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He M, Liu Z, Lian T, Guo P, Zhang W, Huang Y, Zhang Y, Liu G, Zhang W, Li J, Guan H, Zhang W, Luo D, Qi J, Yue H, Wang X, Zhang W. Role of nerve growth factor on cognitive impairment in patients with Alzheimer's disease carrying apolipoprotein E ε4. CNS Neurosci Ther 2024; 30:e14560. [PMID: 38112032 PMCID: PMC11163191 DOI: 10.1111/cns.14560] [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: 09/27/2023] [Revised: 11/23/2023] [Accepted: 11/25/2023] [Indexed: 12/20/2023] Open
Abstract
AIMS To investigate the roles of neurotrophic factors on cognition in patients with Alzheimer's disease (AD) carrying Apolipoprotein E (APOE) ε4. METHODS Totals of 173 patients with AD were divided into APOE ε4 carrier and non-carrier groups, and their demographics, cognition, and neurotrophic factors in cerebrospinal fluid (CSF) were compared. Multiple linear regression analyses were performed to assess correlations among APOE ε4, neurotrophic factors and cognition. Mediation analyses were conducted to assess the sequential associations among APOE ε4, nerve growth factor (NGF), and cognition. RESULTS Global cognition and multiple domains were impaired in the APOE ε4 carrier group (all p < 0.05). NGF level in the APOE ε4 carrier group was lower than that in the non-carrier group (p = 0.016). NGF level showed significant correlations with both global and multiple domains cognitions. Specifically, NGF mediated the association between APOE ε4 and Animal Fluency Test score (β, -0.45; 95% CI [-0.96, -0.07]; p < 0.001) and Trail Making Test-A (time) (β, 0.15; 95% CI [0.01, 0.33]; p < 0.001). CONCLUSION APOE ε4 is associated with cognitive impairment, and those carrying APOE ε4 have decreased NGF level in CSF. Declined NGF level is correlated with compromised cognition. NGF mediates APOE ε4-associated cognitive impairment.
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Affiliation(s)
- Mingyue He
- Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Zhan Liu
- Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Tenghong Lian
- Center for Cognitive Neurology, Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Peng Guo
- Center for Cognitive Neurology, Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Wenjing Zhang
- Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Yue Huang
- Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
- Department of Pharmacology, School of Medical Sciences, Faculty of Medicine & HealthUNSW SydneySydneyNew South WalesAustralia
| | - Yanan Zhang
- Department of Blood TransfusionBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Gaifen Liu
- Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Weijiao Zhang
- Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Jinghui Li
- Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Huiying Guan
- Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Weijia Zhang
- Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Dongmei Luo
- Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Jing Qi
- Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Hao Yue
- Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
| | - Xiaomin Wang
- Department of PhysiologyCapital Medical UniversityBeijingChina
| | - Wei Zhang
- Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
- Center for Cognitive Neurology, Department of NeurologyBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological DiseasesBeijing Tiantan Hospital, Capital Medical UniversityBeijingChina
- Center of Parkinson's DiseaseBeijing Institute for Brain DisordersBeijingChina
- Beijing Key Laboratory on Parkinson DiseaseBeijingChina
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Bailey M, Ilchovska ZG, Hosseini AA, Jung J. The impact of APOE ε4 in Alzheimer's disease: a meta-analysis of voxel-based morphometry studies. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.10.24307165. [PMID: 38766196 PMCID: PMC11100948 DOI: 10.1101/2024.05.10.24307165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Background Alzheimer's disease (AD) is the most prevalent form of dementia, exerting substantial personal and societal impacts. The apolipoprotein E (APOE) ε4 allele is a known genetic factor that increases the risk of AD, contributing to more severe brain atrophy and exacerbated symptoms. Purpose We aim to provide a comprehensive review of the impacts of the APOE ε4 allele on brain atrophy in AD and mild cognitive impairment (MCI) as a transitional stage of AD. Methods We performed a coordinate-based meta-analysis of voxel-based morphometry (VBM) studies to identify the patterns of grey matter atrophy in APOE ε4 carriers vs. non-carriers. We obtained coordinate-based structural magnetic resonance imaging (MRI) data for 1135 individuals from 12 studies on PubMed and Google Scholar that met our inclusion criteria. Results We found significant atrophy in the hippocampus and parahippocampus of APOE ε4 carriers compared to non-carriers, especially within the AD and MCI groups, while healthy controls showed no significant atrophy in these regions. Conclusion Our meta-analysis sheds light on the significant link between the APOE ε4 allele and hippocampal atrophy in both AD and MCI, emphasizing the allele's critical influence on neurodegeneration, especially in the hippocampus. Our findings contribute to the understanding of the disease's pathology, potentially facilitating progress in early detection, targeted interventions, and personalized care strategies for individuals with the APOE ε4 allele who are at risk for Alzheimer's Disease.
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Affiliation(s)
| | | | - Akram A. Hosseini
- School of Medicine, University of Nottingham, UK
- Department of Academic Neurology, Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, UK
- Centre for Dementia, Institute of Mental Health, University of Nottingham, UK
| | - JeYoung Jung
- School of Psychology, University of Nottingham, UK
- Centre for Dementia, Institute of Mental Health, University of Nottingham, UK
- Precision Imaging, University of Nottingham, UK
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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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He M, Lian T, Guo P, Zhang W, Zhang Y, Huang Y, Liu G, Guan H, Li J, Luo D, Zhang W, Zhang W, Qi J, Yue H, Wang X, Zhang W. The roles of apolipoprotein E ε4 on neuropathology and neuroinflammation in patients with Alzheimer's disease. CNS Neurosci Ther 2024; 30:e14440. [PMID: 37697966 PMCID: PMC10916449 DOI: 10.1111/cns.14440] [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: 04/10/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023] Open
Abstract
AIMS To explore the roles of apolipoprotein E (APOE) ε4 on the neuropathology and neuroinflammation in Alzheimer's disease (AD) patients. METHODS AD patients were divided into the APOE ε4 carrier and the APOE ε4 non-carrier groups according to APOE genotype. Demographic information, cognitive function, the levels of neuropathological proteins and neuroinflammatory factors in cerebrospinal fluid (CSF) were compared between the two groups, and their correlations were subsequently analyzed. RESULTS β amyloid protein (Aβ)1-42 level from the APOE ε4 carrier group was significantly lower than that from the non-carrier group (p = 0.023), which was associated with worse cognitive function. The nitric oxide (NO) level was significantly elevated in the APOE ε4 carrier group compared to the non-carrier group (p = 0.016), which was significantly and positively correlated with the Trail Making Test (TMT)-A-time (r = 0.21, p = 0.026) and TMT-B-time (r = 0.38, p < 0.01). CONCLUSION APOE ε4 is associated with poorer cognition, particularly the early symptoms of memory, language, and attention. APOE ε4 is associated with lower Aβ1-42 level, and the more numbers of APOE ε4 are carried, the lower level of Aβ1-42 is measured. APOE ε4 is associated with elevated NO level, which is linked to the impaired attention and executive function.
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Grants
- Basic-Clinical Research Cooperation Funding of Capital Medical University, China (2015-JL-PT-X04, 10-JL-49, 14-JL-15)
- Beijing Healthcare Research Project, China (JING-15-2)
- Capital Clinical Characteristic Application Research (Z121107001012161)
- Capital's Funds for Health Improvement and Research (CFH) (2022-2-2048)
- Excellent Personnel Training Project of Beijing, China (20071D0300400076)
- High Level Technical Personnel Training Project of Beijing Health System, China (2009-3-26)
- Key Project of Natural Science Foundation of Beijing, China (4161004)
- Key Technology R&D Program of Beijing Municipal Education Commission (kz201610025030)
- National Key Research and Development Program of China (2016YFC1306300, 2016YFC1306000)
- National Natural Science Foundation of China (81970992, 81571229, 81071015, 30770745, 82201639)
- Natural Science Foundation of Beijing, China (7082032)
- Natural Science Foundation of Capital Medical University, Beijing, China (PYZ2018077)
- Project of Beijing Institute for Brain Disorders (BIBD-PXM2013_014226_07_000084)
- Project of Construction of Innovative Teams and Teacher Career Development for Universities and Colleges Under Beijing Municipality (IDHT20140514)
- Project of Scientific and Technological Development of Traditional Chinese Medicine in Beijing (JJ2018-48)
- The National Key R&D Program of China-European Commission Horizon 2020 (2017YFE0118800-779238)
- Youth Research Funding, Beijing Tiantan Hospital, Capital Medical University, China (2015-YQN-14, 2015-YQN-15, 2015-YQN-17)
- Capital's Funds for Health Improvement and Research (CFH) (2022‐2‐2048)
- National Key Research and Development Program of China (2016YFC1306300, 2016YFC1306000)
- National Natural Science Foundation of China (81970992, 81571229, 81071015, 30770745, 82201639)
- Natural Science Foundation of Beijing, China (7082032)
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Affiliation(s)
- Mingyue He
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Tenghong Lian
- Department of Neurology, Center for Cognitive Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Peng Guo
- Department of Neurology, Center for Cognitive Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Weijiao Zhang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Yanan Zhang
- Department of Blood Transfusion, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Yue Huang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- Department of Pharmacology, School of Medical Sciences, Faculty of Medicine & HealthUNSW SydneySydneyNew South WalesAustralia
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Gaifen Liu
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Huiying Guan
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Jinghui Li
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Dongmei Luo
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Weijia Zhang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Wenjing Zhang
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Jing Qi
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Hao Yue
- Department of Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Xiaomin Wang
- Department of PhysiologyCapital Medical UniversityBeijingChina
| | - Wei Zhang
- Department of Neurology, Center for Cognitive Neurology, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
- Center of Parkinson's DiseaseBeijing Institute for Brain DisordersBeijingChina
- Beijing Key Laboratory on Parkinson DiseaseBeijingChina
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Li L, Chen Z, Zhang L, Zhang M, Liu H, Wu D, Ren P, Zhang Z. Dynamic reconfiguration of brain coactivation states that underlying working memory correlates with cognitive decline in clinically unimpaired older adults. Cereb Cortex 2024; 34:bhad546. [PMID: 38244565 DOI: 10.1093/cercor/bhad546] [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: 11/24/2023] [Revised: 12/25/2023] [Accepted: 12/27/2023] [Indexed: 01/22/2024] Open
Abstract
Impairments in working memory (WM) are evident in both clinically diagnosed patients with mild cognitive decline and older adults at risk, as indicated by lower scores on neuropsychological tests. Examining the WM-related neural signatures in at-risk older adults becomes essential for timely intervention. WM functioning relies on dynamic brain activities, particularly within the frontoparietal system. However, it remains unclear whether the cognitive decline would be reflected in the decreased dynamic reconfiguration of brain coactivation states during WM tasks. We enrolled 47 older adults and assessed their cognitive function using the Montreal Cognitive Assessment. The temporal dynamics of brain coactivations during a WM task were investigated through graph-based time-frame modularity analysis. Four primary recurring states emerged: two task-positive states with positive activity in the frontoparietal system (dorsal attention and central executive); two task-negative states with positive activity in the default mode network accompanied by negative activity in the frontoparietal networks. Heightened WM load was associated with increased flexibility of the frontoparietal networks, but the cognitive decline was correlated with reduced capacity for neuroplastic changes in response to increased task demands. These findings advance our understanding of aberrant brain reconfiguration linked to cognitive decline, potentially aiding early identification of at-risk individuals.
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Affiliation(s)
- Linling Li
- Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, International Health Science Innovation Center, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Avenue, Nanshan District, Shenzhen, 518055, China
| | - Zaili Chen
- Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, International Health Science Innovation Center, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Avenue, Nanshan District, Shenzhen, 518055, China
- Minzu Normal University of Xingyi, No. 1 Xingyi Road, Mulong Street, Xingyi, Guizhou, 562400, China
| | - Li Zhang
- Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, International Health Science Innovation Center, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Avenue, Nanshan District, Shenzhen, 518055, China
| | - Min Zhang
- Department of Computer Science and Technology, Harbin Institute of Technology, HIT Campus of University Town of Shenzhen, NanShan District, Shenzhen, 518055, China
| | - Honghai Liu
- State Key Laboratory of Robotics and Systems, Harbin Institute of Technology, HIT Campus of University Town of Shenzhen, NanShan District, Shenzhen, 518055, China
| | - Donghui Wu
- Department of Geriatric Psychiatry, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, 1080 Cuizhu Road, Luohu District, Shenzhen, 518003, China
| | - Ping Ren
- Department of Geriatric Psychiatry, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, 1080 Cuizhu Road, Luohu District, Shenzhen, 518003, China
| | - Zhiguo Zhang
- Department of Computer Science and Technology, Harbin Institute of Technology, HIT Campus of University Town of Shenzhen, NanShan District, Shenzhen, 518055, China
- Peng Cheng Laboratory, 2 Xingke 1st Street, Nanshan District, Shenzhen, 518055, China
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Echevarria‐Cooper SL, Ho EH, Gershon RC, Weintraub S, Kahnt T. Evaluation of the NIH Toolbox Odor Identification Test across normal cognition, amnestic mild cognitive impairment, and dementia due to Alzheimer's disease. Alzheimers Dement 2024; 20:288-300. [PMID: 37603693 PMCID: PMC10843554 DOI: 10.1002/alz.13426] [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: 03/21/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 08/23/2023]
Abstract
INTRODUCTION Olfactory decline is associated with cognitive decline in aging, amnestic mild cognitive impairment (aMCI), and amnestic dementia associated with Alzheimer's disease neuropathology (ADd). The National Institutes of Health Toolbox Odor Identification Test (NIHTB-OIT) may distinguish between these clinical categories. METHODS We compared NIHTB-OIT scores across normal cognition (NC), aMCI, and ADd participants (N = 389, ≥65 years) and between participants positive versus negative for AD biomarkers and the APOE ε4 allele. RESULTS NIHTB-OIT scores decreased with age (p < 0.001) and were lower for aMCI (p < 0.001) and ADd (p < 0.001) compared to NC participants, correcting for age and sex. The NIHTB-OIT detects aMCI (ADd) versus NC participants with 49.4% (56.5%) sensitivity and 88.8% (89.5%) specificity. NIHTB-OIT scores were lower for participants with positive AD biomarkers (p < 0.005), but did not differ based on the APOE ε4 allele (p > 0.05). DISCUSSION The NIHTB-OIT distinguishes clinically aMCI and ADd participants from NC participants. HIGHLIGHTS National Institutes of Health Toolbox Odor Identification Test (NIHTB-OIT) discriminated normal controls from mild cognitive impairment. NIHTB-OIT discriminated normal controls from Alzheimer's disease dementia. Rate of olfactory decline with age was similar across all diagnostic categories. NIHTB-OIT scores were lower in participants with positive Alzheimer's biomarker tests. NIHTB-OIT scores did not differ based on APOE genotype.
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Affiliation(s)
| | - Emily H. Ho
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Richard C. Gershon
- Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's DiseaseNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Department of Psychiatry and Behavioral SciencesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Thorsten Kahnt
- Department of NeurologyNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
- Cellular and Neurocomputational Systems BranchNational Institute on Drug Abuse Intramural Research ProgramBaltimoreMarylandUSA
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Scheinman SB, Tseng KY, Alford S, Tai LM. Higher Neuronal Facilitation and Potentiation with APOE4 Suppressed by Angiotensin II. Mol Neurobiol 2024; 61:120-131. [PMID: 37589833 PMCID: PMC10843153 DOI: 10.1007/s12035-023-03556-9] [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: 05/22/2023] [Accepted: 08/01/2023] [Indexed: 08/18/2023]
Abstract
Progressive hippocampal degeneration is a key component of Alzheimer's disease (AD) progression. Therefore, identifying how hippocampal neuronal function is modulated early in AD is an important approach to eventually prevent degeneration. AD-risk factors and signaling molecules likely modulate neuronal function, including APOE genotype and angiotensin II. Compared to APOE3, APOE4 increases AD risk up to 12-fold, and high levels of angiotensin II are hypothesized to disrupt neuronal function in AD. However, the extent that APOE and angiotensin II modulates the hippocampal neuronal phenotype in AD-relevant models is unknown. To address this issue, we used electrophysiological techniques to assess the impact of APOE genotype and angiotensin II on basal synaptic transmission, presynaptic, and post-synaptic activity in mice that express human APOE3 (E3FAD) or APOE4 (E4FAD) and overproduce Aβ. We found that compared to E3FAD mice, E4FAD mice have lower synaptic activity, but higher levels of paired-pulse facilitation (PPF) and long-term potentiation (LTP) in the Schaffer Collateral Commissural Pathway (SCCP) of the hippocampus. We also found that exogenous angiotensin II has a profound inhibitory effect on hippocampal LTP in both E3FAD and E4FAD mice. Collectively, our data suggests that APOE4 and Aβ are associated with a hippocampal phenotype comprised of lower basal activity and higher responses to high-frequency stimulation, the latter of which is suppressed by angiotensin II. These novel data suggest a potential mechanistic link between hippocampal activity, APOE4 genotype, and angiotensin II in AD.
