Dementia Research Centre, University College London, London, UK
| | - Daniel H J Davis
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
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31
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Bougea A, Anagnostouli M, Angelopoulou E, Spanou I, Chrousos G. Psychosocial and Trauma-Related Stress and Risk of Dementia: A Meta-Analytic Systematic Review of Longitudinal Studies. J Geriatr Psychiatry Neurol 2022; 35:24-37. [PMID: 33205677 DOI: 10.1177/0891988720973759] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Stress has deleterious effects on brain health and yet, the prognostic value of psychosocial stress regarding the most common types of dementias, including Alzheimer disease, is still unclear. The primary aim of this systematic review was to explore the association between psychosocial stress and late onset dementia. We classified 24articles from Medline, PsycINFO, CINAHL, and Web of Science, as pertaining toxic categories of psychosocial and trauma-related stress (low socio-economic status [SES] related inequalities, marital status, posttraumatic stress disorder, work stress, "vital exhaustion" [VE], and, combined stressors). Using the Quality of Prognosis Studies in Systematic Reviews tool, we judged the quality of evidence to be low. This systematic review provided some non-robust, yet suggestive evidence that the above psychosocial types of stress are associated with increased risk of dementia in later life. Future robust, longitudinal studies with repeated validated measures of psychosocial stress and dementiaare required to strengthen or refute these findings.
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Affiliation(s)
- Anastasia Bougea
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Anagnostouli
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Demyelinating Diseases Clinic, 1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Aeginition Hospital, Athens, Greece
| | - Efthalia Angelopoulou
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Spanou
- Memory & Movement Disorders Clinic, 1st Department of Neurology, 69078Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Medical School, Athens, Greece
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Association Between Body Mass Index and Cognitive Function in Mild Cognitive Impairment Regardless of APOE ε4 Status. Dement Neurocogn Disord 2022; 21:30-41. [PMID: 35154338 PMCID: PMC8811203 DOI: 10.12779/dnd.2022.21.1.30] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 11/27/2022] Open
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Lu K, Nicholas JM, Pertzov Y, Grogan J, Husain M, Pavisic IM, James SN, Parker TD, Lane CA, Keshavan A, Keuss SE, Buchanan SM, Murray-Smith H, Cash DM, Malone IB, Sudre CH, Coath W, Wong A, Henley SM, Fox NC, Richards M, Schott JM, Crutch SJ. Dissociable effects of APOE-ε4 and β-amyloid pathology on visual working memory. NATURE AGING 2021; 1:1002-1009. [PMID: 34806027 PMCID: PMC7612005 DOI: 10.1038/s43587-021-00117-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 08/17/2021] [Indexed: 01/21/2023]
Abstract
Although APOE-ε4 carriers are at significantly higher risk of developing Alzheimer's disease than non-carriers1, controversial evidence suggests that APOE-ε4 might confer some advantages, explaining the survival of this gene (antagonistic pleiotropy)2,3. In a population-based cohort born in one week in 1946 (assessed aged 69-71), we assessed differential effects of APOE-ε4 and β-amyloid pathology (quantified using 18F-Florbetapir-PET) on visual working memory (object-location binding). In 398 cognitively normal participants, APOE-ε4 and β-amyloid had opposing effects on object identification, predicting better and poorer recall respectively. ε4-carriers also recalled locations more precisely, with a greater advantage at higher β-amyloid burden. These results provide evidence of superior visual working memory in ε4-carriers, showing that some benefits of this genotype are demonstrable in older age, even in the preclinical stages of Alzheimer's disease.
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Affiliation(s)
- Kirsty Lu
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jennifer M. Nicholas
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Yoni Pertzov
- Department of Psychology, The Hebrew University of Jerusalem, Israel
| | - John Grogan
- Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences, University of Oxford, UK
- Department of Experimental Psychology, University of Oxford, UK
| | - Ivanna M. Pavisic
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Sarah-Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Thomas D. Parker
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Christopher A. Lane
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Ashvini Keshavan
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah E. Keuss
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah M. Buchanan
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Heidi Murray-Smith
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - David M. Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute at UCL, University College London, London, UK
| | - Ian B. Malone
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Carole H. Sudre
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - William Coath
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Susie M.D. Henley
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Nick C. Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute at UCL, University College London, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Jonathan M. Schott
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
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Nakahata N, Nakamura T, Kawarabayashi T, Seino Y, Ichii S, Ikeda Y, Amari M, Takatama M, Murashita K, Ihara K, Itoh K, Nakaji S, Shoji M. Age-Related Cognitive Decline and Prevalence of Mild Cognitive Impairment in the Iwaki Health Promotion Project. J Alzheimers Dis 2021; 84:1233-1245. [PMID: 34633321 DOI: 10.3233/jad-210699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Iwaki Health Promotion Project (IHPP) is a community-based study for the prevention of lifestyle-related diseases and improvement of quality of life. OBJECTIVE Between 2014 and 2017, a total of 4,442 Iwaki town residents from 19 to 93 years of age participated in annual surveys to clarify the natural course of age-related cognitive decline and mild cognitive impairment (MCI). METHODS Modified OLD and SED-11Q questionnaires, MMSE, Logical Memory II, educational history, and APOE genotypes were examined at the first screening. MCI and dementia were diagnosed at the second examination by detailed neurological examination, CDR, and MRI, and followed for 3 years. Spline regression analyses based on a linear mixed model was adopted for statistical analysis. RESULTS MMSE scores declined with age from 55 to 64 years. There was also interaction between levels of education and ages. At the second examination, 56 MCI and 5 dementia patients were identified. None of the MCI cases progressed to dementia during the 3 years. During follow-up examinations, 13 cases showed improved MMSE scores (0.95 point/year), 5 remained stable, and 7 deteriorated (-0.83 point/year). Five cases showed improved CDR-SOB scores (-0.28 point/year), 9 remained stable, and 6 deteriorated (0.3 point/year). CONCLUSION IHPP revealed that age- and education-related cognitive decline began and advanced from 55 years of age. The prevalence of MCI and dementia was estimated to be 5.9%in the Iwaki town cohort over 60 yeas of age. About 30%of MCI cases showed progression of cognitive decline.
