1
|
Iaccarino L, Llibre-Guerra JJ, McDade E, Edwards L, Gordon B, Benzinger T, Hassenstab J, Kramer JH, Li Y, Miller BL, Miller Z, Morris JC, Mundada N, Perrin RJ, Rosen HJ, Soleimani-Meigooni D, Strom A, Tsoy E, Wang G, Xiong C, Allegri R, Chrem P, Vazquez S, Berman SB, Chhatwal J, Masters CL, Farlow MR, Jucker M, Levin J, Salloway S, Fox NC, Day GS, Gorno-Tempini ML, Boxer AL, La Joie R, Bateman R, Rabinovici GD. Molecular neuroimaging in dominantly inherited versus sporadic early-onset Alzheimer's disease. Brain Commun 2024; 6:fcae159. [PMID: 38784820 PMCID: PMC11114609 DOI: 10.1093/braincomms/fcae159] [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: 06/06/2023] [Revised: 03/14/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024] Open
Abstract
Approximately 5% of Alzheimer's disease patients develop symptoms before age 65 (early-onset Alzheimer's disease), with either sporadic (sporadic early-onset Alzheimer's disease) or dominantly inherited (dominantly inherited Alzheimer's disease) presentations. Both sporadic early-onset Alzheimer's disease and dominantly inherited Alzheimer's disease are characterized by brain amyloid-β accumulation, tau tangles, hypometabolism and neurodegeneration, but differences in topography and magnitude of these pathological changes are not fully elucidated. In this study, we directly compared patterns of amyloid-β plaque deposition and glucose hypometabolism in sporadic early-onset Alzheimer's disease and dominantly inherited Alzheimer's disease individuals. Our analysis included 134 symptomatic sporadic early-onset Alzheimer's disease amyloid-Positron Emission Tomography (PET)-positive cases from the University of California, San Francisco, Alzheimer's Disease Research Center (mean ± SD age 59.7 ± 5.6 years), 89 symptomatic dominantly inherited Alzheimer's disease cases (age 45.8 ± 9.3 years) and 102 cognitively unimpaired non-mutation carriers from the Dominantly Inherited Alzheimer Network study (age 44.9 ± 9.2). Each group underwent clinical and cognitive examinations, 11C-labelled Pittsburgh Compound B-PET and structural MRI. 18F-Fluorodeoxyglucose-PET was also available for most participants. Positron Emission Tomography scans from both studies were uniformly processed to obtain a standardized uptake value ratio (PIB50-70 cerebellar grey reference and FDG30-60 pons reference) images. Statistical analyses included pairwise global and voxelwise group comparisons and group-independent component analyses. Analyses were performed also adjusting for covariates including age, sex, Mini-Mental State Examination, apolipoprotein ε4 status and average composite cortical of standardized uptake value ratio. Compared with dominantly inherited Alzheimer's disease, sporadic early-onset Alzheimer's disease participants were older at age of onset (mean ± SD, 54.8 ± 8.2 versus 41.9 ± 8.2, Cohen's d = 1.91), with more years of education (16.4 ± 2.8 versus 13.5 ± 3.2, d = 1) and more likely to be apolipoprotein ε4 carriers (54.6% ε4 versus 28.1%, Cramer's V = 0.26), but similar Mini-Mental State Examination (20.6 ± 6.1 versus 21.2 ± 7.4, d = 0.08). Sporadic early-onset Alzheimer's disease had higher global cortical Pittsburgh Compound B-PET binding (mean ± SD standardized uptake value ratio, 1.92 ± 0.29 versus 1.58 ± 0.44, d = 0.96) and greater global cortical 18F-fluorodeoxyglucose-PET hypometabolism (mean ± SD standardized uptake value ratio, 1.32 ± 0.1 versus 1.39 ± 0.19, d = 0.48) compared with dominantly inherited Alzheimer's disease. Fully adjusted comparisons demonstrated relatively higher Pittsburgh Compound B-PET standardized uptake value ratio in the medial occipital, thalami, basal ganglia and medial/dorsal frontal regions in dominantly inherited Alzheimer's disease versus sporadic early-onset Alzheimer's disease. Sporadic early-onset Alzheimer's disease showed relatively greater 18F-fluorodeoxyglucose-PET hypometabolism in Alzheimer's disease signature temporoparietal regions and caudate nuclei, whereas dominantly inherited Alzheimer's disease showed relatively greater hypometabolism in frontal white matter and pericentral regions. Independent component analyses largely replicated these findings by highlighting common and unique Pittsburgh Compound B-PET and 18F-fluorodeoxyglucose-PET binding patterns. In summary, our findings suggest both common and distinct patterns of amyloid and glucose hypometabolism in sporadic and dominantly inherited early-onset Alzheimer's disease.
Collapse
Affiliation(s)
- Leonardo Iaccarino
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Jorge J Llibre-Guerra
- The Dominantly Inherited Alzheimer Network (DIAN), St Louis, MO 63108, USA
- Department of Neurology, Washington University in St Louis, St Louis, MO 63108, USA
| | - Eric McDade
- The Dominantly Inherited Alzheimer Network (DIAN), St Louis, MO 63108, USA
- Department of Neurology, Washington University in St Louis, St Louis, MO 63108, USA
| | - Lauren Edwards
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Brian Gordon
- Department of Radiology, Washington University in St Louis, St Louis, MO 63110, USA
| | - Tammie Benzinger
- Department of Radiology, Washington University in St Louis, St Louis, MO 63110, USA
| | - Jason Hassenstab
- The Dominantly Inherited Alzheimer Network (DIAN), St Louis, MO 63108, USA
- Department of Neurology, Washington University in St Louis, St Louis, MO 63108, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Yan Li
- Department of Biostatistics, Washington University in St Louis, St Louis, MO 63110, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Zachary Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - John C Morris
- The Dominantly Inherited Alzheimer Network (DIAN), St Louis, MO 63108, USA
- Department of Neurology, Washington University in St Louis, St Louis, MO 63108, USA
| | - Nidhi Mundada
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Richard J Perrin
- Department of Pathology and Immunology, Washington University in St Louis, St Louis, MO 63110, USA
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - David Soleimani-Meigooni
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Amelia Strom
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Elena Tsoy
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Guoqiao Wang
- Department of Biostatistics, Washington University in St Louis, St Louis, MO 63110, USA
| | - Chengjie Xiong
- Department of Biostatistics, Washington University in St Louis, St Louis, MO 63110, USA
| | - Ricardo Allegri
- Department of Cognitive Neurology, Institute for Neurological Research Fleni, Buenos Aires 1428, Argentina
| | - Patricio Chrem
- Department of Cognitive Neurology, Institute for Neurological Research Fleni, Buenos Aires 1428, Argentina
| | - Silvia Vazquez
- Department of Cognitive Neurology, Institute for Neurological Research Fleni, Buenos Aires 1428, Argentina
| | - Sarah B Berman
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Jasmeer Chhatwal
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Colin L Masters
- Department of Neuroscience, Florey Institute, The University of Melbourne, Melbourne 3052, Australia
| | - Martin R Farlow
- Neuroscience Center, Indiana University School of Medicine at Indianapolis, Indiana, IN 46202, USA
| | - Mathias Jucker
- DZNE-German Center for Neurodegenerative Diseases, Tübingen 72076, Germany
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-University, Munich 80539, Germany
- German Center for Neurodegenerative Diseases, Munich 81377, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich 81377, Germany
| | - Stephen Salloway
- Memory & Aging Program, Butler Hospital, Brown University in Providence, RI 02906, USA
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, University College London Institute of Neurology, London WC1N 3BG, UK
| | - Gregory S Day
- Department of Neurology, Mayo Clinic Florida, Jacksonville, FL 33224, USA
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Adam L Boxer
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Randall Bateman
- The Dominantly Inherited Alzheimer Network (DIAN), St Louis, MO 63108, USA
- Department of Neurology, Washington University in St Louis, St Louis, MO 63108, USA
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94143, USA
| |
Collapse
|
2
|
Rodriguez-Lopez A, Torres-Paniagua AM, Acero G, Díaz G, Gevorkian G. Increased TSPO expression, pyroglutamate-modified amyloid beta (AβN3(pE)) accumulation and transient clustering of microglia in the thalamus of Tg-SwDI mice. J Neuroimmunol 2023; 382:578150. [PMID: 37467699 DOI: 10.1016/j.jneuroim.2023.578150] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/07/2023] [Accepted: 07/09/2023] [Indexed: 07/21/2023]
Abstract
Epidemiological studies showed that Alzheimer's disease (AD) and cerebral amyloid angiopathy (CAA) frequently co-occur; however, the precise mechanism is not well understood. A unique animal model (Tg-SwDI mice) was developed to investigate the early-onset and robust accumulation of both parenchymal and vascular Aβ in the brain. Tg-SwDI mice have been extensively used to study the mechanisms of cerebrovascular dysfunction, neuroinflammation, neurodegeneration, and cognitive decline observed in AD/CAA patients and to design biomarkers and therapeutic strategies. In the present study, we documented interesting new features in the thalamus of Tg-SwDI mice: 1) a sharp increase in the expression of ionized calcium-binding adapter molecule 1 (Iba-1) in microglia in 6-month-old animals; 2) microglia clustering at six months that disappeared in old animals; 3) N-truncated/modified AβN3(pE) peptide in 9-month-old female and 12-month-old male mice; 4) an age-dependent increase in translocator protein (TSPO) expression. These findings reinforce the versatility of this model for studying multiple pathological issues involved in AD and CAA.
Collapse
Affiliation(s)
- Adrian Rodriguez-Lopez
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Apartado Postal 70228, Cuidad Universitaria, CDMX, CP 04510, Mexico
| | - Alicia M Torres-Paniagua
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Apartado Postal 70228, Cuidad Universitaria, CDMX, CP 04510, Mexico
| | - Gonzalo Acero
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Apartado Postal 70228, Cuidad Universitaria, CDMX, CP 04510, Mexico
| | - Georgina Díaz
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Apartado Postal 70228, Cuidad Universitaria, CDMX, CP 04510, Mexico
| | - Goar Gevorkian
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Apartado Postal 70228, Cuidad Universitaria, CDMX, CP 04510, Mexico.
| |
Collapse
|
3
|
Chen P, Zhao K, Zhang H, Wei Y, Wang P, Wang D, Song C, Yang H, Zhang Z, Yao H, Qu Y, Kang X, Du K, Fan L, Han T, Yu C, Zhou B, Jiang T, Zhou Y, Lu J, Han Y, Zhang X, Liu B, Liu Y. Altered global signal topography in Alzheimer's disease. EBioMedicine 2023; 89:104455. [PMID: 36758481 PMCID: PMC9941064 DOI: 10.1016/j.ebiom.2023.104455] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 12/31/2022] [Accepted: 01/17/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is a neurodegenerative disease associated with widespread disruptions in intrinsic local specialization and global integration in the functional system of the brain. These changes in integration may further disrupt the global signal (GS) distribution, which might represent the local relative contribution to global activity in functional magnetic resonance imaging (fMRI). METHODS fMRI scans from a discovery dataset (n = 809) and a validated dataset (n = 542) were used in the analysis. We investigated the alteration of GS topography using the GS correlation (GSCORR) in patients with mild cognitive impairment (MCI) and AD. The association between GS alterations and functional network properties was also investigated based on network theory. The underlying mechanism of GSCORR alterations was elucidated using imaging-transcriptomics. FINDINGS Significantly increased GS topography in the frontal lobe and decreased GS topography in the hippocampus, cingulate gyrus, caudate, and middle temporal gyrus were observed in patients with AD (Padj < 0.05). Notably, topographical GS changes in these regions correlated with cognitive ability (P < 0.05). The changes in GS topography also correlated with the changes in functional network segregation (ρ = 0.5). Moreover, the genes identified based on GS topographical changes were enriched in pathways associated with AD and neurodegenerative diseases. INTERPRETATION Our findings revealed significant changes in GS topography and its molecular basis, confirming the informative role of GS in AD and further contributing to the understanding of the relationship between global and local neuronal activities in patients with AD. FUNDING Beijing Natural Science Funds for Distinguished Young Scholars, China; Fundamental Research Funds for the Central Universities, China; National Natural Science Foundation, China.
Collapse
Affiliation(s)
- Pindong Chen
- Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Kun Zhao
- School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China; Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science & Medical Engineering, Beihang University, Beijing, China
| | - Han Zhang
- School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China
| | - Yongbin Wei
- School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China
| | - Pan Wang
- Department of Neurology, Tianjin Huanhu Hospital Tianjin University, Tianjin, China
| | - Dawei Wang
- Department of Radiology, Qilu Hospital of Shandong University, Ji'nan, China
| | - Chengyuan Song
- Department of Neurology, Qilu Hospital of Shandong University, Ji'nan, China
| | - Hongwei Yang
- Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | | | - Hongxiang Yao
- Department of Radiology, the Second Medical Centre, National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yida Qu
- Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Xiaopeng Kang
- Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Kai Du
- Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Lingzhong Fan
- Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Tong Han
- Department of Radiology, Tianjin Huanhu Hospital, Tianjin, China
| | - Chunshui Yu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bo Zhou
- Department of Neurology, the Second Medical Centre, National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Tianzi Jiang
- Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Yuying Zhou
- Department of Neurology, Tianjin Huanhu Hospital Tianjin University, Tianjin, China
| | - Jie Lu
- Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China; Beijing Institute of Geriatrics, Beijing, China; National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Xi Zhang
- Department of Neurology, the Second Medical Centre, National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Bing Liu
- State Key Laboratory of Cognition Neuroscience & Learning, Beijing Normal University, Beijing, China
| | - Yong Liu
- Brainnetome Center & National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China.
| | | |
Collapse
|
4
|
Imai A, Matsuoka T, Narumoto J. Older people with severe loneliness have an atrophied thalamus, hippocampus, and entorhinal cortex. Int J Geriatr Psychiatry 2022; 37. [PMID: 36394171 DOI: 10.1002/gps.5845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 11/04/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Loneliness has been shown to increase the risk of dementia. However, it is unclear why greater loneliness is associated with greater susceptibility to dementia. Herein, we aimed to examine the morphological characteristics of the brain associated with loneliness in older people concerned about cognitive dysfunction. METHODS In this retrospective study, 110 participants (80 with amnestic mild cognitive impairment, and 30 cognitively healthy individuals) were included. Participants were assessed using the revised University of California at Los Angeles (UCLA) loneliness scale and had undergone magnetic resonance imaging. Spearman correlation analysis and Mann-Whitney U tests were used to examine the clinical factors associated with loneliness. Multiple regression was performed to examine the relationship between the revised UCLA loneliness scale score and regional gray matter (GM) volume on voxel-based morphometry. RESULTS The revised UCLA loneliness scale scores were not significantly correlated with age, sex, or mini-mental state examination (MMSE) scores. Multiple regression using age, sex, MMSE score, and total brain volume as covariates showed negative correlations of the revised UCLA loneliness scale scores with the grey matter volume in regions centered on the bilateral thalamus, left hippocampus and left parahippocampal gyrus, and left entorhinal area. CONCLUSIONS Subjective loneliness was associated with decreased GM volume in the bilateral thalamus, left hippocampus, and left entorhinal cortex of the brain in the older people, thereby providing a morphological basis for the increased risk of dementia associated with greater loneliness.
Collapse
Affiliation(s)
- Ayu Imai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
5
|
Beach TG. A History of Senile Plaques: From Alzheimer to Amyloid Imaging. J Neuropathol Exp Neurol 2022; 81:387-413. [PMID: 35595841 DOI: 10.1093/jnen/nlac030] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Senile plaques have been studied in postmortem brains for more than 120 years and the resultant knowledge has not only helped us understand the etiology and pathogenesis of Alzheimer disease (AD), but has also pointed to possible modes of prevention and treatment. Within the last 15 years, it has become possible to image plaques in living subjects. This is arguably the single greatest advance in AD research since the identification of the Aβ peptide as the major plaque constituent. The limitations and potentialities of amyloid imaging are still not completely clear but are perhaps best glimpsed through the perspective gained from the accumulated postmortem histological studies. The basic morphological classification of plaques into neuritic, cored and diffuse has been supplemented by sophisticated immunohistochemical and biochemical analyses and increasingly detailed mapping of plaque brain distribution. Changes in plaque classification and staging have in turn contributed to changes in the definition and diagnostic criteria for AD. All of this information continues to be tested by clinicopathological correlations and it is through the insights thereby gained that we will best be able to employ the powerful tool of amyloid imaging.