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Affiliation(s)
- Sarah B Scheinman
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, 808 S. Wood St. Rm 578 MC 512, Chicago, IL, 60612, USA
| | - Kuei Y Tseng
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, 808 S. Wood St. Rm 578 MC 512, Chicago, IL, 60612, USA
| | - Simon Alford
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, 808 S. Wood St. Rm 578 MC 512, Chicago, IL, 60612, USA
| | - Leon M Tai
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, 808 S. Wood St. Rm 578 MC 512, Chicago, IL, 60612, USA.
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Caminiti SP, De Francesco S, Tondo G, Galli A, Redolfi A, Perani D. FDG-PET markers of heterogeneity and different risk of progression in amnestic MCI. Alzheimers Dement 2024; 20:159-172. [PMID: 37505996 PMCID: PMC10962797 DOI: 10.1002/alz.13385] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/19/2023] [Accepted: 06/12/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Amnestic mild cognitive impairment (aMCI) is emerging as a heterogeneous condition. METHODS We looked at a cohort of N = 207 aMCI subjects, with baseline fluorodeoxyglucose positron emission tomography (FDG-PET), T1 magnetic resonance imaging, cerebrospinal fluid (CSF), apolipoprotein E (APOE), and neuropsychological assessment. An algorithm based on FDG-PET hypometabolism classified each subject into subtypes, then compared biomarker measures and clinical progression. RESULTS Three subtypes emerged: hippocampal sparing-cortical hypometabolism, associated with younger age and the highest level of Alzheimer's disease (AD)-CSF pathology; hippocampal/cortical hypometabolism, associated with a high percentage of APOE ε3/ε4 or ε4/ε4 carriers; medial-temporal hypometabolism, characterized by older age, the lowest AD-CSF pathology, the most severe hippocampal atrophy, and a benign course. Within the whole cohort, the severity of temporo-parietal hypometabolism, correlated with AD-CSF pathology and marked the rate of progression of cognitive decline. DISCUSSION FDG-PET can distinguish clinically comparable aMCI at single-subject level with different risk of progression to AD dementia or stability. The obtained results can be useful for the optimization of pharmacological trials and automated-classification models. HIGHLIGHTS Algorithm based on FDG-PET hypometabolism demonstrates distinct subtypes across aMCI; Three different subtypes show heterogeneous biological profiles and risk of progression; The cortical hypometabolism is associated with AD pathology and cognitive decline; MTL hypometabolism is associated with the lowest conversion rate and CSF-AD pathology.
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Affiliation(s)
- Silvia Paola Caminiti
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Silvia De Francesco
- Laboratory of NeuroinformaticsIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Giacomo Tondo
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Alice Galli
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Alberto Redolfi
- Laboratory of NeuroinformaticsIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Daniela Perani
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
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9
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Motter JN, Choi J, Lee S, Goldberg TE, Albert S, Devanand DP. Association of Performance on Olfactory and Cognitive Screening Tests With Conversion to Dementia in a Biracial Cohort of Older Adults. Neurology 2023; 101:e1046-e1055. [PMID: 37414570 PMCID: PMC10491446 DOI: 10.1212/wnl.0000000000207578] [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: 12/11/2022] [Accepted: 05/10/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Odor identification deficits are associated with transition to dementia, whereas intact odor identification and global cognition test performance may identify lack of transition. The purpose of this study was to examine intact odor identification and global cognition as prognostic indicators of lack of transition to dementia in a biracial (Black and White) cohort. METHODS In a community-dwelling sample of older adults from the Health, Aging, and Body Composition study, odor identification was measured using the Brief Smell Identification Test (BSIT), and global cognition was measured using the Teng Modified Mini-Mental State Examination (3MS). Survival analyses for dementia transition over 4 and 8 years of follow-up used Cox proportional hazards models. RESULTS A total of 2,240 participants had an average age of 75.5 years (SD 2.8). Approximately 52.7% were female individuals. Approximately 36.7% were Black and 63.3% were White individuals. Impaired odor identification (hazard ratio [HR] 2.29, 95% CI 1.79-2.94, p < 0.001) and global cognition (HR 3.31, 95% CI 2.26-4.84, p < 0.001) were each independently associated with transition to dementia (n = 281). Odor identification remained robustly associated with transition to dementia for Black (HR 2.02, 95% CI 1.36-3.00, p < 0.001, n = 821) and White participants (HR 2.45, 95% CI 1.77-3.38, p < 0.001, n = 1,419), whereas global cognition was associated with transition among Black participants only (HR 5.06, 95% CI 3.18-8.07, p < 0.001). ApoE genotype was consistently associated with transition among White participants only (HR 1.75, 95% CI 1.20-2.54, p < 0.01). Among participants with intact performance on both odor identification (BSIT ≥9/12 correct) and global cognition (3MS ≥ 78/100 correct), 8.8% transitioned to dementia over 8 years. Intact performance on both measures had high positive predictive value for identifying individuals who did not transition to dementia over 4 years (0.98 for ages 70-75 years with only 2.3% transitioning, 0.94 for ages 76-82 years with only 5.8% transitioning). DISCUSSION Odor identification testing paired with a global cognitive screening test identified individuals at low risk of transition to dementia in a biracial community cohort with a pronounced effect in the eighth decade of life. Identification of such individuals can reduce the need for extensive investigation to establish a diagnosis. Odor identification deficits showed utility in both Black and White participants, unlike the race-dependent utility of a global cognitive test and ApoE genotype.
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Affiliation(s)
- Jeffrey N Motter
- From the Department of Psychiatry (J.N.M., S.L., T.E.G., D.P.D.), Columbia University, New York; Division of Geriatric Psychiatry (J.N.M., T.E.G., D.P.D.), and Division of Mental Health Data Science (J.C., S.L.), New York State Psychiatric Institute, New York; Department of Biostatistics (S.L.), Columbia University, New York, NY; and Department of Behavioral and Community Health Sciences (S.A.), Graduate School of Public Health, University of Pittsburgh, PA.
| | - Jongwoo Choi
- From the Department of Psychiatry (J.N.M., S.L., T.E.G., D.P.D.), Columbia University, New York; Division of Geriatric Psychiatry (J.N.M., T.E.G., D.P.D.), and Division of Mental Health Data Science (J.C., S.L.), New York State Psychiatric Institute, New York; Department of Biostatistics (S.L.), Columbia University, New York, NY; and Department of Behavioral and Community Health Sciences (S.A.), Graduate School of Public Health, University of Pittsburgh, PA
| | - Seonjoo Lee
- From the Department of Psychiatry (J.N.M., S.L., T.E.G., D.P.D.), Columbia University, New York; Division of Geriatric Psychiatry (J.N.M., T.E.G., D.P.D.), and Division of Mental Health Data Science (J.C., S.L.), New York State Psychiatric Institute, New York; Department of Biostatistics (S.L.), Columbia University, New York, NY; and Department of Behavioral and Community Health Sciences (S.A.), Graduate School of Public Health, University of Pittsburgh, PA
| | - Terry E Goldberg
- From the Department of Psychiatry (J.N.M., S.L., T.E.G., D.P.D.), Columbia University, New York; Division of Geriatric Psychiatry (J.N.M., T.E.G., D.P.D.), and Division of Mental Health Data Science (J.C., S.L.), New York State Psychiatric Institute, New York; Department of Biostatistics (S.L.), Columbia University, New York, NY; and Department of Behavioral and Community Health Sciences (S.A.), Graduate School of Public Health, University of Pittsburgh, PA
| | - Steven Albert
- From the Department of Psychiatry (J.N.M., S.L., T.E.G., D.P.D.), Columbia University, New York; Division of Geriatric Psychiatry (J.N.M., T.E.G., D.P.D.), and Division of Mental Health Data Science (J.C., S.L.), New York State Psychiatric Institute, New York; Department of Biostatistics (S.L.), Columbia University, New York, NY; and Department of Behavioral and Community Health Sciences (S.A.), Graduate School of Public Health, University of Pittsburgh, PA
| | - Davangere P Devanand
- From the Department of Psychiatry (J.N.M., S.L., T.E.G., D.P.D.), Columbia University, New York; Division of Geriatric Psychiatry (J.N.M., T.E.G., D.P.D.), and Division of Mental Health Data Science (J.C., S.L.), New York State Psychiatric Institute, New York; Department of Biostatistics (S.L.), Columbia University, New York, NY; and Department of Behavioral and Community Health Sciences (S.A.), Graduate School of Public Health, University of Pittsburgh, PA
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10
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Walters S, Contreras AG, Eissman JM, Mukherjee S, Lee ML, Choi SE, Scollard P, Trittschuh EH, Mez JB, Bush WS, Kunkle BW, Naj AC, Peterson A, Gifford KA, Cuccaro ML, Cruchaga C, Pericak-Vance MA, Farrer LA, Wang LS, Haines JL, Jefferson AL, Kukull WA, Keene CD, Saykin AJ, Thompson PM, Martin ER, Bennett DA, Barnes LL, Schneider JA, Crane PK, Hohman TJ, Dumitrescu L. Associations of Sex, Race, and Apolipoprotein E Alleles With Multiple Domains of Cognition Among Older Adults. JAMA Neurol 2023; 80:929-939. [PMID: 37459083 PMCID: PMC10352930 DOI: 10.1001/jamaneurol.2023.2169] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/15/2023] [Indexed: 07/20/2023]
Abstract
Importance Sex differences are established in associations between apolipoprotein E (APOE) ε4 and cognitive impairment in Alzheimer disease (AD). However, it is unclear whether sex-specific cognitive consequences of APOE are consistent across races and extend to the APOE ε2 allele. Objective To investigate whether sex and race modify APOE ε4 and ε2 associations with cognition. Design, Setting, and Participants This genetic association study included longitudinal cognitive data from 4 AD and cognitive aging cohorts. Participants were older than 60 years and self-identified as non-Hispanic White or non-Hispanic Black (hereafter, White and Black). Data were previously collected across multiple US locations from 1994 to 2018. Secondary analyses began December 2021 and ended September 2022. Main Outcomes and Measures Harmonized composite scores for memory, executive function, and language were generated using psychometric approaches. Linear regression assessed interactions between APOE ε4 or APOE ε2 and sex on baseline cognitive scores, while linear mixed-effect models assessed interactions on cognitive trajectories. The intersectional effect of race was modeled using an APOE × sex × race interaction term, assessing whether APOE × sex interactions differed by race. Models were adjusted for age at baseline and corrected for multiple comparisons. Results Of 32 427 participants who met inclusion criteria, there were 19 007 females (59%), 4453 Black individuals (14%), and 27 974 White individuals (86%); the mean (SD) age at baseline was 74 years (7.9). At baseline, 6048 individuals (19%) had AD, 4398 (14%) were APOE ε2 carriers, and 12 538 (38%) were APOE ε4 carriers. Participants missing APOE status were excluded (n = 9266). For APOE ε4, a robust sex interaction was observed on baseline memory (β = -0.071, SE = 0.014; P = 9.6 × 10-7), whereby the APOE ε4 negative effect was stronger in females compared with males and did not significantly differ among races. Contrastingly, despite the large sample size, no APOE ε2 × sex interactions on cognition were observed among all participants. When testing for intersectional effects of sex, APOE ε2, and race, an interaction was revealed on baseline executive function among individuals who were cognitively unimpaired (β = -0.165, SE = 0.066; P = .01), whereby the APOE ε2 protective effect was female-specific among White individuals but male-specific among Black individuals. Conclusions and Relevance In this study, while race did not modify sex differences in APOE ε4, the APOE ε2 protective effect could vary by race and sex. Although female sex enhanced ε4-associated risk, there was no comparable sex difference in ε2, suggesting biological pathways underlying ε4-associated risk are distinct from ε2 and likely intersect with age-related changes in sex biology.
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Affiliation(s)
- Skylar Walters
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alex G. Contreras
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jaclyn M. Eissman
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Michael L. Lee
- Department of Medicine, University of Washington, Seattle
| | - Seo-Eun Choi
- Department of Medicine, University of Washington, Seattle
| | | | - Emily H. Trittschuh
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
- Geriatric Research Education and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, Washington
| | - Jesse B. Mez
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - William S. Bush
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Brian W. Kunkle
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Adam C. Naj
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Amalia Peterson
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Katherine A. Gifford
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Michael L. Cuccaro
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St Louis, Missouri
| | - Margaret A. Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Lindsay A. Farrer
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
- Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Li-San Wang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Jonathan L. Haines
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Angela L. Jefferson
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Walter A. Kukull
- Department of Epidemiology, School of Public Health, University of Washington, Seattle
| | - C. Dirk Keene
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle
| | - Andrew J. Saykin
- Department of Radiology and Imaging Services, Indiana University School of Medicine, Indianapolis
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis
| | - Paul M. Thompson
- Keck School of Medicine, University of Southern California, Los Angeles
| | - Eden R. Martin
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Julie A. Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Paul K. Crane
- Department of Medicine, University of Washington, Seattle
| | - Timothy J. Hohman
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Logan Dumitrescu
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
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11
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Pizzonia KL, Suhr JA, Clark LA, Clark BC. The relation of ApoE and COMT gene-gene interactions to cognitive and motor function in community-dwelling older adults: a pilot study. Front Aging Neurosci 2023; 15:1206473. [PMID: 37744392 PMCID: PMC10513033 DOI: 10.3389/fnagi.2023.1206473] [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: 04/15/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Certain genes increase the risk of age-related neurological dysfunction and/or disease. For instance, ApoE is a well-known gene carrying risk for Alzheimer's disease, while COMT has been associated with age-related reductions in motor function. There is growing interest in the interrelationship between age-related changes in cognitive and motor function, and examining gene-gene interactions in this context. In this pilot study we examined the relations of the ApoE and COMT genes and their interaction to both cognitive and motor performance in community-dwelling older adults. Methods We leveraged an archived dataset from a prior study on age-related muscle weakness in community-dwelling older adults. Sample size was between 72 and 82 individuals based on missing data. We examined the relationship of ApoE (Ɛ4 presence/absence), rs4680 SNP on the COMT gene (Val/Met, Val/Val, Met/Met), and sex on (1) overall cognitive functioning and specific cognitive domains known to decline in aging (processing speed, immediate and delayed memory, semantic and phonemic fluency, and executive functioning), and (2) indices of motor function (four square step test, short physical performance battery, grip strength/forearm lean mass, and purdue pegboard test). Results Homozygous COMT genotypes were associated with worse global cognitive performance, immediate memory, and semantic fluency, but only for older adults with at least one ApoE Ɛ4 allele. There were main effects for COMT for delayed memory and a main effect for both COMT and ApoE for coding and phonemic fluency. Women scored higher than men in overall cognition, immediate and delayed memory, and semantic fluency. There were no main effects or gene interactions for a measure of executive functioning (trial making test part B) or any of the measures of motor function. Discussion COMT, ApoE, and their interaction influence cognitive performance, but not motor functioning, in community dwelling older adults. Our work supports prior literature concluding that a heterozygous COMT genotype may be beneficial to sustain healthy cognitive functioning with advancing age for those who have a higher ApoE genetic risk status (at least one Ɛ4 allele). Future research should investigate interactions between COMT and ApoE in larger samples with comprehensive assessment of cognition and motor functioning.
