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Hwang G, Abdulkadir A, Erus G, Habes M, Pomponio R, Shou H, Doshi J, Mamourian E, Rashid T, Bilgel M, Fan Y, Sotiras A, Srinivasan D, Morris JC, Albert MS, Bryan NR, Resnick SM, Nasrallah IM, Davatzikos C, Wolk DA. Disentangling Alzheimer's disease neurodegeneration from typical brain ageing using machine learning. Brain Commun 2022; 4:fcac117. [PMID: 35611306 PMCID: PMC9123890 DOI: 10.1093/braincomms/fcac117] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 02/17/2022] [Accepted: 05/04/2022] [Indexed: 11/17/2022] Open
Abstract
Neuroimaging biomarkers that distinguish between changes due to typical brain ageing and Alzheimer's disease are valuable for determining how much each contributes to cognitive decline. Supervised machine learning models can derive multivariate patterns of brain change related to the two processes, including the Spatial Patterns of Atrophy for Recognition of Alzheimer's Disease (SPARE-AD) and of Brain Aging (SPARE-BA) scores investigated herein. However, the substantial overlap between brain regions affected in the two processes confounds measuring them independently. We present a methodology, and associated results, towards disentangling the two. T1-weighted MRI scans of 4054 participants (48-95 years) with Alzheimer's disease, mild cognitive impairment (MCI), or cognitively normal (CN) diagnoses from the Imaging-based coordinate SysTem for AGIng and NeurodeGenerative diseases (iSTAGING) consortium were analysed. Multiple sets of SPARE scores were investigated, in order to probe imaging signatures of certain clinically or molecularly defined sub-cohorts. First, a subset of clinical Alzheimer's disease patients (n = 718) and age- and sex-matched CN adults (n = 718) were selected based purely on clinical diagnoses to train SPARE-BA1 (regression of age using CN individuals) and SPARE-AD1 (classification of CN versus Alzheimer's disease) models. Second, analogous groups were selected based on clinical and molecular markers to train SPARE-BA2 and SPARE-AD2 models: amyloid-positive Alzheimer's disease continuum group (n = 718; consisting of amyloid-positive Alzheimer's disease, amyloid-positive MCI, amyloid- and tau-positive CN individuals) and amyloid-negative CN group (n = 718). Finally, the combined group of the Alzheimer's disease continuum and amyloid-negative CN individuals was used to train SPARE-BA3 model, with the intention to estimate brain age regardless of Alzheimer's disease-related brain changes. The disentangled SPARE models, SPARE-AD2 and SPARE-BA3, derived brain patterns that were more specific to the two types of brain changes. The correlation between the SPARE-BA Gap (SPARE-BA minus chronological age) and SPARE-AD was significantly reduced after the decoupling (r = 0.56-0.06). The correlation of disentangled SPARE-AD was non-inferior to amyloid- and tau-related measurements and to the number of APOE ε4 alleles but was lower to Alzheimer's disease-related psychometric test scores, suggesting the contribution of advanced brain ageing to the latter. The disentangled SPARE-BA was consistently less correlated with Alzheimer's disease-related clinical, molecular and genetic variables. By employing conservative molecular diagnoses and introducing Alzheimer's disease continuum cases to the SPARE-BA model training, we achieved more dissociable neuroanatomical biomarkers of typical brain ageing and Alzheimer's disease.
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Affiliation(s)
- Gyujoon Hwang
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
| | - Ahmed Abdulkadir
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
| | - Guray Erus
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Mohamad Habes
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Raymond Pomponio
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Haochang Shou
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jimit Doshi
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth Mamourian
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Tanweer Rashid
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Yong Fan
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Aristeidis Sotiras
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Dhivya Srinivasan
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - John C. Morris
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Marilyn S. Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nick R. Bryan
- Department of Diagnostic Medicine, University of Texas, Austin, TX, USA
| | - Susan M. Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Ilya M. Nasrallah
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - David A. Wolk
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology and Penn Memory Center, University of Pennsylvania, Philadelphia, PA, USA
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2
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Shea TB. Improvement of cognitive performance by a nutraceutical formulation: Underlying mechanisms revealed by laboratory studies. Free Radic Biol Med 2021; 174:281-304. [PMID: 34352370 DOI: 10.1016/j.freeradbiomed.2021.07.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 12/28/2022]
Abstract
Cognitive decline, decrease in neuronal function and neuronal loss that accompany normal aging and dementia are the result of multiple mechanisms, many of which involve oxidative stress. Herein, we review these various mechanisms and identify pharmacological and non-pharmacological approaches, including modification of diet, that may reduce the risk and progression of cognitive decline. The optimal degree of neuronal protection is derived by combinations of, rather than individual, compounds. Compounds that provide antioxidant protection are particularly effective at delaying or improving cognitive performance in the early stages of Mild Cognitive Impairment and Alzheimer's disease. Laboratory studies confirm alleviation of oxidative damage in brain tissue. Lifestyle modifications show a degree of efficacy and may augment pharmacological approaches. Unfortunately, oxidative damage and resultant accumulation of biomarkers of neuronal damage can precede cognitive decline by years to decades. This underscores the importance of optimization of dietary enrichment, antioxidant supplementation and other lifestyle modifications during aging even for individuals who are cognitively intact.