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Affiliation(s)
- Naoko Nakahata
- Department of Rehabilitation Sciences, Division of Speech-Language-Hearing Therapy, School of Health Sciences, Hirosaki University of Health and Welfare, Hirosaki, Aomori, Japan.,Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takumi Nakamura
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Neurology, Gunma University Hospital, Maebashi, Japan
| | - Takeshi Kawarabayashi
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Neurology, Gunma University Hospital, Maebashi, Japan.,Department of Neurology, Dementia Research Center, Geriatrics Research Institute and Hospital, Maebashi, Japan
| | - Yusuke Seino
- Department of Neurology, Hirosaki National Hospital, Hirosaki, Japan
| | - Sadanobu Ichii
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yoshio Ikeda
- Department of Neurology, Gunma University Hospital, Maebashi, Japan
| | - Masakuni Amari
- Department of Neurology, Dementia Research Center, Geriatrics Research Institute and Hospital, Maebashi, Japan
| | - Masamitsu Takatama
- Department of Neurology, Dementia Research Center, Geriatrics Research Institute and Hospital, Maebashi, Japan
| | - Koichi Murashita
- Center of Innovation Research Initiatives Organization, Hirosaki University, Hirosaki, Aomori, Japan
| | - Kazunari Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Ken Itoh
- Department of Stress Response Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shigeyuki Nakaji
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Mikio Shoji
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Neurology, Gunma University Hospital, Maebashi, Japan.,Department of Neurology, Dementia Research Center, Geriatrics Research Institute and Hospital, Maebashi, Japan
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Du M, Andersen SL, Schupf N, Feitosa MF, Barker MS, Perls TT, Sebastiani P. Association Between APOE Alleles and Change of Neuropsychological Tests in the Long Life Family Study. J Alzheimers Dis 2021; 79:117-125. [PMID: 33216038 DOI: 10.3233/jad-201113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND The Long Life Family Study (LLFS) is a family based, prospective study of healthy aging and familial longevity. The study includes two assessments of cognitive function that were administered approximately 8 years apart. OBJECTIVE To test whether APOE genotype is associated with change of cognitive function in older adults. METHODS We used Bayesian hierarchical models to test the association between APOE alleles and change of cognitive function. Six longitudinally collected neuropsychological test scores were modelled as a function of age at enrollment, follow-up time, gender, education, field center, birth cohort indicator (≤1935, or >1935), and the number of copies of ɛ2 or ɛ4 alleles. RESULTS Out of 4,587 eligible participants, 2,064 were male (45.0%), and age at enrollment ranged from 25 to 110 years, with mean of 70.85 years (SD: 15.75). We detected a significant cross-sectional effect of the APOEɛ4 allele on Logical Memory. Participants carrying at least one copy of the ɛ4 allele had lower scores in both immediate (-0.31 points, 95% CI: -0.57, -0.05) and delayed (-0.37 points, 95% CI: -0.64, -0.10) recall comparing to non-ɛ4 allele carriers. We did not detect any significant longitudinal effect of the ɛ4 allele. There was no cross-sectional or longitudinal effect of the ɛ2 allele. CONCLUSION The APOEɛ4 allele was identified as a risk factor for poorer episodic memory in older adults, while the APOEɛ2 allele was not significantly associated with any of the cognitive test scores.
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Affiliation(s)
- Mengtian Du
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Stacy L Andersen
- Geriatrics Section, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Nicole Schupf
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, and the Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA.,Department of Epidemiology, Columbia University Mailman School of Public Health, Sergievsky Center, New York, NY, USA
| | - Mary F Feitosa
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - Megan S Barker
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, and the Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA
| | - Thomas T Perls
- Geriatrics Section, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Paola Sebastiani
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
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Perez-Lasierra JL, Casajús JA, Casasnovas JA, Arbones-Mainar JM, Lobo A, Lobo E, Moreno-Franco B, Gonzalez-Agüero A. Can Physical Activity Reduce the Risk of Cognitive Decline in Apolipoprotein e4 Carriers? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7238. [PMID: 34299687 PMCID: PMC8303365 DOI: 10.3390/ijerph18147238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/27/2021] [Accepted: 07/01/2021] [Indexed: 12/16/2022]
Abstract
Physical activity (PA) reduces the risk of cognitive decline (CD) in the general population. However, little is known about whether the presence of the apolipoprotein E epsilon 4 allele (APOE e4) could modify this beneficial effect. The aim of this systematic review was to analyze and synthetize the scientific evidence related to PA levels and CD risk in cognitively healthy APOE e4 carriers. Four electronic databases were analyzed. Only original articles with longitudinal study design were selected to analyze the relationship between PA and CD in APOE e4 carriers. Five studies were included in the systematic review. All studies except one stated that PA is a protective factor against CD in APOE e4 carriers. Moreover, partial support was found for the hypothesis that a greater amount and intensity of PA are more beneficial in CD prevention. The results support the idea that PA is a protective factor against CD in APOE e4 carriers. Nevertheless, it would be necessary to carry out further studies that would allow these findings to be contrasted.
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Affiliation(s)
- Jose Luis Perez-Lasierra
- Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (J.L.P.-L.); (J.A.C.)
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
| | - Jose Antonio Casajús
- Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (J.L.P.-L.); (J.A.C.)
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- CIBEROBN Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - José Antonio Casasnovas
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- CIBERCV Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Jose Miguel Arbones-Mainar
- CIBEROBN Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- Adipocyte and Fat Biology Laboratory (AdipoFat), 50009 Zaragoza, Spain
| | - Antonio Lobo
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- CIBERSAM Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Elena Lobo
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- CIBERSAM Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Microbiology, Pediatrics, Radiology and Public Health, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Belén Moreno-Franco
- Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain; (J.A.C.); (A.L.); (E.L.); (B.M.-F.)