Collapse
Affiliation(s)
- Thomas G Beach
- From the Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Sun City, Arizona, USA
| |
Collapse
|
6
|
Forno G, Lladó A, Hornberger M. Going round in circles-The Papez circuit in Alzheimer's disease. Eur J Neurosci 2021; 54:7668-7687. [PMID: 34656073 DOI: 10.1111/ejn.15494] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/01/2021] [Accepted: 10/12/2021] [Indexed: 11/29/2022]
Abstract
The hippocampus is regarded as the pivotal structure for episodic memory symptoms associated with Alzheimer's disease (AD) pathophysiology. However, what is often overlooked is that the hippocampus is 'only' one part of a network of memory critical regions, the Papez circuit. Other Papez circuit regions are often regarded as less relevant for AD as they are thought to sit 'downstream' of the hippocampus. However, this notion is oversimplistic, and increasing evidence suggests that other Papez regions might be affected before or concurrently with the hippocampus. In addition, AD research has mostly focused on episodic memory deficits, whereas spatial navigation processes are also subserved by the Papez circuit with increasing evidence supporting its valuable potential as a diagnostic measure of incipient AD pathophysiology. In the current review, we take a step forward analysing recent evidence on the structural and functional integrity of the Papez circuit across AD disease stages. Specifically, we will review the integrity of specific Papez regions from at-genetic-risk (APOE4 carriers), to mild cognitive impairment (MCI), to dementia stage of sporadic AD and autosomal dominant AD (ADAD). We related those changes to episodic memory and spatial navigation/orientation deficits in AD. Finally, we provide an overview of how the Papez circuit is affected in AD diseases and their specific symptomology contributions. This overview strengthened the need for moving away from a hippocampal-centric view to a network approach on how the whole Papez circuit is affected in AD and contributes to its symptomology, informing future research and clinical approaches.
Collapse
Affiliation(s)
- Gonzalo Forno
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,School of Psychology, Universidad de los Andes, Santiago, Chile.,Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, ICBM, Neurosciences Department, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | | |
Collapse
|
7
|
Provost K, La Joie R, Strom A, Iaccarino L, Edwards L, Mellinger TJ, Pham J, Baker SL, Miller BL, Jagust WJ, Rabinovici GD. Crossed cerebellar diaschisis on 18F-FDG PET: Frequency across neurodegenerative syndromes and association with 11C-PIB and 18F-Flortaucipir. J Cereb Blood Flow Metab 2021; 41:2329-2343. [PMID: 33691512 PMCID: PMC8393295 DOI: 10.1177/0271678x211001216] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/08/2021] [Accepted: 02/15/2021] [Indexed: 11/16/2022]
Abstract
We used 18F-FDG-PET to investigate the frequency of crossed cerebellar diaschisis (CCD) in 197 patients with various syndromes associated with neurodegenerative diseases. In a subset of 117 patients, we studied relationships between CCD and cortical asymmetry of Alzheimer's pathology (β-amyloid (11C-PIB) and tau (18F-Flortaucipir)). PET images were processed using MRIs to derive parametric SUVR images and define regions of interest. Indices of asymmetry were calculated in the cerebral cortex, basal ganglia and cerebellar cortex. Across all patients, cerebellar 18F-FDG asymmetry was associated with reverse asymmetry of 18F-FDG in the cerebral cortex (especially frontal and parietal areas) and basal ganglia. Based on our operational definition (cerebellar asymmetry >3% with contralateral supratentorial hypometabolism), significant CCD was present in 47/197 (24%) patients and was most frequent in corticobasal syndrome and semantic and logopenic variants of primary progressive aphasia. In β-amyloid-positive patients, mediation analyses showed that 18F-Flortaucipir cortical asymmetry was associated with cerebellar 18F-FDG asymmetry, but that cortical 18F-FDG asymmetry mediated this relationship. Analysis of 18F-FDG-SUVR values suggested that CCD might also occur in the absence of frank cerebellar 18F-FDG asymmetry due to symmetrical supratentorial degeneration resulting in a bilateral diaschisis process.
Collapse
Affiliation(s)
- Karine Provost
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Amelia Strom
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Leonardo Iaccarino
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Lauren Edwards
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Taylor J Mellinger
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Julie Pham
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | | | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - William J Jagust
- Lawrence Berkeley National Laboratory, Berkeley, USA
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- Lawrence Berkeley National Laboratory, Berkeley, USA
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
8
|
Kim HR, Jang JH, Ham H, Choo SH, Park J, Kang SH, Hwangbo S, Jang H, Na DL, Seo SW, Baek JH, Kim HJ. A Case of Early-Onset Alzheimer's Disease Mimicking Schizophrenia in a Patient with Presenilin 1 Mutation (S170P). J Alzheimers Dis 2021; 83:1025-1031. [PMID: 34366354 DOI: 10.3233/jad-210650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Atypical psychological symptoms frequently occur in early-onset Alzheimer's disease (EOAD), which makes it difficult to differentiate it from other psychiatric disorders. We report the case of a 28-year-old woman with EOAD, carrying a presenilin-1 mutation (S170P), who was initially misdiagnosed with schizophrenia because of prominent psychiatric symptoms in the first 1-2 years of the disease. Amyloid-β positron emission tomography (PET) showed remarkably high tracer uptake in the striatum and thalamus. Tau PET showed widespread cortical uptake and relatively low uptake in the subcortical and medial temporal regions. Our case advocates for considering EOAD diagnosis for young patients with psychiatric and atypical cognitive symptoms.
Collapse
Affiliation(s)
- Hang-Rai Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea.,Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Alzheimer's Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Ja Hyun Jang
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Honggi Ham
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Alzheimer's Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Digital Health, SAIHST, Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea.,Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea
| | - Seung Ho Choo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeongho Park
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Hoon Kang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Alzheimer's Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Song Hwangbo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Alzheimer's Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Alzheimer's Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Alzheimer's Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.,Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Alzheimer's Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Ji Hyun Baek
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Alzheimer's Disease Convergence Research Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Digital Health, SAIHST, Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| |
Collapse
|
9
|
Ghisays V, Lopera F, Goradia DD, Protas HD, Malek-Ahmadi MH, Chen Y, Devadas V, Luo J, Lee W, Baena A, Bocanegra Y, Guzmán-Vélez E, Pardilla-Delgado E, Vila-Castelar C, Fox-Fuller JT, Hu N, Clayton D, Thomas RG, Alvarez S, Espinosa A, Acosta-Baena N, Giraldo MM, Rios-Romenets S, Langbaum JB, Chen K, Su Y, Tariot PN, Quiroz YT, Reiman EM. PET evidence of preclinical cerebellar amyloid plaque deposition in autosomal dominant Alzheimer's disease-causing Presenilin-1 E280A mutation carriers. NEUROIMAGE-CLINICAL 2021; 31:102749. [PMID: 34252876 PMCID: PMC8278433 DOI: 10.1016/j.nicl.2021.102749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/21/2021] [Accepted: 06/26/2021] [Indexed: 11/16/2022]
Abstract
PET evidence of cerebellar Aβ deposition in unimpaired (CU) PSEN1 E280A kindred. Cerebellar Aβ PET SUVR began to distinguish CU carriers from non-carriers at age 34. Cortical and cerebellar Aβ PET SUVR are positively associated in CU carriers. Cerebellar florbetapir SUVR correlated with lower composite score in CU carriers.
Background In contrast to sporadic Alzheimer’s disease, autosomal dominant Alzheimer’s disease (ADAD) is associated with greater neuropathological evidence of cerebellar amyloid plaque (Aβ) deposition. In this study, we used positron emission tomography (PET) measurements of fibrillar Aβ burden to characterize the presence and age at onset of cerebellar Aβ deposition in cognitively unimpaired (CU) Presenilin-1 (PSEN1) E280A mutation carriers from the world’s largest extended family with ADAD. Methods 18F florbetapir and 11C Pittsburgh compound B (PiB) PET data from two independent studies – API ADAD Colombia Trial (NCT01998841) and Colombia-Boston (COLBOS) longitudinal biomarker study were included. The tracers were selected independently by the respective sponsors prior to the start of each study and used exclusively throughout. Template-based cerebellar Aβ-SUVR (standard-uptake value ratios) using a known-to-be-spared pons reference region (cerebellar SUVR_pons), to a) compare 28–56-year-old CU carriers and non-carriers; b) estimate the age at which cerebellar SUVR_pons began to differ significantly in carrier and non-carrier groups; and c) characterize in carriers associations with age, cortical SUVR_pons, delayed recall memory, and API ADAD composite score. Results Florbetapir and PiB cerebellar SUVR_pons were significantly higher in carriers than non-carriers (p < 0.0001). Cerebellar SUVR_pons began to distinguish carriers from non-carriers at age 34, 10 years before the carriers’ estimated age at mild cognitive impairment onset. Florbetapir and PiB cerebellar SUVR_pons in carriers were positively correlated with age (r = 0.44 & 0.69, p < 0.001), cortical SUVR_pons (r = 0.55 & 0.69, p < 0.001), and negatively correlated with delayed recall memory (r = −0.21 & −0.50, p < 0.05, unadjusted for cortical SUVR_pons) and API ADAD composite (r = −0.25, p < 0.01, unadjusted for cortical SUVR_pons in florbetapir API ADAD cohort). Conclusion This PET study provides evidence of cerebellar Aβ plaque deposition in CU carriers starting about a decade before the clinical onset of ADAD. Additional studies are needed to clarify the impact of using a cerebellar versus pons reference region on the power to detect and track ADAD changes, even in preclinical stages of this disorder.
Collapse
Affiliation(s)
- Valentina Ghisays
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Francisco Lopera
- Neurosciences Group of Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Dhruman D Goradia
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Hillary D Protas
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Michael H Malek-Ahmadi
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Yinghua Chen
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Vivek Devadas
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Ji Luo
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Wendy Lee
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Ana Baena
- Neurosciences Group of Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Yamile Bocanegra
- Neurosciences Group of Antioquia, Universidad de Antioquia, Medellín, Colombia
| | | | | | | | - Joshua T Fox-Fuller
- Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Boston University, Boston, MA, USA
| | - Nan Hu
- Genentech Inc., South San Francisco, CA, USA
| | | | - Ronald G Thomas
- University of California San Diego School of Medicine, La Jolla, CA, USA
| | | | - Alejandro Espinosa
- Neurosciences Group of Antioquia, Universidad de Antioquia, Medellín, Colombia
| | | | - Margarita M Giraldo
- Neurosciences Group of Antioquia, Universidad de Antioquia, Medellín, Colombia
| | | | - Jessica B Langbaum
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA; Arizona State University, Tempe, AZ, USA; University of Arizona, Tucson, AZ, USA
| | - Yi Su
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Pierre N Tariot
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Yakeel T Quiroz
- Neurosciences Group of Antioquia, Universidad de Antioquia, Medellín, Colombia; Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| | - Eric M Reiman
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Arizona Alzheimer's Consortium, Phoenix, AZ, USA; Arizona State University, Tempe, AZ, USA; University of Arizona, Tucson, AZ, USA; Translational Genomics Research Institute, Phoenix, AZ, USA.
| | | |
Collapse
|
10
|
Pardilla-Delgado E, Torrico-Teave H, Sanchez JS, Ramirez-Gomez LA, Baena A, Bocanegra Y, Vila-Castelar C, Fox-Fuller JT, Guzmán-Vélez E, Martínez J, Alvarez S, Ochoa-Escudero M, Lopera F, Quiroz YT. Associations between subregional thalamic volume and brain pathology in autosomal dominant Alzheimer's disease. Brain Commun 2021; 3:fcab101. [PMID: 34095834 PMCID: PMC8172494 DOI: 10.1093/braincomms/fcab101] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/01/2021] [Accepted: 03/19/2021] [Indexed: 12/02/2022] Open
Abstract
Histopathological reports suggest that subregions of the thalamus, which regulates multiple physiological and cognitive processes, are not uniformly affected by Alzheimer's disease. Despite this, structural neuroimaging studies often consider the thalamus as a single region. Identification of in vivo Alzheimer's-dependent volumetric changes in thalamic subregions may aid the characterization of early nuclei-specific neurodegeneration in Alzheimer's disease. Here, we leveraged access to the largest single-mutation cohort of autosomal-dominant Alzheimer's disease to test whether cross-sectional abnormalities in subregional thalamic volumes are evident in non-demented mutation carriers (n = 31), compared to non-carriers (n = 36), and whether subregional thalamic volume is associated with age, markers of brain pathology and cognitive performance. Using automatic parcellation we examined the thalamus in six subregions (anterior, lateral, ventral, intralaminar, medial, and posterior) and their relation to age and brain pathology (amyloid and tau), as measured by PET imaging. No between-group differences were observed in the volume of the thalamic subregions. In carriers, lower volume in the medial subregion was related to increased cortical amyloid and entorhinal tau burden. These findings suggest that thalamic Alzheimer's-related volumetric reductions are not uniform even in preclinical and prodromal stages of autosomal-dominant Alzheimer's disease and therefore, this structure should not be considered as a single, unitary structure in Alzheimer's disease research.
Collapse
Affiliation(s)
| | | | - Justin S Sanchez
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | | | - Ana Baena
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin 050010, Colombia
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin 050010, Colombia
| | - Clara Vila-Castelar
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Joshua T Fox-Fuller
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Boston University, Boston, MA 02215, USA
| | | | - Jairo Martínez
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | | | | | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin 050010, Colombia
| | - Yakeel T Quiroz
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellin 050010, Colombia
| |
Collapse
|
11
|
Ayodele T, Rogaeva E, Kurup JT, Beecham G, Reitz C. Early-Onset Alzheimer's Disease: What Is Missing in Research? Curr Neurol Neurosci Rep 2021; 21:4. [PMID: 33464407 PMCID: PMC7815616 DOI: 10.1007/s11910-020-01090-y] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Early-onset Alzheimer's disease (EOAD), defined as Alzheimer's disease (AD) occurring before age 65, is significantly less well studied than the late-onset form (LOAD) despite EOAD often presenting with a more aggressive disease progression. The aim of this review is to summarize the current understanding of the etiology of EOAD, their translation into clinical practice, and to suggest steps to be taken to move our understanding forward. RECENT FINDINGS EOAD cases make up 5-10% of AD cases but only 10-15% of these cases show known mutations in the APP, PSEN1, and PSEN2, which are linked to EOAD. New data suggests that these unexplained cases following a non-Mendelian pattern of inheritance is potentially caused by a mix of common and newly discovered rare variants. However, only a fraction of this genetic variation has been identified to date leaving the molecular mechanisms underlying this type of AD and their association with clinical, biomarker, and neuropathological changes unclear. While great advancements have been made in characterizing EOAD, much work is needed to disentangle the molecular mechanisms underlying this type of AD and to identify putative targets for more precise disease screening, diagnosis, prevention, and treatment.
Collapse
Affiliation(s)
- Temitope Ayodele
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, 60 Leonard Avenue, Toronto, ON, M5T 0S8, Canada
| | - Jiji T Kurup
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Gary Beecham
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA
| | - Christiane Reitz
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.
- The Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA.
- Department of Neurology, Columbia University, New York, NY, USA.