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Affiliation(s)
- Kendra L. Pizzonia
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States
- Department of Psychology, Ohio University, Athens, OH, United States
| | - Julie A. Suhr
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States
- Department of Psychology, Ohio University, Athens, OH, United States
| | - Leatha A. Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States
| | - Brian C. Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, United States
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States
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12
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Donato L, Mordà D, Scimone C, Alibrandi S, D'Angelo R, Sidoti A. How Many Alzheimer-Perusini's Atypical Forms Do We Still Have to Discover? Biomedicines 2023; 11:2035. [PMID: 37509674 PMCID: PMC10377159 DOI: 10.3390/biomedicines11072035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/17/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Alzheimer-Perusini's (AD) disease represents the most spread dementia around the world and constitutes a serious problem for public health. It was first described by the two physicians from whom it took its name. Nowadays, we have extensively expanded our knowledge about this disease. Starting from a merely clinical and histopathologic description, we have now reached better molecular comprehension. For instance, we passed from an old conceptualization of the disease based on plaques and tangles to a more modern vision of mixed proteinopathy in a one-to-one relationship with an alteration of specific glial and neuronal phenotypes. However, no disease-modifying therapies are yet available. It is likely that the only way to find a few "magic bullets" is to deepen this aspect more and more until we are able to draw up specific molecular profiles for single AD cases. This review reports the most recent classifications of AD atypical variants in order to summarize all the clinical evidence using several discrimina (for example, post mortem neurofibrillary tangle density, cerebral atrophy, or FDG-PET studies). The better defined four atypical forms are posterior cortical atrophy (PCA), logopenic variant of primary progressive aphasia (LvPPA), behavioral/dysexecutive variant and AD with corticobasal degeneration (CBS). Moreover, we discuss the usefulness of such classifications before outlining the molecular-genetic aspects focusing on microglial activity or, more generally, immune system control of neuroinflammation and neurodegeneration.
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Affiliation(s)
- Luigi Donato
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Division of Medical Biotechnologies and Preventive Medicine, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
- Department of Biomolecular Strategies, Genetics, Cutting-Edge Therapies, Euro-Mediterranean Institute of Science and Technology, Via Michele Miraglia, 98139 Palermo, Italy
| | - Domenico Mordà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Division of Medical Biotechnologies and Preventive Medicine, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
- Department of Biomolecular Strategies, Genetics, Cutting-Edge Therapies, Euro-Mediterranean Institute of Science and Technology, Via Michele Miraglia, 98139 Palermo, Italy
| | - Concetta Scimone
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Division of Medical Biotechnologies and Preventive Medicine, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
- Department of Biomolecular Strategies, Genetics, Cutting-Edge Therapies, Euro-Mediterranean Institute of Science and Technology, Via Michele Miraglia, 98139 Palermo, Italy
| | - Simona Alibrandi
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Division of Medical Biotechnologies and Preventive Medicine, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno D'Alcontres 31, 98166 Messina, Italy
| | - Rosalia D'Angelo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Division of Medical Biotechnologies and Preventive Medicine, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
| | - Antonina Sidoti
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Division of Medical Biotechnologies and Preventive Medicine, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
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13
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Scheinman SB, Tseng KY, Alford S, Tai LM. Higher Neuronal Facilitation and Potentiation with APOE4 Suppressed by Angiotensin II. RESEARCH SQUARE 2023:rs.3.rs-2960437. [PMID: 37292788 PMCID: PMC10246245 DOI: 10.21203/rs.3.rs-2960437/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Progressive hippocampal degeneration is a key component of Alzheimer's disease (AD) progression. Therefore, identifying how hippocampal neuronal function is modulated early in AD is an important approach to eventually prevent degeneration. AD-risk factors and signaling molecules likely modulate neuronal function, including APOE genotype and angiotensin II. Compared to APOE3 , APOE4 increases AD risk up to 12-fold, and high levels of angiotensin II are hypothesized to disrupt neuronal function in AD. However, the extent that APOE and angiotensin II modulates the hippocampal neuronal phenotype in AD-relevant models is unknown. To address this issue, we used electrophysiological techniques to assess the impact of APOE genotype and angiotensin II on basal synaptic transmission, presynaptic and post-synaptic activity in mice that express human APOE3 (E3FAD) or APOE4 (E4FAD) and overproduce Aβ. We found that compared to E3FAD mice, E4FAD mice had lower basal synaptic activity, but higher levels of paired pulse facilitation (PPF) and Long-Term Potentiation (LTP) in the Schaffer Collateral Commissural Pathway (SCCP) of the hippocampus. We also found that exogenous angiotensin II has a profound inhibitory effect on hippocampal LTP in both E3FAD and E4FAD mice. Collectively, our data suggests that APOE4 and Aβ are associated with a hippocampal phenotype comprised of lower basal activity and higher responses to high frequency stimulation, the latter of which is suppressed by angiotensin II. These novel data suggest a potential mechanistic link between hippocampal activity, APOE4 genotype and angiotensin II in AD.
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Affiliation(s)
| | - Kuei Y Tseng
- University of Illinois at Chicago College of Medicine
| | - Simon Alford
- University of Illinois at Chicago College of Medicine
| | - Leon M Tai
- University of Illinois at Chicago College of Medicine
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14
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Ribas MZ, Paticcié GF, Noleto FM, Ramanzini LG, Veras ADO, Dall'Oglio R, Filho LBDA, Martins da Silva JG, Lima MPP, Teixeira BE, Nunes de Sousa G, Alves AFC, Vieira Lima LMF, Sallem CC, Garcia TFM, Ponte de Oliveira IM, Rocha RSDC, Jucá MDS, Barroso ST, Claudino Dos Santos JC. Impact of dysexecutive syndrome in quality of life in Alzheimer disease: What we know now and where we are headed. Ageing Res Rev 2023; 86:101866. [PMID: 36709886 DOI: 10.1016/j.arr.2023.101866] [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: 12/26/2022] [Revised: 01/18/2023] [Accepted: 01/25/2023] [Indexed: 01/27/2023]
Abstract
Alzheimer's disease (AD) is a common form of dementia that leads to multiple repercussions in the patient's life. This condition's clinical characteristics include loss of memory, temporal and spatial disorientation, language or executive dysfunction, and subsequent decline of social function. Dysexecutive syndrome (DS), the second most frequent neuropsychological dysfunction in AD, affects multiple brain areas and causes cognitive, behavioral, and emotional difficulties. We aimed to analyze the association between DS and AD and elucidate possible lack of evidence that may urge further research on this theme. Especially when dealing with such a disabling disease, where new findings can directly imply a better prognosis.
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Affiliation(s)
| | | | - Felipe Micelli Noleto
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil
| | | | - Arthur de Oliveira Veras
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | - Renato Dall'Oglio
- Faculdade Evangélica Mackenzie do Paraná (FEMPAR), Curitiba, PR, Brazil
| | | | | | | | | | | | | | | | - Camilla Costa Sallem
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil
| | - Tulia Fernanda Meira Garcia
- Escola Multicampi de Ciências Médicas do RN, Universidade Federal do Rio Grande do Norte (EMCM-UFRN), Caicó, RN, Brazil
| | | | | | - Mikaio de Sousa Jucá
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil
| | - Sarah Távora Barroso
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil
| | - Júlio César Claudino Dos Santos
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil; Universidade Federal de São Paulo, São Paulo, SP, Brazil.
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15
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Quan M, Wang Q, Qin W, Wang W, Li F, Zhao T, Li T, Qiu Q, Cao S, Wang S, Wang Y, Jin H, Zhou A, Fang J, Jia L, Jia J. Shared and unique effects of ApoEε4 and pathogenic gene mutation on cognition and imaging in preclinical familial Alzheimer's disease. Alzheimers Res Ther 2023; 15:40. [PMID: 36850008 PMCID: PMC9972804 DOI: 10.1186/s13195-023-01192-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 02/13/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Neuropsychology and imaging changes have been reported in the preclinical stage of familial Alzheimer's disease (FAD). This study investigated the effects of APOEε4 and known pathogenic gene mutation on different cognitive domains and circuit imaging markers in preclinical FAD. METHODS One hundred thirty-nine asymptomatic subjects in FAD families, including 26 APOEε4 carriers, 17 APP and 20 PS1 mutation carriers, and 76 control subjects, went through a series of neuropsychological tests and MRI scanning. Test scores and imaging measures including volumes, diffusion indices, and functional connectivity (FC) of frontostriatal and hippocampus to posterior cingulate cortex pathways were compared between groups and analyzed for correlation. RESULTS Compared with controls, the APOEε4 group showed increased hippocampal volume and decreased FC of fronto-caudate pathway. The APP group showed increased recall scores in auditory verbal learning test, decreased fiber number, and increased radial diffusivity and FC of frontostriatal pathway. All three genetic groups showed decreased fractional anisotropy of hippocampus to posterior cingulate cortex pathway. These neuropsychological and imaging measures were able to discriminate genetic groups from controls, with areas under the curve from 0.733 to 0.837. Circuit imaging measures are differentially associated with scores in various cognitive scales in control and genetic groups. CONCLUSIONS There are neuropsychological and imaging changes in the preclinical stage of FAD, some of which are shared by APOEε4 and known pathogenic gene mutation, while some are unique to different genetic groups. These findings are helpful for the early identification of Alzheimer's disease and for developing generalized and individualized prevention and intervention strategies.
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Affiliation(s)
- Meina Quan
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China ,grid.24696.3f0000 0004 0369 153XClinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China
| | - Qi Wang
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China ,grid.24696.3f0000 0004 0369 153XClinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China
| | - Wei Qin
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China ,grid.24696.3f0000 0004 0369 153XClinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China
| | - Wei Wang
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China ,grid.24696.3f0000 0004 0369 153XClinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China
| | - Fangyu Li
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China ,grid.24696.3f0000 0004 0369 153XClinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China
| | - Tan Zhao
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Tingting Li
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China ,grid.24696.3f0000 0004 0369 153XClinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China
| | - Qiongqiong Qiu
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China ,grid.24696.3f0000 0004 0369 153XClinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China
| | - Shuman Cao
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China ,grid.24696.3f0000 0004 0369 153XClinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China
| | - Shiyuan Wang
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China ,grid.24696.3f0000 0004 0369 153XClinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China
| | - Yan Wang
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China ,grid.24696.3f0000 0004 0369 153XClinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China
| | - Hongmei Jin
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China ,grid.24696.3f0000 0004 0369 153XClinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China
| | - Aihong Zhou
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China ,grid.24696.3f0000 0004 0369 153XClinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China
| | - Jiliang Fang
- grid.464297.aGuang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Longfei Jia
- grid.413259.80000 0004 0632 3337Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China ,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China ,grid.24696.3f0000 0004 0369 153XClinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China ,grid.24696.3f0000 0004 0369 153XCenter of Alzheimer’s Disease, Beijing Institute for Brain Disorders, Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China
| | - Jianping Jia
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China. .,National Center for Neurological Disorders and National Clinical Research Center for Geriatric Diseases, Beijing, China. .,Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China. .,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China. .,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China. .,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, China.
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16
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Qian J, Zhang Y, Betensky RA, Hyman BT, Serrano-Pozo A. Neuropathology-Independent Association Between APOE Genotype and Cognitive Decline Rate in the Normal Aging-Early Alzheimer Continuum. Neurol Genet 2023; 9:e200055. [PMID: 36698453 PMCID: PMC9869750 DOI: 10.1212/nxg.0000000000200055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/16/2022] [Indexed: 01/22/2023]
Abstract
Background and Objectives We previously found that the APOE genotype affects the rate of cognitive decline in mild-to-moderate Alzheimer disease (AD) dementia independently of its effects on AD neuropathologic changes (ADNC) and copathologies. In this study, we tested the hypothesis that the APOE alleles differentially affect the rate of cognitive decline at the normal aging-early AD continuum and that this association is independent of their effects on classical ADNC and copathologies. Methods We analyzed APOE associations with the cognitive trajectories (Clinical Dementia Rating scale Sum of Boxes [CDR-SOB] and Mini-Mental State Examination [MMSE]) of more than 1,000 individuals from a national clinicopathologic sample who had either no, mild (sparse neuritic plaques and the Braak neurofibrillary tangle [NFT] stage I/II), or intermediate (moderate neuritic plaques and the Braak NFT stage III/IV) ADNC levels at autopsy via 2 latent classes reverse-time longitudinal modeling. Results Carrying the APOEε4 allele was associated with a faster rate of cognitive decline by both CDR-SOB and MMSE relative to APOEε3 homozygotes. This association remained statistically significant after adjusting for ADNC severity, comorbid pathologies, and the effects of ADNC on the slope of cognitive decline. Our modeling strategy identified 2 latent classes in which APOEε4 carriers declined faster than APOEε3 homozygotes, with latent class 1 members representing slow decliners (CDR-SOB: 76.7% of individuals, 0.195 vs 0.146 points/y in APOEε4 vs APOEε3/ε3; MMSE: 88.6% of individuals, -0.303 vs -0.153 points/y in APOEε4 vs APOEε3/ε3), whereas latent class 2 members were fast decliners (CDR-SOB: 23.3% of participants, 1.536 vs 1.487 points/y in APOEε4 vs APOEε3/ε3; MMSE: 11.4% of participants, -2.538 vs -2.387 points/y in APOEε4 vs APOEε3/ε3). Compared with slow decliners, fast decliners were more likely to carry the APOEε4 allele, younger at initial visit and death, more impaired at initial and last visits, and more likely to have intermediate (vs none or mild) ADNC levels, as well as concurrent Lewy bodies and hippocampal sclerosis at autopsy. Discussion In a large national sample selected to represent the normal aging-early AD continuum, the APOEε4 allele is associated with a modest but statistically significant acceleration of the cognitive decline rate even after controlling for its effects on ADNC and comorbid pathologies.
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Affiliation(s)
- Jing Qian
- University of Massachusetts School of Public Health & Health Sciences (J.Q., Y.Z.), Amherst; Massachusetts General Hospital Biostatistics Center (J.Q.), Boston; New York University School of Global Public Health (R.A.B.); New York University Alzheimer's Disease Research Center (R.A.B.); Massachusetts General Hospital Neurology Department (B.T.H., A.S.-P.), Boston; Massachusetts Alzheimer's Disease Research Center (B.T.H., A.S.-P.), Charlestown; and Harvard Medical School (B.T.H., A.S.-P.), Boston, MA
| | - Yiding Zhang
- University of Massachusetts School of Public Health & Health Sciences (J.Q., Y.Z.), Amherst; Massachusetts General Hospital Biostatistics Center (J.Q.), Boston; New York University School of Global Public Health (R.A.B.); New York University Alzheimer's Disease Research Center (R.A.B.); Massachusetts General Hospital Neurology Department (B.T.H., A.S.-P.), Boston; Massachusetts Alzheimer's Disease Research Center (B.T.H., A.S.-P.), Charlestown; and Harvard Medical School (B.T.H., A.S.-P.), Boston, MA
| | - Rebecca A Betensky
- University of Massachusetts School of Public Health & Health Sciences (J.Q., Y.Z.), Amherst; Massachusetts General Hospital Biostatistics Center (J.Q.), Boston; New York University School of Global Public Health (R.A.B.); New York University Alzheimer's Disease Research Center (R.A.B.); Massachusetts General Hospital Neurology Department (B.T.H., A.S.-P.), Boston; Massachusetts Alzheimer's Disease Research Center (B.T.H., A.S.-P.), Charlestown; and Harvard Medical School (B.T.H., A.S.-P.), Boston, MA
| | - Bradley T Hyman
- University of Massachusetts School of Public Health & Health Sciences (J.Q., Y.Z.), Amherst; Massachusetts General Hospital Biostatistics Center (J.Q.), Boston; New York University School of Global Public Health (R.A.B.); New York University Alzheimer's Disease Research Center (R.A.B.); Massachusetts General Hospital Neurology Department (B.T.H., A.S.-P.), Boston; Massachusetts Alzheimer's Disease Research Center (B.T.H., A.S.-P.), Charlestown; and Harvard Medical School (B.T.H., A.S.-P.), Boston, MA
| | - Alberto Serrano-Pozo
- University of Massachusetts School of Public Health & Health Sciences (J.Q., Y.Z.), Amherst; Massachusetts General Hospital Biostatistics Center (J.Q.), Boston; New York University School of Global Public Health (R.A.B.); New York University Alzheimer's Disease Research Center (R.A.B.); Massachusetts General Hospital Neurology Department (B.T.H., A.S.-P.), Boston; Massachusetts Alzheimer's Disease Research Center (B.T.H., A.S.-P.), Charlestown; and Harvard Medical School (B.T.H., A.S.-P.), Boston, MA
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17
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Roseborough AD, Saad L, Goodman M, Cipriano LE, Hachinski VC, Whitehead SN. White matter hyperintensities and longitudinal cognitive decline in cognitively normal populations and across diagnostic categories: A meta-analysis, systematic review, and recommendations for future study harmonization. Alzheimers Dement 2023; 19:194-207. [PMID: 35319162 DOI: 10.1002/alz.12642] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The primary aim of this paper is to improve the clinical interpretation of white matter hyperintensities (WMHs) and provide an overarching summary of methodological approaches, allowing researchers to design future studies targeting current knowledge gaps. METHODS A meta-analysis and systematic review was performed investigating associations between baseline WMHs and longitudinal cognitive outcomes in cognitively normal populations, and populations with mild cognitive impairment (MCI), Alzheimer's disease (AD), and stroke. RESULTS Baseline WMHs increase the risk of cognitive impairment and dementia across diagnostic categories and most consistently in MCI and post-stroke populations. Apolipoprotein E (APOE) genotype and domain-specific cognitive changes relating to strategic anatomical locations, such as frontal WMH and executive decline, represent important considerations. Meta-analysis reliability was assessed using multiple methods of estimation, and results suggest that heterogeneity in study design and reporting remains a significant barrier. DISCUSSION Recommendations and future directions for study of WMHs are provided to improve cross-study comparison and translation of research into consistent clinical interpretation.