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Affiliation(s)
- Thomas B Shea
- Laboratory for Neuroscience, Department of Biological Sciences, University of Massachusetts Lowell, Lowell, MA, 01854, USA.
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3
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Dartora CM, Borelli WV, Koole M, Marques da Silva AM. Cognitive Decline Assessment: A Review From Medical Imaging Perspective. Front Aging Neurosci 2021; 13:704661. [PMID: 34489675 PMCID: PMC8416532 DOI: 10.3389/fnagi.2021.704661] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Aging is a complex process that involves changes at both molecular and morphological levels. However, our understanding of how aging affects brain anatomy and function is still poor. In addition, numerous biomarkers and imaging markers, usually associated with neurodegenerative diseases such as Alzheimer's disease (AD), have been clinically used to study cognitive decline. However, the path of cognitive decline from healthy aging to a mild cognitive impairment (MCI) stage has been studied only marginally. This review presents aspects of cognitive decline assessment based on the imaging differences between individuals cognitively unimpaired and in the decline spectrum. Furthermore, we discuss the relationship between imaging markers and the change in their patterns with aging by using neuropsychological tests. Our goal is to delineate how aging has been studied by using medical imaging tools and further explore the aging brain and cognitive decline. We find no consensus among the biomarkers to assess the cognitive decline and its relationship with the cognitive decline trajectory. Brain glucose hypometabolism was found to be directly related to aging and indirectly to cognitive decline. We still need to understand how to quantify an expected hypometabolism during cognitive decline during aging. The Aβ burden should be longitudinally studied to achieve a better consensus on its association with changes in the brain and cognition decline with aging. There exists a lack of standardization of imaging markers that highlight the need for their further improvement. In conclusion, we argue that there is a lot to investigate and understand cognitive decline better and seek a window for a suitable and effective treatment strategy.
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Affiliation(s)
- Caroline Machado Dartora
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
| | - Wyllians Vendramini Borelli
- Neurology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Brain Institute of Rio Grande do Sul, BraIns, Porto Alegre, Brazil
| | - Michel Koole
- Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Ana Maria Marques da Silva
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul, PUCRS, Porto Alegre, Brazil.,Brain Institute of Rio Grande do Sul, BraIns, Porto Alegre, Brazil.,Medical Image Computing Laboratory, School of Technology, Pontifical Catholic University of Rio Grande do Sul, PUCRS, Porto Alegre, Brazil
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4
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Hays CC, Zlatar ZZ, Meloy MJ, Osuna J, Liu TT, Galasko DR, Wierenga CE. Anterior Cingulate Structure and Perfusion is Associated with Cerebrospinal Fluid Tau among Cognitively Normal Older Adult APOEɛ4 Carriers. J Alzheimers Dis 2021; 73:87-101. [PMID: 31743999 DOI: 10.3233/jad-190504] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Evidence suggests the ɛ4 allele of the apolipoprotein E (APOE) gene may accelerate an age-related process of cortical thickening and cerebral blood flow (CBF) reduction in the anterior cingulate cortex (ACC). Although the neural basis of this association remains unclear, evidence suggests it might reflect early neurodegenerative processes. However, to date, associations between cerebrospinal fluid (CSF) biomarkers of neurodegeneration, such as CSF tau, and APOE-related alterations in ACC cortical thickness (CTH) and CBF have yet to be explored. The current study explored the interaction of CSF tau and APOE genotype (ɛ4+, ɛ4-) on FreeSurfer-derived CTH and arterial spin labeling MRI-measured resting CBF in the ACC (caudal ACC [cACC] and rostral ACC [rACC]) among a sample of 45 cognitively normal older adults. Secondary analyses also examined associations between APOE, CTH/CBF, and cognitive performance. In the cACC, higher CSF tau was associated with higher CTH and lower CBF in ɛ4+, whereas these relationships were not evident in ɛ4-. In the rACC, higher CSF tau was associated with higher CTH for both ɛ4+ and ɛ4-, and with lower CBF only in ɛ4+. Significant interactions of CSF tau and APOE on CTH/CBF were not observed in two posterior reference regions implicated in Alzheimer's disease. Secondary analyses revealed a negative relationship between cACC CTH and executive functioning in ɛ4+ and a positive relationship in ɛ4-. Findings suggest the presence of an ɛ4-related pattern of increased CTH and reduced CBF in the ACC that is associated with biomarkers of neurodegeneration and subtle decrements in cognition.