- CIBERCV Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Microbiology, Pediatrics, Radiology and Public Health, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Alejandro Gonzalez-Agüero
- Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (J.L.P.-L.); (J.A.C.)
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain
- CIBEROBN Instituto de Salud Carlos III, 28029 Madrid, Spain;
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Bracko O, Cruz Hernández JC, Park L, Nishimura N, Schaffer CB. Causes and consequences of baseline cerebral blood flow reductions in Alzheimer's disease. J Cereb Blood Flow Metab 2021; 41:1501-1516. [PMID: 33444096 PMCID: PMC8221770 DOI: 10.1177/0271678x20982383] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/27/2020] [Accepted: 11/16/2020] [Indexed: 12/23/2022]
Abstract
Reductions of baseline cerebral blood flow (CBF) of ∼10-20% are a common symptom of Alzheimer's disease (AD) that appear early in disease progression and correlate with the severity of cognitive impairment. These CBF deficits are replicated in mouse models of AD and recent work shows that increasing baseline CBF can rapidly improve the performance of AD mice on short term memory tasks. Despite the potential role these data suggest for CBF reductions in causing cognitive symptoms and contributing to brain pathology in AD, there remains a poor understanding of the molecular and cellular mechanisms causing them. This review compiles data on CBF reductions and on the correlation of AD-related CBF deficits with disease comorbidities (e.g. cardiovascular and genetic risk factors) and outcomes (e.g. cognitive performance and brain pathology) from studies in both patients and mouse models, and discusses several potential mechanisms proposed to contribute to CBF reductions, based primarily on work in AD mouse models. Future research aimed at improving our understanding of the importance of and interplay between different mechanisms for CBF reduction, as well as at determining the role these mechanisms play in AD patients could guide the development of future therapies that target CBF reductions in AD.
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Affiliation(s)
- Oliver Bracko
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Jean C Cruz Hernández
- Center for Systems Biology and Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Laibaik Park
- Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York, NY, USA
| | - Nozomi Nishimura
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Chris B Schaffer
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, USA
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Hestad K, Engedal K, Horndalsveen P, Strand BH. Cognition in Patients With Memory Difficulties and Dementia Relative to APOE e4 Status. Front Psychol 2021; 12:686036. [PMID: 34194377 PMCID: PMC8236580 DOI: 10.3389/fpsyg.2021.686036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/07/2021] [Indexed: 12/23/2022] Open
Abstract
The aim of this study was to investigate whether cognitive performance was equally influenced by Apolipoprotein E (APOE, with its three alleles, e2, e3, and e4) in patients with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and Alzheimer’s disease (AD). In addition, we examined a group of patients with a combination of Vascular dementia (VaD) and AD (VaD/AD). We asked if the APOE e4 allele influenced cognition in these patient groups in the same way. Our study comprised data from 1,991 patients (55% women), with a mean age of 70.9 years (SD 10.8) and 12.1 years of education (SD 3.8). Of them, 1,111 (56%) had at least one APOE e4 allele; 871 (44%) had one and 240 (12%) had two e4 alleles. Three neurocognitive tests were used to measure cognition: the Mini Mental State Examination (MMSE), the 10-word test of the Consortium to Establish a Registry for Alzheimer’s Disease Word List (CERAD-WL) (immediate and delayed recall), and the Trail Making Test Part A (TMTA). The APOE genotypes were regressed against cognitive function using linear regression, adjusting for diagnosis, age, sex, and education. The interaction diagnosis∗APOE was investigated. The allele type had the largest effect on cognitive performance assessed by the CERAD-WL delayed recall test, less for the other tests. Those without the e4 type scored 0.7 units better than those with e4 allele(s) (p < 0.001). Furthermore, there was a significant inverse dose-response pattern between number of e4 alleles and cognitive performance; those with one allele scored 0.4 units better than those with two alleles (p = 0.006), and those without e4 scored 0.7 units better than those with one e4 (p < 0.001). This pattern did not differ between the four diagnostic groups studied.
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Affiliation(s)
- Knut Hestad
- Department of Health and Nursing Science, Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway.,Department of Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Ageing and Health, Vestfold County Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Peter Horndalsveen
- Department of Old Age Psychiatry, Innlandet Hospital Trust, Ottestad, Norway
| | - Bjørn Heine Strand
- Norwegian National Advisory Unit on Ageing and Health, Vestfold County Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
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Schmitt J, Paradis AL, Boucher M, Andrieu L, Barnéoud P, Rondi-Reig L. Flexibility as a marker of early cognitive decline in humanized apolipoprotein E ε4 (ApoE4) mice. Neurobiol Aging 2021; 102:129-138. [PMID: 33765426 DOI: 10.1016/j.neurobiolaging.2021.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 01/11/2021] [Accepted: 01/16/2021] [Indexed: 12/30/2022]
Abstract
To test the hypothesis that ApoE4 may be involved in cognitive deficits associated with aging, we investigated the impact of APOE4 status and aging on the flexibility and memory components of spatial learning in mice. Young adult (6 months) and middle-aged (14 months) ApoE4, ApoE3 and C57BL/6 male mice were tested for flexibility in an aquatic Y-maze, and for spatio-temporal memory acquisition in the Starmaze. Our results revealed a flexibility deficit of the 6-month-old ApoE4 mice compared to controls. However, this deficit was not associated with spatio-temporal memory deficit at the same age. Importantly, the ApoE4 flexibility deficit did not increase with age, nor turn into memory deficit, or was able to predict individual variations of memory performance at 14 months. By contrast, control ApoE3 mice showed a decline of flexibility at 14 months resulting in performance similar to that of ApoE4. Overall, our results suggest that ApoE4 could be associated with an acceleration of the flexibility decrease otherwise observed in normal aging.