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Affiliation(s)
- Austyn D Roseborough
- Vulnerable Brain Laboratory, Department of Anatomy and Cell Biology, The Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Lorenzo Saad
- Vulnerable Brain Laboratory, Department of Anatomy and Cell Biology, The Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Maren Goodman
- Western Libraries, The University of Western Ontario, London, Ontario, Canada
| | - Lauren E Cipriano
- Ivey Business School and Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada
| | - Vladimir C Hachinski
- Department of Clinical Neurological Sciences, The Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Shawn N Whitehead
- Vulnerable Brain Laboratory, Department of Anatomy and Cell Biology, The Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
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18
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Rogojin A, Gorbet DJ, Hawkins KM, Sergio LE. Differences in resting state functional connectivity underlie visuomotor performance declines in older adults with a genetic risk (APOE ε4) for Alzheimer’s disease. Front Aging Neurosci 2022; 14:1054523. [DOI: 10.3389/fnagi.2022.1054523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/15/2022] [Indexed: 12/04/2022] Open
Abstract
IntroductionNon-standard visuomotor integration requires the interaction of large networks in the brain. Previous findings have shown that non-standard visuomotor performance is impaired in individuals with specific dementia risk factors (family history of dementia and presence of the APOE ε4 allele) in advance of any cognitive impairments. These findings suggest that visuomotor impairments are associated with early dementia-related brain changes. The current study examined the underlying resting state functional connectivity (RSFC) associated with impaired non-standard visuomotor performance, as well as the impacts of dementia family history, sex, and APOE status.MethodsCognitively healthy older adults (n = 48) were tested on four visuomotor tasks where reach and gaze were increasingly spatially dissociated. Participants who had a family history of dementia or the APOE ε4 allele were considered to be at an increased risk for AD. To quantify RSFC within networks of interest, an EPI sequence sensitive to BOLD contrast was collected. The networks of interest were the default mode network (DMN), somatomotor network (SMN), dorsal attention network (DAN), ventral attention network (VAN), and frontoparietal control network (FPN).ResultsIndividuals with the ε4 allele showed abnormalities in RSFC between posterior DMN nodes that predicted poorer non-standard visuomotor performance. Specifically, multiple linear regression analyses revealed lower RSFC between the precuneus/posterior cingulate cortex and the left inferior parietal lobule as well as the left parahippocampal cortex. Presence of the APOE ε4 allele also modified the relationship between mean DAN RSFC and visuomotor control, where lower mean RSFC in the DAN predicted worse non-standard visuomotor performance only in APOE ε4 carriers. There were otherwise no effects of family history, APOE ε4 status, or sex on the relationship between RSFC and visuomotor performance for any of the other resting networks.ConclusionThe preliminary findings provide insight into the impact of APOE ε4-related genetic risk on neural networks underlying complex visuomotor transformations, and demonstrate that the non-standard visuomotor task paradigm discussed in this study may be used as a non-invasive, easily accessible assessment tool for dementia risk.
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Duong MT, Wolk DA. Limbic-Predominant Age-Related TDP-43 Encephalopathy: LATE-Breaking Updates in Clinicopathologic Features and Biomarkers. Curr Neurol Neurosci Rep 2022; 22:689-698. [PMID: 36190653 PMCID: PMC9633415 DOI: 10.1007/s11910-022-01232-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW Limbic-predominant age-related TDP-43 encephalopathy (LATE) is a recently defined neurodegenerative disease characterized by amnestic phenotype and pathological inclusions of TAR DNA-binding protein 43 (TDP-43). LATE is distinct from rarer forms of TDP-43 diseases such as frontotemporal lobar degeneration with TDP-43 but is also a common copathology with Alzheimer's disease (AD) and cerebrovascular disease and accelerates cognitive decline. LATE contributes to clinicopathologic heterogeneity in neurodegenerative diseases, so it is imperative to distinguish LATE from other etiologies. RECENT FINDINGS Novel biomarkers for LATE are being developed with magnetic resonance imaging (MRI) and positron emission tomography (PET). When cooccurring with AD, LATE exhibits identifiable patterns of limbic-predominant atrophy on MRI and hypometabolism on 18F-fluorodeoxyglucose PET that are greater than expected relative to levels of local AD pathology. Efforts are being made to develop TDP-43-specific radiotracers, molecularly specific biofluid measures, and genomic predictors of TDP-43. LATE is a highly prevalent neurodegenerative disease distinct from previously characterized cognitive disorders.
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Affiliation(s)
- Michael Tran Duong
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - David A Wolk
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Alzheimer's Disease Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Institute On Aging, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA.
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20
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Li L, Yu X, Sheng C, Jiang X, Zhang Q, Han Y, Jiang J. A review of brain imaging biomarker genomics in Alzheimer’s disease: implementation and perspectives. Transl Neurodegener 2022; 11:42. [PMID: 36109823 PMCID: PMC9476275 DOI: 10.1186/s40035-022-00315-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/24/2022] [Indexed: 11/25/2022] Open
Abstract
Alzheimer’s disease (AD) is a progressive neurodegenerative disease with phenotypic changes closely associated with both genetic variants and imaging pathology. Brain imaging biomarker genomics has been developed in recent years to reveal potential AD pathological mechanisms and provide early diagnoses. This technique integrates multimodal imaging phenotypes with genetic data in a noninvasive and high-throughput manner. In this review, we summarize the basic analytical framework of brain imaging biomarker genomics and elucidate two main implementation scenarios of this technique in AD studies: (1) exploring novel biomarkers and seeking mutual interpretability and (2) providing a diagnosis and prognosis for AD with combined use of machine learning methods and brain imaging biomarker genomics. Importantly, we highlight the necessity of brain imaging biomarker genomics, discuss the strengths and limitations of current methods, and propose directions for development of this research field.
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21
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Chino B, Cuesta P, Pacios J, de Frutos-Lucas J, Torres-Simón L, Doval S, Marcos A, Bruña R, Maestú F. Episodic memory dysfunction and hypersynchrony in brain functional networks in cognitively intact subjects and MCI: a study of 379 individuals. GeroScience 2022; 45:477-489. [PMID: 36109436 PMCID: PMC9886758 DOI: 10.1007/s11357-022-00656-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/01/2022] [Indexed: 02/03/2023] Open
Abstract
Delayed recall (DR) impairment is one of the most significant predictive factors in defining the progression to Alzheimer's disease (AD). Changes in brain functional connectivity (FC) could accompany this decline in the DR performance even in a resting state condition from the preclinical stages to the diagnosis of AD itself, so the characterization of the relationship between the two phenomena has attracted increasing interest. Another aspect to contemplate is the potential moderator role of the APOE genotype in this association, considering the evidence about their implication for the disease. 379 subjects (118 mild cognitive impairment (MCI) and 261 cognitively intact (CI) individuals) underwent an extensive evaluation, including MEG recording. Applying cluster-based permutation test, we identified a cluster of differences in FC and studied which connections drove such an effect in DR. The moderation effect of APOE genotype between FC results and delayed recall was evaluated too. Higher FC in beta band in the right occipital region is associated with lower DR scores in both groups. A significant anteroposterior link emerged in the seed-based analysis with higher values in MCI. Moreover, APOE genotype appeared as a moderator between beta FC and DR performance only in the CI group. An increased beta FC in the anteroposterior brain region appears to be associated with lower memory performance in MCI. This finding could help discriminate the pattern of the progression of healthy aging to MCI and the relation between resting state and memory performance.
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Affiliation(s)
- Brenda Chino
- Institute of Neuroscience, Autonomous University of Barcelona, Barcelona, Spain. .,Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain.
| | - Pablo Cuesta
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain ,Department of Radiology, Rehabilitation, and Physiotherapy, Complutense University of Madrid, Madrid, Spain ,Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Javier Pacios
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain ,Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain ,Department of Experimental Psychology, Complutense University of Madrid, Madrid, Spain
| | - Jaisalmer de Frutos-Lucas
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain ,Department of Experimental Psychology, Complutense University of Madrid, Madrid, Spain ,Centre for Precision Health, Edith Cowan University, Joondalup, WA 6027 Australia ,Centro de Investigación Nebrija en Cognición (CINC), Universidad de Nebrija, Madrid, Spain
| | - Lucía Torres-Simón
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain ,Department of Experimental Psychology, Complutense University of Madrid, Madrid, Spain
| | - Sandra Doval
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain ,Department of Experimental Psychology, Complutense University of Madrid, Madrid, Spain
| | - Alberto Marcos
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain ,Neurology Department, Hospital Clinico San Carlos, Madrid, Spain
| | - Ricardo Bruña
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain ,Department of Radiology, Rehabilitation, and Physiotherapy, Complutense University of Madrid, Madrid, Spain ,Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Fernando Maestú
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, Madrid, Spain ,Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain ,Department of Experimental Psychology, Complutense University of Madrid, Madrid, Spain
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22
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Wang J, Sun T, Zhang Y, Yu X, Wang H. Distinct Effects of the Apolipoprotein E ε4 Genotype on Associations Between Delayed Recall Performance and Resting-State Electroencephalography Theta Power in Elderly People Without Dementia. Front Aging Neurosci 2022; 14:830149. [PMID: 35693343 PMCID: PMC9178171 DOI: 10.3389/fnagi.2022.830149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 05/06/2022] [Indexed: 11/21/2022] Open
Abstract
Background Abnormal electroencephalography (EEG) activity has been demonstrated in mild cognitive impairment (MCI), and theta rhythm might be inversely related to memory. The apolipoprotein E (ApoE) epsilon 4 (ε4) allele, as a genetic vulnerability factor for pathologic and normal age-related cognitive decline, may influence different patterns of cognitive dysfunction. Therefore, the present study primarily aimed to verify the role of resting theta rhythm in delayed recall deficits, and further explore the effects of the ApoE genotype on the associations between the resting theta power and delayed recall performance in the elderly individuals without dementia. Methods A total of 47 individuals without dementia, including 23 MCI and 24 healthy subjects (HCs), participated in the study. All subjects were administered the Hopkins Verbal Learning Test–Revised (HVLT-R) to measure delayed recall performance. Power spectra based on resting-state EEG data were used to examine brain oscillations. Linear regression was used to examine the relationships between EEG power and delayed recall performance in each subgroup. Results The increased theta power in the bilateral central and temporal areas (Ps = 0.02–0.044, uncorrected) was found in the patients with MCI, and were negatively correlated with delayed recall performance (rs = −0.358 to −0.306, Ps = 0.014–0.036, FDR corrected) in the elderly individuals without dementia. The worse delayed recall performance was associated with higher theta power in the left central and temporal areas, especially in ApoE ε4 non-carriers and not in carriers (rs = −0.404 to −0.369, Ps = 0.02–0.035, uncorrected). Conclusion Our study suggests that theta disturbances might contribute to delayed recall memory decline. The ApoE genotype may have distinct effects on EEG-based neural correlates of episodic memory performance.
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Affiliation(s)
- Jing Wang
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health, Peking University, Beijing, China
- Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, China
| | - Tingting Sun
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health, Peking University, Beijing, China
- Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, China
- Department of Psychiatry, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ying Zhang
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health, Peking University, Beijing, China
- Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, China
| | - Xin Yu
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health, Peking University, Beijing, China
- Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, China
| | - Huali Wang
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health, Peking University, Beijing, China
- Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, China
- *Correspondence: Huali Wang,
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Lee WJ, Brown JA, Kim HR, La Joie R, Cho H, Lyoo CH, Rabinovici GD, Seong JK, Seeley WW. Regional Aβ-tau interactions promote onset and acceleration of Alzheimer's disease tau spreading. Neuron 2022; 110:1932-1943.e5. [PMID: 35443153 DOI: 10.1016/j.neuron.2022.03.034] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/19/2022] [Accepted: 03/28/2022] [Indexed: 12/22/2022]
Abstract
Amyloid-beta and tau are key molecules in the pathogenesis of Alzheimer's disease, but it remains unclear how these proteins interact to promote disease. Here, by combining cross-sectional and longitudinal molecular imaging and network connectivity analyses in living humans, we identified two amyloid-beta/tau interactions associated with the onset and propagation of tau spreading. First, we show that the lateral entorhinal cortex, an early site of tau neurofibrillary tangle formation, is subject to remote, connectivity-mediated amyloid-beta/tau interactions linked to initial tau spreading. Second, we identify the inferior temporal gyrus as the region featuring the greatest local amyloid-beta/tau interactions and a connectivity profile well suited to accelerate tau propagation. Taken together, our data address long-standing questions regarding the topographical dissimilarity between early amyloid-beta and tau deposition.
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Affiliation(s)
- Wha Jin Lee
- School of Biomedical Engineering, Korea University, Seoul 02841, South Korea
| | - Jesse A Brown
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA 94143, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Hye Ryun Kim
- School of Biomedical Engineering, Korea University, Seoul 02841, South Korea; Global Health Technology Research Center, College of Health Science, Korea University, Seoul 02841, South Korea
| | - Renaud La Joie
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA 94143, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Seoul 06273, South Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Seoul 06273, South Korea
| | - Gil D Rabinovici
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA 94143, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94143, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Joon-Kyung Seong
- School of Biomedical Engineering, Korea University, Seoul 02841, South Korea; Department of Artificial Intelligence, Korea University, Seoul 02841, South Korea.
| | - William W Seeley
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA 94143, USA; Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94143, USA; Department of Pathology, University of California, San Francisco, San Francisco, CA 94143, USA.
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Jung M, Apostolova LG, Moser DK, Gradus‐Pizlo I, Gao S, Rogers JL, Pressler SJ. Virtual reality cognitive intervention for heart failure: CORE study protocol. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12230. [PMID: 35317082 PMCID: PMC8923344 DOI: 10.1002/trc2.12230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 11/12/2022]
Abstract
Introduction Heart failure (HF) is a prevalent, serious chronic illness that affects 6.5 million adults in the United States. Among patients with HF, the prevalence of attention impairment is reported to range from 15% to 27%. Although attention is fundamental to human activities including HF self-care, cognitive interventions for patients with HF that target improvement in attention are scarce. The COgnitive intervention to Restore attention using nature Environment (CORE) study aims to test the preliminary efficacy of the newly developed Nature-VR, a virtual reality-based cognitive intervention that is based on the restorative effects of nature. Nature-VR development was guided by Attention Restoration Theory. The target outcomes are attention, HF self-care, and health-related quality of life (HRQoL). Our exploratory aims examine the associations between attention and several putative/established HF biomarkers (eg, oxygen saturation, brain-derived neurotrophic factor, apolipoprotein E, dopamine receptor, and dopamine transporter genes) as well as the effect of Nature-VR on cognitive performance in other domains (ie, global cognition, memory, visuospatial, executive function, and language), cardiac and neurological events, and mortality. Methods This single-blinded, two-group randomized-controlled pilot study will enroll 74 participants with HF. The Nature-VR intervention group will view three-dimensional nature pictures using a virtual reality headset for 10 minutes per day, 5 days per week for 4 weeks (a total of 200 minutes). The active comparison group, Urban-VR, will view three-dimensional urban pictures using a virtual reality headset to match the Nature-VR intervention in intervention dose and delivery mode, but not in content. After baseline interviews, four follow-up interviews will be conducted to assess sustained effects of Nature-VR at 4, 8, 26, and 52 weeks. Discussion The importance and novelty of this study consists of using a first-of-its kind, immersive virtual reality technology to target attention and in investigating the health outcomes of the Nature-VR cognitive intervention among patients with HF.