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Affiliation(s)
- Chelsea C Hays
- VA San Diego Healthcare System, San Diego, CA, USA.,SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Zvinka Z Zlatar
- Department of Psychiatry, UC San Diego, La Jolla, CA, USA.,SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - M J Meloy
- VA San Diego Healthcare System, San Diego, CA, USA
| | - Jessica Osuna
- VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, UC San Diego, La Jolla, CA, USA
| | - Thomas T Liu
- Department of Radiology, UC San Diego, La Jolla, CA, USA
| | - Douglas R Galasko
- VA San Diego Healthcare System, San Diego, CA, USA.,Department of Neurosciences, UC San Diego, La Jolla, CA, USA
| | - Christina E Wierenga
- VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, UC San Diego, La Jolla, CA, USA.,SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
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5
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Sala A, Nordberg A, Rodriguez-Vieitez E. Longitudinal pathways of cerebrospinal fluid and positron emission tomography biomarkers of amyloid-β positivity. Mol Psychiatry 2021; 26:5864-5874. [PMID: 33303945 PMCID: PMC8758501 DOI: 10.1038/s41380-020-00950-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 10/09/2020] [Accepted: 11/02/2020] [Indexed: 01/20/2023]
Abstract
Mismatch between CSF and PET amyloid-β biomarkers occurs in up to ≈20% of preclinical/prodromal Alzheimer's disease individuals. Factors underlying mismatching results remain unclear. In this study we hypothesized that CSF/PET discordance provides unique biological/clinical information. To test this hypothesis, we investigated non-demented and demented participants with CSF amyloid-β42 and [18F]Florbetapir PET assessments at baseline (n = 867) and at 2-year follow-up (n = 289). Longitudinal trajectories of amyloid-β positivity were tracked simultaneously for CSF and PET biomarkers. In the longitudinal cohort (n = 289), we found that participants with normal CSF/PET amyloid-β biomarkers progressed more frequently toward CSF/PET discordance than to full CSF/PET positivity (χ2(1) = 5.40; p < 0.05). Progression to CSF+/PET+ status was ten times more frequent in cases with discordant biomarkers, as compared to csf-/pet- cases (χ2(1) = 18.86; p < 0.001). Compared to the CSF+/pet- group, the csf-/PET+ group had lower APOE-ε4ε4 prevalence (χ2(6) = 197; p < 0.001; n = 867) and slower rate of brain amyloid-β accumulation (F(3,600) = 12.76; p < 0.001; n = 608). These results demonstrate that biomarker discordance is a typical stage in the natural history of amyloid-β accumulation, with CSF or PET becoming abnormal first and not concurrently. Therefore, biomarker discordance allows for identification of individuals with elevated risk of progression toward fully abnormal amyloid-β biomarkers, with subsequent risk of neurodegeneration and cognitive decline. Our results also suggest that there are two alternative pathways ("CSF-first" vs. "PET-first") toward established amyloid-β pathology, characterized by different genetic profiles and rates of amyloid-β accumulation. In conclusion, CSF and PET amyloid-β biomarkers provide distinct information, with potential implications for their use as biomarkers in clinical trials.