- Department of Epidemiology, Sergievsky Center, Taub Institute for Research on the Aging Brain, Columbia University, 630 W 168th Street, New York, NY, 10032, USA.
| |
Collapse
|
12
|
Reitz C, Rogaeva E, Beecham GW. Late-onset vs nonmendelian early-onset Alzheimer disease: A distinction without a difference? NEUROLOGY-GENETICS 2020; 6:e512. [PMID: 33225065 PMCID: PMC7673282 DOI: 10.1212/nxg.0000000000000512] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 08/07/2020] [Indexed: 12/21/2022]
Abstract
There is mounting evidence that only a small fraction of early-onset Alzheimer disease cases (onset <65 years) are explained by known mutations. Even multiplex families with early onset often also have late-onset cases, suggesting that the commonly applied categorization of Alzheimer disease into early- and late-onset forms may not reflect distinct underlying etiology. Nevertheless, this categorization continues to govern today's research and the design of clinical trials. The aim of this review is to evaluate this categorization by providing a comprehensive, critical review of reported clinical, neuropathologic, and genomic characteristics of both onset-based subtypes and explore potential overlap between both categories. The article will lay out the need to comprehensively assess the phenotypic, neuropathologic, and molecular variability in Alzheimer disease and identify factors explaining the observed significant variation in onset age in persons with and without known mutations. The article will critically review ongoing large-scale genomic efforts in Alzheimer disease research (e.g., Alzheimer Disease Sequencing Project, Dominantly Inherited Alzheimer Network, Alzheimer Disease Neuroimaging Initiative) and their shortcomings to disentangle the delineation of unexplained nonmendelian early-onset from late-onset and mendelian forms of Alzheimer disease. In addition, it will outline specific approaches including epigenetic research through which a comprehensive characterization of this delineation can be achieved.
Collapse
Affiliation(s)
- Christiane Reitz
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R.), Gertrude H. Sergievsky Center (C.R.), Department of Neurology (C.R.), and Department of Epidemiology (C.R.), College of Physicians and Surgeons, Columbia University, New York, NY; Tanz Centre for Research in Neurodegenerative Disease (E.R.), University of Toronto, ON, Canada; and The John P. Hussman Institute for Human Genomics (G.W.B.), University of Miami, FL
| | - Ekaterina Rogaeva
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R.), Gertrude H. Sergievsky Center (C.R.), Department of Neurology (C.R.), and Department of Epidemiology (C.R.), College of Physicians and Surgeons, Columbia University, New York, NY; Tanz Centre for Research in Neurodegenerative Disease (E.R.), University of Toronto, ON, Canada; and The John P. Hussman Institute for Human Genomics (G.W.B.), University of Miami, FL
| | - Gary W Beecham
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R.), Gertrude H. Sergievsky Center (C.R.), Department of Neurology (C.R.), and Department of Epidemiology (C.R.), College of Physicians and Surgeons, Columbia University, New York, NY; Tanz Centre for Research in Neurodegenerative Disease (E.R.), University of Toronto, ON, Canada; and The John P. Hussman Institute for Human Genomics (G.W.B.), University of Miami, FL
| |
Collapse
|
13
|
Giovacchini G, Giovannini E, Borsò E, Lazzeri P, Duce V, Ferrando O, Foppiano F, Ciarmiello A. Impact of Tracer Retention Levels on Visual Analysis of Cerebral [ 18F]- Florbetaben Pet Images. Curr Radiopharm 2020; 14:70-77. [PMID: 32727344 DOI: 10.2174/1874471013666200729155717] [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: 02/25/2019] [Revised: 06/15/2020] [Accepted: 06/19/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND To compare visual and semi-quantitative analysis of brain [18F]Florbetaben PET images in Mild Cognitive Impairment (MCI) patients and relate this finding to the degree of ß-amyloid burden. METHODS A sample of 71 amnestic MCI patients (age 74 ± 7.3 years, Mini Mental State Examination 24.2 ± 5.3) underwent cerebral [18F]Florbetaben PET/CT. Images were visually scored as positive or negative independently by three certified readers blinded to clinical and neuropsychological assessment. Amyloid positivity was also assessed by semiquantitative approach by means of a previously published threshold (SUVr ≥ 1.3). Fleiss kappa coefficient was used to compare visual analysis (after consensus among readers) and semi-quantitative analysis. Statistical significance was taken at P<0.05. RESULTS After the consensus reading, 43/71 (60.6%) patients were considered positive. Cases that were interpreted as visually positive had higher SUVr than visually negative patients (1.48 ± 0.19 vs 1.11 ± 0.09) (P<0.05). Agreement between visual analysis and semi-quantitative analysis was excellent (k=0.86, P<0.05). Disagreement occurred in 7/71 patients (9.9%) (6 false positives and 1 false negative). Agreement between the two analyses was 90.0% (18/20) for SUVr < 1.1, 83% (24/29) for SUVr between 1.1 and 1.5, and 100% (22/22) for SUVr > 1.5 indicating lowest agreement for the group with intermediate amyloid burden. CONCLUSION Inter-rater agreement of visual analysis of amyloid PET images is high. Agreement between visual analysis and SUVr semi-quantitative analysis decreases in the range of 1.1<SUVr <=1.5, where the clinical scenario is more challenging.
Collapse
Affiliation(s)
- Giampiero Giovacchini
- Nuclear Medicine Unit S. Andrea Hospital Via Vittorio Veneto, 197 19124 La Spezia, Italy
| | - Elisabetta Giovannini
- Nuclear Medicine Unit S. Andrea Hospital Via Vittorio Veneto, 197 19124 La Spezia, Italy
| | - Elisa Borsò
- Nuclear Medicine Unit S. Andrea Hospital Via Vittorio Veneto, 197 19124 La Spezia, Italy
| | - Patrizia Lazzeri
- Nuclear Medicine Unit S. Andrea Hospital Via Vittorio Veneto, 197 19124 La Spezia, Italy
| | - Valerio Duce
- Nuclear Medicine Unit S. Andrea Hospital Via Vittorio Veneto, 197 19124 La Spezia, Italy
| | | | | | - Andrea Ciarmiello
- Nuclear Medicine Unit S. Andrea Hospital Via Vittorio Veneto, 197 19124 La Spezia, Italy
| |
Collapse
|
14
|
Dong Y, Stewart T, Bai L, Li X, Xu T, Iliff J, Shi M, Zheng D, Yuan L, Wei T, Yang X, Zhang J. Coniferaldehyde attenuates Alzheimer's pathology via activation of Nrf2 and its targets. Am J Cancer Res 2020; 10:179-200. [PMID: 31903114 PMCID: PMC6929631 DOI: 10.7150/thno.36722] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 09/02/2019] [Indexed: 01/22/2023] Open
Abstract
Background: Alzheimer's disease (AD) currently lacks a cure. Because substantial neuronal damage usually occurs before AD is advanced enough for diagnosis, the best hope for disease-modifying AD therapies likely relies on early intervention or even prevention, and targeting multiple pathways implicated in early AD pathogenesis rather than focusing exclusively on excessive production of β-amyloid (Aβ) species. Methods: Coniferaldehyde (CFA), a food flavoring and agonist of NF-E2-related factor 2 (Nrf2), was selected by multimodal in vitro screening, followed by investigation of several downstream effects potentially involved. Furthermore, in the APP/PS1 AD mouse model, the therapeutic effects of CFA (0.2 mmol kg-1d-1) were tested beginning at 3 months of age. Behavioral phenotypes related to learning and memory capacity, brain pathology and biochemistry, including Aβ transport, were assessed at different time intervals. Results: CFA promoted neuron viability and showed potent neuroprotective effects, especially on mitochondrial structure and functions. In addition, CFA greatly enhanced the brain clearance of Aβ in both free and extracellular vesicle (EV)-contained Aβ forms. In the APP/PS1 mouse model, CFA effectively abolished brain Aβ deposits and reduced the level of toxic soluble Aβ peptides, thus eliminating AD-like pathological changes in the hippocampus and cerebral cortex and preserving learning and memory capacity of the mice. Conclusion: The experimental evidence overall indicated that Nrf2 activation may contribute to the potent anti-AD effects of CFA. With an excellent safety profile, further clinical investigation of coniferaldehyde might bring hope for AD prevention/therapy.
Collapse
|
15
|
Novellino F, López ME, Vaccaro MG, Miguel Y, Delgado ML, Maestu F. Association Between Hippocampus, Thalamus, and Caudate in Mild Cognitive Impairment APOEε4 Carriers: A Structural Covariance MRI Study. Front Neurol 2019; 10:1303. [PMID: 31920926 PMCID: PMC6933953 DOI: 10.3389/fneur.2019.01303] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/26/2019] [Indexed: 12/24/2022] Open
Abstract
Objective: Although, the apolipoprotein E (APOE) genotype is widely recognized as one of the most important risk factors for Alzheimer's disease (AD) development, the neural mechanisms by which the ε4 allele promotes the AD occurring remain under debate. The aim of this study was to evaluate neurobiological effects of the APOE-genotype on the pattern of the structural covariance in mild cognitive impairment (MCI) subjects. Methods: We enrolled 95 MCI subjects and 49 healthy controls. According to APOE-genotype, MCI subjects were divided into three groups: APOEε4 non-carriers (MCIε4-/-, n = 55), APOEε4 heterozygous carriers (MCIε4+/-, n = 31), and APOEε4 homozygous carriers (MCIε4+/+, n = 9) while all controls were APOEε4 non-carriers. In order to explore their brain structural pattern, T1-weighted anatomical brain 1.5-T MRI scans were collected. A whole-brain voxel-based morphometry analysis was performed, and all significant regions (p < 0.05 family-wise error, whole brain) were selected as a region of interest for the structural covariance analysis. Moreover, in order to evaluate the progression of the disease, a clinical follow-up was performed for 2 years. Results: The F-test showed in voxel-based morphometry analysis a strong overall difference among the groups in the middle frontal and temporal gyri and in the bilateral hippocampi, thalami, and parahippocampal gyri, with a grading in the atrophy in these latter three structures according to the following order: MCIε4+/+ > MCIε4+/- > MCIε4-/- > controls. Structural covariance analysis revealed a strong structural association between the left thalamus and the left caudate and between the right hippocampus and the left caudate (p < 0.05 family-wise error, whole brain) in the MCIε4 carrier groups (MCIε4+/+ > MCIε4+/-), whereas no significant associations were observed in MCIε4-/- subjects. Of note, the 38% of MCIs enrolled in this study developed AD within 2 years of follow-up. Conclusion: This study improves the knowledge on neurobiological effect of APOE ε4 in early pathophysiological phenomena underlying the MCI-to-AD evolution, as our results demonstrate changes in the structural association between hippocampal formation and thalamo-striatal connections occurring in MCI ε4 carriers. Our results strongly support the role of subcortical structures in MCI ε4 carriers and open a clinical window on the role of these structures as early disease markers.
Collapse
Affiliation(s)
- Fabiana Novellino
- Neuroimaging Research Unit, Institute of Bioimaging and Molecular Physiology, National Research Council, Catanzaro, Italy
| | - María Eugenia López
- Department of Experimental Psychology, Universidad Complutense de Madrid, Madrid, Spain
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | | | - Yus Miguel
- Radiology Department, San Carlos Clinical Hospital, Madrid, Spain
| | - María Luisa Delgado
- Department of Experimental Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - Fernando Maestu
- Department of Experimental Psychology, Universidad Complutense de Madrid, Madrid, Spain
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Madrid, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| |
Collapse
|
16
|
López-González FJ, Moscoso A, Efthimiou N, Fernández-Ferreiro A, Piñeiro-Fiel M, Archibald SJ, Aguiar P, Silva-Rodríguez J. Spill-in counts in the quantification of 18F-florbetapir on Aβ-negative subjects: the effect of including white matter in the reference region. EJNMMI Phys 2019; 6:27. [PMID: 31858289 PMCID: PMC6923310 DOI: 10.1186/s40658-019-0258-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 10/25/2019] [Indexed: 12/17/2022] Open
Abstract
Background We aim to provide a systematic study of the impact of white matter (WM) spill-in on the calculation of standardized uptake value ratios (SUVRs) on Aβ-negative subjects, and we study the effect of including WM in the reference region as a compensation. In addition, different partial volume correction (PVC) methods are applied and evaluated. Methods We evaluated magnetic resonance imaging and 18F-AV-45 positron emission tomography data from 122 cognitively normal (CN) patients recruited at the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Cortex SUVRs were obtained by using the cerebellar grey matter (CGM) (SUVRCGM) and the whole cerebellum (SUVRWC) as reference regions. The correlations between the different SUVRs and the WM uptake (WM-SUVRCGM) were studied in patients, and in a well-controlled framework based on Monte Carlo (MC) simulation. Activity maps for the MC simulation were derived from ADNI patients by using a voxel-wise iterative process (BrainViset). Ten WM uptakes covering the spectrum of WM values obtained from patient data were simulated for different patients. Three different PVC methods were tested (a) the regional voxel-based (RBV), (b) the iterative Yang (iY), and (c) a simplified analytical correction derived from our MC simulation. Results WM-SUVRCGM followed a normal distribution with an average of 1.79 and a standard deviation of 0.243 (13.6%). SUVRCGM was linearly correlated to WM-SUVRCGM (r = 0.82, linear fit slope = 0.28). SUVRWC was linearly correlated to WM-SUVRCGM (r = 0.64, linear fit slope = 0.13). Our MC results showed that these correlations are compatible with those produced by isolated spill-in effect (slopes of 0.23 and 0.11). The impact of the spill-in was mitigated by using PVC for SUVRCGM (slopes of 0.06 and 0.07 for iY and RBV), while SUVRWC showed a negative correlation with SUVRCGM after PVC. The proposed analytical correction also reduced the observed correlations when applied to patient data (r = 0.27 for SUVRCGM, r = 0.18 for SUVRWC). Conclusions There is a high correlation between WM uptake and the measured SUVR due to spill-in effect, and that this effect is reduced when including WM in the reference region. We also evaluated the performance of PVC, and we proposed an analytical correction that can be applied to preprocessed data.
Collapse
Affiliation(s)
- Francisco Javier López-González
- Molecular Imaging and Medical Physics Group, Radiology Department, Faculty of Medicine, Universidade de Santiago de Compostela, Galicia, Spain
| | - Alexis Moscoso
- Nuclear Medicine Department and Molecular Imaging Research Group, University Hospital (SERGAS) and Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Galicia, Spain
| | - Nikos Efthimiou
- PET Research Centre, Faculty of Health Sciences, University of Hull, Hull, UK
| | - Anxo Fernández-Ferreiro
- Pharmacy Department and Pharmacology Group, University Hospital (SERGAS) and Health Research Institute Santiago Compostela (IDIS), Santiago de Compostela, Galicia, Spain
| | - Manuel Piñeiro-Fiel
- Molecular Imaging and Medical Physics Group, Radiology Department, Faculty of Medicine, Universidade de Santiago de Compostela, Galicia, Spain
| | - Stephen J Archibald
- PET Research Centre, Faculty of Health Sciences, University of Hull, Hull, UK
| | - Pablo Aguiar
- Molecular Imaging and Medical Physics Group, Radiology Department, Faculty of Medicine, Universidade de Santiago de Compostela, Galicia, Spain. .,Nuclear Medicine Department and Molecular Imaging Research Group, University Hospital (SERGAS) and Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Galicia, Spain.
| | - Jesús Silva-Rodríguez
- Nuclear Medicine Department and Molecular Imaging Research Group, University Hospital (SERGAS) and Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Galicia, Spain.,R&D Department, Qubiotech Health Intelligence SL, A Coruña, Galicia, Spain
| | | |
Collapse
|
17
|
Metaxas A, Thygesen C, Kempf SJ, Anzalone M, Vaitheeswaran R, Petersen S, Landau AM, Audrain H, Teeling JL, Darvesh S, Brooks DJ, Larsen MR, Finsen B. Ageing and amyloidosis underlie the molecular and pathological alterations of tau in a mouse model of familial Alzheimer's disease. Sci Rep 2019; 9:15758. [PMID: 31673052 PMCID: PMC6823454 DOI: 10.1038/s41598-019-52357-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 10/13/2019] [Indexed: 02/07/2023] Open
Abstract
Despite compelling evidence that the accumulation of amyloid-beta (Aβ) promotes neocortical MAPT (tau) aggregation in familial and idiopathic Alzheimer's disease (AD), murine models of cerebral amyloidosis are not considered to develop tau-associated pathology. In the present study, we show that tau can accumulate spontaneously in aged transgenic APPswe/PS1ΔE9 mice. Tau pathology is abundant around Aβ deposits, and further characterized by accumulation of Gallyas and thioflavin-S-positive inclusions, which were detected in the APPswe/PS1ΔE9 brain at 18 months of age. Age-dependent increases in argyrophilia correlated positively with binding levels of the paired helical filament (PHF) tracer [18F]Flortaucipir, in all brain areas examined. Sarkosyl-insoluble PHFs were visualized by electron microscopy. Quantitative proteomics identified sequences of hyperphosphorylated and three-repeat tau in transgenic mice, along with signs of RNA missplicing, ribosomal dysregulation and disturbed energy metabolism. Tissue from the frontal gyrus of human subjects was used to validate these findings, revealing primarily quantitative differences between the tau pathology observed in AD patient vs. transgenic mouse tissue. As physiological levels of endogenous, 'wild-type' tau aggregate secondarily to Aβ in APPswe/PS1ΔE9 mice, this study suggests that amyloidosis is both necessary and sufficient to drive tauopathy in experimental models of familial AD.