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Affiliation(s)
- Miyeon Jung
- Indiana University School of NursingIndianapolisIndianaUSA
| | - Liana G. Apostolova
- Indiana University School of Medicine, Department of Neurology, Radiology, and Medical and Molecular GeneticsIndianapolisIndianaUSA
| | - Debra K. Moser
- University of Kentucky College of NursingLexingtonKentuckyUSA
| | - Irmina Gradus‐Pizlo
- Department of MedicineUniversity of California Irvine School of MedicineOrangeCaliforniaUSA
| | - Sujuan Gao
- Department of Biostatistics and Health Data ScienceIndiana University School of MedicineIndianapolisIndianaUSA
| | - Jeff L. Rogers
- Indiana University UITS Advanced Visualization LabIndianapolisIndianaUSA
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25
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APOE, TOMM40, and sex interactions on neural network connectivity. Neurobiol Aging 2022; 109:158-165. [PMID: 34740077 PMCID: PMC8694046 DOI: 10.1016/j.neurobiolaging.2021.09.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 01/03/2023]
Abstract
The Apolipoprotein E ε4 (APOE ε4) haplotype is the strongest genetic risk factor for late-onset Alzheimer's disease (AD). The Translocase of Outer Mitochondrial Membrane-40 (TOMM40) gene maintains cellular bioenergetics, which is disrupted in AD. TOMM40 rs2075650 ('650) G versus A carriage is consistently related to neural and cognitive outcomes, but it is unclear if and how it interacts with APOE. We examined 21 orthogonal neural networks among 8,222 middle-aged to aged participants in the UK Biobank cohort. ANOVA and multiple linear regression tested main effects and interactions with APOE and TOMM40 '650 genotypes, and if age and sex acted as moderators. APOE ε4 was associated with less strength in multiple networks, while '650 G versus A carriage was related to more language comprehension network strength. In APOE ε4 carriers, '650 G-carriage led to less network strength with increasing age, while in non-G-carriers this was only seen in women but not men. TOMM40 may shift what happens to network activity in aging APOE ε4 carriers depending on sex.
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26
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Almkvist O, Graff C. The APOE ε4 Allele Affects Cognitive Functions Differently in Carriers of APP Mutations Compared to Carriers of PSEN1 Mutations in Autosomal-Dominant Alzheimer's Disease. Genes (Basel) 2021; 12:genes12121954. [PMID: 34946903 PMCID: PMC8701239 DOI: 10.3390/genes12121954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/26/2021] [Accepted: 12/03/2021] [Indexed: 11/21/2022] Open
Abstract
Mounting evidence shows that the APOE ε4 allele interferes with cognition in sporadic Alzheimer’s disease. Less is known about APOE in autosomal-dominant Alzheimer’s disease (adAD). The present study explored the effects on cognition associated with the gene–gene interactions between the APOE gene and the APP and PSEN1 genes in adAD. This study includes mutation carriers (MC) and non-carriers (NC) from adAD families with mutations in APP (n = 28 and n = 25; MC and NC, respectively) and PSEN1 (n = 12 and n = 15; MC and NC, respectively) that represent the complete spectrum of disease: AD dementia (n = 8) and mild cognitive impairment (MCI, n = 15 and presymptomatic AD, n = 17). NC represented unimpaired normal aging. There was no significant difference in the distribution of APOE ε4 (absence vs. presence) between the APP vs. PSEN1 adAD genes and mutation status (MC vs. NC). However, episodic memory was significantly affected by the interaction between APOE and the APP vs. PSEN1 genes in MC. This was explained by favorable performance in the absence of APOE ε4 in PSEN1 compared to APP MC. Similar trends were seen in other cognitive functions. No significant associations between APOE ε4 and cognitive performance were obtained in NC. In conclusion, cognitive effects of APOE–adAD gene interaction were differentiated between the PSEN1 and APP mutation carriers, indicating epistasis.
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Affiliation(s)
- Ove Almkvist
- Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, SE-14157 Stockholm, Sweden
- Theme Aging, Karolinska University Hospital, SE-14157 Stockholm, Sweden;
- Department of Psychology, Stockholm University, SE-10691 Stockholm, Sweden
- Correspondence: ; Tel.: +46-70-690-9880; Fax: +468-524-868-09
| | - Caroline Graff
- Theme Aging, Karolinska University Hospital, SE-14157 Stockholm, Sweden;
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, SE-14157 Stockholm, Sweden
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Cruz-Sanabria F, Bonilla-Vargas K, Estrada K, Mancera O, Vega E, Guerrero E, Ortega-Rojas J, Mahecha María F, Romero A, Montañés P, Celeita V, Arboleda H, Pardo R. Analysis of cognitive performance and polymorphisms of SORL1, PVRL2, CR1, TOMM40, APOE, PICALM, GWAS_14q, CLU, and BIN1 in patients with mild cognitive impairment and cognitively healthy controls. NEUROLOGÍA (ENGLISH EDITION) 2021; 36:681-691. [PMID: 34752346 DOI: 10.1016/j.nrleng.2018.07.012] [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] [Received: 02/03/2018] [Accepted: 07/28/2018] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Alzheimer disease risk polymorphisms have been studied in patients with dementia, but have not yet been explored in mild cognitive impairment (MCI) in our population; nor have they been addressed in relation to cognitive variables, which can be predictive biomarkers of disease. OBJECTIVE To evaluate cognitive performance and presence of polymorphisms of the genes SORL1(rs11218304), PVRL2(rs6859), CR1(rs6656401), TOMM40(rs2075650), APOE (isoforms ε2, ε3, ε4), PICALM(rs3851179), GWAS_14q(rs11622883), BIN1(rs744373), and CLU(rs227959 and rs11136000) in patients with MCI and healthy individuals. METHODOLOGY We performed a cross-sectional, exploratory, descriptive study of a prospective cohort of participants selected by non-probabilistic sampling, evaluated with neurological, neuropsychological, and genetic testing, and classified as cognitively healthy individuals and patients with MCI. Cognition was evaluated with the Neuronorma battery and analysed in relation to the polymorphic variants by means of measures of central tendency, confidence intervals, and nonparametric statistics. RESULTS We found differences in performance in language and memory tasks between carriers and non-carriers of BIN1, CLU, and CR1 variants and a trend towards poor cognitive performance for PICALM, GWAS_14q, SORL1, and PVRL2 variants; the APOE and TOMM40 variants were not associated with poor cognitive performance. DISCUSSION Differences in cognitive performance associated with these polymorphic variants may suggest that the mechanisms regulating these genes could have an effect on cognition in the absence of dementia; however, this study was exploratory and hypotheses based on these results must be explored in larger samples.
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Affiliation(s)
- F Cruz-Sanabria
- Grupo de Neurociencias, Universidad Nacional de Colombia, Bogotá, Colombia; Departamento de Psicología, Universidad Nacional de Colombia, Bogotá, Colombia; PhD Program in Clinical and Translational Science, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Italy.
| | - K Bonilla-Vargas
- Grupo de Neurociencias, Universidad Nacional de Colombia, Bogotá, Colombia; Departamento de Psicología, Universidad Nacional de Colombia, Bogotá, Colombia; Unidad de Neurología, Hospital Universitario Nacional, Bogotá, Colombia
| | - K Estrada
- Grupo de Neurociencias, Universidad Nacional de Colombia, Bogotá, Colombia; Instituto de Investigaciones Clínicas, Universidad Nacional de Colombia, Bogotá, Colombia
| | - O Mancera
- Grupo de Neurociencias, Universidad Nacional de Colombia, Bogotá, Colombia; Unidad de Neurología, Hospital Universitario Nacional, Bogotá, Colombia
| | - E Vega
- Grupo de Neurociencias, Universidad Nacional de Colombia, Bogotá, Colombia
| | - E Guerrero
- Grupo de Neurociencias, Universidad Nacional de Colombia, Bogotá, Colombia
| | - J Ortega-Rojas
- Grupo de Neurociencias, Universidad Nacional de Colombia, Bogotá, Colombia
| | - F Mahecha María
- Grupo de Neurociencias, Universidad Nacional de Colombia, Bogotá, Colombia
| | - A Romero
- Grupo de Neurociencias, Universidad Nacional de Colombia, Bogotá, Colombia; Departamento de Psicología, Universidad Nacional de Colombia, Bogotá, Colombia
| | - P Montañés
- Grupo de Neurociencias, Universidad Nacional de Colombia, Bogotá, Colombia; Departamento de Psicología, Universidad Nacional de Colombia, Bogotá, Colombia
| | - V Celeita
- Departamento de Psicología, Universidad Nacional de Colombia, Bogotá, Colombia
| | - H Arboleda
- Grupo de Neurociencias, Universidad Nacional de Colombia, Bogotá, Colombia
| | - R Pardo
- Grupo de Neurociencias, Universidad Nacional de Colombia, Bogotá, Colombia; Unidad de Neurología, Hospital Universitario Nacional, Bogotá, Colombia; Instituto de Investigaciones Clínicas, Universidad Nacional de Colombia, Bogotá, Colombia
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28
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Rhea EM, Hansen K, Pemberton S, Torres ERS, Holden S, Raber J, Banks WA. Effects of apolipoprotein E isoform, sex, and diet on insulin BBB pharmacokinetics in mice. Sci Rep 2021; 11:18636. [PMID: 34545146 PMCID: PMC8452709 DOI: 10.1038/s41598-021-98061-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/02/2021] [Indexed: 11/26/2022] Open
Abstract
Age, apolipoprotein E (apoE) isoform, sex, and diet can independently affect the risk for the development of Alzheimer’s disease (AD). Additionally, synergy between some of these risk factors have been observed. However, the relation between the latter three risk factors has not been investigated. Central nervous system (CNS) insulin resistance is commonly involved in each of these risk factors. CNS insulin is primarily derived from the periphery in which insulin must be transported across the blood–brain barrier (BBB). Additionally, insulin can bind the brain endothelial cell to affect intracellular signaling. Therefore, we hypothesized CNS access to insulin could be affected by the combination of apoE isoform, sex, and diet. We analyzed insulin BBB pharmacokinetics in aged apoE targeted replacement (E3 and E4) male and female mice on a low-fat and high-fat diet. There were differences within males and females due to apoE genotype and diet in insulin interactions at the BBB. These sex-, diet-, and apoE isoform-dependent differences could contribute to the cognitive changes observed due to altered CNS insulin signaling.
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Affiliation(s)
- Elizabeth M Rhea
- Department of Medicine, Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, WA, 98195, USA. .,Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, 98108, USA.
| | - Kim Hansen
- Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, 98108, USA
| | - Sarah Pemberton
- Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, 98108, USA
| | - Eileen Ruth S Torres
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Sarah Holden
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Jacob Raber
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, 97239, USA.,Division of Neuroscience, Departments of Neurology and Radiation Medicine, ONPRC, Oregon Health & Science University, Portland, OR, 97239, USA
| | - William A Banks
- Department of Medicine, Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, WA, 98195, USA.,Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, 98108, USA
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Ho SH, Yang DW. Risk Factors Predicting Amyloid PET Positivity in Patients with Mild Cognitive Impairment and Apolipoprotein E ɛ3/ɛ3 Genotypes. J Alzheimers Dis 2021; 77:1017-1024. [PMID: 32804143 DOI: 10.3233/jad-200439] [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: 11/15/2022]
Abstract
BACKGROUND The apolipoprotein E (APOE) ɛ4 allele is a well-known risk factor for AD and is associated with higher amyloid deposition and earlier dementia onset. However, the relationship between amyloid pathology and the most common APOE allele, ɛ3, has not been well studied. OBJECTIVE In this study, we aimed to identify the risk factors predicting amyloid PET positivity in patients with mild cognitive impairment (MCI) and APOEɛ3/ɛ3 genotypes. METHODS We retrospectively reviewed the medical records of MCI patients with APOEɛ3/ɛ3 genotypes who underwent amyloid PET scanning. Demographics, neuropsychological tests, and brain MRI were obtained. We analyzed which risk factors could affect amyloid PET positivity in MCI patients with APOEɛ3/ɛ3 genotypes using logistic regression models. RESULTS We recruited 171 MCI patients with APOEɛ3/ɛ3 genotypes in this study. Out of 171 patients, 49 patients (28.65%) showed positive results in the amyloid PET scans. In a multivariate logistic regression model, amyloid positivity was associated with frontal atrophy (OR = 2.63, p = 0.009), and CDR-SOB scores (OR = 2.46, p = 0.013). The odds ratio for amyloid PET positivity in patients older than and equal to 75 years with both frontal atrophy and CDR-SOB scores >1.0 was 3.63. CONCLUSION Our study demonstrated that frontal atrophy, high CDR-SOB scores, and old age were risk factors associated with amyloid PET positivity in MCI with APOEɛ3/ɛ3 genotypes.
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Affiliation(s)
- Seong Hee Ho
- Department of Neurology, The Catholic University of Korea Seoul St. Mary's hospital, Seoul, Republic of Korea
| | - Dong-Won Yang
- Department of Neurology, The Catholic University of Korea Seoul St. Mary's hospital, Seoul, Republic of Korea
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Yu M, Sporns O, Saykin AJ. The human connectome in Alzheimer disease - relationship to biomarkers and genetics. Nat Rev Neurol 2021; 17:545-563. [PMID: 34285392 PMCID: PMC8403643 DOI: 10.1038/s41582-021-00529-1] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 02/06/2023]
Abstract
The pathology of Alzheimer disease (AD) damages structural and functional brain networks, resulting in cognitive impairment. The results of recent connectomics studies have now linked changes in structural and functional network organization in AD to the patterns of amyloid-β and tau accumulation and spread, providing insights into the neurobiological mechanisms of the disease. In addition, the detection of gene-related connectome changes might aid in the early diagnosis of AD and facilitate the development of personalized therapeutic strategies that are effective at earlier stages of the disease spectrum. In this article, we review studies of the associations between connectome changes and amyloid-β and tau pathologies as well as molecular genetics in different subtypes and stages of AD. We also highlight the utility of connectome-derived computational models for replicating empirical findings and for tracking and predicting the progression of biomarker-indicated AD pathophysiology.
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Affiliation(s)
- Meichen Yu
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana University Network Science Institute, Bloomington, IN, USA
| | - Olaf Sporns
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana University Network Science Institute, Bloomington, IN, USA
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Andrew J Saykin
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA.
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
- Indiana University Network Science Institute, Bloomington, IN, USA.