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Affiliation(s)
- Julien Schmitt
- Sorbonne Université, CNRS, INSERM, Institut de Biologie Paris Seine (IBPS), Neurosciences Paris Seine (NPS), Cerebellum Navigation and Memory Team (CeZaMe), Paris, France; Neurodegeneration Cluster, Rare & Neurologic Diseases Research, Sanofi R&D, Chilly-Mazarin, France
| | - Anne-Lise Paradis
- Sorbonne Université, CNRS, INSERM, Institut de Biologie Paris Seine (IBPS), Neurosciences Paris Seine (NPS), Cerebellum Navigation and Memory Team (CeZaMe), Paris, France
| | | | - Laurent Andrieu
- Biostatistics & Programming Department, Non-Clinical Efficacy & Safety team, Sanofi R&D, Vitry-Sur-Seine, Paris, France
| | - Pascal Barnéoud
- Neurodegeneration Cluster, Rare & Neurologic Diseases Research, Sanofi R&D, Chilly-Mazarin, France
| | - Laure Rondi-Reig
- Sorbonne Université, CNRS, INSERM, Institut de Biologie Paris Seine (IBPS), Neurosciences Paris Seine (NPS), Cerebellum Navigation and Memory Team (CeZaMe), Paris, France.
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Pedroso RV, Fraga FJ, Pavarini SCI, Nascimento CMC, Ayán C, Cominetti MR. A Systematic Review of Altered P300 Event-Related Potential in Apolipoprotein E4 ( APOE4) Carriers. Clin EEG Neurosci 2021; 52:193-200. [PMID: 32945192 DOI: 10.1177/1550059420959966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Apolipoprotein ε4 allele (APOE4) is the strongest genetic risk factor for Alzheimer's disease and seems to be related to cognitive decline and damaged event-related potential P300, which is a sensitive measure to assess cognitive processing. OBJECTIVE This research aims to critically review the existing scientific evidence regarding the association between APOE4 and P300. METHODS A systematic review was carried out up to January 2020 on the following databases: Web of Science, Scopus and Medline/PubMed. Articles were considered for inclusion if they are original research that provided information regarding the association between APOE4 and P300, available in English, Spanish, or Portuguese, and available in full text. The methodological quality of the studies selected was evaluated using the quality assessment tool for observational cohort and cross-sectional studies recommended by Cochrane. RESULTS Out of 993 studies, 14 met the inclusion criteria. The results obtained showed that APOE4 is related to a longer P300 latency. However, the data supplied do not allow us to confirm if this relationship also occurs in amplitude measures. Moreover, it was observed that APOE genotype may influence P300 in different ages, from younger individuals to demented older people. CONCLUSION Evidence shows that APOE4 negatively influences cortical activities related to cognitive functions, as indicated by P300.
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Affiliation(s)
- Renata Valle Pedroso
- Department of Gerontology, 67828Federal University of São Carlos, São Carlos, SP, Brazil
| | - Francisco José Fraga
- Engineering, Modelling and Applied Social Sciences Center (CECS), 488580Federal University of the ABC (UFABC), Santo André, SP, Brazil
| | | | | | - Carlos Ayán
- Well-Move Research Group, Department of Special Didactics, 16784University of Vigo, Vigo, Spain.,IIS Galicia Sur, Vigo, Spain
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41
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Piers RJ, Liu Y, Ang TFA, Tao Q, Au R, Qiu WQ. Association Between Elevated Depressive Symptoms and Cognitive Function Moderated by APOE4 Status: Framingham Offspring Study. J Alzheimers Dis 2021; 80:1269-1279. [PMID: 33646152 DOI: 10.3233/jad-200998] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Depression and Apolipoprotein E4 (APOE4) are associated with decreased cognitive function and differences in brain structure. OBJECTIVE This study investigated whether APOE4 status moderates the association between elevated depressive symptoms, cognitive function, and brain structure. METHODS Stroke- and dementia-free participants (n = 1,968) underwent neuropsychological evaluation, brain MRI, and depression screening. Linear and logistic regression was used to examine all associations. Secondary analyses were performed using interaction terms to assess effect modification by APOE4 status. RESULTS Elevated depressive symptoms were associated with lower cognitive performance in several domains. In stratified analyses, elevated depressive symptoms were associated with poorer visual short- and long-term memory performance for APOE4 + participants. Elevated depressive symptoms were not associated with any brain structure in this study sample. CONCLUSION Elevated depressive symptoms impact cognitive function in non-demented individuals. Having the APOE4 allele may exacerbate the deleterious effects of elevated depressive symptoms on visual memory performance. Screening for elevated depressive symptoms in both research studies and clinical practice may be warranted to avoid false positive identification of neurodegeneration, particularly among those who are APOE4 + .
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Affiliation(s)
- Ryan J Piers
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Yulin Liu
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Ting F A Ang
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.,Slone Epidemiology Center, Boston University School of Medicine, Boston, MA, USA
| | - Qiushan Tao
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA
| | - Rhoda Au
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.,Slone Epidemiology Center, Boston University School of Medicine, Boston, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.,Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA
| | - Wei Qiao Qiu
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, USA.,Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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42
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Cancela-Carral JM, López-Rodríguez A, Mollinedo-Cardalda I. Effect of physical exercise on cognitive function in older adults' carriers versus noncarriers of apolipoprotein E4: systematic review and meta-analysis. J Exerc Rehabil 2021; 17:69-80. [PMID: 34012932 PMCID: PMC8103191 DOI: 10.12965/jer.2142130.065] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/13/2021] [Indexed: 12/15/2022] Open
Abstract
The presence of apolipoprotein (Apo) E4 is a genetic risk factor in cognitive impairment. Physical exercise contributes to slowing cognitive impairment in older adults, but little is known about the influence of exercise on ApoE4 carriers and noncarriers. The objective of systematic review is to study the role of physical exercise in older adults' ApoE4 carriers and noncarriers. A systematic literature search was carried out in five international databases: PubMed, Web of Science, PeDro, Scopus, and SPORTDiscus. A total of nine randomized controlled trials were included with a sample size of 2,025 subjects (901 ApoE4 carriers). The exercise reported a significant improvement on cognitive performance in older adults' ApoE4 noncarriers (standardized mean difference [SMD]=0.653; 95% confidence interval [CI], 0.29-1.00; chi2=35.36; degrees of freedom [df ]=7; P<0.0001; l 2=80%). It was also reported that a total program duration greater than 50 sessions generated different and significant effects on cognitive performance in older adults' ApoE4 noncarriers (SMD=0.878; 95% CI, 0.14-1.61; chi2=31.82; df=3; P<0.0001; l 2=91%). The results reported that high intensity generated a differential effect on cognitive performance in older adults' ApoE4 carriers versus noncarriers (SMD=0.963; 95% CI, 0.25-1.67; chi2=18.11; df=3; P<0.0004; l 2=83%). The effect of physical exercise on cognitive performance in older adults is conditioned by the presence or not of ApoE4.