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Affiliation(s)
- Arianna Sala
- grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden ,grid.15496.3f0000 0001 0439 0892Vita-Salute San Raffaele University, Milan, Italy ,grid.18887.3e0000000417581884In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Agneta Nordberg
- grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Theme Aging, The Aging Brain, Karolinska University Hospital, Stockholm, Sweden
| | - Elena Rodriguez-Vieitez
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
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6
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Rubinski A, Franzmeier N, Neitzel J, Ewers M. FDG-PET hypermetabolism is associated with higher tau-PET in mild cognitive impairment at low amyloid-PET levels. ALZHEIMERS RESEARCH & THERAPY 2020; 12:133. [PMID: 33076977 PMCID: PMC7574434 DOI: 10.1186/s13195-020-00702-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/05/2020] [Indexed: 12/04/2022]
Abstract
Background FDG-PET hypermetabolism can be observed in mild cognitive impairment (MCI), but the link to primary pathologies of Alzheimer’s diseases (AD) including amyloid and tau is unclear. Methods Using voxel-based regression, we assessed local interactions between amyloid- and tau-PET on spatially matched FDG-PET in 72 MCI patients. Control groups included cerebrospinal fluid biomarker characterized cognitively normal (CN, n = 70) and AD dementia subjects (n = 95). Results In MCI, significant amyloid-PET by tau-PET interactions were found in frontal, lateral temporal, and posterior parietal regions, where higher local tau-PET was associated with higher spatially corresponding FDG-PET at low levels of local amyloid-PET. FDG-PET in brain regions with a significant local amyloid- by tau-PET interaction was higher compared to that in CN and AD dementia and associated with lower episodic memory. Conclusion Higher tau-PET in the presence of low amyloid-PET is associated with abnormally increased glucose metabolism that is accompanied by episodic memory impairment.
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Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen-Straße 17, 81377, Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen-Straße 17, 81377, Munich, Germany
| | - Julia Neitzel
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen-Straße 17, 81377, Munich, Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen-Straße 17, 81377, Munich, Germany. .,German Center for Neurodegenerative Diseases, Munich, Germany.
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7
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The preclinical amyloid sensitive composite to determine subtle cognitive differences in preclinical Alzheimer's disease. Sci Rep 2020; 10:13583. [PMID: 32788669 PMCID: PMC7423599 DOI: 10.1038/s41598-020-70386-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 07/22/2020] [Indexed: 12/13/2022] Open
Abstract
Recently, the focus of Alzheimer's disease (AD) research has shifted from the clinical stage to the preclinical stage. We, therefore, aimed to develop a cognitive composite score that can detect the subtle cognitive differences between the amyloid positive (Aβ+) and negative (Aβ-) status in cognitively normal (CN) participants. A total of 423 CN participants with Aβ positron emission tomography images were recruited. The multiple-indicators multiple-causes model found the latent mean difference between the Aβ+ and Aβ- groups in the domains of verbal memory, visual memory, and executive functions. The multivariate analysis of covariance (MANCOVA) showed that the Aβ+ group performed worse in tests related to the verbal and visual delayed recall, semantic verbal fluency, and inhibition of cognitive inference within the three cognitive domains. The Preclinical Amyloid Sensitive Composite (PASC) model we developed using the result of MANCOVA and the MMSE presented a good fit with the data. The accuracy of the PASC score when applied with age, sex, education, and APOE ε4 for distinguishing between Aβ+ and Aβ- was adequate (AUC = 0.764; 95% CI = 0.667-0.860) in the external validation set (N = 179). We conclude that the PASC can eventually contribute to facilitating more prevention trials in preclinical AD.
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Yang BH, Chen JC, Chou WH, Huang WS, Fuh JL, Liu R, Wu CH. Classification of Alzheimer’s Disease from 18F-FDG and 11C-PiB PET Imaging Biomarkers Using Support Vector Machine. J Med Biol Eng 2020. [DOI: 10.1007/s40846-020-00548-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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9
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Abstract
Technologies for imaging the pathophysiology of Alzheimer disease (AD) now permit studies of the relationships between the two major proteins deposited in this disease - amyloid-β (Aβ) and tau - and their effects on measures of neurodegeneration and cognition in humans. Deposition of Aβ in the medial parietal cortex appears to be the first stage in the development of AD, although tau aggregates in the medial temporal lobe (MTL) precede Aβ deposition in cognitively healthy older people. Whether aggregation of tau in the MTL is the first stage in AD or a fairly benign phenomenon that may be transformed and spread in the presence of Aβ is a major unresolved question. Despite a strong link between Aβ and tau, the relationship between Aβ and neurodegeneration is weak; rather, it is tau that is associated with brain atrophy and hypometabolism, which, in turn, are related to cognition. Although there is support for an interaction between Aβ and tau resulting in neurodegeneration that leads to dementia, the unknown nature of this interaction, the strikingly different patterns of brain Aβ and tau deposition and the appearance of neurodegeneration in the absence of Aβ and tau are challenges to this model that ultimately must be explained.