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31
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Saeed U, Desmarais P, Masellis M. The APOE ε4 variant and hippocampal atrophy in Alzheimer's disease and Lewy body dementia: a systematic review of magnetic resonance imaging studies and therapeutic relevance. Expert Rev Neurother 2021; 21:851-870. [PMID: 34311631 DOI: 10.1080/14737175.2021.1956904] [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: 10/20/2022]
Abstract
Introduction: The apolipoprotein E ɛ4-allele (APOE-ɛ4) increases the risk not only for Alzheimer's disease (AD) but also for Parkinson's disease dementia and dementia with Lewy bodies (collectively, Lewy body dementia [LBD]). Hippocampal volume is an important neuroimaging biomarker for AD and LBD, although its association with APOE-ɛ4 is inconsistently reported. We investigated the association of APOE-ε4 with hippocampal atrophy quantified using magnetic resonance imaging in AD and LBD.Areas covered: Databases were searched for volumetric and voxel-based morphometric studies published up until December 31st, 2020. Thirty-nine studies (25 cross-sectional, 14 longitudinal) were included. We observed that (1) APOE-ε4 was associated with greater rate of hippocampal atrophy in longitudinal studies in AD and in those who progressed from mild cognitive impairment to AD, (2) association of APOE-ε4 with hippocampal atrophy in cross-sectional studies was inconsistent, (3) APOE-ɛ4 may influence hippocampal atrophy in dementia with Lewy bodies, although longitudinal investigations are needed. We comprehensively discussed methodological aspects, APOE-based therapeutic approaches, and the association of APOE-ε4 with hippocampal sub-regions and cognitive performance.Expert opinion: The role of APOE-ɛ4 in modulating hippocampal phenotypes may be further clarified through more homogenous, well-powered, and pathology-proven, longitudinal investigations. Understanding the underlying mechanisms will facilitate the development of prevention strategies targeting APOE-ɛ4.
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Affiliation(s)
- Usman Saeed
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada.,L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Toronto, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
| | - Philippe Desmarais
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada.,L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Toronto, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada
| | - Mario Masellis
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada.,L.C. Campbell Cognitive Neurology Research Unit, Sunnybrook Health Sciences Centre, Toronto, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada.,Cognitive and Movement Disorders Clinic, Sunnybrook Health Sciences Centre, Toronto, Canada
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32
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Dintica CS, Haaksma ML, Olofsson JK, Bennett DA, Xu W. Joint trajectories of episodic memory and odor identification in older adults: patterns and predictors. Aging (Albany NY) 2021; 13:17080-17096. [PMID: 34232918 PMCID: PMC8312450 DOI: 10.18632/aging.203280] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/23/2021] [Indexed: 11/29/2022]
Abstract
Emerging evidence suggests that olfactory function is closely linked to memory function. The aims of this study were to assess whether olfactory and episodic memory functions follow similar age-related decline trajectories, to identify different patterns of decline, as well as predictors of the patterns. 1023 participants from the Memory and Aging Project were followed for up to 8 years with annual episodic memory and odor identification assessments. Trajectories were modelled using growth mixture models. Multivariate logistic regression was used to identify pattern predictors. Three patterns of joint trajectories were identified; Class 1- stable average performance in both functions (n=690, 67.4%); Class 2- stable average episodic memory and declining odor identification (n=231, 22.6%); and Class 3- decline in both functions (n= 102, 10.0%). Class predictors included age, sex, APOE ε4 status, cognitive activity level and BMI. Participants in Class 3 were most likely to develop dementia. Episodic memory and olfactory function show similar trajectories in aging. Such classification can contribute to a better understanding of the factors related to cognitive decline and dementia.
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Affiliation(s)
- Christina S. Dintica
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Miriam L. Haaksma
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Jonas K. Olofsson
- Gösta Ekman Laboratory, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, China
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Jannati A, Ryan MA, Block G, Kayarian FB, Oberman LM, Rotenberg A, Pascual-Leone A. Modulation of motor cortical excitability by continuous theta-burst stimulation in adults with autism spectrum disorder. Clin Neurophysiol 2021; 132:1647-1662. [PMID: 34030059 PMCID: PMC8197744 DOI: 10.1016/j.clinph.2021.03.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 02/23/2021] [Accepted: 03/15/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To test whether change in motor evoked potential (ΔMEP) induced by continuous theta-burst stimulation (cTBS) of motor cortex (M1) distinguishes adults with autism spectrum disorder (ASD) from neurotypicals, and to explore the contribution of two common polymorphisms related to neuroplasticity. METHODS 44 adult neurotypical (NT) participants (age 21-65, 34 males) and 19 adults with ASD (age 21-58, 17 males) prospectively underwent M1 cTBS. Their data were combined with previously obtained results from 35 NT and 35 ASD adults. RESULTS ΔMEP at 15 minutes post-cTBS (T15) was a significant predictor of diagnosis (p = 0.04) in the present sample (n=63). T15 remained a significant predictor in a larger sample (n=91) and when partially imputed based on T10-T20 from a yet-greater sample (N=133). T15 also remained a significant predictor of diagnosis among brain-derived neurotrophic factor (BDNF) Met+ and apolipoprotein E (APOE) ε4- subjects (p's < 0.05), but not among Met- or ε4+ subjects (p's > 0.19). CONCLUSIONS ΔMEP at T15 post-cTBS is a significant biomarker for adults with ASD, and its utility is modulated by BDNF and APOE polymorphisms. SIGNIFICANCE M1 cTBS response is a physiologic biomarker for adults with ASD in large samples, and controlling for BDNF and APOE polymorphisms can improve its diagnostic utility.
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Affiliation(s)
- Ali Jannati
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA; F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Mary A Ryan
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Gabrielle Block
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Fae B Kayarian
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Lindsay M Oberman
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Alexander Rotenberg
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA; F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA, USA; Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA; Guttman Brain Health Institute, Institut Guttman de Neurorehabilitació, Universitat Autónoma de Barcelona, Badalona, Barcelona, Spain.
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Piersson AD, Mohamad M, Suppiah S, Rajab NF. Topographical patterns of whole-brain structural alterations in association with genetic risk, cerebrospinal fluid, positron emission tomography biomarkers of Alzheimer’s disease, and neuropsychological measures. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00440-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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35
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Li T, Wang B, Gao Y, Wang X, Yan T, Xiang J, Niu Y, Liu T, Chen D, Fang B, Xie Y, Funahashi S, Yan T. APOE ε4 and cognitive reserve effects on the functional network in the Alzheimer's disease spectrum. Brain Imaging Behav 2021; 15:758-771. [PMID: 32314201 DOI: 10.1007/s11682-020-00283-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The apolipoprotein E (APOE) ε4 allele is a genetic risk factor for Alzheimer's disease, whereas educational attainments have protective effects against cognitive decline in aging and patients with Alzheimer's disease. We examined the possible effects of years of education and APOE genotype on the topological properties of the functional network in normal aging, mild cognitive impairment and Alzheimer's disease. The years of education showed a significant, negative association with the local efficiency, clustering coefficient and small-worldness of functional networks in APOE ε4 noncarriers but not in ε4 carriers. These associations were mainly observed in normal aging and were reduced in mild cognitive impairment and Alzheimer's disease. Moreover, regions of the inferior frontal gyrus, temporal pole, and cuneus also showed correlations between education and nodal degree. Our findings demonstrated that the protective effects of education persist in APOE ε4 noncarriers but diminish in ε4 carriers. In addition, the protective effects of education were attenuated or reduced in the progression of Alzheimer's disease.
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Affiliation(s)
- Ting Li
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Bin Wang
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, Shanxi, China
| | - Yuan Gao
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, Shanxi, China
| | - Xin Wang
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, Shanxi, China
| | - Ting Yan
- Translational Medicine Research Center, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Jie Xiang
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, Shanxi, China
| | - Yan Niu
- College of Information and Computer, Taiyuan University of Technology, Taiyuan, Shanxi, China
| | - Tiantian Liu
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Duanduan Chen
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Boyan Fang
- Department of Neurology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yunyan Xie
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Shintaro Funahashi
- Advanced research institute of multidisciplinary science, Beijing Institute of Technology, Beijing, China
| | - Tianyi Yan
- School of Life Science, Beijing Institute of Technology, Beijing, China.
- Key Laboratory of Biomimetic Robots and Systems, Ministry of Education, Beijing Institute of Technology, Beijing, China.
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Association of apolipoprotein E variation with cognitive impairment across multiple neurodegenerative diagnoses. Neurobiol Aging 2021; 105:378.e1-378.e9. [PMID: 34039480 DOI: 10.1016/j.neurobiolaging.2021.04.011] [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: 12/22/2020] [Revised: 03/16/2021] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
For many years there has been uncertainty regarding how apolipoprotein E (APOE) E2 and E4 variants may influence overlapping features of neurodegeneration, such as cognitive impairment. We aimed to identify whether the APOE variants are associated with cognitive function across various neurodegenerative and cerebrovascular diagnoses (n = 513). Utilizing a comprehensive neuropsychology battery, multivariate multiple regression was used to assess the influence of APOE carrier status and disease cohort on performance across five cognitive domains. Irrespective of disease cohort, E4 carriers had significantly lower performance in verbal memory and visuospatial domains than those with E3/3, while E2 carriers' cognitive performance was not significantly different. However, E2 carriers with frontotemporal dementia (FTD) performed significantly worse than those with E3/3 in the attention/working memory, executive function, and visuospatial domains. Our results highlight that the influence of APOE variation on cognition is complex, in some cases varying based on diagnosis and possibly underlying disease pathology.
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Gellersen HM, Coughlan G, Hornberger M, Simons JS. Memory precision of object-location binding is unimpaired in APOE ε4-carriers with spatial navigation deficits. Brain Commun 2021; 3:fcab087. [PMID: 33987536 PMCID: PMC8108563 DOI: 10.1093/braincomms/fcab087] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/09/2021] [Accepted: 03/29/2021] [Indexed: 12/19/2022] Open
Abstract
Research suggests that tests of memory fidelity, feature binding and spatial navigation are promising for early detection of subtle behavioural changes related to Alzheimer's disease. In the absence of longitudinal data, one way of testing the early detection potential of cognitive tasks is through the comparison of individuals at different genetic risk for Alzheimer's dementia. Most studies have done so using samples aged 70 years or older. Here, we tested whether memory fidelity of long-term object-location binding may be a sensitive marker even among cognitively healthy individuals in their mid-60s by comparing participants at low and higher risk based on presence of the ε4-allele of the apolipoprotein gene (n = 26 ε3ε3, n = 20 ε3ε4 carriers). We used a continuous report paradigm in a visual memory task that required participants to recreate the spatial position of objects in a scene. We employed mixture modelling to estimate the two distinct memory processes that underpin the trial-by-trial variation in localization errors: retrieval success which indexes the proportion of trials where participants recalled any information about an object's position and the precision with which participants retrieved this information. Prior work has shown that these memory paradigms that separate retrieval success from precision are capable of detecting subtle differences in mnemonic fidelity even when retrieval success could not. Nonetheless, Bayesian analyses found good evidence that ε3ε4 carriers did not remember fewer object locations [F(1, 42) = 0.450, P = 0.506, BF01 = 3.02], nor was their precision for the spatial position of objects reduced compared to ε3ε3 carriers [F(1, 42) = 0.12, P = 0.726, BF01 = 3.19]. Because the participants in the sample presented here were a subset of a study on apolipoprotein ε4-carrier status and spatial navigation in the Sea Hero Quest game [Coughlan et al., 2019. PNAS, 116(9)], we obtained these data to contrast genetic effects on the two tasks within the same sample (n = 33). Despite the smaller sample size, wayfinding deficits among ε3ε4 carriers could be replicated [F(1, 33) = 5.60, P = 0.024, BF10 = 3.44]. Object-location memory metrics and spatial navigation scores were not correlated (all r < 0.25, P > 0.1, 0 < BF10 < 3). These findings show spared object-location binding in the presence of a detrimental apolipoprotein ε4 effect on spatial navigation. This suggests that the sensitivity of memory fidelity and binding tasks may not extend to individuals with one ε4-allele in their early to mid-60s. The results provide further support to prior proposals that spatial navigation may be a sensitive marker for the earliest cognitive changes in Alzheimer's disease, even before episodic memory.
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Affiliation(s)
- Helena M Gellersen
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
| | - Gillian Coughlan
- Rotman Research Institute, Baycrest Hospital, Toronto, ON M6A 1W1, Canada
| | | | - Jon S Simons
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
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Latimer CS, Lucot KL, Keene CD, Cholerton B, Montine TJ. Genetic Insights into Alzheimer's Disease. ANNUAL REVIEW OF PATHOLOGY-MECHANISMS OF DISEASE 2021; 16:351-376. [PMID: 33497263 DOI: 10.1146/annurev-pathmechdis-012419-032551] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Alzheimer's disease (AD) is a pervasive, relentlessly progressive neurodegenerative disorder that includes both hereditary and sporadic forms linked by common underlying neuropathologic changes and neuropsychological manifestations. While a clinical diagnosis is often made on the basis of initial memory dysfunction that progresses to involve multiple cognitive domains, definitive diagnosis requires autopsy examination of the brain to identify amyloid plaques and neurofibrillary degeneration. Over the past 100 years, there has been remarkable progress in our understanding of the underlying pathophysiologic processes, pathologic changes, and clinical phenotypes of AD, largely because genetic pathways that include but expand beyond amyloid processing have been uncovered. This review discusses the current state of understanding of the genetics of AD with a focus on how these advances are both shaping our understanding of the disease and informing novel avenues and approaches for development of potential therapeutic targets.
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Affiliation(s)
- Caitlin S Latimer
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington 98104, USA
| | - Katherine L Lucot
- Department of Pathology, Stanford University, Stanford, California 94304, USA;
| | - C Dirk Keene
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington 98104, USA
| | - Brenna Cholerton
- Department of Pathology, Stanford University, Stanford, California 94304, USA;
| | - Thomas J Montine
- Department of Pathology, Stanford University, Stanford, California 94304, USA;
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Qian J, Betensky RA, Hyman BT, Serrano-Pozo A. Association of APOE Genotype With Heterogeneity of Cognitive Decline Rate in Alzheimer Disease. Neurology 2021; 96:e2414-e2428. [PMID: 33771840 PMCID: PMC8166439 DOI: 10.1212/wnl.0000000000011883] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 02/12/2021] [Indexed: 12/03/2022] Open
Abstract
Objective To test the hypothesis that the APOE genotype is a significant driver of heterogeneity in Alzheimer disease (AD) clinical progression, which could have important implications for clinical trial design and interpretation. Methods We applied novel reverse-time longitudinal models to analyze the trajectories of Clinical Dementia Rating Sum of Boxes (CDR-SOB) and Mini-Mental State Examination (MMSE) scores—2 common outcome measures in AD clinical trials—in 1,102 autopsy-proven AD cases (moderate/frequent neuritic plaques and Braak tangle stage III or greater) from the National Alzheimer's Coordinating Center Neuropathology database resembling participants with mild to moderate AD in therapeutic clinical trials. Results APOE ε4 carriers exhibited ≈1.5 times faster CDR-SOB increase than APOE ε3/ε3 carriers (2.12 points per year vs 1.44 points per year) and ≈1.3 times faster increase than APOE ε2 carriers (1.65 points per year), whereas APOE ε2 vs APOE ε3/ε3 difference was not statistically significant. APOE ε4 carriers had ≈1.1 times faster MMSE decline than APOE ε3/ε3 carriers (−3.45 vs −3.03 points per year) and ≈1.4 times faster decline than APOE ε2 carriers (−2.43 points per year), whereas APOE ε2 carriers had ≈1.2 times slower decline than APOE ε3/ε3 carriers (−2.43 vs −3.03 points per year). These findings remained largely unchanged after controlling for the effect of AD neuropathologic changes on the rate of cognitive decline and for the presence and severity of comorbid pathologies. Conclusion Compared to the APOE ε3/ε3 reference genotype, the APOE ε2 and ε4 alleles have opposite (slowing and accelerating, respectively) effects on the rate of cognitive decline, which are clinically relevant and largely independent of the differential APOE allele effects on AD and comorbid pathologies. Thus, APOE genotype contributes to the heterogeneity in rate of clinical progression in AD.