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Affiliation(s)
- José María Cancela-Carral
- HealthyFit Research Group, University of Vigo, Pontevedra, Spain
- Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-UVIGO, Pontevedra, Spain
- Faculty of Education and Sports Science, University of Vigo, Pontevedra, Spain
| | - Adriana López-Rodríguez
- Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-UVIGO, Pontevedra, Spain
- Faculty of Education and Sports Science, University of Vigo, Pontevedra, Spain
| | - Irimia Mollinedo-Cardalda
- Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-UVIGO, Pontevedra, Spain
- Faculty of Physiotherapy, University of Vigo, Pontevedra, Spain
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43
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Elverman KH, Paitel ER, Figueroa CM, McKindles RJ, Nielson KA. Event-Related Potentials, Inhibition, and Risk for Alzheimer's Disease Among Cognitively Intact Elders. J Alzheimers Dis 2021; 80:1413-1428. [PMID: 33682720 DOI: 10.3233/jad-201559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Despite advances in understanding Alzheimer's disease (AD), prediction of AD prior to symptom onset remains severely limited, even when primary risk factors such as the apolipoprotein E (APOE) ɛ4 allele are known. OBJECTIVE Although executive dysfunction is highly prevalent and is a primary contributor to loss of independence in those with AD, few studies have examined neural differences underlying executive functioning as indicators of risk for AD prior to symptom onset, when intervention might be effective. METHODS This study examined event-related potential (ERP) differences during inhibitory control in 44 cognitively intact older adults (20 ɛ4+, 24 ɛ4-), relative to 41 young adults. All participants completed go/no-go and stop-signal tasks. RESULTS Overall, both older adult groups exhibited slower reaction times and longer ERP latencies compared to young adults. Older adults also had generally smaller N200 and P300 amplitudes, except at frontal electrodes and for N200 stop-signal amplitudes, which were larger in older adults. Considered with intact task accuracy, these findings suggest age-related neural compensation. Although ɛ4 did not distinguish elders during go or no-go tasks, this study uniquely showed that the more demanding stop-signal task was sensitive to ɛ4 differences, despite comparable task and neuropsychological performance with non-carriers. Specifically, ɛ4+ elders had slower frontal N200 latency and larger N200 amplitude, which was most robust at frontal sites, compared with ɛ4-. CONCLUSION N200 during a stop-signal task is sensitive to AD risk, prior to any evidence of cognitive dysfunction, suggesting that stop-signal ERPs may be an important protocol addition to neuropsychological testing.
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Affiliation(s)
| | | | | | - Ryan J McKindles
- Marquette University, Department of Biomedical Engineering, Milwaukee, WI, USA
| | - Kristy A Nielson
- Marquette University, Department of Psychology, Milwaukee, WI, USA.,Medical College of Wisconsin, Department of Neurology, Milwaukee, WI, USA
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44
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Keshavan A, Pannee J, Karikari TK, Rodriguez JL, Ashton NJ, Nicholas JM, Cash DM, Coath W, Lane CA, Parker TD, Lu K, Buchanan SM, Keuss SE, James SN, Murray-Smith H, Wong A, Barnes A, Dickson JC, Heslegrave A, Portelius E, Richards M, Fox NC, Zetterberg H, Blennow K, Schott JM. Population-based blood screening for preclinical Alzheimer's disease in a British birth cohort at age 70. Brain 2021; 144:434-449. [PMID: 33479777 PMCID: PMC7940173 DOI: 10.1093/brain/awaa403] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/10/2020] [Accepted: 09/17/2020] [Indexed: 11/14/2022] Open
Abstract
Alzheimer's disease has a preclinical stage when cerebral amyloid-β deposition occurs before symptoms emerge, and when amyloid-β-targeted therapies may have maximum benefits. Existing amyloid-β status measurement techniques, including amyloid PET and CSF testing, are difficult to deploy at scale, so blood biomarkers are increasingly considered for screening. We compared three different blood-based techniques-liquid chromatography-mass spectrometry measures of plasma amyloid-β, and single molecule array (Simoa) measures of plasma amyloid-β and phospho-tau181-to detect cortical 18F-florbetapir amyloid PET positivity (defined as a standardized uptake value ratio of >0.61 between a predefined cortical region of interest and eroded subcortical white matter) in dementia-free members of Insight 46, a substudy of the population-based British 1946 birth cohort. We used logistic regression models with blood biomarkers as predictors of amyloid PET status, with or without age, sex and APOE ε4 carrier status as covariates. We generated receiver operating characteristics curves and quantified areas under the curves to compare the concordance of the different blood tests with amyloid PET. We determined blood test cut-off points using Youden's index, then estimated numbers needed to screen to obtain 100 amyloid PET-positive individuals. Of the 502 individuals assessed, 441 dementia-free individuals with complete data were included; 82 (18.6%) were amyloid PET-positive. The area under the curve for amyloid PET status using a base model comprising age, sex and APOE ε4 carrier status was 0.695 (95% confidence interval: 0.628-0.762). The two best-performing Simoa plasma biomarkers were amyloid-β42/40 (0.620; 0.548-0.691) and phospho-tau181 (0.707; 0.646-0.768), but neither outperformed the base model. Mass spectrometry plasma measures performed significantly better than any other measure (amyloid-β1-42/1-40: 0.817; 0.770-0.864 and amyloid-β composite: 0.820; 0.775-0.866). At a cut-off point of 0.095, mass spectrometry measures of amyloid-β1-42/1-40 detected amyloid PET positivity with 86.6% sensitivity and 71.9% specificity. Without screening, to obtain 100 PET-positive individuals from a population with similar amyloid PET positivity prevalence to Insight 46, 543 PET scans would need to be performed. Screening using age, sex and APOE ε4 status would require 940 individuals, of whom 266 would proceed to scan. Using mass spectrometry amyloid-β1-42/1-40 alone would reduce these numbers to 623 individuals and 243 individuals, respectively. Across a theoretical range of amyloid PET positivity prevalence of 10-50%, mass spectrometry measures of amyloid-β1-42/1-40 would consistently reduce the numbers proceeding to scans, with greater cost savings demonstrated at lower prevalence.