Collapse
Affiliation(s)
- Athanasios Metaxas
- Institute of Molecular Medicine, University of Southern Denmark, Odense C, Denmark.
| | - Camilla Thygesen
- Institute of Molecular Medicine, University of Southern Denmark, Odense C, Denmark.,Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense M, Denmark
| | - Stefan J Kempf
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense M, Denmark
| | - Marco Anzalone
- Institute of Molecular Medicine, University of Southern Denmark, Odense C, Denmark
| | | | - Sussanne Petersen
- Institute of Molecular Medicine, University of Southern Denmark, Odense C, Denmark
| | - Anne M Landau
- Department of Nuclear Medicine and PET-Centre, Aarhus University, Aarhus, Denmark.,Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
| | - Hélène Audrain
- Department of Nuclear Medicine and PET-Centre, Aarhus University, Aarhus, Denmark
| | - Jessica L Teeling
- Biological Sciences, University of Southampton, Southampton, United Kingdom
| | - Sultan Darvesh
- Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada.,Department of Medicine (Neurology and Geriatric Medicine), Dalhousie University, Halifax, NS, Canada
| | - David J Brooks
- Department of Nuclear Medicine and PET-Centre, Aarhus University, Aarhus, Denmark.,Division of Neuroscience, Faculty of Medical Science, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Martin R Larsen
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, Odense M, Denmark
| | - Bente Finsen
- Institute of Molecular Medicine, University of Southern Denmark, Odense C, Denmark
| |
Collapse
|
18
|
Striatal amyloid is associated with tauopathy and memory decline in familial Alzheimer's disease. ALZHEIMERS RESEARCH & THERAPY 2019; 11:17. [PMID: 30717814 PMCID: PMC6362587 DOI: 10.1186/s13195-019-0468-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 01/14/2019] [Indexed: 01/15/2023]
Abstract
Background Autosomal dominant Alzheimer’s disease (ADAD) is distinguished from late-onset AD by early striatal amyloid-β deposition. To determine whether striatal Pittsburgh compound B (PiB)-PET measurements of amyloid-β can help predict disease severity in ADAD, we compared relationships of striatal and neocortical PiB-PET to age, tau-PET, and memory performance in the Colombian Presenilin 1 E280A kindred. Methods Fourteen carriers (age = 28–42, Mini-Mental State Examination = 26–30) and 20 age-matched non-carriers were evaluated using PiB, flortaucipir (FTP; tau), and memory testing (CERAD Word List Learning). PiB-PET signal was measured in neocortical and striatal aggregates. FTP-PET signal was measured in entorhinal cortex. Results Compared to non-carriers, mutation carriers had age-related elevations in both neocortical and striatal PiB binding. The PiB elevation in carriers was significantly greater in the striatum than in the neocortex. In mutation carriers, PiB binding in both the neocortex and the striatum is related to entorhinal FTP; however, the association was stronger with the striatum. Only striatal PiB was associated with worse memory. Remarkably, PiB binding in the striatum, but not in the neocortex, predicted entorhinal FTP and lower memory scores after adjusting for age, indicating that striatal PiB identified the carriers with the most severe disease. Conclusions Based on these preliminary cross-sectional findings, striatal PiB-PET measurements may offer particular value in the detection and tracking of preclinical ADAD, informing a mutation carrier’s prognosis and evaluating amyloid-β-modifying ADAD treatments.
Collapse
|
19
|
Wang ML, Wei XE, Fu JL, Li W, Yu MM, Li PY, Li WB. Subcortical nuclei in Alzheimer's disease: a volumetric and diffusion kurtosis imaging study. Acta Radiol 2018; 59:1365-1371. [PMID: 29482345 DOI: 10.1177/0284185118758122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Previous studies revealed that subcortical nuclei were harmed in the process of Alzheimer's disease (AD). Purpose To investigate the volumetric and diffusion kurtosis imaging (DKI) parameter changes of subcortical nuclei in AD and their relationship with cognitive function. Materials and Methods A total of 17 mild AD patients, 15 moderate to severe AD patients, and 16 controls underwent neuropsychological tests and magnetic resonance imaging (MRI) scans. Volume, mean kurtosis (MK), mean diffusivity (MD), and fractional anisotropy (FA) were measured in hippocampus, thalamus, caudate, putamen, pallidum, and amygdala. MRI parameters were compared. Correlation analysis was performed between subcortical nuclei volume, DKI parameters, and MMSE score. Results Significant volume reduction was seen in the left hippocampus in mild AD, and the bilateral hippocampus, thalamus, putamen, left caudate, and right amygdala in moderate to severe AD ( P < 0.05). Increased MD values were observed in the left hippocampus, left amygdala, and right caudate in mild AD, and the bilateral hippocampus and right amygdala in moderate to severe AD ( P < 0.05). Decreased MK values were observed only in the bilateral hippocampus in moderate to severe AD ( P < 0.05). No group significances were found in FA value. MMSE score was positively correlated with the volume of the bilateral hippocampus, thalamus, and putamen, and MK value of the left hippocampus ( P < 0.05). A negative correlation was found with the MD value of the bilateral hippocampus and left amygdala ( P < 0.05). Conclusion Mild AD mainly has microscopic subcortical changes revealed by increased MD value, and moderate to severe AD mainly has macroscopic subcortical changes revealed by volume reduction. MK is more sensitive in severe AD than mild AD.
Collapse
Affiliation(s)
- Ming-Liang Wang
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Xiao-Er Wei
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jian-Liang Fu
- Department of Neurology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Wei Li
- Department of Geriatrics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Meng-Meng Yu
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Peng-Yang Li
- Department of Cardiology, Peking University Aerospace School of Clinical Medicine, Peking University Health Science Center, Beijing, PR China
| | - Wen-Bin Li
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
- Imaging center, Kashgar Prefecture Second People’s Hospital, Kashgar, PR China
| |
Collapse
|
20
|
Ashton NJ, Schöll M, Heurling K, Gkanatsiou E, Portelius E, Höglund K, Brinkmalm G, Hye A, Blennow K, Zetterberg H. Update on biomarkers for amyloid pathology in Alzheimer's disease. Biomark Med 2018; 12:799-812. [DOI: 10.2217/bmm-2017-0433] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
At the center of Alzheimer's disease pathogenesis is the aberrant aggregation of amyloid-β (Aβ) into oligomers, fibrils and plaques. Effective monitoring of Aβ deposition directly in patients is essential to assist anti-Aβ therapeutics in target engagement and participant selection. In the advent of approved anti-Aβ therapeutics, biomarkers will become of fundamental importance in initiating treatments having disease modifying effects at the earliest stage. Two well-established Aβ biomarkers are widely utilized: Aβ-binding ligands for positron emission tomography and immunoassays to measure Aβ42 in cerebrospinal fluid. In this review, we will discuss the current clinical, diagnostic and research state of biomarkers for Aβ pathology. Furthermore, we will explore the current application of blood-based markers to assess Aβ pathology.
Collapse
Affiliation(s)
- Nicholas J Ashton
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, London, UK
- NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
- Wallenberg Centre for Molecular & Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Michael Schöll
- Wallenberg Centre for Molecular & Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Kerstin Heurling
- Wallenberg Centre for Molecular & Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Eleni Gkanatsiou
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Erik Portelius
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Kina Höglund
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Gunnar Brinkmalm
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Abdul Hye
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, London, UK
- NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Kaj Blennow
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry & Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
| |
Collapse
|
21
|
Zeydan B, Lowe VJ, Schwarz CG, Przybelski SA, Tosakulwong N, Zuk SM, Senjem ML, Gunter JL, Roberts RO, Mielke MM, Benarroch EE, Rodriguez M, Machulda MM, Lesnick TG, Knopman DS, Petersen RC, Jack CR, Kantarci K, Kantarci OH. Pittsburgh compound-B PET white matter imaging and cognitive function in late multiple sclerosis. Mult Scler 2018; 24:739-749. [PMID: 28474977 PMCID: PMC5665724 DOI: 10.1177/1352458517707346] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND There is growing interest in white matter (WM) imaging with positron emission tomography (PET). OBJECTIVES We studied the association of cognitive function in late multiple sclerosis (MS) with cortical and WM Pittsburgh compound-B PET (PiB-PET) binding. METHODS In the population-based Mayo Clinic Study of Aging, 24 of 4869 participants had MS (12 underwent PiB-PET). Controls were age and sex matched (5:1). We used automated or semi-automated processing for quantitative image analyses and conditional logistic regression for group differences. RESULTS MS patients had lower memory ( p = 0.03) and language ( p = 0.02) performance; smaller thalamic volumes ( p = 0.003); and thinner temporal ( p = 0.001) and frontal ( p = 0.045) cortices on magnetic resonance imaging (MRI) than controls. There was no difference in global cortical PiB standardized uptake value ratios between MS and controls ( p = 0.35). PiB uptake was lower in areas of WM hyperintensities compared to normal-appearing white matter (NAWM) in MS ( p = 0.0002). Reduced PiB uptake in both the areas of WM hyperintensities ( r = 0.65; p = 0.02) and NAWM ( r = 0.69; p = 0.01) was associated with decreased visuospatial performance in MS. CONCLUSION PiB uptake in the cortex in late MS is not different from normal age-matched controls. PiB uptake in the WM in late MS may be a marker of the large network structures' integrity such as those involved in visuospatial performance.
Collapse
Affiliation(s)
- Burcu Zeydan
- Mayo Clinic College of Medicine, Department of Neurology, Rochester, Minnesota, United States of America
- Mayo Clinic College of Medicine, Department of Radiology, Rochester, Minnesota, United States of America
| | - Val J. Lowe
- Mayo Clinic College of Medicine, Department of Radiology, Rochester, Minnesota, United States of America
| | - Christopher G. Schwarz
- Mayo Clinic College of Medicine, Department of Radiology, Rochester, Minnesota, United States of America
| | - Scott A. Przybelski
- Mayo Clinic College of Medicine, Department of Health Sciences Research, Rochester, Minnesota, United States of America
| | - Nirubol Tosakulwong
- Mayo Clinic College of Medicine, Department of Health Sciences Research, Rochester, Minnesota, United States of America
| | - Samantha M. Zuk
- Mayo Clinic College of Medicine, Department of Radiology, Rochester, Minnesota, United States of America
| | - Matthew L. Senjem
- Mayo Clinic College of Medicine, Department of Radiology, Rochester, Minnesota, United States of America
- Mayo Clinic College of Medicine, Department of Information Technology, Rochester, Minnesota, United States of America
| | - Jeffrey L. Gunter
- Mayo Clinic College of Medicine, Department of Information Technology, Rochester, Minnesota, United States of America
| | - Rosebud O. Roberts
- Mayo Clinic College of Medicine, Department of Neurology, Rochester, Minnesota, United States of America
- Mayo Clinic College of Medicine, Department of Health Sciences Research, Rochester, Minnesota, United States of America
| | - Michelle M. Mielke
- Mayo Clinic College of Medicine, Department of Neurology, Rochester, Minnesota, United States of America
- Mayo Clinic College of Medicine, Department of Health Sciences Research, Rochester, Minnesota, United States of America
| | - Eduardo E. Benarroch
- Mayo Clinic College of Medicine, Department of Neurology, Rochester, Minnesota, United States of America
| | - Moses Rodriguez
- Mayo Clinic College of Medicine, Department of Neurology, Rochester, Minnesota, United States of America
| | - Mary M. Machulda
- Mayo Clinic College of Medicine, Department of Psychiatry and Psychology, Rochester, Minnesota, United States of America
| | - Timothy G. Lesnick
- Mayo Clinic College of Medicine, Department of Health Sciences Research, Rochester, Minnesota, United States of America
| | - David S. Knopman
- Mayo Clinic College of Medicine, Department of Neurology, Rochester, Minnesota, United States of America
| | - Ronald C. Petersen
- Mayo Clinic College of Medicine, Department of Neurology, Rochester, Minnesota, United States of America
| | - Clifford R. Jack
- Mayo Clinic College of Medicine, Department of Radiology, Rochester, Minnesota, United States of America
| | - Kejal Kantarci
- Mayo Clinic College of Medicine, Department of Radiology, Rochester, Minnesota, United States of America
| | - Orhun H. Kantarci
- Mayo Clinic College of Medicine, Department of Neurology, Rochester, Minnesota, United States of America
| |
Collapse
|
22
|
Tucholka A, Grau-Rivera O, Falcon C, Rami L, Sánchez-Valle R, Lladó A, Gispert JD, Molinuevo JL. Structural Connectivity Alterations Along the Alzheimer's Disease Continuum: Reproducibility Across Two Independent Samples and Correlation with Cerebrospinal Fluid Amyloid-β and Tau. J Alzheimers Dis 2018; 61:1575-1587. [PMID: 29376852 PMCID: PMC5798529 DOI: 10.3233/jad-170553] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND Gray matter changes associated with the progression of Alzheimer's disease (AD) have been thoroughly studied. However, alterations in white matter tracts have received less attention, particularly during early or preclinical stages of the disease. OBJECTIVE To identify the structural connectivity changes across the AD continuum. METHODS We performed probabilistic tractography in a total of 183 subjects on two independent samples that include control (n = 68) and preclinical AD individuals (n = 28), patients diagnosed with mild cognitive impairment (MCI) due to AD (n = 44), and AD patients (n = 43). We compared the connectivity between groups, and with CSF Aβ42 and tau biomarkers. RESULTS We observed disconnections in preclinical individuals, mainly located in the temporal lobe. This pattern of disconnection spread to the parietal and frontal lobes at the MCI stage and involved almost all the brain in AD. These findings were not driven by gray matter atrophy. DISCUSSION Using tractography, we were able to identify white matter changes between subsequent disease stages and, notably, also in preclinical AD. Therefore, this method may be useful for detecting early and specific brain structural changes during preclinical AD stage.
Collapse
Affiliation(s)
- Alan Tucholka
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Carles Falcon
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN). Zaragoza, Spain
| | - Lorena Rami
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Albert Lladó
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN). Zaragoza, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | |
Collapse
|
23
|
Abstract
Single-photon emission computed tomography (SPECT) and positron emission tomography (PET) with different radiotracers enable regional evaluation of blood flow and glucose metabolism, of receptors and transporters of several molecules, and of abnormal deposition of peptides and proteins in the brain. The cerebellum has been used as a reference region for different radiotracers in several disease conditions. Whole-brain voxel-wise analysis is not affected by a priori knowledge bias and should be preferred. SPECT and PET have contributed to establishing the cerebellum role in motion, cognition, and emotion control in physiologic and pathophysiologic conditions. The basic abnormal imaging findings include decreased or increased uptake of flow or metabolism tracers in the cerebellum alone or as part of a network. Decreased uptake is generally observed in primary structural damage of the cerebellum, but can also represent a distant effect of cerebral damage (crossed diaschisis). Increased uptake can be observed in Freidreich ataxia, inflammatory or immune-mediated diseases of the cerebellum, and in status epilepticus. The possibility is also recognized that primary structural damage of the cerebellum might determine distance effects on other brain structures (reversed diaschisis). So far, SPECT and PET have been predominantly used in clinical studies to investigate cerebellar changes in neurologic and psychiatric diseases and in connection with pharmacologic, transcranial magnetic stimulation, deep-brain stimulation, or surgical treatments.