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Affiliation(s)
- Jing Qian
- From the Department of Biostatistics and Epidemiology (J.Q.), University of Massachusetts, Amherst; New York University College of Global Public Health (R.A.B.), New York City; Department of Neurology (B.T.H., A.S.-P.), Massachusetts General Hospital, Boston; Massachusetts Alzheimer's Disease Research Center (B.T.H., A.S.-P.), Charlestown; and Harvard Medical School (B.T.H., A.S.-P.), Boston, MA
| | - Rebecca A Betensky
- From the Department of Biostatistics and Epidemiology (J.Q.), University of Massachusetts, Amherst; New York University College of Global Public Health (R.A.B.), New York City; Department of Neurology (B.T.H., A.S.-P.), Massachusetts General Hospital, Boston; Massachusetts Alzheimer's Disease Research Center (B.T.H., A.S.-P.), Charlestown; and Harvard Medical School (B.T.H., A.S.-P.), Boston, MA
| | - Bradley T Hyman
- From the Department of Biostatistics and Epidemiology (J.Q.), University of Massachusetts, Amherst; New York University College of Global Public Health (R.A.B.), New York City; Department of Neurology (B.T.H., A.S.-P.), Massachusetts General Hospital, Boston; Massachusetts Alzheimer's Disease Research Center (B.T.H., A.S.-P.), Charlestown; and Harvard Medical School (B.T.H., A.S.-P.), Boston, MA
| | - Alberto Serrano-Pozo
- From the Department of Biostatistics and Epidemiology (J.Q.), University of Massachusetts, Amherst; New York University College of Global Public Health (R.A.B.), New York City; Department of Neurology (B.T.H., A.S.-P.), Massachusetts General Hospital, Boston; Massachusetts Alzheimer's Disease Research Center (B.T.H., A.S.-P.), Charlestown; and Harvard Medical School (B.T.H., A.S.-P.), Boston, MA.
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Duong MT, Nasrallah IM, Wolk DA, Chang CCY, Chang TY. Cholesterol, Atherosclerosis, and APOE in Vascular Contributions to Cognitive Impairment and Dementia (VCID): Potential Mechanisms and Therapy. Front Aging Neurosci 2021; 13:647990. [PMID: 33841127 PMCID: PMC8026881 DOI: 10.3389/fnagi.2021.647990] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/08/2021] [Indexed: 12/18/2022] Open
Abstract
Vascular contributions to cognitive impairment and dementia (VCID) are a common cause of cognitive decline, yet limited therapies exist. This cerebrovascular disease results in neurodegeneration via acute, chronic, local, and systemic mechanisms. The etiology of VCID is complex, with a significant impact from atherosclerosis. Risk factors including hypercholesterolemia and hypertension promote intracranial atherosclerotic disease and carotid artery stenosis (CAS), which disrupt cerebral blood flow and trigger ischemic strokes and VCID. Apolipoprotein E (APOE) is a cholesterol and phospholipid carrier present in plasma and various tissues. APOE is implicated in dyslipidemia and Alzheimer disease (AD); however, its connection with VCID is less understood. Few experimental models for VCID exist, so much of the present information has been drawn from clinical studies. Here, we review the literature with a focus on the clinical aspects of atherosclerotic cerebrovascular disease and build a working model for the pathogenesis of VCID. We describe potential intermediate steps in this model, linking cholesterol, atherosclerosis, and APOE with VCID. APOE4 is a minor isoform of APOE that promotes lipid dyshomeostasis in astrocytes and microglia, leading to chronic neuroinflammation. APOE4 disturbs lipid homeostasis in macrophages and smooth muscle cells, thus exacerbating systemic inflammation and promoting atherosclerotic plaque formation. Additionally, APOE4 may contribute to stromal activation of endothelial cells and pericytes that disturb the blood-brain barrier (BBB). These and other risk factors together lead to chronic inflammation, atherosclerosis, VCID, and neurodegeneration. Finally, we discuss potential cholesterol metabolism based approaches for future VCID treatment.
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Affiliation(s)
- Michael Tran Duong
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Ilya M Nasrallah
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - David A Wolk
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | | | - Ta-Yuan Chang
- Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
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Lin L, Sun Y, Wang X, Su L, Wang X, Han Y. Resilience to Plasma and Cerebrospinal Fluid Amyloid-β in Cognitively Normal Individuals: Findings From Two Cohort Studies. Front Aging Neurosci 2021; 13:610755. [PMID: 33716709 PMCID: PMC7943465 DOI: 10.3389/fnagi.2021.610755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/28/2021] [Indexed: 01/17/2023] Open
Abstract
Objective: To define resilience metrics for cognitive decline based on plasma and cerebrospinal fluid (CSF) amyloid-β (Aβ) and examine the demographic, genetic, and neuroimaging factors associated with interindividual differences among metrics of resilience and to demonstrate the ability of such metrics to predict the diagnostic conversion to mild cognitive impairment (MCI). Methods: In this study, cognitively normal (CN) participants with Aβ-positive were included from the Sino Longitudinal Study on Cognitive Decline (SILCODE, n = 100) and Alzheimer's Disease Neuroimaging Initiative (ADNI, n = 144). Using a latent variable model of data, metrics of resilience [brain resilience (BR), cognitive resilience (CR), and global resilience (GR)] were defined based on the plasma Aβ and CSF Aβ. Linear regression analyses were applied to investigate the association between characteristics of individuals (age, sex, educational level, genetic, and neuroimaging factors) and their resilience. The plausibility of these metrics was tested using linear mixed-effects models and Cox regression models in longitudinal analyses. We also compared the effectiveness of these metrics with conventional metrics in predicting the clinical progression. Results: Although individuals in the ADNI cohort were older (74.68 [5.65] vs. 65.38 [4.66], p < 0.001) and had higher educational levels (16.3 [2.6] vs. 12.6 [2.8], p < 0.001) than those in the SILCODE cohort, similar loadings between resilience and its indicators were found within both models. BR and GR were mainly associated with age, women, and brain volume in both cohorts. Prediction models showed that higher CR and GR were related to better cognitive performance, and specifically, all types of resilience to CSF Aβ could predict longitudinal cognitive decline. Conclusion: Different phenotypes of resilience depending on cognition and brain volumes were associated with different factors. Such comprehensive resilience provided insight into the mechanisms of susceptibility for Alzheimer's disease (AD) at the individual level, and interindividual differences in resilience had the potential to predict the disease progression in CN people.
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Affiliation(s)
- Li Lin
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Yu Sun
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Xiaoqi Wang
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Li Su
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Xiaoni Wang
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Ying Han
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
- Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China
- National Clinical Research Center for Geriatric Disorders, Beijing, China
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Ossenkoppele R, Lyoo CH, Jester-Broms J, Sudre CH, Cho H, Ryu YH, Choi JY, Smith R, Strandberg O, Palmqvist S, Kramer J, Boxer AL, Gorno-Tempini ML, Miller BL, La Joie R, Rabinovici GD, Hansson O. Assessment of Demographic, Genetic, and Imaging Variables Associated With Brain Resilience and Cognitive Resilience to Pathological Tau in Patients With Alzheimer Disease. JAMA Neurol 2021; 77:632-642. [PMID: 32091549 PMCID: PMC7042808 DOI: 10.1001/jamaneurol.2019.5154] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Question Which demographic, genetic, and neuroimaging factors are associated with cognitive and brain resilience to pathological tau in patients with Alzheimer disease? Findings In this multicenter, cross-sectional, longitudinal study of 260 cognitively impaired amyloid-β–positive participants, young age and female sex were associated with greater brain resilience, whereas higher educational level and cortical thickness were associated with greater cognitive resilience. Meaning Cognitive and brain resilience may be associated with differential mechanisms, which may help explain interindividual differences in how well patients tolerate pathological tau. Importance Better understanding is needed of the degree to which individuals tolerate Alzheimer disease (AD)–like pathological tau with respect to brain structure (brain resilience) and cognition (cognitive resilience). Objective To examine the demographic (age, sex, and educational level), genetic (APOE-ε4 status), and neuroimaging (white matter hyperintensities and cortical thickness) factors associated with interindividual differences in brain and cognitive resilience to tau positron emission tomography (PET) load and to changes in global cognition over time. Design, Setting, an Participants In this cross-sectional, longitudinal study, tau PET was performed from June 1, 2014, to November 30, 2017, and global cognition monitored for a mean [SD] interval of 2.0 [1.8] years at 3 dementia centers in South Korea, Sweden, and the United States. The study included amyloid-β–positive participants with mild cognitive impairment or AD dementia. Data analysis was performed from October 26, 2018, to December 11, 2019. Exposures Standard dementia screening, cognitive testing, brain magnetic resonance imaging, amyloid-β PET and cerebrospinal fluid analysis, and flortaucipir (tau) labeled with fluor-18 (18F) PET. Main Outcomes and Measures Separate linear regression models were performed between whole cortex [18F]flortaucipir uptake and cortical thickness, and standardized residuals were used to obtain a measure of brain resilience. The same procedure was performed for whole cortex [18F]flortaucipir uptake vs Mini-Mental State Examination (MMSE) as a measure of cognitive resilience. Bivariate and multivariable linear regression models were conducted with age, sex, educational level, APOE-ε4 status, white matter hyperintensity volumes, and cortical thickness as independent variables and brain and cognitive resilience measures as dependent variables. Linear mixed models were performed to examine whether changes in MMSE scores over time differed as a function of a combined brain and cognitive resilience variable. Results A total of 260 participants (145 [55.8%] female; mean [SD] age, 69.2 [9.5] years; mean [SD] MMSE score, 21.9 [5.5]) were included in the study. In multivariable models, women (standardized β = −0.15, P = .02) and young patients (standardized β = −0.20, P = .006) had greater brain resilience to pathological tau. Higher educational level (standardized β = 0.23, P < .001) and global cortical thickness (standardized β = 0.23, P < .001) were associated with greater cognitive resilience to pathological tau. Linear mixed models indicated a significant interaction of brain resilience × cognitive resilience × time on MMSE (β [SE] = −0.235 [0.111], P = .03), with steepest slopes for individuals with both low brain and cognitive resilience. Conclusions and Relevance Results of this study suggest that women and young patients with AD have relative preservation of brain structure when exposed to neocortical pathological tau. Interindividual differences in resilience to pathological tau may be important to disease progression because participants with both low brain and cognitive resilience had the most rapid cognitive decline over time.
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Affiliation(s)
- Rik Ossenkoppele
- Lund University, Clinical Memory Research Unit, Lund, Sweden.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Chul Hyoung Lyoo
- Gangnam Severance Hospital, Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Carole H Sudre
- King's College London School of Biomedical Engineering and Imaging Sciences, London, United Kingdom.,Dementia Research Centre, Department of Neurodegenerative Disease, University College London Institute of Neurology, London, United Kingdom.,Centre for Medical Image Computing, Department of Medical Physics, University College London, London, United Kingdom
| | - Hanna Cho
- Dementia Research Centre, Department of Neurodegenerative Disease, University College London Institute of Neurology, London, United Kingdom
| | - Young Hoon Ryu
- Gangnam Severance Hospital, Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Yong Choi
- Gangnam Severance Hospital, Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Division of Applied RI, Korea Institute Radiological and Medical Sciences, Seoul, South Korea
| | - Ruben Smith
- Lund University, Clinical Memory Research Unit, Lund, Sweden
| | - Olof Strandberg
- Lund University, Clinical Memory Research Unit, Lund, Sweden
| | | | - Joel Kramer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Adam L Boxer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Maria L Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, University of California, San Francisco
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco.,Department of Radiology and Biomedical Imaging, University of California, San Francisco.,Molecular Biophysics and Integrated Bioimaging Division, Lawrence Berkeley National Laboratory, Berkeley, California.,Associate Editor
| | - Oskar Hansson
- Lund University, Clinical Memory Research Unit, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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Wisse LEM, Ungrady MB, Ittyerah R, Lim SA, Yushkevich PA, Wolk DA, Irwin DJ, Das SR, Grossman M. Cross-sectional and longitudinal medial temporal lobe subregional atrophy patterns in semantic variant primary progressive aphasia. Neurobiol Aging 2021; 98:231-241. [PMID: 33341654 PMCID: PMC8018475 DOI: 10.1016/j.neurobiolaging.2020.11.012] [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: 01/27/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 10/22/2022]
Abstract
T1-magnetic resonance imaging (MRI) studies report early atrophy in the left anterior temporal lobe, especially the perirhinal cortex, in semantic variant primary progressive aphasia (svPPA). Improved segmentation protocols using high-resolution T2-MRI have enabled fine-grained medial temporal lobe (MTL) subregional measurements, which may provide novel information on the atrophy pattern and disease progression in svPPA. We aimed to investigate the MTL subregional atrophy pattern cross-sectionally and longitudinally in patients with svPPA as compared with controls and patients with Alzheimer's disease (AD). MTL subregional volumes were obtained using the Automated Segmentation for Hippocampal Subfields software from high-resolution T2-MRIs in 15 svPPA, 37 AD, and 23 healthy controls. All MTL volumes were corrected for intracranial volume and parahippocampal cortices for slice number. Longitudinal atrophy rates of all subregions were obtained using an unbiased deformation-based morphometry pipeline in 6 svPPA patients, 9 controls, and 12 AD patients. Cross-sectionally, significant volume loss was observed in svPPA compared with controls in the left MTL, right cornu ammonis 1 (CA1), Brodmann area (BA)35, and BA36 (subdivisions of the perirhinal cortex). Compared with AD patients, svPPA patients had significantly smaller left CA1, BA35, and left and right BA36 volumes. Longitudinally, svPPA patients had significantly greater atrophy rates of left and right BA36 than controls but not relative to AD patients. Fine-grained analysis of MTL atrophy patterns provides information about the evolution of atrophy in svPPA. These results indicate that MTL subregional measures might be useful markers to track disease progression or for clinical trials in svPPA.
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Affiliation(s)
- Laura E M Wisse
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, Penn Memory Center, University of Pennsylvania, Philadelphia, PA, USA; Department of Diagnostic Radiology, Lund University, Lund, Sweden.
| | - Molly B Ungrady
- Department of Neurology, Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Ranjit Ittyerah
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Sydney A Lim
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Paul A Yushkevich
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - David A Wolk
- Department of Neurology, Penn Memory Center, University of Pennsylvania, Philadelphia, PA, USA
| | - David J Irwin
- Department of Neurology, Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine Center for Neurodegenerative Disease Research (CNDR), University of Pennsylvania, Philadelphia, PA, USA
| | - Sandhitsu R Das
- Department of Neurology, Penn Memory Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Murray Grossman
- Department of Neurology, Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, USA
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Zheng LJ, Lin L, Schoepf UJ, Varga-Szemes A, Savage RH, Zhang H, Wang YF, Zhang XY, Luo S, Liu Y, Yang GF, Lu GM, Zhang LJ. Different posterior hippocampus and default mode network modulation in young APOE ε4 carriers: a functional connectome-informed phenotype longitudinal study. Mol Neurobiol 2021; 58:2757-2769. [PMID: 33496907 DOI: 10.1007/s12035-021-02292-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/12/2021] [Indexed: 12/27/2022]
Abstract
To determine the functional connectome change pattern based on subregions of the hippocampus in young APOEε4 carriers during a 3-year follow-up. All the participants (n = 213) were tested for resting-state functional MRI, neuropsychological scales, and APOE genotype. The age- and sex-matched APOE ε4/ε3 (23.9 ± 3.2 years old, 6 female/7 male) carriers and APOE ε3/ε3 (22.9 ± 1.6 years old, 7 female/12 male) carriers were finally followed up. The hippocampus and its anterior/middle/posterior subregion-based functional connectivity (FC) patterns were compared between APOEε4 and APOEε3 groups by a two-sample t-test at baseline and mixed-effect analysis at follow-up. The effective connectivity (EC) patterns among the altered regions of interaction effect were examined in the APOEε4 groups. APOEε4 carries displayed saliently enhanced FC in the right anterior/middle hippocampus and core regions of the default mode network (DMN) (P < 0.05 by Gaussian Random Fields (GRF) correction). However, the APOEε4-by-time interaction was evident in the middle/posterior hippocampus with connection to the lateral temporal lobe and anterior cingulate cortex (ACC) (P < 0.05 by GRF correction). Moreover, the APOEε4 group at follow-up showed increased EC separately from both the left middle hippocampus and lateral temporal lobe to the left posterior hippocampus, and its changes of FC/EC significantly correlated with altered memory function. The posterior hippocampus might be especially vulnerable to early modulation in young APOEε4 carriers. Its connection with the lateral temporal lobe, rather than with DMN, might be the early compensative mechanism of memory function regulation influenced by APOE ε4 in the young adults.