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Affiliation(s)
- Ashvini Keshavan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Josef Pannee
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Thomas K Karikari
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Juan Lantero Rodriguez
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Nicholas J Ashton
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- National Institute for Health Research Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust, London, UK
| | - Jennifer M Nicholas
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - David M Cash
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - William Coath
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Christopher A Lane
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Thomas D Parker
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Kirsty Lu
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah M Buchanan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah E Keuss
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | | | - Heidi Murray-Smith
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Anna Barnes
- Institute of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, UK
| | - John C Dickson
- Institute of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, UK
| | - Amanda Heslegrave
- UK Dementia Research Institute Fluid Biomarkers Laboratory, UK DRI at UCL, London, UK
| | - Erik Portelius
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | | | - Nick C Fox
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute Fluid Biomarkers Laboratory, UK DRI at UCL, London, UK
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
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45
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Stickel AM, McKinnon AC, Matijevic S, Grilli MD, Ruiz J, Ryan L. Apolipoprotein E ε4 Allele-Based Differences in Brain Volumes Are Largely Uniform Across Late Middle Aged and Older Hispanic/Latino- and Non-Hispanic/Latino Whites Without Dementia. Front Aging Neurosci 2021; 13:627322. [PMID: 33716715 PMCID: PMC7952627 DOI: 10.3389/fnagi.2021.627322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/01/2021] [Indexed: 12/01/2022] Open
Abstract
Hispanics/Latinos are at an equal or a greater risk for Alzheimer's disease (AD), yet risk factors remain more poorly characterized as compared to non-Hispanic/Latino Whites. Among non-Hispanic/Latino White cohorts, the apolipoprotein E (APOE) ε4 allele is one of the strongest risk factors for AD with subtle declines in episodic memory and brain volumes detectable in the preclinical stages. We examined whether the APOE ε4 status had a differential impact on cognition and brain volumes among cognitively healthy and mild cognitively impaired Hispanics/Latinos (n = 86; ε4 n = 23) compared to a well-matched group of non-Hispanic/Latino Whites (n = 92; ε4 n = 29). Neither the APOE ε4 status nor the interaction between the ε4 status and ethnicity was associated with cognitive performance. The APOE ε4 status was associated with white matter and not with gray matter volumes. APOE ε4 carriers had a significantly smaller total brain white matter volumes, as well as smaller right middle temporal and left superior temporal volumes. The Hispanics/Latinos had significantly smaller left middle frontal gray matter volumes, yet marginally larger overall white matter volumes, than the non-Hispanic/Latino Whites. Exploratory analysis within the Hispanic/Latino sample found that those people whose primary language was Spanish had larger total brain white matter volumes compared primarily to the English speakers. Importantly, primary language differences only held for Hispanic/Latino ε4 carriers and did not differentiate Hispanic/Latino non-carriers, underscoring the need for further investigation into the impacts of language and acculturation on cognitive aging among the fastest growing ethnic minority group in the United States.
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Affiliation(s)
- Ariana M. Stickel
- Department of Psychology, University of Arizona, Tucson, AZ, United States
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, United States
| | - Andrew C. McKinnon
- Department of Psychology, University of Arizona, Tucson, AZ, United States
- Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | | | - Matthew D. Grilli
- Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - John Ruiz
- Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Lee Ryan
- Department of Psychology, University of Arizona, Tucson, AZ, United States
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46
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Zhou X, Fu AK, Ip NY. APOE signaling in neurodegenerative diseases: an integrative approach targeting APOE coding and noncoding variants for disease intervention. Curr Opin Neurobiol 2021; 69:58-67. [PMID: 33647674 DOI: 10.1016/j.conb.2021.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/05/2021] [Accepted: 02/05/2021] [Indexed: 10/22/2022]
Abstract
APOE (apolipoprotein E) is a key regulator of lipid metabolism and a leading genetic risk factor for Alzheimer's disease. While APOE participates in multiple biological pathways, its roles in diseases are largely due to the mutant protein encoded by APOE-ε4. However, emerging evidence suggests that some noncoding Alzheimer's disease risk variants residing in APOE and its nearby regions exert APOE-ε4-independent risks and modify APOE gene expression. Moreover, intervention strategies targeting APOE are being explored. In this review, we summarize the literature on the genetic risks and roles of APOE in biological systems. Moreover, we propose an integrative approach to evaluate disease risk and tailor interventions to aid research on APOE-associated diseases.
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Affiliation(s)
- Xiaopu Zhou
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Hong Kong, China; Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China; Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, Hong Kong University of Science and Technology Shenzhen Research Institute, Shenzhen-Hong Kong Institute of Brain Science, 518057 Shenzhen, Guangdong, China
| | - Amy Ky Fu
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Hong Kong, China; Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China; Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, Hong Kong University of Science and Technology Shenzhen Research Institute, Shenzhen-Hong Kong Institute of Brain Science, 518057 Shenzhen, Guangdong, China
| | - Nancy Y Ip
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Hong Kong, China; Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China; Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, Hong Kong University of Science and Technology Shenzhen Research Institute, Shenzhen-Hong Kong Institute of Brain Science, 518057 Shenzhen, Guangdong, China.
