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Santillán-Morales V, Rodriguez-Espinosa N, Muñoz-Estrada J, Alarcón-Elizalde S, Acebes Á, Benítez-King G. Biomarkers in Alzheimer's Disease: Are Olfactory Neuronal Precursors Useful for Antemortem Biomarker Research? Brain Sci 2024; 14:46. [PMID: 38248261 PMCID: PMC10813897 DOI: 10.3390/brainsci14010046] [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: 11/16/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Alzheimer's disease (AD), as the main cause of dementia, affects millions of people around the world, whose diagnosis is based mainly on clinical criteria. Unfortunately, the diagnosis is obtained very late, when the neurodegenerative damage is significant for most patients. Therefore, the exhaustive study of biomarkers is indispensable for diagnostic, prognostic, and even follow-up support. AD is a multifactorial disease, and knowing its underlying pathological mechanisms is crucial to propose new and valuable biomarkers. In this review, we summarize some of the main biomarkers described in AD, which have been evaluated mainly by imaging studies in cerebrospinal fluid and blood samples. Furthermore, we describe and propose neuronal precursors derived from the olfactory neuroepithelium as a potential resource to evaluate some of the widely known biomarkers of AD and to gear toward searching for new biomarkers. These neuronal lineage cells, which can be obtained directly from patients through a non-invasive and outpatient procedure, display several characteristics that validate them as a surrogate model to study the central nervous system, allowing the analysis of AD pathophysiological processes. Moreover, the ease of obtaining and harvesting endows them as an accessible and powerful resource to evaluate biomarkers in clinical practice.
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Affiliation(s)
- Valeria Santillán-Morales
- Laboratory of Neuropharmacology, Clinical Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico; (V.S.-M.); (S.A.-E.)
| | - Norberto Rodriguez-Espinosa
- Department of Neurology, University Hospital Nuestra Señora de Candelaria, 38010 Tenerife, Spain;
- Department of Internal Medicine, Dermatology and Psychiatry, Faculty of Health Sciences, University of La Laguna (ULL), 38200 Tenerife, Spain
| | - Jesús Muñoz-Estrada
- Department of Computational Biomedicine, Cedars Sinai Medical Center, Los Angeles, CA 90069, USA;
| | - Salvador Alarcón-Elizalde
- Laboratory of Neuropharmacology, Clinical Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico; (V.S.-M.); (S.A.-E.)
| | - Ángel Acebes
- Department of Basic Medical Sciences, Institute of Biomedical Technologies (ITB), University of La Laguna (ULL), 38200 Tenerife, Spain
| | - Gloria Benítez-King
- Laboratory of Neuropharmacology, Clinical Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City 14370, Mexico; (V.S.-M.); (S.A.-E.)
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Chong JSX, Tan YJ, Koh AJ, Ting SKS, Kandiah N, Ng ASL, Zhou JH. Plasma Neurofilament Light Relates to Divergent Default and Salience Network Connectivity in Alzheimer's Disease and Behavioral Variant Frontotemporal Dementia. J Alzheimers Dis 2024; 99:965-980. [PMID: 38759005 DOI: 10.3233/jad-231251] [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] [Indexed: 05/19/2024]
Abstract
Background Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) show differential vulnerability to large-scale brain functional networks. Plasma neurofilament light (NfL), a promising biomarker of neurodegeneration, has been linked in AD patients to glucose metabolism changes in AD-related regions. However, it is unknown whether plasma NfL would be similarly associated with disease-specific functional connectivity changes in AD and bvFTD. Objective Our study examined the associations between plasma NfL and functional connectivity of the default mode and salience networks in patients with AD and bvFTD. Methods Plasma NfL and neuroimaging data from patients with bvFTD (n = 16) and AD or mild cognitive impairment (n = 38; AD + MCI) were analyzed. Seed-based functional connectivity maps of key regions within the default mode and salience networks were obtained and associated with plasma NfL in these patients. RESULTS We demonstrated divergent associations between NfL and functional connectivity in AD + MCI and bvFTD patients. Specifically, AD + MCI patients showed lower default mode network functional connectivity with higher plasma NfL, while bvFTD patients showed lower salience network functional connectivity with higher plasma NfL. Further, lower NfL-related default mode network connectivity in AD + MCI patients was associated with lower Montreal Cognitive Assessment scores and higher Clinical Dementia Rating sum-of-boxes scores, although NfL-related salience network connectivity in bvFTD patients was not associated with Neuropsychiatric Inventory Questionnaire scores. CONCLUSIONS Our findings indicate that plasma NfL is differentially associated with brain functional connectivity changes in AD and bvFTD.