Collapse
|
24
|
Yun HJ, Moon SH, Kim HJ, Lockhart SN, Choe YS, Lee KH, Na DL, Lee JM, Seo SW. Centiloid method evaluation for amyloid PET of subcortical vascular dementia. Sci Rep 2017; 7:16322. [PMID: 29176753 PMCID: PMC5701176 DOI: 10.1038/s41598-017-16236-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 10/27/2017] [Indexed: 11/08/2022] Open
Abstract
Reference region selection is important for proper amyloid PET analysis, especially in subcortical vascular dementia (SVaD) patients. We investigated reference region differences between SVaD and Alzheimer's disease (AD) using Centiloid scores. In 57 [C-11] Pittsburgh compound B (PiB) positive (+) AD and 23 PiB (+) SVaD patients, we assessed standardized PiB uptake and Centiloid scores in disease-specific cortical regions, with several reference regions: cerebellar gray (CG), whole cerebellum (WC), WC with brainstem (WC + B), pons, and white matter (WM). We calculated disease group differences from young controls (YC) and YC variance according to reference region. SVaD patients showed large effect sizes (Cohen's d > 0.8) using all reference regions. WM and pons showed larger YC variances than other regions. Findings were similar for AD patients. CG, WC, and WC + B, but not WM or pons, are reliable reference regions for amyloid imaging analysis in SVaD.
Collapse
Affiliation(s)
- Hyuk Jin Yun
- Department of Biomedical Engineering, Hanyang University, Seoul, 04763, Korea
- Fetal Neonatal Neuroimaging and Developmental Science Center, Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, 02115, MA, USA
| | - Seung Hwan Moon
- Department of Nuclear Medicine, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea
- Neuroscience Center, Samsung Medical Center, Seoul, 06351, Korea
| | - Samuel N Lockhart
- Helen Wills Neuroscience Institute, University of California, Berkeley, 94720, CA, USA
- Department of Internal Medicine, Division of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, 27157, NC, USA
| | - Yearn Seong Choe
- Department of Nuclear Medicine, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea
| | - Kyung Han Lee
- Department of Nuclear Medicine, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea
- Neuroscience Center, Samsung Medical Center, Seoul, 06351, Korea
- Department of Health Sciences and Technology, Sungkyunkwan University, Seoul, 06351, Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, 04763, Korea.
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea.
- Neuroscience Center, Samsung Medical Center, Seoul, 06351, Korea.
- Department of Health Sciences and Technology, Sungkyunkwan University, Seoul, 06351, Korea.
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, 06351, Korea.
| |
Collapse
|
25
|
Alderson T, Kehoe E, Maguire L, Farrell D, Lawlor B, Kenny RA, Lyons D, Bokde ALW, Coyle D. Disrupted Thalamus White Matter Anatomy and Posterior Default Mode Network Effective Connectivity in Amnestic Mild Cognitive Impairment. Front Aging Neurosci 2017; 9:370. [PMID: 29167639 PMCID: PMC5682321 DOI: 10.3389/fnagi.2017.00370] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 10/26/2017] [Indexed: 11/21/2022] Open
Abstract
Alzheimer’s disease (AD) and its prodromal state amnestic mild cognitive impairment (aMCI) are characterized by widespread abnormalities in inter-areal white matter fiber pathways and parallel disruption of default mode network (DMN) resting state functional and effective connectivity. In healthy subjects, DMN and task positive network interaction are modulated by the thalamus suggesting that abnormal task-based DMN deactivation in aMCI may be a consequence of impaired thalamo-cortical white matter circuitry. Thus, this article uses a multimodal approach to assess white matter integrity between thalamus and DMN components and associated effective connectivity in healthy controls (HCs) relative to aMCI patients. Twenty-six HC and 20 older adults with aMCI underwent structural, functional and diffusion MRI scanning using the high angular resolution diffusion-weighted acquisition protocol. The DMN of each subject was identified using independent component analysis (ICA) and resting state effective connectivity was calculated between thalamus and DMN nodes. White matter integrity changes between thalamus and DMN were investigated with constrained spherical deconvolution (CSD) tractography. Significant structural deficits in thalamic white matter projection fibers to posterior DMN components posterior cingulate cortex (PCC) and lateral inferior parietal lobe (IPL) were identified together with significantly reduced effective connectivity from left thalamus to left IPL. Crucially, impaired thalamo-cortical white matter circuitry correlated with memory performance. Disrupted thalamo-cortical structure was accompanied by significant reductions in IPL and PCC cortico-cortical effective connectivity. No structural deficits were found between DMN nodes. Abnormal posterior DMN activity may be driven by changes in thalamic white matter connectivity; a view supported by the close anatomical and functional association of thalamic nuclei effected by AD pathology and the posterior DMN nodes. We conclude that dysfunctional posterior DMN activity in aMCI is consistent with disrupted cortico-thalamo-cortical processing and thalamic-based dissemination of hippocampal disease agents to cortical hubs.
Collapse
Affiliation(s)
- Thomas Alderson
- Intelligent Systems Research Centre, University Ulster, Derry, United Kingdom
| | - Elizabeth Kehoe
- Trinity College Institute of Neuroscience and Cognitive Systems Group, Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Liam Maguire
- Intelligent Systems Research Centre, University Ulster, Derry, United Kingdom
| | - Dervla Farrell
- Trinity College Institute of Neuroscience and Cognitive Systems Group, Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Brian Lawlor
- Mercer's Institute for Research on Ageing, St. James's Hospital, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Rose A Kenny
- Mercer's Institute for Research on Ageing, St. James's Hospital, Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | | | - Arun L W Bokde
- Trinity College Institute of Neuroscience and Cognitive Systems Group, Discipline of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Damien Coyle
- Intelligent Systems Research Centre, University Ulster, Derry, United Kingdom
| |
Collapse
|
26
|
Functional neuroimaging findings in healthy middle-aged adults at risk of Alzheimer's disease. Ageing Res Rev 2017; 36:88-104. [PMID: 28342882 DOI: 10.1016/j.arr.2017.03.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 02/27/2017] [Accepted: 03/17/2017] [Indexed: 12/28/2022]
Abstract
It is well established that the neurodegenerative process of Alzheimer's disease (AD) begins many years before symptom onset. This preclinical phase provides a crucial time-window for therapeutic intervention, though this requires biomarkers that could evaluate the efficacy of future disease-modification treatments in asymptomatic individuals. The last decade has witnessed a proliferation of studies characterizing the temporal sequence of the earliest functional and structural brain imaging changes in AD. These efforts have focused on studying individuals who are highly vulnerable to develop AD, such as those with familial genetic mutations, susceptibility genes (i.e. apolipoprotein epsilon-4 allele), and/or a positive family history of AD. In this paper, we review the rapidly growing literature of functional imaging changes in cognitively intact individuals who are middle-aged: positron emission tomography (PET) studies of amyloid deposition, glucose metabolism, as well as arterial spin labeling (ASL), task-dependent, resting-state functional magnetic resonance imaging (fMRI) and magnetic resonance spectroscopy (MRS) studies. The prevailing evidence points to early brain functional changes in the relative absence of cognitive impairment and structural atrophy, although there is marked variability in the directionality of the changes, which could, in turn, be related to antagonistic pleiotropy early in life. A common theme across studies relates to the spatial extent of these changes, most of which overlap with brain regions that are implicated in established AD. Notwithstanding several methodological caveats, functional imaging techniques could be preferentially sensitive to the earliest events of AD pathology prior to macroscopic grey matter loss and clinical manifestations of AD. We conclude that while these techniques have great potential to serve as biomarkers to identify at-risk individuals, more longitudinal studies with greater sample size and robust correction for multiple comparisons are still warranted to establish their utility.
Collapse
|
27
|
Youn YC, Jang JW, Han SH, Kim H, Seok JW, Byun JS, Park KY, An SSA, Chun IK, Kim S. 11C-PIB PET imaging reveals that amyloid deposition in cases with early-onset Alzheimer's disease in the absence of known mutations retains higher levels of PIB in the basal ganglia. Clin Interv Aging 2017; 12:1041-1048. [PMID: 28721032 PMCID: PMC5500536 DOI: 10.2147/cia.s132884] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Early-onset Alzheimer’s disease (EOAD) has a different pathologic burden and clinical features compared with late-onset Alzheimer’s disease (LOAD). We examined the effects of age at onset on the burden and distribution of β-amyloid in patients with EOAD, in whom well-characterized mutations associated with Alzheimer’s disease were absent. Methods We genotyped ApoE, APP, PSEN1 and PSEN2 in the patients with Alzheimer’s disease: 9 patients with EOAD (age <65), 11 with LOAD (age >70) and 8 normal controls (NCs), all of whom had undergone 11C-labeled Pittsburgh compound B-positron emission tomography imaging. Results Patients with EOAD exhibited higher z scores and larger cluster sizes, and retained higher levels of Pittsburgh compound B in the bilateral thalamus and in some parts of the globus pallidus (P<0.05, false discovery rate). Conclusion Distribution of amyloid deposition in EOAD outside the context of genetic mutations topographically showed some differences from that in LOAD.
Collapse
Affiliation(s)
- Young Chul Youn
- Department of Neurology, Chung-Ang University College of Medicine, Seoul
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital
| | - Su-Hyun Han
- Department of Neurology, Chung-Ang University College of Medicine, Seoul
| | | | | | - Jun Soo Byun
- Department of Radiology, Chung-Ang University College of Medicine
| | - Kwang-Yeol Park
- Department of Neurology, Chung-Ang University College of Medicine, Seoul
| | - Seong Soo A An
- College of Bionano Technology, Gachon Bionano Research Institute, Gachon University
| | - In Kook Chun
- Department of Nuclear Medicine, Kangwon National University Hospital
| | - SangYun Kim
- Department of Neurology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
| |
Collapse
|
28
|
Bullich S, Seibyl J, Catafau AM, Jovalekic A, Koglin N, Barthel H, Sabri O, De Santi S. Optimized classification of 18F-Florbetaben PET scans as positive and negative using an SUVR quantitative approach and comparison to visual assessment. NEUROIMAGE-CLINICAL 2017; 15:325-332. [PMID: 28560157 PMCID: PMC5440277 DOI: 10.1016/j.nicl.2017.04.025] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/24/2017] [Accepted: 04/25/2017] [Indexed: 11/28/2022]
Abstract
Introduction Standardized uptake value ratios (SUVRs) calculated from cerebral cortical areas can be used to categorize 18F-Florbetaben (FBB) PET scans by applying appropriate cutoffs. The objective of this work was first to generate FBB SUVR cutoffs using visual assessment (VA) as standard of truth (SoT) for a number of reference regions (RR) (cerebellar gray matter (GCER), whole cerebellum (WCER), pons (PONS), and subcortical white matter (SWM)). Secondly, to validate the FBB PET scan categorization performed by SUVR cutoffs against the categorization made by post-mortem histopathological confirmation of the Aβ presence. Finally, to evaluate the added value of SUVR cutoff categorization to VA. Methods SUVR cutoffs were generated for each RR using FBB scans from 143 subjects who were visually assessed by 3 readers. SUVR cutoffs were validated in 78 end-of life subjects using VA from 8 independent blinded readers (3 expert readers and 5 non-expert readers) and histopathological confirmation of the presence of neuritic beta-amyloid plaques as SoT. Finally, the number of correctly or incorrectly classified scans according to pathology results using VA and SUVR cutoffs was compared. Results Composite SUVR cutoffs generated were 1.43 (GCER), 0.96 (WCER), 0.78 (PONS) and 0.71 (SWM). Accuracy values were high and consistent across RR (range 83–94% for histopathology, and 85–94% for VA). SUVR cutoff performed similarly as VA but did not improve VA classification of FBB scans read either by expert readers or the majority read but provided higher accuracy than some non-expert readers. Conclusion The accurate scan classification obtained in this study supports the use of VA as SoT to generate site-specific SUVR cutoffs. For an elderly end of life population, VA and SUVR cutoff categorization perform similarly in classifying FBB scans as Aβ-positive or Aβ-negative. These results emphasize the additional contribution that SUVR cutoff classification may have compared with VA performed by non-expert readers. SUVR cutoffs to classify Florbetaben PET scans as positive and negative were generated. SUVR cutoffs were validated against post-mortem histopathological confirmation. Added value of SUVR cutoff classification to visual assessment was evaluated. SUVR cutoff classification provided higher accuracy than some non-expert readers. Results emphasize the contribution that SUVR cutoffs may have to visual assessment.
Collapse
Affiliation(s)
| | | | | | | | | | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | | |
Collapse
|
29
|
Metabolomics and mitochondrial dysfunction in Alzheimer’s disease. Genes Genomics 2017. [DOI: 10.1007/s13258-016-0494-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
30
|
Tentolouris-Piperas V, Ryan NS, Thomas DL, Kinnunen KM. Brain imaging evidence of early involvement of subcortical regions in familial and sporadic Alzheimer's disease. Brain Res 2016; 1655:23-32. [PMID: 27847196 DOI: 10.1016/j.brainres.2016.11.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/08/2016] [Accepted: 11/09/2016] [Indexed: 12/15/2022]
Abstract
Recent brain imaging studies have found changes in subcortical regions in presymptomatic autosomal dominant Alzheimer's disease (ADAD). These regions are also affected in sporadic Alzheimer's disease (sAD), but whether such changes are seen in early-stage disease is still uncertain. In this review, we discuss imaging studies published in the past 12 years that have found evidence of subcortical involvement in early-stage ADAD and/or sAD. Several papers have reported amyloid deposition in the striatum of presymptomatic ADAD mutation carriers, prior to amyloid deposition elsewhere. Altered caudate volume has also been implicated in early-stage ADAD, but findings have been variable. Less is known about subcortical involvement in sAD: the thalamus and striatum have been found to be atrophied in symptomatic patients, but their involvement in the preclinical phase remains unclear, in part due to the difficulties of studying this stage in sporadic disease. Longitudinal imaging studies comparing ADAD mutation carriers with individuals at high-risk for sAD may be needed to elucidate the significance of subcortical involvement in different AD clinical stages.
Collapse
Affiliation(s)
| | - Natalie S Ryan
- Dementia Research Centre, UCL Institute of Neurology, University College London, Queen Square, London, UK
| | - David L Thomas
- Dementia Research Centre, UCL Institute of Neurology, University College London, Queen Square, London, UK; Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, Queen Square, London, UK
| | - Kirsi M Kinnunen
- Dementia Research Centre, UCL Institute of Neurology, University College London, Queen Square, London, UK.
| |
Collapse
|
31
|
Ni R, Gillberg PG, Bogdanovic N, Viitanen M, Myllykangas L, Nennesmo I, Långström B, Nordberg A. Amyloid tracers binding sites in autosomal dominant and sporadic Alzheimer's disease. Alzheimers Dement 2016; 13:419-430. [PMID: 27693181 DOI: 10.1016/j.jalz.2016.08.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 08/26/2016] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Amyloid imaging has been integrated into diagnostic criteria for Alzheimer's disease (AD). How amyloid tracers binding differ for different tracer structures and amyloid-β aggregates in autosomal dominant AD (ADAD) and sporadic AD is unclear. METHODS Binding properties of different amyloid tracers were examined in brain homogenates from six ADAD with APPswe, PS1 M146V, and PS1 EΔ9 mutations, 13 sporadic AD, and 14 control cases. RESULTS 3H-PIB, 3H-florbetaben, 3H-AZD2184, and BTA-1 shared a high- and a varying low-affinity binding site in the frontal cortex of sporadic AD. AZD2184 detected another binding site (affinity 33 nM) in the frontal cortex of ADAD. The 3H-AZD2184 and 3H-PIB binding were significantly higher in the striatum of ADAD compared to sporadic AD and control. Polyphenol resveratrol showed strongest inhibition on 3H-AZD84 binding followed by 3H-florbetaben and minimal on 3H-PIB. DISCUSSION This study implies amyloid tracers of different structures detect different sites on amyloid-β fibrils or conformations.