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47
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Song J, Mailick MR, Greenberg JS. Apolipoprotein ɛ4 Allele and Subjective Cognitive Functioning in Parents of Adults With Disabilities. J Gerontol B Psychol Sci Soc Sci 2021; 75:e189-e197. [PMID: 32361736 DOI: 10.1093/geronb/gbaa061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Parents of individuals with disabilities face ongoing responsibilities of providing care and support for their children, even during the child's adulthood. Past research has shown that this caregiving role is linked to chronic stress and subsequent adverse health outcomes for parents, including impaired cognition. This study examines the impacts of genetic risk for cognitive impairment (apolipoprotein [APOE] ɛ4 allele) among parents of adults with disabilities and comparison parents whose adult children do not have disabilities. METHOD We performed rank order regression analysis of data from the Wisconsin Longitudinal Study (2004-2006 and 2010-2012 surveys and DNA samples). Participants included parents of adults with disabilities (247 mothers and 159 fathers) and comparison parents whose adult children were not disabled (1,482 mothers and 954 fathers). RESULTS Mothers who had adult children with disabilities and who were APOE ɛ4 carriers reported significantly declining levels of subjective cognitive functioning over time, but mothers of adults with disabilities who did not have the APOE ɛ4 allele did not manifest this change. Among comparison group mothers, cognitive change over time was not a function of their APOE ɛ4 carrier status. Fathers' cognitive function did not differ significantly by either parental status or APOE ɛ4 carrier status. DISCUSSION The results show that older mothers of adults with disabilities are more susceptible to cognitive impairment than their age peers if they have the genetic risk factor of APOE ɛ4 allele.
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Affiliation(s)
- Jieun Song
- Waisman Center, University of Wisconsin-Madison
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48
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Makkar SR, Lipnicki DM, Crawford JD, Kochan NA, Castro-Costa E, Lima-Costa MF, Diniz BS, Brayne C, Stephan B, Matthews F, Llibre-Rodriguez JJ, Llibre-Guerra JJ, Valhuerdi-Cepero AJ, Lipton RB, Katz MJ, Wang C, Ritchie K, Carles S, Carriere I, Scarmeas N, Yannakoulia M, Kosmidis M, Lam L, Chan WC, Fung A, Guaita A, Vaccaro R, Davin A, Kim KW, Han JW, Suh SW, Riedel-Heller SG, Roehr S, Pabst A, Ganguli M, Hughes TF, Snitz B, Anstey KJ, Cherbuin N, Easteal S, Haan MN, Aiello AE, Dang K, Pin Ng T, Gao Q, Zin Nyunt MS, Brodaty H, Trollor JN, Leung Y, Lo JW, Sachdev P. APOE ε4 and the Influence of Sex, Age, Vascular Risk Factors, and Ethnicity on Cognitive Decline. J Gerontol A Biol Sci Med Sci 2021; 75:1863-1873. [PMID: 32396611 DOI: 10.1093/gerona/glaa116] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Indexed: 01/08/2023] Open
Abstract
We aimed to examine the relationship between Apolipoprotein E ε4 (APOE*4) carriage on cognitive decline, and whether these associations were moderated by sex, baseline age, ethnicity, and vascular risk factors. Participants were 19,225 individuals aged 54-103 years from 15 longitudinal cohort studies with a mean follow-up duration ranging between 1.2 and 10.7 years. Two-step individual participant data meta-analysis was used to pool results of study-wise analyses predicting memory and general cognitive decline from carriage of one or two APOE*4 alleles, and moderation of these associations by age, sex, vascular risk factors, and ethnicity. Separate pooled estimates were calculated in both men and women who were younger (ie, 62 years) and older (ie, 80 years) at baseline. Results showed that APOE*4 carriage was related to faster general cognitive decline in women, and faster memory decline in men. A stronger dose-dependent effect was observed in older men, with faster general cognitive and memory decline in those carrying two versus one APOE*4 allele. Vascular risk factors were related to an increased effect of APOE*4 on memory decline in younger women, but a weaker effect of APOE*4 on general cognitive decline in older men. The relationship between APOE*4 carriage and memory decline was larger in older-aged Asians than Whites. In sum, APOE*4 is related to cognitive decline in men and women, although these effects are enhanced by age and carriage of two APOE*4 alleles in men, a higher numbers of vascular risk factors during the early stages of late adulthood in women, and Asian ethnicity.