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10
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Skoog I, Kern S, Zetterberg H, Östling S, Börjesson-Hanson A, Guo X, Blennow K. Low Cerebrospinal Fluid Aβ42 and Aβ40 are Related to White Matter Lesions in Cognitively Normal Elderly. J Alzheimers Dis 2019; 62:1877-1886. [PMID: 29614655 PMCID: PMC5900552 DOI: 10.3233/jad-170950] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: Low cerebrospinal fluid (CSF) levels of Aβ42 may be the earliest manifestation of Alzheimer’s disease (AD). Knowledge on how CSF Aβ interacts with different brain pathologies early in the disease process is limited. We examined how CSF Aβ markers relate to brain atrophy and white matter lesions (WMLs) in octogenarians with and without dementia to explore the earliest pathogenetic pathways of AD in the oldest old. Objective: To study CSF amyloid biomarkers in relation to brain atrophy and WMLs in 85-year-olds with and without dementia. Methods: 53 octogenarians took part in neuropsychiatric examinations and underwent both a lumbar puncture and a brain CT scan. CSF levels of Aβ42 and Aβ40 were examined in relation to cerebral atrophy and WMLs. Dementia was diagnosed. Results: In 85-year-olds without dementia, lower levels of both CSF Aβ42 and CSF Aβ40 were associated with WMLs. CSF Aβ42 also correlated with measures of central atrophy, but not with cortical atrophy. In participants with dementia, lower CSF levels of Aβ42 were related to frontal, temporal, and parietal cortical atrophy but not to WMLs. Conclusions: Our findings may suggest that there is an interrelationship between Aβ and subcortical WMLs in older persons without dementia. After onset of dementia, low CSF Aβ42, probably representing amyloid deposition in plaques, is associated with cortical atrophy. WMLs may be an earlier manifestation of Aβ deposition than cortical degeneration.
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Affiliation(s)
- Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Silke Kern
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,UCL Institute of Neurology, Queen Square, London, UK
| | - Svante Östling
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Anne Börjesson-Hanson
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Xinxin Guo
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Ko H, Ihm JJ, Kim HG. Cognitive Profiling Related to Cerebral Amyloid Beta Burden Using Machine Learning Approaches. Front Aging Neurosci 2019; 11:95. [PMID: 31105554 PMCID: PMC6499028 DOI: 10.3389/fnagi.2019.00095] [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: 11/29/2018] [Accepted: 04/08/2019] [Indexed: 12/31/2022] Open
Abstract
Background: Cerebral amyloid beta (Aβ) is a hallmark of Alzheimer’s disease (AD). Aβ can be detected in vivo with amyloid imaging or cerebrospinal fluid assessments. However, these technologies can be both expensive and invasive, and their accessibility is limited in many clinical settings. Hence the current study aims to identify multivariate cost-efficient markers for Aβ positivity among non-demented individuals using machine learning (ML) approaches. Methods: The relationship between cost-efficient candidate markers and Aβ status was examined by analyzing 762 participants from the Alzheimer’s Disease Neuroimaging Initiative-2 cohort at baseline visit (286 cognitively normal, 332 with mild cognitive impairment, and 144 with AD; mean age 73.2 years, range 55–90). Demographic variables (age, gender, education, and APOE status) and neuropsychological test scores were used as predictors in an ML algorithm. Cerebral Aβ burden and Aβ positivity were measured using 18F-florbetapir positron emission tomography images. The adaptive least absolute shrinkage and selection operator (LASSO) ML algorithm was implemented to identify cognitive performance and demographic variables and distinguish individuals from the population at high risk for cerebral Aβ burden. For generalizability, results were further checked by randomly dividing the data into training sets and test sets and checking predictive performances by 10-fold cross-validation. Results: Out of neuropsychological predictors, visuospatial ability and episodic memory test results were consistently significant predictors for Aβ positivity across subgroups with demographic variables and other cognitive measures considered. The adaptive LASSO model using out-of-sample classification could distinguish abnormal levels of Aβ. The area under the curve of the receiver operating characteristic curve was 0.754 in the mild change group, 0.803 in the moderate change group, and 0.864 in the severe change group, respectively. Conclusion: Our results showed that the cost-efficient neuropsychological model with demographics could predict Aβ positivity, suggesting a potential surrogate method for detecting Aβ deposition non-invasively with clinical utility. More specifically, it could be a very brief screening tool in various settings to recruit participants with potential biomarker evidence of AD brain pathology. These identified individuals would be valuable participants in secondary prevention trials aimed at detecting an anti-amyloid drug effect in the non-demented population.
