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Vanderlinden G, Ceccarini J, Vande Casteele T, Michiels L, Lemmens R, Triau E, Serdons K, Tournoy J, Koole M, Vandenbulcke M, Van Laere K. Spatial decrease of synaptic density in amnestic mild cognitive impairment follows the tau build-up pattern. Mol Psychiatry 2022; 27:4244-4251. [PMID: 35794185 DOI: 10.1038/s41380-022-01672-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/03/2022] [Accepted: 06/10/2022] [Indexed: 02/07/2023]
Abstract
Next to amyloid and tau, synaptic loss is a key pathological hallmark in Alzheimer's disease, closely related to cognitive dysfunction and neurodegeneration. Tau is thought to cause synaptic loss, but this has not been experimentally verified in vivo. In a 2-year follow-up study, dual tracer PET-MR was performed in 12 amnestic MCI patients using 18F-MK-6240 for tau and 11C-UCB-J for SV2A as a proxy for synaptic density. Tau already accumulated in the neocortex at baseline with progression in Braak V/VI at follow-up. While synaptic loss was limited to limbic regions at baseline, it followed the specific tau pattern to stage IV/V regions two years later, indicating that tau spread might drive synaptic vulnerability. Moreover, synaptic density changes correlated to changes in cognitive function. This study shows for the first time in vivo that synaptic loss regionally follows tau accumulation after two years, providing a disease-modifying window of opportunity for (combined) tau-targeting therapies.
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Affiliation(s)
- Greet Vanderlinden
- Nuclear Medicine and Molecular Imaging, Imaging Pathology, KU Leuven, Leuven, Belgium.
| | - Jenny Ceccarini
- Nuclear Medicine and Molecular Imaging, Imaging Pathology, KU Leuven, Leuven, Belgium
| | - Thomas Vande Casteele
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Laura Michiels
- Department of Neurosciences, KU Leuven, Leuven, Belgium.,Department of Neurology, University Hospitals UZ Leuven, Leuven, Belgium.,VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium
| | - Robin Lemmens
- Department of Neurosciences, KU Leuven, Leuven, Belgium.,Department of Neurology, University Hospitals UZ Leuven, Leuven, Belgium.,VIB, Center for Brain & Disease Research, Laboratory of Neurobiology, Leuven, Belgium
| | - Eric Triau
- Private Practice Neurology, Leuven, Belgium
| | - Kim Serdons
- Department of Nuclear Medicine, University Hospitals UZ Leuven, Leuven, Belgium
| | - Jos Tournoy
- Department of Geriatric Medicine, University Hospitals UZ Leuven, Leuven, Belgium.,Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Leuven, Belgium
| | - Michel Koole
- Nuclear Medicine and Molecular Imaging, Imaging Pathology, KU Leuven, Leuven, Belgium
| | - Mathieu Vandenbulcke
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium.,Department of Old-Age Psychiatry, University Hospitals UZ Leuven, Leuven, Belgium
| | - Koen Van Laere
- Nuclear Medicine and Molecular Imaging, Imaging Pathology, KU Leuven, Leuven, Belgium.,Department of Nuclear Medicine, University Hospitals UZ Leuven, Leuven, Belgium
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