Collapse
Affiliation(s)
- Ruiqing Ni
- Division of Translational Alzheimer Neurobiology, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Per-Göran Gillberg
- Division of Translational Alzheimer Neurobiology, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Nenad Bogdanovic
- Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, University of Oslo, Oslo, Norway
| | - Matti Viitanen
- Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | | | - Inger Nennesmo
- Division of Pathology, Department of Laboratory Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Bengt Långström
- Department of Chemistry, Uppsala University, Uppsala, Sweden
| | - Agneta Nordberg
- Division of Translational Alzheimer Neurobiology, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden.
| |
Collapse
|
32
|
Lista S, O'Bryant SE, Blennow K, Dubois B, Hugon J, Zetterberg H, Hampel H. Biomarkers in Sporadic and Familial Alzheimer's Disease. J Alzheimers Dis 2016; 47:291-317. [PMID: 26401553 DOI: 10.3233/jad-143006] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Most forms of Alzheimer's disease (AD) are sporadic (sAD) or inherited in a non-Mendelian fashion, and less than 1% of cases are autosomal-dominant. Forms of sAD do not exhibit familial aggregation and are characterized by complex genetic and environmental interactions. Recently, the expansion of genomic methodologies, in association with substantially larger combined cohorts, has resulted in various genome-wide association studies that have identified several novel genetic associations of AD. Currently, the most effective methods for establishing the diagnosis of AD are defined by multi-modal pathways, starting with clinical and neuropsychological assessment, cerebrospinal fluid (CSF) analysis, and brain-imaging procedures, all of which have significant cost- and access-to-care barriers. Consequently, research efforts have focused on the development and validation of non-invasive and generalizable blood-based biomarkers. Among the modalities conceptualized by the systems biology paradigm and utilized in the "exploratory biomarker discovery arena", proteome analysis has received the most attention. However, metabolomics, lipidomics, transcriptomics, and epigenomics have recently become key modalities in the search for AD biomarkers. Interestingly, biomarker changes for familial AD (fAD), in many but not all cases, seem similar to those for sAD. The integration of neurogenetics with systems biology/physiology-based strategies and high-throughput technologies for molecular profiling is expected to help identify the causes, mechanisms, and biomarkers associated with the various forms of AD. Moreover, in order to hypothesize the dynamic trajectories of biomarkers through disease stages and elucidate the mechanisms of biomarker alterations, updated and more sophisticated theoretical models have been proposed for both sAD and fAD.
Collapse
Affiliation(s)
- Simone Lista
- AXA Research Fund & UPMC Chair, Paris, France.,Sorbonne Universités, Université Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) & Institut du Cerveau et de la Moelle épinière (ICM), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France
| | - Sid E O'Bryant
- Institute for Aging and Alzheimer's Disease Research & Department of Internal Medicine, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Bruno Dubois
- Sorbonne Universités, Université Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) & Institut du Cerveau et de la Moelle épinière (ICM), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France
| | - Jacques Hugon
- Centre Mémoire de Ressources et de Recherche (CMRR) Paris Nord Ile-de-France, Groupe Hospitalier Saint Louis Lariboisière - Fernand Widal, Université Paris Diderot, Paris 07, Paris, France.,Institut du Fer à Moulin (IFM), Inserm UMR_S 839, Paris, France
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,University College London Institute of Neurology, Queen Square, London, UK
| | - Harald Hampel
- AXA Research Fund & UPMC Chair, Paris, France.,Sorbonne Universités, Université Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) & Institut du Cerveau et de la Moelle épinière (ICM), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France
| |
Collapse
|
33
|
Catafau AM, Bullich S, Seibyl JP, Barthel H, Ghetti B, Leverenz J, Ironside JW, Schulz-Schaeffer WJ, Hoffmann A, Sabri O. Cerebellar Amyloid-β Plaques: How Frequent Are They, and Do They Influence 18F-Florbetaben SUV Ratios? J Nucl Med 2016; 57:1740-1745. [PMID: 27363836 DOI: 10.2967/jnumed.115.171652] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 04/14/2016] [Indexed: 11/16/2022] Open
Abstract
SUV ratios (SUVRs) are used for relative quantification of 18F-florbetaben scans. The cerebellar cortex can be used as a reference region for quantification. However, cerebellar amyloid-β (Aβ) plaques may be present in Alzheimer disease (AD). The aim of this study was to assess the influence of Aβ pathology, including neuritic plaques, diffuse plaques, and vascular deposits, in 18F-florbetaben SUVR when cerebellum is used as the reference. METHODS Using immunohistochemistry to demonstrate Aβ plaques and vascular deposits, and using the Bielschowsky method to demonstrate neuritic plaques, we performed a neuropathologic assessment of the frontal, occipital, anterior cingulate, and posterior cingulate cerebral cortices and the cerebellar cortex of 87 end-of-life patients (64 with AD, 14 with other types of dementia, and 9 nondemented aged volunteers; mean age ± SD, 80.4 ± 10.2 y) who had undergone 18F-florbetaben PET before death. The lesions were rated as absent (none or sparse) or present (moderate or frequent). Mean cortical SUVRs were compared among cases with different cerebellar Aβ loads. RESULTS None of the 83 evaluable cerebellar samples showed frequent diffuse Aβ or neuritic plaques; 8 samples showed frequent vascular Aβ deposits. Diffuse Aβ plaques were rated as absent in 78 samples (94%) and present in 5 samples (6%). Vascular Aβ was rated as absent in 62 samples (74.7%) and present in 21 samples (25.3%). No significant differences in cerebellar SUVs were found among cases with different amounts or types of Aβ deposits in the cerebral cortex. Both diffuse and neuritic plaques were found in the cerebral cortex of 26-44 cases. No significant SUVR differences were found between these brains with different cerebellar Aβ loads. CONCLUSION The effect of cerebellar plaques on cortical 18F-florbetaben SUVRs appears to be negligible even in advanced stages of AD with a higher cerebellar Aβ load.
Collapse
Affiliation(s)
| | | | | | | | | | - James Leverenz
- VA-Puget Sound Health Care System and University of Washington, Seattle, Washington
| | | | | | | | | |
Collapse
|
34
|
Aggleton JP, Pralus A, Nelson AJD, Hornberger M. Thalamic pathology and memory loss in early Alzheimer's disease: moving the focus from the medial temporal lobe to Papez circuit. Brain 2016; 139:1877-90. [PMID: 27190025 PMCID: PMC4939698 DOI: 10.1093/brain/aww083] [Citation(s) in RCA: 212] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 02/26/2016] [Indexed: 11/13/2022] Open
Abstract
It is widely assumed that incipient protein pathology in the medial temporal lobe instigates the loss of episodic memory in Alzheimer’s disease, one of the earliest cognitive deficits in this type of dementia. Within this region, the hippocampus is seen as the most vital for episodic memory. Consequently, research into the causes of memory loss in Alzheimer’s disease continues to centre on hippocampal dysfunction and how disease-modifying therapies in this region can potentially alleviate memory symptomology. The present review questions this entrenched notion by bringing together findings from post-mortem studies, non-invasive imaging (including studies of presymptomatic, at-risk cases) and genetically modified animal models. The combined evidence indicates that the loss of episodic memory in early Alzheimer’s disease reflects much wider neurodegeneration in an extended mnemonic system (Papez circuit), which critically involves the limbic thalamus. Within this system, the anterior thalamic nuclei are prominent, both for their vital contributions to episodic memory and for how these same nuclei appear vulnerable in prodromal Alzheimer’s disease. As thalamic abnormalities occur in some of the earliest stages of the disease, the idea that such changes are merely secondary to medial temporal lobe dysfunctions is challenged. This alternate view is further strengthened by the interdependent relationship between the anterior thalamic nuclei and retrosplenial cortex, given how dysfunctions in the latter cortical area provide some of the earliest
in vivo
imaging evidence of prodromal Alzheimer’s disease. Appreciating the importance of the anterior thalamic nuclei for memory and attention provides a more balanced understanding of Alzheimer’s disease. Furthermore, this refocus on the limbic thalamus, as well as the rest of Papez circuit, would have significant implications for the diagnostics, modelling, and experimental treatment of cognitive symptoms in Alzheimer’s disease.
Collapse
Affiliation(s)
- John P Aggleton
- School of Psychology, Cardiff University, Park Place, Cardiff, CF10 3AT, UK
| | - Agathe Pralus
- Master of Biosciences, ENS de Lyon, 46 allée d'Italie, 69007 Lyon, France
| | - Andrew J D Nelson
- School of Psychology, Cardiff University, Park Place, Cardiff, CF10 3AT, UK
| | | |
Collapse
|
35
|
Yi HA, Möller C, Dieleman N, Bouwman FH, Barkhof F, Scheltens P, van der Flier WM, Vrenken H. Relation between subcortical grey matter atrophy and conversion from mild cognitive impairment to Alzheimer's disease. J Neurol Neurosurg Psychiatry 2016; 87:425-32. [PMID: 25904810 DOI: 10.1136/jnnp-2014-309105] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 03/30/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate whether subcortical grey matter atrophy predicts progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD), and to compare subcortical volumes between AD, MCI and controls. To assess the correlation between subcortical grey matter volumes and severity of cognitive impairment. METHODS We included 773 participants with three-dimensional T1-weighted MRI at 3 T, made up of 181 controls, who had subjective memory symptoms with normal cognition, 201 MCIs and 391 AD. During follow-up (2.0 ± 0.9 years), 35 MCIs converted to AD (progressive MCI) and 160 MCIs remained stable (stable MCI). We segmented volumes of six subcortical structures of the amygdala, thalamus, caudate nucleus, putamen, globus pallidus and nucleus accumbens, and of the hippocampus, using FMRIBs integrated registration and segmentation tool. RESULTS Analysis of variances, adjusted for sex and age, showed that all structures, except the globus pallidus, were smaller in AD than in controls. In addition, the amygdala, thalamus, putamen, nucleus accumbens and hippocampus were smaller in MCIs than in controls. Across groups, all subcortical greymatter volumes, except the globus pallidus, showed a positive correlation with cognitive function, as measured by Mini Mental State Examination (MMSE) (0.16<r<0.28, all p<0.05). Cox proportional hazards analyses adjusted for age, sex, education, Cambridge Cognitive Examination-Revised (CAMCOG-R) and MMSE showed that smaller volumes of the hippocampus and nucleus accumbens were associated with increased risk of progression from MCI to AD (HR (95% CI) 1.60 (1.15 to 2.21); 1.60 (1.09 to 2.35), p<0.05). CONCLUSIONS In addition to the hippocampus, the nucleus accumbens volume loss was also associated with increased risk of progression from MCI to AD. Furthermore, volume loss of subcortical grey matter structures was associated with severity of cognitive impairment.
Collapse
Affiliation(s)
- Hyon-Ah Yi
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea
| | - Christiane Möller
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Nikki Dieleman
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Femke H Bouwman
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands Department of Epidemiology & Biostatistics, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Hugo Vrenken
- Department of Radiology & Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands Department of Physics & Medical Technology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
36
|
Gorgoni M, Lauri G, Truglia I, Cordone S, Sarasso S, Scarpelli S, Mangiaruga A, D'Atri A, Tempesta D, Ferrara M, Marra C, Rossini PM, De Gennaro L. Parietal Fast Sleep Spindle Density Decrease in Alzheimer's Disease and Amnesic Mild Cognitive Impairment. Neural Plast 2016; 2016:8376108. [PMID: 27066274 PMCID: PMC4811201 DOI: 10.1155/2016/8376108] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 02/02/2016] [Accepted: 02/17/2016] [Indexed: 02/05/2023] Open
Abstract
Several studies have identified two types of sleep spindles: fast (13-15 Hz) centroparietal and slow (11-13 Hz) frontal spindles. Alterations in spindle activity have been observed in Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI). Only few studies have separately assessed fast and slow spindles in these patients showing a reduction of fast spindle count, but the possible local specificity of this phenomenon and its relation to cognitive decline severity are not clear. Moreover, fast and slow spindle density have never been assessed in AD/MCI. We have assessed fast and slow spindles in 15 AD patients, 15 amnesic MCI patients, and 15 healthy elderly controls (HC). Participants underwent baseline polysomnographic recording (19 cortical derivations). Spindles during nonrapid eye movements sleep were automatically detected, and spindle densities of the three groups were compared in the derivations where fast and slow spindles exhibited their maximum expression (parietal and frontal, resp.). AD and MCI patients showed a significant parietal fast spindle density decrease, positively correlated with Minimental State Examination scores. Our results suggest that AD-related changes in spindle density are specific for frequency and location, are related to cognitive decline severity, and may have an early onset in the pathology development.
Collapse
Affiliation(s)
- Maurizio Gorgoni
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Giulia Lauri
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Ilaria Truglia
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Susanna Cordone
- Department of Physiology and Pharmacology, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy
| | - Serena Scarpelli
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| | | | - Aurora D'Atri
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Daniela Tempesta
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 Coppito, Italy
| | - Camillo Marra
- Institute of Neurology, Catholic University of The Sacred Heart, 00168 Rome, Italy
| | - Paolo Maria Rossini
- Institute of Neurology, Catholic University of The Sacred Heart, 00168 Rome, Italy
- IRCCS San Raffaele Pisana, 00163 Rome, Italy
| | - Luigi De Gennaro
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| |
Collapse
|
37
|
Rethinking on the concept of biomarkers in preclinical Alzheimer's disease. Neurol Sci 2016; 37:663-72. [PMID: 26792010 DOI: 10.1007/s10072-016-2477-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 01/09/2016] [Indexed: 01/01/2023]
Abstract
The neuropathological processes eventually leading to Alzheimer's disease (AD) are thought to start decades before the appearance of clinical symptoms and the clinical diagnosis of AD dementia. The term "preclinical AD" has been recently introduced to identify this "silent stage" of AD, when the disease is already present, but symptoms are not yet clinically evident. Advances in AD biomarkers have dramatically improved the ability to detect AD pathological processes in vivo in cognitively intact subjects, thus demonstrating the presence of AD pathology in the preclinical phase. This review focuses on the recent advances in the field of neuroimaging and CSF AD biomarkers specifically in the preclinical phase of AD, and aims to discuss the significance that such biomarkers could have in cognitively intact subjects. Even though the use of such biomarkers in AD preclinical phase has contributed to improve our understanding of AD early pathological processes, it raised also a number of new challenges that still remain to be overcome, such as a better definition of the clinical and individual significance of currently known biomarkers in preclinical stages and the development of novel biomarkers of different early AD-related events.
Collapse
|
38
|
Del Campo N, Payoux P, Djilali A, Delrieu J, Hoogendijk EO, Rolland Y, Cesari M, Weiner MW, Andrieu S, Vellas B. Relationship of regional brain β-amyloid to gait speed. Neurology 2015; 86:36-43. [PMID: 26643548 DOI: 10.1212/wnl.0000000000002235] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 08/31/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate in vivo the relationship of regional brain β-amyloid (Aβ) to gait speed in a group of elderly individuals at high risk for dementia. METHODS Cross-sectional associations between brain Aβ as measured with [18F]florbetapir PET and gait speed were examined in 128 elderly participants. Subjects ranged from healthy to mildly cognitively impaired enrolled in the control arm of the multidomain intervention in the Multidomain Alzheimer Preventive Trial (MAPT). Nearly all participants presented spontaneous memory complaints. Regional [18F]florbetapir (AV45) standardized uptake volume ratios were obtained via semiautomated quantitative analysis using the cerebellum as reference region. Gait speed was measured by timing participants while they walked 4 meters. Associations were explored with linear regression, correcting for age, sex, education, body mass index (BMI), and APOE genotype. RESULTS We found a significant association between Aβ in the posterior and anterior putamen, occipital cortex, precuneus, and anterior cingulate and slow gait speed (all corrected p < 0.05). A multivariate model emphasized the locations of the posterior putamen and the precuneus. Aβ burden explained up to 9% of the variance in gait speed, and significantly improved regression models already containing demographic variables, BMI, and APOE status. CONCLUSIONS The present PET study confirms, in vivo, previous postmortem evidence showing an association between Alzheimer disease (AD) pathology and gait speed, and provides additional evidence on potential regional effects of brain Aβ on motor function. More research is needed to elucidate the neural mechanisms underlying these regional associations, which may involve motor and sensorimotor circuits hitherto largely neglected in the pathophysiology of AD.