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Affiliation(s)
- Hyunwoong Ko
- Interdisciplinary Program in Cognitive Science, Seoul National University, Seoul, South Korea.,Biomedical Knowledge Engineering Laboratory, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Jung-Joon Ihm
- School of Dentistry, Seoul National University, Seoul, South Korea
| | - Hong-Gee Kim
- Interdisciplinary Program in Cognitive Science, Seoul National University, Seoul, South Korea.,Biomedical Knowledge Engineering Laboratory, School of Dentistry, Seoul National University, Seoul, South Korea.,School of Dentistry, Seoul National University, Seoul, South Korea
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12
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Cohen AD, Landau SM, Snitz BE, Klunk WE, Blennow K, Zetterberg H. Fluid and PET biomarkers for amyloid pathology in Alzheimer's disease. Mol Cell Neurosci 2018; 97:3-17. [PMID: 30537535 DOI: 10.1016/j.mcn.2018.12.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 12/05/2018] [Indexed: 02/04/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by amyloid plaques and tau pathology (neurofibrillary tangles and neuropil threads). Amyloid plaques are primarily composed of aggregated and oligomeric β-amyloid (Aβ) peptides ending at position 42 (Aβ42). The development of fluid and PET biomarkers for Alzheimer's disease (AD), has allowed for detection of Aβ pathology in vivo and marks a major advancement in understanding the role of Aβ in Alzheimer's disease (AD). In the recent National Institute on Aging and Alzheimer's Association (NIA-AA) Research Framework, AD is defined by the underlying pathology as measured in patients during life by biomarkers (Jack et al., 2018), while clinical symptoms are used for staging of the disease. Therefore, sensitive, specific and robust biomarkers to identify brain amyloidosis are central in AD research. Here, we discuss fluid and PET biomarkers for Aβ and their application.
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Affiliation(s)
- Ann D Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America.
| | - Susan M Landau
- Neurology Helen Wills Neuroscience Institute, University of California, Berkeley, United States of America; Lawrence Berkeley National Laboratory, Molecular Biophysics and Integrated Bioimaging Functional Imaging Department, Life Sciences Division, United States of America
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, United States of America
| | - William E Klunk
- Department of Psychiatry, University of Pittsburgh School of Medicine, United States of America
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Molndal, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, University College, London, United Kingdom of Great Britain and Northern Ireland
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Molndal, Sweden; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, University College, London, United Kingdom of Great Britain and Northern Ireland; Department of Molecular Neuroscience, UCL Institute of Neurology, United Kingdom of Great Britain and Northern Ireland; UK Dementia Research Institute at UCL, United Kingdom of Great Britain and Northern Ireland
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13
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Camacho V, Gómez-Grande A, Sopena P, García-Solís D, Gómez Río M, Lorenzo C, Rubí S, Arbizu J. Amyloid PET in neurodegenerative diseases with dementia. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2018.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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14
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ten Kate M, Ingala S, Schwarz AJ, Fox NC, Chételat G, van Berckel BNM, Ewers M, Foley C, Gispert JD, Hill D, Irizarry MC, Lammertsma AA, Molinuevo JL, Ritchie C, Scheltens P, Schmidt ME, Visser PJ, Waldman A, Wardlaw J, Haller S, Barkhof F. Secondary prevention of Alzheimer's dementia: neuroimaging contributions. Alzheimers Res Ther 2018; 10:112. [PMID: 30376881 PMCID: PMC6208183 DOI: 10.1186/s13195-018-0438-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 10/10/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND In Alzheimer's disease (AD), pathological changes may arise up to 20 years before the onset of dementia. This pre-dementia window provides a unique opportunity for secondary prevention. However, exposing non-demented subjects to putative therapies requires reliable biomarkers for subject selection, stratification, and monitoring of treatment. Neuroimaging allows the detection of early pathological changes, and longitudinal imaging can assess the effect of interventions on markers of molecular pathology and rates of neurodegeneration. This is of particular importance in pre-dementia AD trials, where clinical outcomes have a limited ability to detect treatment effects within the typical time frame of a clinical trial. We review available evidence for the use of neuroimaging in clinical trials in pre-dementia AD. We appraise currently available imaging markers for subject selection, stratification, outcome measures, and safety in the context of such populations. MAIN BODY