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Affiliation(s)
- Li Juan Zheng
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002, Jiangsu, China
| | - Li Lin
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002, Jiangsu, China
| | - U Joseph Schoepf
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002, Jiangsu, China.,Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29425, USA
| | - Akos Varga-Szemes
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29425, USA
| | - Rock H Savage
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr, Charleston, SC, 29425, USA
| | - Han Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002, Jiangsu, China
| | - Yun Fei Wang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002, Jiangsu, China
| | - Xin Yuan Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002, Jiangsu, China
| | - Song Luo
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002, Jiangsu, China
| | - Ya Liu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002, Jiangsu, China
| | - Gui Fen Yang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002, Jiangsu, China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002, Jiangsu, China.
| | - Long Jiang Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, 210002, Jiangsu, China.
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Pillai JA, Bena J, Bonner-Jackson A, Leverenz JB. Impact of APOE ε4 genotype on initial cognitive symptoms differs for Alzheimer's and Lewy body neuropathology. ALZHEIMERS RESEARCH & THERAPY 2021; 13:31. [PMID: 33485373 PMCID: PMC7825215 DOI: 10.1186/s13195-021-00771-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/07/2021] [Indexed: 11/10/2022]
Abstract
Background APOE ε4 carrier status is known to increase odds of amnestic presentations with Alzheimer’s pathology. It is unknown how APOE ε4 carrier status impacts odds of specific initial cognitive symptoms in the presence of Lewy body pathology. Here we evaluate the impact of APOE ε4 genotype on initial cognitive symptoms among those with Alzheimer’s disease pathology (ADP) and Lewy-related pathology (LRP). Methods A retrospective cohort study of 2288 participants with neuropathology confirmed ADP or LRP in the National Alzheimer’s Coordinating Center database, who had initial cognitive symptoms documented and had a Clinical Dementia Rating-Global (CDR-G) score ≤ 1 (cognitively normal, MCI, or early dementia). Unadjusted and adjusted logistic regression models taking into account age at evaluation, sex, and education examined the relationship between APOE ε4 genotype and initial symptoms (memory, executive, language visuospatial) among ADP with LRP and ADP-LRP groups. Results One thousand three hundred three participants met criteria for ADP alone, 90 for LRP alone, and 895 for co-existing ADP and LRP (ADP-LRP). Younger age increased odds of non-amnestic symptoms across all three groups. In the adjusted model among ADP, APOE ε4 carriers had higher odds of amnestic initial symptoms 1.5 [95% CI, 1.7–2.14, p = 0.003] and lower odds of initial language symptoms 0.67 [95% CI, 0.47–0.96, p = 0.03] than non-carriers. The odds for these two symptoms were not different between ADP and mixed ADP-LRP groups. Female sex and higher education increased odds of initial language symptoms in the ADP group in the adjusted model. In the unadjusted model, APOE ε4 carriers with LRP had a higher odds of visuospatial initial symptoms 21.96 [95% CI, 4.02–110.62, p < 0.0001], while no difference was noted for initial executive/attention symptoms. Among LRP, the odds of APOE ε4 on amnestic symptom was not significant; however, the interaction effect evaluating the difference in odds ratios of amnestic symptom between ADP and LRP groups also did not reach statistical significance. Conclusions The odds of specific initial cognitive symptoms differed between ADP and LRP among APOE ε4 carriers compared to non-carriers. The odds of initial amnestic symptom was higher among ADP APOE ε4 carriers and the odds of visuospatial initial symptom was higher with LRP APOE ε4 carriers. This supports the hypothesis that APOE ε4 differentially impacts initial cognitive symptoms together with underlying neuropathology. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-021-00771-1.
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Affiliation(s)
- Jagan A Pillai
- Department of Neurology, Lou Ruvo Center for Brain Health, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, 9500 Euclid Ave / U10, Cleveland, OH, 44195, USA. .,Cleveland Clinic, Neurological Institute, Cleveland, OH, 44195, USA. .,Department of Neurology, Cleveland Clinic, Cleveland, OH, 44195, USA.
| | - James Bena
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Aaron Bonner-Jackson
- Department of Neurology, Lou Ruvo Center for Brain Health, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, 9500 Euclid Ave / U10, Cleveland, OH, 44195, USA.,Cleveland Clinic, Neurological Institute, Cleveland, OH, 44195, USA.,Department of Neurology, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - James B Leverenz
- Department of Neurology, Lou Ruvo Center for Brain Health, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, 9500 Euclid Ave / U10, Cleveland, OH, 44195, USA.,Cleveland Clinic, Neurological Institute, Cleveland, OH, 44195, USA.,Department of Neurology, Cleveland Clinic, Cleveland, OH, 44195, USA
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46
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Camarda C, Torelli P, Pipia C, Sottile G, Cilluffo G, Camarda R. APOE Genotypes and Brain Imaging Classes in Normal Cognition, Mild Cognitive Impairment, and Alzheimer's Disease: A Longitudinal Study. Curr Alzheimer Res 2020; 17:766-780. [PMID: 33167837 DOI: 10.2174/1567205017666201109093314] [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: 01/30/2020] [Revised: 08/20/2020] [Accepted: 10/10/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate in 419 stroke-free cognitively normal subjects (CN) aged 45-82 years covering during a long prospective study (11.54 ± 1.47 years) the preclinical to dementia spectrum: 1) the distribution of small vessel disease (V) and brain atrophy (A) aggregated as following: V-/A-, V-/A+, V+/A-, V+/A+; 2) the relationship of these imaging classes with individual apolipoprotein E (APOE) genotypes; 3) the risk of progression to Alzheimer Disease (AD) of the individual APOE genotypes. METHODS Participants underwent one baseline (t0), and 4 clinical and neuropsychological assessments (t1,t2,t3, and t4). Brain MRI was performed in all subjects at t0, t2, t3 and t4.. White matter hyperintensities were assessed through two visual rating scales. Lacunes were also rated. Subcortical and global brain atrophy were determined through the bicaudate ratio and the lateral ventricle to brain ratio, respectively. APOE genotypes were determined at t0 in all subjects. Cox proportional hazard model was used to evaluate the risk of progression to AD. RESULTS The imaging class of mixed type was very common in AD, and in non amnestic mild cognitive impaired APOE ε4 non carriers. In these subjects, frontal and parieto-occipital regions were most affected by small vessel disease. CONCLUSION Our findings suggest that the APOE ε3 allele is probably linked to the brain vascular pathology.
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Affiliation(s)
- Cecilia Camarda
- Department of Biomedicine, Neurosciences, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Paola Torelli
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | | | - Gianluca Sottile
- Department of Economics, Business, and Statistics, University of Palermo, Palermo, Italy,Institute for Research and Biomedical Innovation (IRIB), National Research Council, Palermo, Italy
| | - Giovanna Cilluffo
- Institute for Research and Biomedical Innovation (IRIB), National Research Council, Palermo, Italy
| | - Rosolino Camarda
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy
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Emrani S, Arain HA, DeMarshall C, Nuriel T. APOE4 is associated with cognitive and pathological heterogeneity in patients with Alzheimer's disease: a systematic review. ALZHEIMERS RESEARCH & THERAPY 2020; 12:141. [PMID: 33148345 PMCID: PMC7643479 DOI: 10.1186/s13195-020-00712-4] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/22/2020] [Indexed: 02/06/2023]
Abstract
Possession of the ε4 allele of apolipoprotein E (APOE) is the primary genetic risk factor for the sporadic form of Alzheimer’s disease (AD). While researchers have extensively characterized the impact that APOE ε4 (APOE4) has on the susceptibility of AD, far fewer studies have investigated the phenotypic differences of patients with AD who are APOE4 carriers vs. those who are non-carriers. In order to understand these differences, we performed a qualitative systematic literature review of the reported cognitive and pathological differences between APOE4-positive (APOE4+) vs. APOE4-negative (APOE4−) AD patients. The studies performed on this topic to date suggest that APOE4 is not only an important mediator of AD susceptibility, but that it likely confers specific phenotypic heterogeneity in AD presentation, as well. Specifically, APOE4+ AD patients appear to possess more tau accumulation and brain atrophy in the medial temporal lobe, resulting in greater memory impairment, compared to APOE4− AD patients. On the other hand, APOE4− AD patients appear to possess more tau accumulation and brain atrophy in the frontal and parietal lobes, resulting in greater impairment in executive function, visuospatial abilities, and language, compared to APOE4+ AD patients. Although more work is necessary to validate and interrogate these findings, these initial observations of pathological and cognitive heterogeneity between APOE4+ vs. APOE4− AD patients suggest that there is a fundamental divergence in AD manifestation related to APOE genotype, which may have important implications in regard to the therapeutic treatment of these two patient populations.
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Affiliation(s)
- Sheina Emrani
- Department of Psychology, Rowan University, 201 Mullica Hill Road, Glassboro, NJ, 08028, USA
| | - Hirra A Arain
- Department of Pathology and Cell Biology, Columbia University, 630 West 168th Street, New York, NY, 10032, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, 630 West 168th Street, New York, NY, 10032, USA
| | - Cassandra DeMarshall
- Department of Geriatrics and Gerontology, Rowan University School of Osteopathic Medicine, One Medical Center Drive, Stratford, NJ, 08084, USA
| | - Tal Nuriel
- Department of Pathology and Cell Biology, Columbia University, 630 West 168th Street, New York, NY, 10032, USA. .,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, 630 West 168th Street, New York, NY, 10032, USA.
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Werden E, Khlif MS, Bird LJ, Cumming T, Bradshaw J, Khan W, Pase M, Restrepo C, Veldsman M, Egorova N, Patel SK, Gottlieb E, Brodtmann A. APOE ɛ4 Carriers Show Delayed Recovery of Verbal Memory and Smaller Entorhinal Volume in the First Year After Ischemic Stroke. J Alzheimers Dis 2020; 71:245-259. [PMID: 31381519 DOI: 10.3233/jad-190566] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The apolipoprotein E (APOE) gene ɛ4 allele is a risk factor for Alzheimer's disease and cardiovascular disease. However, its relationship with cognition and brain volume after stroke is not clear. OBJECTIVE We compared cognition and medial temporal lobe volumes in APOEɛ4 carriers and non-carriers in the first year after ischemic stroke. METHODS We sampled 20 APOEɛ4 carriers and 20 non-carriers from a larger cohort of 135 ischemic stroke participants in the longitudinal CANVAS study. Participants were matched on a range of demographic and stroke characteristics. We used linear mixed-effect models to compare cognitive domain z-scores (attention, processing speed, executive function, verbal and visual memory, language, visuospatial function) and regional medial temporal lobe volumes (hippocampal, entorhinal cortex) between groups at each time-point (3, 12-months post-stroke), and within groups across time-points. APOE gene single nucleotide polymorphisms (SNPs; rs7412, rs429358) were genotyped on venous blood. RESULTS APOEɛ4 carriers and non-carriers did not differ on any demographic, clinical, or stroke variable. Carriers performed worse than non-carriers in verbal memory at 3 months post-stroke (p = 0.046), but were better in executive function at 12 months (p = 0.035). Carriers demonstrated a significant improvement in verbal memory (p = 0.012) and executive function (p = 0.015) between time-points. Non-carriers demonstrated a significant improvement in visual memory (p = 0.0005). Carriers had smaller bilateral entorhinal cortex volumes (p < 0.05), and larger right sided and contralesional hippocampal volumes, at both time-points (p < 0.05). CONCLUSION APOE ɛ4 is associated with delayed recovery of verbal memory function and reduced entorhinal cortex volumes in the first year after ischemic stroke.
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Affiliation(s)
- Emilio Werden
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Mohamed Salah Khlif
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Laura J Bird
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Toby Cumming
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | | | - Wasim Khan
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Matthew Pase
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Carolina Restrepo
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Michele Veldsman
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Natalia Egorova
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Sheila K Patel
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Elie Gottlieb
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Amy Brodtmann
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.,Austin Health, Heidelberg, Melbourne, VIC, Australia.,Eastern Clinical Research Unit, Box Hill Hospital, Melbourne, VIC, Australia
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Zhu Y, Gong L, He C, Wang Q, Ren Q, Xie C. Default Mode Network Connectivity Moderates the Relationship Between the APOE Genotype and Cognition and Individualizes Identification Across the Alzheimer's Disease Spectrum. J Alzheimers Dis 2020; 70:843-860. [PMID: 31282419 DOI: 10.3233/jad-190254] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Although previous studies have investigated the effects of the apolipoprotein E (APOE) ɛ4 genotype on the default mode network (DMN) in the Alzheimer's disease (AD) spectrum, it is still unclear how the APOE genotype regulates the DMN and subsequently affects cognitive decline in the AD spectrum. One hundred sixty-nine subjects with resting-state functional magnetic resonance imaging data and neuropsychological test scores were selected from the Alzheimer's Disease Neuroimaging Initiative. The main effects and interaction of the APOE genotype and disease status on the DMN were explored. A moderation analysis was performed to investigate the relationship among the APOE genotype, DMN connectivity, and cognition. Additionally, the pair-wised DMN connectivity was used to classify AD spectrum, and the classification accuracy was validated. Compared to APOEɛ4 non-carriers, APOEɛ4 carriers showed the opposite trajectory of DMN connectivity across the AD spectrum. Specifically, the strengths in the posterior cingulate cortex (PCC) connecting with the right precuneus, insular, and fusiform area (FFA) were positively correlated with Mini-Mental State Examination (MMSE) scores in APOEɛ4 non-carriers but not in APOEɛ4 carriers. Furthermore, PCC-right FFA connectivity could moderate the effects of the APOE genotype on MMSE scores across the disease groups. More importantly, using a receiver operating characteristic analysis, these altered connectivities yielded strong classification powers in a pathological stage-dependent manner in the AD spectrum. These findings first identified the intrinsic DMN connectivity moderating the effect of the APOE genotype on cognition and provided a pathological stage-dependent neuroimaging biomarker for early differentiation of the AD spectrum.
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Affiliation(s)
- Yao Zhu
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Liang Gong
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Cancan He
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Qing Wang
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Qingguo Ren
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Chunming Xie
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China
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Martí-Juan G, Sanroma-Guell G, Cacciaglia R, Falcon C, Operto G, Molinuevo JL, González Ballester MÁ, Gispert JD, Piella G. Nonlinear interaction between APOE ε4 allele load and age in the hippocampal surface of cognitively intact individuals. Hum Brain Mapp 2020; 42:47-64. [PMID: 33017488 PMCID: PMC7721244 DOI: 10.1002/hbm.25202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/16/2020] [Accepted: 08/11/2020] [Indexed: 01/27/2023] Open
Abstract
The ε4 allele of the gene Apolipoprotein E is the major genetic risk factor for Alzheimer's Disease. APOE ε4 has been associated with changes in brain structure in cognitively impaired and unimpaired subjects, including atrophy of the hippocampus, which is one of the brain structures that is early affected by AD. In this work we analyzed the impact of APOE ε4 gene dose and its association with age, on hippocampal shape assessed with multivariate surface analysis, in a ε4‐enriched cohort of n = 479 cognitively healthy individuals. Furthermore, we sought to replicate our findings on an independent dataset of n = 969 individuals covering the entire AD spectrum. We segmented the hippocampus of the subjects with a multi‐atlas‐based approach, obtaining high‐dimensional meshes that can be analyzed in a multivariate way. We analyzed the effects of different factors including APOE, sex, and age (in both cohorts) as well as clinical diagnosis on the local 3D hippocampal surface changes. We found specific regions on the hippocampal surface where the effect is modulated by significant APOE ε4 linear and quadratic interactions with age. We compared between APOE and diagnosis effects from both cohorts, finding similarities between APOE ε4 and AD effects on specific regions, and suggesting that age may modulate the effect of APOE ε4 and AD in a similar way.
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Affiliation(s)
- Gerard Martí-Juan
- BCN MedTech, Departament de Tecnologies de la Informació i les Comunicacions, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Raffaele Cacciaglia
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Carles Falcon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBERBBN), Madrid, Spain
| | - Grégory Operto
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Miguel Ángel González Ballester
- BCN MedTech, Departament de Tecnologies de la Informació i les Comunicacions, Universitat Pompeu Fabra, Barcelona, Spain.,ICREA, Barcelona, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBERBBN), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Gemma Piella
- BCN MedTech, Departament de Tecnologies de la Informació i les Comunicacions, Universitat Pompeu Fabra, Barcelona, Spain
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