Collapse
Affiliation(s)
- Natalia Del Campo
- From Gérontopôle, Institute of Ageing (N.d.C., J.D., E.O.H., Y.R., M.C., B.V.), and the Department of Epidemiology and Public Health (S.A.), University Hospital Toulouse, France; the Department of Psychiatry (N.d.C.), University of Cambridge, UK; INSERM U825 (P.P., A.D.) and INSERM UMR 1027 (M.C., S.A., B.V.), University Toulouse III Paul Sabatier, France; Department of Epidemiology & Biostatistics (E.O.H.), EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands; Center for Imaging of Neurodegenerative Diseases (M.W.W.), Department of Veterans Affairs Medical Center, San Francisco; and the Departments of Radiology (M.W.W.), Medicine (M.W.W.), Psychiatry (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco.
| | - Pierre Payoux
- From Gérontopôle, Institute of Ageing (N.d.C., J.D., E.O.H., Y.R., M.C., B.V.), and the Department of Epidemiology and Public Health (S.A.), University Hospital Toulouse, France; the Department of Psychiatry (N.d.C.), University of Cambridge, UK; INSERM U825 (P.P., A.D.) and INSERM UMR 1027 (M.C., S.A., B.V.), University Toulouse III Paul Sabatier, France; Department of Epidemiology & Biostatistics (E.O.H.), EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands; Center for Imaging of Neurodegenerative Diseases (M.W.W.), Department of Veterans Affairs Medical Center, San Francisco; and the Departments of Radiology (M.W.W.), Medicine (M.W.W.), Psychiatry (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco
| | - Adel Djilali
- From Gérontopôle, Institute of Ageing (N.d.C., J.D., E.O.H., Y.R., M.C., B.V.), and the Department of Epidemiology and Public Health (S.A.), University Hospital Toulouse, France; the Department of Psychiatry (N.d.C.), University of Cambridge, UK; INSERM U825 (P.P., A.D.) and INSERM UMR 1027 (M.C., S.A., B.V.), University Toulouse III Paul Sabatier, France; Department of Epidemiology & Biostatistics (E.O.H.), EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands; Center for Imaging of Neurodegenerative Diseases (M.W.W.), Department of Veterans Affairs Medical Center, San Francisco; and the Departments of Radiology (M.W.W.), Medicine (M.W.W.), Psychiatry (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco
| | - Julien Delrieu
- From Gérontopôle, Institute of Ageing (N.d.C., J.D., E.O.H., Y.R., M.C., B.V.), and the Department of Epidemiology and Public Health (S.A.), University Hospital Toulouse, France; the Department of Psychiatry (N.d.C.), University of Cambridge, UK; INSERM U825 (P.P., A.D.) and INSERM UMR 1027 (M.C., S.A., B.V.), University Toulouse III Paul Sabatier, France; Department of Epidemiology & Biostatistics (E.O.H.), EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands; Center for Imaging of Neurodegenerative Diseases (M.W.W.), Department of Veterans Affairs Medical Center, San Francisco; and the Departments of Radiology (M.W.W.), Medicine (M.W.W.), Psychiatry (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco
| | - Emiel O Hoogendijk
- From Gérontopôle, Institute of Ageing (N.d.C., J.D., E.O.H., Y.R., M.C., B.V.), and the Department of Epidemiology and Public Health (S.A.), University Hospital Toulouse, France; the Department of Psychiatry (N.d.C.), University of Cambridge, UK; INSERM U825 (P.P., A.D.) and INSERM UMR 1027 (M.C., S.A., B.V.), University Toulouse III Paul Sabatier, France; Department of Epidemiology & Biostatistics (E.O.H.), EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands; Center for Imaging of Neurodegenerative Diseases (M.W.W.), Department of Veterans Affairs Medical Center, San Francisco; and the Departments of Radiology (M.W.W.), Medicine (M.W.W.), Psychiatry (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco
| | - Yves Rolland
- From Gérontopôle, Institute of Ageing (N.d.C., J.D., E.O.H., Y.R., M.C., B.V.), and the Department of Epidemiology and Public Health (S.A.), University Hospital Toulouse, France; the Department of Psychiatry (N.d.C.), University of Cambridge, UK; INSERM U825 (P.P., A.D.) and INSERM UMR 1027 (M.C., S.A., B.V.), University Toulouse III Paul Sabatier, France; Department of Epidemiology & Biostatistics (E.O.H.), EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands; Center for Imaging of Neurodegenerative Diseases (M.W.W.), Department of Veterans Affairs Medical Center, San Francisco; and the Departments of Radiology (M.W.W.), Medicine (M.W.W.), Psychiatry (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco
| | - Matteo Cesari
- From Gérontopôle, Institute of Ageing (N.d.C., J.D., E.O.H., Y.R., M.C., B.V.), and the Department of Epidemiology and Public Health (S.A.), University Hospital Toulouse, France; the Department of Psychiatry (N.d.C.), University of Cambridge, UK; INSERM U825 (P.P., A.D.) and INSERM UMR 1027 (M.C., S.A., B.V.), University Toulouse III Paul Sabatier, France; Department of Epidemiology & Biostatistics (E.O.H.), EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands; Center for Imaging of Neurodegenerative Diseases (M.W.W.), Department of Veterans Affairs Medical Center, San Francisco; and the Departments of Radiology (M.W.W.), Medicine (M.W.W.), Psychiatry (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco
| | - Michael W Weiner
- From Gérontopôle, Institute of Ageing (N.d.C., J.D., E.O.H., Y.R., M.C., B.V.), and the Department of Epidemiology and Public Health (S.A.), University Hospital Toulouse, France; the Department of Psychiatry (N.d.C.), University of Cambridge, UK; INSERM U825 (P.P., A.D.) and INSERM UMR 1027 (M.C., S.A., B.V.), University Toulouse III Paul Sabatier, France; Department of Epidemiology & Biostatistics (E.O.H.), EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands; Center for Imaging of Neurodegenerative Diseases (M.W.W.), Department of Veterans Affairs Medical Center, San Francisco; and the Departments of Radiology (M.W.W.), Medicine (M.W.W.), Psychiatry (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco
| | - Sandrine Andrieu
- From Gérontopôle, Institute of Ageing (N.d.C., J.D., E.O.H., Y.R., M.C., B.V.), and the Department of Epidemiology and Public Health (S.A.), University Hospital Toulouse, France; the Department of Psychiatry (N.d.C.), University of Cambridge, UK; INSERM U825 (P.P., A.D.) and INSERM UMR 1027 (M.C., S.A., B.V.), University Toulouse III Paul Sabatier, France; Department of Epidemiology & Biostatistics (E.O.H.), EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands; Center for Imaging of Neurodegenerative Diseases (M.W.W.), Department of Veterans Affairs Medical Center, San Francisco; and the Departments of Radiology (M.W.W.), Medicine (M.W.W.), Psychiatry (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco
| | - Bruno Vellas
- From Gérontopôle, Institute of Ageing (N.d.C., J.D., E.O.H., Y.R., M.C., B.V.), and the Department of Epidemiology and Public Health (S.A.), University Hospital Toulouse, France; the Department of Psychiatry (N.d.C.), University of Cambridge, UK; INSERM U825 (P.P., A.D.) and INSERM UMR 1027 (M.C., S.A., B.V.), University Toulouse III Paul Sabatier, France; Department of Epidemiology & Biostatistics (E.O.H.), EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands; Center for Imaging of Neurodegenerative Diseases (M.W.W.), Department of Veterans Affairs Medical Center, San Francisco; and the Departments of Radiology (M.W.W.), Medicine (M.W.W.), Psychiatry (M.W.W.), and Neurology (M.W.W.), University of California, San Francisco
| | | |
Collapse
|
39
|
Zhu QY, Bi SW, Yao XT, Ni ZY, Li Y, Chen BY, Fan GG, Shang XL. Disruption of thalamic connectivity in Alzheimer's disease: a diffusion tensor imaging study. Metab Brain Dis 2015; 30:1295-308. [PMID: 26141074 DOI: 10.1007/s11011-015-9708-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 06/26/2015] [Indexed: 12/15/2022]
Abstract
The aim of this study was to evaluate the structural integrity of the thalamic connectivity of specific fiber tracts in different stages of Alzheimer's disease (AD) using diffusion tensor imaging (DTI). Thirty-five patients with AD and 22 normal control (NC) subjects were recruited. Based on Mini Mental State Examination score, the AD patients were divided into three subgroups for comparison with the NC group: mild (mi-AD, n = 14), moderate (mo-AD, n = 12), and severe (se-AD, n = 9) AD. The fornix (FX), anterior thalamic radiation (ATR), and posterior thalamic radiation (PTR) were selected to represent the thalamic connectivity with other brain regions. The fornix was divided into the column and body of the fornix (FX-1) and the bilateral fornix (crus)/stria terminalis (FX-2/ST) based on the atlas. Through the atlas-based analysis and fiber tracking method, we measured fractional anisotropy (FA), mean diffusivity (MD), and tract volume to reflect the microstructural and macrostructural changes of these fibers during AD progression. There were significant differences in the FA and MD of all fibers, except the right PTR, between the AD and NC subjects. Further subgroup analyses revealed that the mi-AD subgroup had decreased FA only in the FX-1 and increased MD in the FX-1 and bilateral ATR, the mo-AD subgroup showed declined FA and increased MD in the FX-1, bilateral FX-2/ST and ATR; the se-AD subgroup exhibited lower FA and higher MD values in all fibers except the right PTR. We also found reduced tract volume values in the FX and left ATR in the AD patients. Further subgroup analyses revealed that these differences only existed in the se-AD patients. Our DTI analyses indicate that the integrity of thalamic connectivity is progressively disrupted following cognitive decline in AD and that DTI parameters in the column and body of the fornix show promise as potential markers for the early diagnosis of AD and for monitoring disease progression.
Collapse
Affiliation(s)
- Qing-Yong Zhu
- Department of Neurology, The First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, People's Republic of China
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Hamilton LK, Dufresne M, Joppé SE, Petryszyn S, Aumont A, Calon F, Barnabé-Heider F, Furtos A, Parent M, Chaurand P, Fernandes KJL. Aberrant Lipid Metabolism in the Forebrain Niche Suppresses Adult Neural Stem Cell Proliferation in an Animal Model of Alzheimer's Disease. Cell Stem Cell 2015; 17:397-411. [PMID: 26321199 DOI: 10.1016/j.stem.2015.08.001] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 06/09/2015] [Accepted: 08/02/2015] [Indexed: 11/24/2022]
Abstract
Lipid metabolism is fundamental for brain development and function, but its roles in normal and pathological neural stem cell (NSC) regulation remain largely unexplored. Here, we uncover a fatty acid-mediated mechanism suppressing endogenous NSC activity in Alzheimer's disease (AD). We found that postmortem AD brains and triple-transgenic Alzheimer's disease (3xTg-AD) mice accumulate neutral lipids within ependymal cells, the main support cell of the forebrain NSC niche. Mass spectrometry and microarray analyses identified these lipids as oleic acid-enriched triglycerides that originate from niche-derived rather than peripheral lipid metabolism defects. In wild-type mice, locally increasing oleic acid was sufficient to recapitulate the AD-associated ependymal triglyceride phenotype and inhibit NSC proliferation. Moreover, inhibiting the rate-limiting enzyme of oleic acid synthesis rescued proliferative defects in both adult neurogenic niches of 3xTg-AD mice. These studies support a pathogenic mechanism whereby AD-induced perturbation of niche fatty acid metabolism suppresses the homeostatic and regenerative functions of NSCs.
Collapse
Affiliation(s)
- Laura K Hamilton
- Research Center of the University of Montreal Hospital (CRCHUM), Montreal, QC H2X 0A9, Canada; CNS Research Group (GRSNC), Montreal, QC H3T 1J4, Canada; Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Martin Dufresne
- Department of Chemistry, Faculty of Arts and Sciences, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Sandra E Joppé
- Research Center of the University of Montreal Hospital (CRCHUM), Montreal, QC H2X 0A9, Canada; CNS Research Group (GRSNC), Montreal, QC H3T 1J4, Canada; Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Sarah Petryszyn
- Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Quebec City, QC G1J 2G3, Canada
| | - Anne Aumont
- Research Center of the University of Montreal Hospital (CRCHUM), Montreal, QC H2X 0A9, Canada; CNS Research Group (GRSNC), Montreal, QC H3T 1J4, Canada; Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Frédéric Calon
- Faculty of Pharmacy, Université Laval, Quebec City, QC G1V 0A6, Canada; CHU-Q Research Center, Quebec City, QC G1V 4G2, Canada
| | | | - Alexandra Furtos
- Department of Chemistry, Faculty of Arts and Sciences, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Martin Parent
- Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Quebec City, QC G1J 2G3, Canada
| | - Pierre Chaurand
- Department of Chemistry, Faculty of Arts and Sciences, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Karl J L Fernandes
- Research Center of the University of Montreal Hospital (CRCHUM), Montreal, QC H2X 0A9, Canada; CNS Research Group (GRSNC), Montreal, QC H3T 1J4, Canada; Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.
| |
Collapse
|
41
|
Weston PS, Simpson IJ, Ryan NS, Ourselin S, Fox NC. Diffusion imaging changes in grey matter in Alzheimer's disease: a potential marker of early neurodegeneration. Alzheimers Res Ther 2015; 7:47. [PMID: 26136857 PMCID: PMC4487800 DOI: 10.1186/s13195-015-0132-3] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Alzheimer's disease (AD) is recognized to have a long presymptomatic period, during which there is progressive accumulation of molecular pathology, followed by inexorable neuronal damage. The ability to identify presymptomatic individuals with evidence of neurodegenerative change, to stage their disease, and to track progressive changes will be important for early diagnosis and for prevention trials. Despite recent advances, particularly in magnetic resonance imaging, our ability to identify early neurodegenerative changes reliably is limited. The development of diffusion-weighted magnetic resonance imaging, which is sensitive to microstructural changes not visible with conventional volumetric techniques, has led to a number of diffusion imaging studies in AD; these have largely focused on white matter changes. However, in AD cerebral grey matter is affected very early, with pathological studies suggesting that grey matter changes predate those in white matter. In this article we review the growing number of studies that assess grey matter diffusivity changes in AD. Although use of the technique is still at a relatively early stage, results so far have been promising. Initial studies identified changes in diffusion measures in the hippocampi of patients with mild cognitive impairment, which predated macroscopic volume loss, with positive predictive value for progression to AD dementia. More recent studies have identified abnormalities in multiple neocortical areas (particularly the posterior cingulate) at various stages of disease progression. Studies of patients who carry genetic mutations predisposing to autosomal dominant familial AD have shown cortical and subcortical grey matter diffusivity changes several years before the expected onset of the first clinical symptoms. The technique is not without potential methodological difficulties, especially relating to partial volume effects, although recent advances appear to be reducing such issues. Going forward, further utilization of grey matter diffusion measurements in AD may improve our understanding with regards to the timing and nature of the earliest presymptomatic neurodegenerative changes. This imaging technique may also be useful in comparing and contrasting subtle variations in different disease subgroups, and as a sensitive outcome measure for presymptomatic clinical trials in AD and other neurodegenerative diseases.