Amyloid positron emission tomography (PET) is a validated in-vivo marker of fibrillar amyloid plaques. It is appropriate for inclusion in trials targeting the amyloid pathway, as well as to monitor treatment target engagement. Amyloid PET, however, has limited ability to stage the disease and does not perform well as a prognostic marker within the time frame of a pre-dementia AD trial. Structural magnetic resonance imaging (MRI), providing markers of neurodegeneration, can improve the identification of subjects at risk of imminent decline and hence play a role in subject inclusion. Atrophy rates (either hippocampal or whole brain), which can be reliably derived from structural MRI, are useful in tracking disease progression and have the potential to serve as outcome measures. MRI can also be used to assess comorbid vascular pathology and define homogeneous groups for inclusion or for subject stratification. Finally, MRI also plays an important role in trial safety monitoring, particularly the identification of amyloid-related imaging abnormalities (ARIA). Tau PET to measure neurofibrillary tangle burden is currently under development. Evidence to support the use of advanced MRI markers such as resting-state functional MRI, arterial spin labelling, and diffusion tensor imaging in pre-dementia AD is preliminary and requires further validation. CONCLUSION We propose a strategy for longitudinal imaging to track early signs of AD including quantitative amyloid PET and yearly multiparametric MRI.
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Affiliation(s)
- Mara ten Kate
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, PO Box 7056, 1007 MB Amsterdam, the Netherlands
| | - Silvia Ingala
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Adam J. Schwarz
- Takeda Pharmaceuticals Comparny, Cambridge, MA USA
- Eli Lilly and Company, Indianapolis, Indiana USA
| | - Nick C. Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Gaël Chételat
- Institut National de la Santé et de la Recherche Médicale, Inserm UMR-S U1237, Université de Caen-Normandie, GIP Cyceron, Caen, France
| | - Bart N. M. van Berckel
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | | | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | | | | | - Adriaan A. Lammertsma
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Craig Ritchie
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Philip Scheltens
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, PO Box 7056, 1007 MB Amsterdam, the Netherlands
| | | | - Pieter Jelle Visser
- Alzheimer Center & Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, PO Box 7056, 1007 MB Amsterdam, the Netherlands
| | - Adam Waldman
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Joanna Wardlaw
- Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Dementia Research Centre, University of Edinburgh, Edinburgh, UK
| | - Sven Haller
- Affidea Centre de Diagnostic Radiologique de Carouge, Geneva, Switzerland
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
- Insititutes of Neurology and Healthcare Engineering, University College London, London, UK
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15
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Camacho V, Gómez-Grande A, Sopena P, García-Solís D, Gómez Río M, Lorenzo C, Rubí S, Arbizu J. Amyloid PET in neurodegenerative diseases with dementia. Rev Esp Med Nucl Imagen Mol 2018; 37:397-406. [PMID: 29776894 DOI: 10.1016/j.remn.2018.03.004] [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: 02/21/2018] [Revised: 03/01/2018] [Accepted: 03/05/2018] [Indexed: 11/16/2022]
Abstract
Alzheimer's disease (AD) is a neurodegenerative condition characterized by progressive cognitive decline and memory loss, and is the most common form of dementia. Amyloid plaques with neurofibrillary tangles are a neuropathological hallmark of AD that produces synaptic dysfunction and culminates later in neuronal loss. Amyloid PET is a useful, available and non-invasive technique that provides in vivo information about the cortical amyloid burden. In the latest revised criteria for the diagnosis of AD biomarkers were defined and integrated: pathological and diagnostic biomarkers (increased retention on fibrillar amyloid PET or decreased Aβ1-42 and increased T-Tau or P-Tau in CSF) and neurodegeneration or topographical biomarkers (temporoparietal hypometabolism on 18F-FDG PET and temporal atrophy on MRI). Recently specific recommendations have been created as a consensus statement on the appropriate use of the imaging biomarkers, including amyloid PET: early-onset cognitive impairment/dementia, atypical forms of AD, mild cognitive impairment with early age of onset, and to differentiate between AD and other neurodegenerative diseases that occur with dementia. Amyloid PET is also contributing to the development of new therapies for AD, as well as in research studies for the study of other neurodegenerative diseases that occur with dementia where the deposition of Aβ amyloid is involved in its pathogenesis. In this paper, we review some general concepts and study the use of amyloid PET in depth and its relationship with neurodegenerative diseases and other diagnostic techniques.