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Affiliation(s)
- Joanna Su Xian Chong
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Human Potential Translational Research Programme and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yi Jayne Tan
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore
| | - Amelia Jialing Koh
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Human Potential Translational Research Programme and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Simon Kang Seng Ting
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore
| | - Adeline Su Lyn Ng
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore
| | - Juan Helen Zhou
- Centre for Sleep and Cognition & Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Human Potential Translational Research Programme and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Integrative Sciences and Engineering Programme (ISEP), NUS Graduate School, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- Neuroscience and Behavioural Disorders Programme, Duke-NUS Medical School, Singapore
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Tu JC, Millar PR, Strain JF, Eck A, Adeyemo B, Daniels A, Karch C, Huey ED, McDade E, Day GS, Yakushev I, Hassenstab J, Morris J, Llibre-Guerra JJ, Ibanez L, Jucker M, Mendez PC, Bateman RJ, Perrin RJ, Benzinger T, Jack CR, Betzel R, Ances BM, Eggebrecht AT, Gordon BA, Wheelock MD. Increasing hub disruption parallels dementia severity in autosomal dominant Alzheimer disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.29.564633. [PMID: 37961586 PMCID: PMC10634945 DOI: 10.1101/2023.10.29.564633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Hub regions in the brain, recognized for their roles in ensuring efficient information transfer, are vulnerable to pathological alterations in neurodegenerative conditions, including Alzheimer Disease (AD). Given their essential role in neural communication, disruptions to these hubs have profound implications for overall brain network integrity and functionality. Hub disruption, or targeted impairment of functional connectivity at the hubs, is recognized in AD patients. Computational models paired with evidence from animal experiments hint at a mechanistic explanation, suggesting that these hubs may be preferentially targeted in neurodegeneration, due to their high neuronal activity levels-a phenomenon termed "activity-dependent degeneration". Yet, two critical issues were unresolved. First, past research hasn't definitively shown whether hub regions face a higher likelihood of impairment (targeted attack) compared to other regions or if impairment likelihood is uniformly distributed (random attack). Second, human studies offering support for activity-dependent explanations remain scarce. We applied a refined hub disruption index to determine the presence of targeted attacks in AD. Furthermore, we explored potential evidence for activity-dependent degeneration by evaluating if hub vulnerability is better explained by global connectivity or connectivity variations across functional systems, as well as comparing its timing relative to amyloid beta deposition in the brain. Our unique cohort of participants with autosomal dominant Alzheimer Disease (ADAD) allowed us to probe into the preclinical stages of AD to determine the hub disruption timeline in relation to expected symptom emergence. Our findings reveal a hub disruption pattern in ADAD aligned with targeted attacks, detectable even in pre-clinical stages. Notably, the disruption's severity amplified alongside symptomatic progression. Moreover, since excessive local neuronal activity has been shown to increase amyloid deposition and high connectivity regions show high level of neuronal activity, our observation that hub disruption was primarily tied to regional differences in global connectivity and sequentially followed changes observed in Aβ PET cortical markers is consistent with the activity-dependent degeneration model. Intriguingly, these disruptions were discernible 8 years before the expected age of symptom onset. Taken together, our findings not only align with the targeted attack on hubs model but also suggest that activity-dependent degeneration might be the cause of hub vulnerability. This deepened understanding could be instrumental in refining diagnostic techniques and developing targeted therapeutic strategies for AD in the future.
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Affiliation(s)
- Jiaxin Cindy Tu
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Peter R Millar
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Jeremy F Strain
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Andrew Eck
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Babatunde Adeyemo
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Alisha Daniels
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Celeste Karch
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Edward D Huey
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, 02912
| | - Eric McDade
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Gregory S Day
- Department of Neurology, Mayo Clinic College of Medicine, Jacksonville, FL, USA, 32224
| | - Igor Yakushev
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany, 81675
| | - Jason Hassenstab
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - John Morris
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Jorge J Llibre-Guerra
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Laura Ibanez
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA, 63108
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA, 63108
- NeuroGenomics and Informatics Center, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Mathias Jucker
- Department of Cellular Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany, 72076
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany, 72076
| | | | - Randell J Bateman
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Richard J Perrin
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA, 63108
- Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Tammie Benzinger
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, USA 55905
| | - Richard Betzel
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN USA, 47405
| | - Beau M Ances
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Adam T Eggebrecht
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Brian A Gordon
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA, 63108
| | - Muriah D Wheelock
- Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA, 63108
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Imbimbo BP, Watling M, Imbimbo C, Nisticò R. Plasma ATN(I) classification and precision pharmacology in Alzheimer's disease. Alzheimers Dement 2023; 19:4729-4734. [PMID: 37079778 DOI: 10.1002/alz.13084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 04/22/2023]
Abstract
Evaluating potential therapies for Alzheimer's disease (AD) depends on use of biomarkers for appropriate subject selection and monitoring disease progression. Biomarkers that predict onset of clinical symptoms are particularly important for AD because they enable intervention before irreversible neurodegeneration occurs. The amyloid-β-tau-neurodegeneration (ATN) classification system is currently used as a biological staging model for AD and is based on three classes of biomarkers evaluating amyloid-β (Aβ), tau pathology and neurodegeneration or neuronal injury. Promising blood-based biomarkers for each of these categories have been identified (Aβ42/Aβ40 ratio, phosphorylated tau, neurofilament light chain), and this matrix is now being expanded toward an ATN(I) system, where "I" represents a neuroinflammatory biomarker. The plasma ATN(I) system, together with APOE genotyping, offers a basis for individualized evaluation and a move away from the classic "one size fits all" approach toward a biomarker-driven individualisation of therapy for patients with AD.
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Affiliation(s)
- Bruno P Imbimbo
- Department of Research & Development, Chiesi Farmaceutici, Parma, Italy
| | - Mark Watling
- Independent Scholar (formerly at TranScrip Ltd, Reading, UK), Ruthin, UK
| | - Camillo Imbimbo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Robert Nisticò
- Department of Biology, School of Pharmacy, University of Tor Vergata, and European Brain Research Institute (EBRI), Rome, Italy
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