Collapse
Affiliation(s)
- Philip S.J. Weston
- />Dementia Research Centre, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Box 16, Queen Square, London, WC1N 3BG UK
| | - Ivor J.A. Simpson
- />Dementia Research Centre, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Box 16, Queen Square, London, WC1N 3BG UK
- />Centre for Medical Image Computing, The Engineering Front Building, University College London, Malet Place, London, WC1E 6BT UK
| | - Natalie S. Ryan
- />Dementia Research Centre, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Box 16, Queen Square, London, WC1N 3BG UK
| | - Sebastien Ourselin
- />Dementia Research Centre, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Box 16, Queen Square, London, WC1N 3BG UK
- />Centre for Medical Image Computing, The Engineering Front Building, University College London, Malet Place, London, WC1E 6BT UK
| | - Nick C. Fox
- />Dementia Research Centre, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Box 16, Queen Square, London, WC1N 3BG UK
| |
Collapse
|
42
|
Abstract
OBJECTIVE This review provides a brief account of the clinically relevant functional neuroanatomy of the thalamus, before considering the utility of various modalities utilized to image the thalamus and technical challenges therein, and going on to provide an overview of studies utilizing structural imaging techniques to map thalamic morphology in the spectrum of neurodegenerative disorders. METHODS A systematic search was conducted for peer-reviewed studies involving structural neuroimaging modalities investigating the morphology (shape and/or size) of the thalamus in the spectrum of neurodegenerative disorders. RESULTS While the precise role of the thalamus in the healthy brain remains unclear, there is a large body of knowledge accumulating which defines more precisely its functional connectivity within the connectome, and a burgeoning literature implicating its involvement in neurodegenerative disorders. It is proposed that correlation of clinical features with thalamic morphology (as a component of a quantifiable subcortical connectome) will provide a better understanding of neuropsychiatric dysfunction in various neurodegenerative disorders, potentially yielding clinically useful endophenotypes and disease biomarkers. CONCLUSION Thalamic biomarkers in the neurodegenerative disorders have great potential to provide clinically meaningful knowledge regarding not only disease onset and progression but may yield targets of and perhaps a way of gauging response to future disease-modifying modalities.
Collapse
Affiliation(s)
- Brian D Power
- School of Medicine Fremantle, The University of Notre Dame Australia, Fremantle, WA, Australia Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, WA, Australia
| | - Jeffrey C L Looi
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, ACT, Australia
| |
Collapse
|
43
|
Graham SF, Chevallier OP, Elliott CT, Hölscher C, Johnston J, McGuinness B, Kehoe PG, Passmore AP, Green BD. Untargeted metabolomic analysis of human plasma indicates differentially affected polyamine and L-arginine metabolism in mild cognitive impairment subjects converting to Alzheimer's disease. PLoS One 2015; 10:e0119452. [PMID: 25803028 PMCID: PMC4372431 DOI: 10.1371/journal.pone.0119452] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/13/2015] [Indexed: 11/19/2022] Open
Abstract
This study combined high resolution mass spectrometry (HRMS), advanced chemometrics and pathway enrichment analysis to analyse the blood metabolome of patients attending the memory clinic: cases of mild cognitive impairment (MCI; n = 16), cases of MCI who upon subsequent follow-up developed Alzheimer's disease (MCI_AD; n = 19), and healthy age-matched controls (Ctrl; n = 37). Plasma was extracted in acetonitrile and applied to an Acquity UPLC HILIC (1.7μm x 2.1 x 100 mm) column coupled to a Xevo G2 QTof mass spectrometer using a previously optimised method. Data comprising 6751 spectral features were used to build an OPLS-DA statistical model capable of accurately distinguishing Ctrl, MCI and MCI_AD. The model accurately distinguished (R2 = 99.1%; Q2 = 97%) those MCI patients who later went on to develop AD. S-plots were used to shortlist ions of interest which were responsible for explaining the maximum amount of variation between patient groups. Metabolite database searching and pathway enrichment analysis indicated disturbances in 22 biochemical pathways, and excitingly it discovered two interlinked areas of metabolism (polyamine metabolism and L-Arginine metabolism) were differentially disrupted in this well-defined clinical cohort. The optimised untargeted HRMS methods described herein not only demonstrate that it is possible to distinguish these pathologies in human blood but also that MCI patients 'at risk' from AD could be predicted up to 2 years earlier than conventional clinical diagnosis. Blood-based metabolite profiling of plasma from memory clinic patients is a novel and feasible approach in improving MCI and AD diagnosis and, refining clinical trials through better patient stratification.
Collapse
Affiliation(s)
- Stewart F. Graham
- Advanced Asset Technology Centre, Institute for Global Food Security, Queen’s University Belfast, Stranmillis Road, Belfast, BT9 5AG, United Kingdom
- William Beaumont Research Institute, 3811 W. 13 Mile Road, Royal Oak, Michigan 48073, United States of America
- * E-mail:
| | - Olivier P. Chevallier
- Advanced Asset Technology Centre, Institute for Global Food Security, Queen’s University Belfast, Stranmillis Road, Belfast, BT9 5AG, United Kingdom
| | - Christopher T. Elliott
- Advanced Asset Technology Centre, Institute for Global Food Security, Queen’s University Belfast, Stranmillis Road, Belfast, BT9 5AG, United Kingdom
| | - Christian Hölscher
- Division of Biomedical Sciences and Life Sciences, Lancaster University, Lancaster, LA1 4YG, United Kingdom
| | - Janet Johnston
- Ageing Group, Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BA, United Kingdom
| | - Bernadette McGuinness
- Ageing Group, Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BA, United Kingdom
| | - Patrick G. Kehoe
- Dementia Research Group, Institute of Clinical Neurosciences, School of Clinical Sciences, University of Bristol, Frenchay Hospital, Bristol, BS16 1LE, United Kingdom
| | - Anthony Peter Passmore
- Ageing Group, Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BA, United Kingdom
| | - Brian D. Green
- Advanced Asset Technology Centre, Institute for Global Food Security, Queen’s University Belfast, Stranmillis Road, Belfast, BT9 5AG, United Kingdom
| |
Collapse
|
44
|
Abstract
PURPOSE OF REVIEW The availability of PET neuroimaging tools for the in-vivo assessment of metabolic dysfunction and amyloid burden in Alzheimer's disease has opened important methodological and practical issues in the diagnostic design and the conduct of new clinical trials. This review, addressing the different molecular information that the amyloid-PET and fluorodeoxyglucose-PET (FDG-PET) tools can provide, highlights their diverging paths in Alzheimer's disease and possible new perspectives in research and clinical applications. RECENT FINDINGS Senile plaques and neurofibrillary tangles are prominent neuropathological hallmarks in Alzheimer's disease and are considered to be targets for therapeutic intervention and biomarkers for diagnostic in-vivo imaging agents. Alzheimer's disease is a slowly progressing disorder, in which pathophysiological abnormalities, detectable in vivo by PET biomarkers, precede clinical symptoms by many years to decades. The unitary view of Alzheimer's disease as a sequential pathological pathway, with beta-amyloid (Aβ) as the only initial and causal event (the 'amyloid cascade hypothesis'), is likely to be progressively replaced by a more complex picture, also on the basis of recent PET imaging findings showing that neuronal injury biomarkers and tau pathology can be independent of β-amyloid deposition. SUMMARY The different molecular paths that PET in-vivo biomarkers can reveal in the timeframe of Alzheimer's disease progression reflect the events leading to deposition of Aβ and phosphorylated tau, neuronal injury and neurodegeneration, which can run in parallel instead of in a sequential manner. The amyloid and neuronal injury paths may diverge along the Alzheimer's disease cascade and bear separate relationships with Alzheimer's disease symptoms and clinical phenotypes. All these evidences are crucial for the diagnosis and the development of new drugs aimed at slowing or preventing dementia.
Collapse
|
45
|
Aggleton JP. Looking beyond the hippocampus: old and new neurological targets for understanding memory disorders. Proc Biol Sci 2015; 281:rspb.2014.0565. [PMID: 24850926 PMCID: PMC4046414 DOI: 10.1098/rspb.2014.0565] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Although anterograde amnesia can occur after damage in various brain sites, hippocampal dysfunction is usually seen as the ultimate cause of the failure to learn new episodic information. This assumption is supported by anatomical evidence showing direct hippocampal connections with all other sites implicated in causing anterograde amnesia. Likewise, behavioural and clinical evidence would seem to strengthen the established notion of an episodic memory system emanating from the hippocampus. There is, however, growing evidence that key, interconnected sites may also regulate the hippocampus, reflecting a more balanced, integrated network that enables learning. Recent behavioural evidence strongly suggests that medial diencephalic structures have some mnemonic functions independent of the hippocampus, which can then act upon the hippocampus. Anatomical findings now reveal that nucleus reuniens and the retrosplenial cortex provide parallel, disynaptic routes for prefrontal control of hippocampal activity. There is also growing clinical evidence that retrosplenial cortex dysfunctions contribute to both anterograde amnesia and the earliest stages of Alzheimer's disease, revealing the potential significance of this area for clinical studies. This array of findings underlines the importance of redressing the balance and the value of looking beyond the hippocampus when seeking to explain failures in learning new episodic information.
Collapse
Affiliation(s)
- John P Aggleton
- School of Psychology, Cardiff University, Park Place, Cardiff, Wales CF10 3AT, UK
| |
Collapse
|
46
|
Cash DM, Rohrer JD, Ryan NS, Ourselin S, Fox NC. Imaging endpoints for clinical trials in Alzheimer's disease. Alzheimers Res Ther 2014; 6:87. [PMID: 25621018 PMCID: PMC4304258 DOI: 10.1186/s13195-014-0087-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
As the need to develop a successful disease-modifying treatment for Alzheimer's disease (AD) becomes more urgent, imaging is increasingly used in therapeutic trials. We provide an overview of how the different imaging modalities are used in AD studies and the current regulatory guidelines for their use in clinical trials as endpoints. We review the current literature for results of imaging endpoints of efficacy and safety in published clinical trials. We start with trials in mild to moderate AD, where imaging (largely magnetic resonance imaging (MRI)) has long played a role in inclusion and exclusion criteria; more recently, MRI has been used to identify adverse events and to measure rates of brain atrophy. The advent of amyloid imaging using positron emission tomography has led to trials incorporating amyloid measurements as endpoints and incidentally to the recognition of the high proportion of amyloid-negative individuals that may be recruited into these trials. Ongoing and planned trials now commonly include multimodality imaging: amyloid positron emission tomography, MRI and other modalities. At the same time, the failure of recent large profile trials in mild to moderate AD together with the realisation that there is a long prodromal period to AD has driven a push to move studies to earlier in the disease. Imaging has particularly important roles, alongside other biomarkers, in assessing efficacy because conventional clinical outcomes may have limited ability to detect treatment effects in these early stages.
Collapse
Affiliation(s)
- David M Cash
- />Dementia Research Centre, Box 16, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG UK
- />Translational Imaging Group, Centre for Medical Image Computing, University College of London, 3rd Floor, Wolfson House, 4 Stephenson Way, London, NW1 2HE UK
| | - Jonathan D Rohrer
- />Dementia Research Centre, Box 16, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG UK
| | - Natalie S Ryan
- />Dementia Research Centre, Box 16, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG UK
| | - Sebastien Ourselin
- />Dementia Research Centre, Box 16, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG UK
- />Translational Imaging Group, Centre for Medical Image Computing, University College of London, 3rd Floor, Wolfson House, 4 Stephenson Way, London, NW1 2HE UK
| | - Nick C Fox
- />Dementia Research Centre, Box 16, The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG UK
| |
Collapse
|
47
|
Schmidt ME, Chiao P, Klein G, Matthews D, Thurfjell L, Cole PE, Margolin R, Landau S, Foster NL, Mason NS, De Santi S, Suhy J, Koeppe RA, Jagust W. The influence of biological and technical factors on quantitative analysis of amyloid PET: Points to consider and recommendations for controlling variability in longitudinal data. Alzheimers Dement 2014; 11:1050-68. [PMID: 25457431 DOI: 10.1016/j.jalz.2014.09.004] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 08/05/2014] [Accepted: 09/12/2014] [Indexed: 10/24/2022]
Abstract
In vivo imaging of amyloid burden with positron emission tomography (PET) provides a means for studying the pathophysiology of Alzheimer's and related diseases. Measurement of subtle changes in amyloid burden requires quantitative analysis of image data. Reliable quantitative analysis of amyloid PET scans acquired at multiple sites and over time requires rigorous standardization of acquisition protocols, subject management, tracer administration, image quality control, and image processing and analysis methods. We review critical points in the acquisition and analysis of amyloid PET, identify ways in which technical factors can contribute to measurement variability, and suggest methods for mitigating these sources of noise. Improved quantitative accuracy could reduce the sample size necessary to detect intervention effects when amyloid PET is used as a treatment end point and allow more reliable interpretation of change in amyloid burden and its relationship to clinical course.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Susan Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA
| | - Norman L Foster
- Division of Cognitive Neurology, University of Utah, Salt Lake City, UT, USA
| | - N Scott Mason
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Robert A Koeppe
- Division of Nuclear Medicine, University of Michigan, Ann Arbor, MI, USA
| | - William Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA
| | | |
Collapse
|
48
|
Paterson RW, Toombs J, Slattery CF, Schott JM, Zetterberg H. Biomarker modelling of early molecular changes in Alzheimer's disease. Mol Diagn Ther 2014; 18:213-27. [PMID: 24281842 DOI: 10.1007/s40291-013-0069-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The preclinical phase of Alzheimer's disease (AD) occurs years, possibly decades, before the onset of clinical symptoms. Being able to detect the very earliest stages of AD is critical to improving understanding of AD biology, and identifying individuals at greatest risk of developing clinical symptoms with a view to treating AD pathophysiology before irreversible neurodegeneration occurs. Studies of dominantly inherited AD families and longitudinal studies of sporadic AD have contributed to knowledge of the earliest AD biomarkers. Here we appraise this evidence before reviewing novel, particularly fluid, biomarkers that may provide insights into AD pathogenesis and relate these to existing hypothetical disease models.
Collapse
Affiliation(s)
- Ross W Paterson
- Dementia Research Centre, Department of Neurodegeneration, UCL Institute of Neurology, London, UK,
| | | | | | | | | |
Collapse
|
49
|
Striatum and entorhinal cortex atrophy in AD mouse models: MRI comprehensive analysis. Neurobiol Aging 2014; 36:776-88. [PMID: 25433456 DOI: 10.1016/j.neurobiolaging.2014.10.027] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 09/19/2014] [Accepted: 10/07/2014] [Indexed: 01/24/2023]
Abstract
Alzheimer's disease is experimentally modeled in transgenic (Tg) mice overexpressing mutated forms of the human amyloid precursor protein either alone or combined with mutated presenilins and tau. In the present study, we developed a systematic approach to compare double (TASTPM) and triple (APP/PS2/Tau) Tg mice by serial magnetic resonance imaging and spectroscopy analysis from 4 to 26 months of age to define homologous biomarkers between mice and humans. Hippocampal atrophy was found in Tg mice compared with WT. In APP/PS2/Tau the effect was age-dependent, whereas in TASTPM it was detectable from the first investigated time point. Importantly, both mice displayed an age-related entorhinal cortex thinning and robust striatal atrophy, the latter associated with a significant loss of synaptophysin. Hippocampal magnetic resonance spectroscopy revealed lower glutamate levels in both Tg mice and a selective myo-inositol increase in TASTPM. This noninvasive magnetic resonance imaging analysis, revealed common biomarkers between humans and mice, and could, thus, be promoted as a fully translational tool to be adopted in the preclinical investigation of therapeutic approaches.
Collapse
|
50
|
Abstract
Neuroimaging is a potentially valuable tool to link individual differences in the human genome to structure and functional variations, narrowing the gaps in the casual chain from a given genetic variation to a brain disorder. Because genes are not usually expressed at the level of mental behavior, but are mediated by their molecular and cellular effects, molecular imaging could play a key role. This article reviews the literature using molecular imaging as an intermediate phenotype and/or biomarker for illness related to certain genetic alterations, focusing on the most common neurodegenerative disorders, Alzheimer's disease (AD) and Parkinson disease.
Collapse
Affiliation(s)
- José Leite
- PET/CT, Clínica de Diagnóstico Por Imagem (CDPI), Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Roberta Hespanhol
- PET/CT, Clínica de Diagnóstico Por Imagem (CDPI), Rio de Janeiro, Rio de Janeiro, Brazil
| | | |
Collapse
|