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Affiliation(s)
- Steve R Makkar
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | | | | | - Breno Satler Diniz
- Department of Psychiatry, Faculty of Medicine University Toronto, Ontario, Canada.,Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Carol Brayne
- Department of Public Health and Primary Care, Cambridge University, UK
| | - Blossom Stephan
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona Matthews
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | | | - Jorge J Llibre-Guerra
- Institute of Neurology and Neurosurgery, Havana, Cuba.,Memory and Aging Center, UCSF, San Francisco, California
| | | | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York City, New York
| | - Mindy J Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York City, New York
| | - Cuiling Wang
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York City, New York
| | - Karen Ritchie
- Inserm, U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, France.,Université de Montpellier, Montpellier, France
| | - Sophie Carles
- Inserm, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Paris, France.,Paris Descartes University, Paris, France
| | - Isabelle Carriere
- Inserm, U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, France.,Université de Montpellier, Montpellier, France
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.,Taub Institute for Research in Alzheimer's disease and the Aging Brain, Gertrude H Sergievsky Center, Department of Neurology, Columbia University, New York city, New York
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics (M.Y.), Harokopio University, Athens, Greece
| | - Mary Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Linda Lam
- Department of Psychiatry, The Chinese University of Hong Kong
| | - Wai Chi Chan
- Department of Psychiatry, The Chinese University of Hong Kong
| | - Ada Fung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University
| | | | | | | | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seung Wan Suh
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Roehr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Tiffany F Hughes
- Department of Sociology, Anthropology, and Gerontology, Youngstown State University, Youngstown, Ohio
| | - Beth Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Kaarin J Anstey
- Neuroscience Research Australia, Sydney, Australia.,Centre for Research on Ageing, Health and Wellbeing, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Simon Easteal
- John Curtin School of Medical Research, College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Mary N Haan
- University of California, School of Medicine, Department of Epidemiology and Biostatistics, San Francisco, California
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina.,Carolina Population Center, Chapel Hill, North Carolina
| | - Kristina Dang
- University of California, School of Medicine, Department of Epidemiology and Biostatistics, San Francisco, California
| | - Tze Pin Ng
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Qi Gao
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ma Shwe Zin Nyunt
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.,Dementia Collaborative Research Centre, University of New South Wales Sydney, Sydney, Australia
| | - Julian N Trollor
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.,Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Australia
| | - Yvonne Leung
- School of Psychology, University of Nottingham Malaysia, Semenyih, Malaysia
| | - Jessica W Lo
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.,Dementia Collaborative Research Centre, University of New South Wales Sydney, Sydney, Australia
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49
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Gharbi-Meliani A, Dugravot A, Sabia S, Regy M, Fayosse A, Schnitzler A, Kivimäki M, Singh-Manoux A, Dumurgier J. The association of APOE ε4 with cognitive function over the adult life course and incidence of dementia: 20 years follow-up of the Whitehall II study. ALZHEIMERS RESEARCH & THERAPY 2021; 13:5. [PMID: 33397450 PMCID: PMC7784268 DOI: 10.1186/s13195-020-00740-0] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/07/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Approximately 25% of the general population carries at least one ε4 allele of the Apolipoprotein E (APOE ε4), the strongest genetic risk factor for late onset Alzheimer's disease. Beyond its association with late-onset dementia, the association between APOE ε4 and change in cognition over the adult life course remains uncertain. This study aims to examine whether the association between Apolipoprotein E (APOE) ε4 zygosity and cognition function is modified between midlife and old age. METHODS A cohort study of 5561 participants (mean age 55.5 (SD = 5.9) years, 27.1% women) with APOE genotyping and repeated cognitive tests for reasoning, memory, and semantic and phonemic fluency, during a mean (SD) follow-up of 20.2 (2.8) years (the Whitehall II study). We used joint models to examine the association of APOE genotype with cognitive function trajectories between 45 and 85 years taking drop-out, dementia, and death into account and Fine and Gray models to examine associations with dementia. RESULTS Compared to non-carriers, heterozygote (prevalence 25%) and homozygote (prevalence 2%) APOE ε4 carriers had increased risk of dementia, sub-distribution hazard ratios 2.19 (95% CI 1.73, 2.77) and 5.97 (95% CI 3.85, 9.28) respectively. Using data spanning 45-85 years with non-ε4 carriers as the reference, ε4 homozygotes had poorer global cognitive score starting from 65 years; ε4 heterozygotes had better scores between 45 and 55 years, then no difference until poorer cognitive scores from 75 years onwards. In analysis of individual cognitive tests, better cognitive performance in the younger ε4 heterozygotes was primarily attributable to executive function. CONCLUSIONS Both heterozygous and homozygous ε4 carriers had poorer cognition and greater risk of dementia at older ages. Our findings show some support for a complex antagonist pleiotropic effect of APOE ε4 heterozygosity over the adult life course, characterized by cognitive advantage in midlife.
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Affiliation(s)
- Amin Gharbi-Meliani
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Aline Dugravot
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Séverine Sabia
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Melina Regy
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Aurore Fayosse
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Alexis Schnitzler
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Archana Singh-Manoux
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Julien Dumurgier
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France. .,Cognitive Neurology Center, Lariboisiere - Fernand Widal Hospital, AP-HP, Université de Paris, 200 rue du Faubourg Saint Denis, 75010, Paris, France.
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50
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Theodore LE, Kellow NJ, McNeil EA, Close EO, Coad EG, Cardoso BR. Nut Consumption for Cognitive Performance: A Systematic Review. Adv Nutr 2020; 12:777-792. [PMID: 33330927 PMCID: PMC8166568 DOI: 10.1093/advances/nmaa153] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/14/2020] [Accepted: 10/27/2020] [Indexed: 01/24/2023] Open
Abstract
Diet is considered an important modifiable lifestyle factor capable of attenuating early cognitive changes in healthy older people. The inclusion of nuts in the diet has been investigated as a dietary strategy for maintenance of brain health across the lifespan. This review aimed to present up-to-date evidence regarding the association between nut intake and cognitive performance. Four databases (Ovid MEDLINE, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, and Embase) were systematically searched from inception to April 2020. Eligible articles were interventional or observational studies in humans aged ≥18 y that measured the effects (or association) of nuts (almond, hazelnut, macadamia, pistachio, walnut, pecan, pine nut, Brazil nut, cashew, peanut) on cognitive outcomes. Out of the 2374 articles identified in the searches, 22 involving 43,793 participants met the criteria and were ultimately included in this review. Memory (immediate and delayed), attention, processing speed, executive function, and visual-spatial ability, as well as risk of mild cognitive impairment, were the outcomes investigated. Lack of consistency across the studies regarding study design, types of nut used, and cognitive outcomes measured resulted in inconsistent evidence that the regular consumption of mixed nuts has a protective effect on cognition in adults of different ages. Nonetheless, we observed that studies targeting populations with a higher risk of cognitive decline tended to find a more favorable outcome. Furthermore, homogeneous findings were observed in the studies that specifically addressed the association between walnut consumption and cognitive performance: out of the 6 studies, including 2 randomized controlled trials, only 1 did not find a positive association.
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Affiliation(s)
- Lauren E Theodore
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - Nicole J Kellow
- Department of Nutrition, Dietetics and Food, Monash University, Victoria, Australia
| | - Emily A McNeil
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - Evangeline O Close
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
| | - Eliza G Coad
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
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