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Affiliation(s)
- V Camacho
- Servicio de Medicina Nuclear, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España.
| | - A Gómez-Grande
- Servicio de Medicina Nuclear, Hospital 12 de Octubre, Madrid, España
| | - P Sopena
- Servicio de Medicina Nuclear, Hospital Vithas-Nisa 9 de Octubre, Valencia, España; Servicio de Medicina Nuclear, Hospital Universitario y Politécnico la Fe, Valencia, España
| | - D García-Solís
- Servicio de Medicina Nuclear, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - M Gómez Río
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria de Granada (IBS), Granada, España
| | - C Lorenzo
- Servicio de Medicina Nuclear, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España
| | - S Rubí
- Servicio de Medicina Nuclear, Hospital Universitari Son Espases, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, España
| | - J Arbizu
- Servicio de Medicina Nuclear, Clínica Universidad de Navarra, Pamplona, Navarra, España
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16
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Wildburger NC, Gyngard F, Guillermier C, Patterson BW, Elbert D, Mawuenyega KG, Schneider T, Green K, Roth R, Schmidt RE, Cairns NJ, Benzinger TLS, Steinhauser ML, Bateman RJ. Amyloid-β Plaques in Clinical Alzheimer's Disease Brain Incorporate Stable Isotope Tracer In Vivo and Exhibit Nanoscale Heterogeneity. Front Neurol 2018; 9:169. [PMID: 29623063 PMCID: PMC5874304 DOI: 10.3389/fneur.2018.00169] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 03/06/2018] [Indexed: 01/01/2023] Open
Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder with clinical manifestations of progressive memory decline and loss of executive function and language. AD affects an estimated 5.3 million Americans alone and is the most common form of age-related dementia with a rapidly growing prevalence among the aging population-those 65 years of age or older. AD is characterized by accumulation of aggregated amyloid-beta (Aβ) in the brain, which leads to one of the pathological hallmarks of AD-Aβ plaques. As a result, Aβ plaques have been extensively studied after being first described over a century ago. Advances in brain imaging and quantitative measures of Aβ in biological fluids have yielded insight into the time course of plaque development decades before and after AD symptom onset. However, despite the fundamental role of Aβ plaques in AD, in vivo measures of individual plaque growth, growth distribution, and dynamics are still lacking. To address this question, we combined stable isotope labeling kinetics (SILK) and nanoscale secondary ion mass spectrometry (NanoSIMS) imaging in an approach termed SILK-SIMS to resolve plaque dynamics in three human AD brains. In human AD brain, plaques exhibit incorporation of a stable isotope tracer. Tracer enrichment was highly variable between plaques and the spatial distribution asymmetric with both quiescent and active nanometer sub-regions of tracer incorporation. These data reveal that Aβ plaques are dynamic structures with deposition rates over days indicating a highly active process. Here, we report the first, direct quantitative measures of in vivo deposition into plaques in human AD brain. Our SILK-SIMS studies will provide invaluable information on plaque dynamics in the normal and diseased brain and offer many new avenues for investigation into pathological mechanisms of the disease, with implications for therapeutic development.
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Affiliation(s)
- Norelle C Wildburger
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
| | - Frank Gyngard
- Department of Physics, Washington University in St. Louis, St. Louis, MO, United States
| | - Christelle Guillermier
- NanoImaging Center, Division of Genetics, Brigham and Women's Hospital, Cambridge, MA, United States.,Brigham and Women's Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Bruce W Patterson
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Donald Elbert
- Department of Neurology, The University of Texas at Austin Dell Medical School, Austin, TX, United States
| | - Kwasi G Mawuenyega
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
| | - Theresa Schneider
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
| | - Karen Green
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Robyn Roth
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO, United States.,Washington University Center for Cellular Imaging, Washington University School of Medicine, St. Louis, MO, United States
| | - Robert E Schmidt
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Nigel J Cairns
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States.,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, United States.,Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, MO, United States.,Hope Center for Neurological Disorders, Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
| | - Tammie L S Benzinger
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, MO, United States.,Department of Radiology, Washington University School of Medicine, St. Louis, MO, United States.,Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, United States
| | - Matthew L Steinhauser
- NanoImaging Center, Division of Genetics, Brigham and Women's Hospital, Cambridge, MA, United States.,Brigham and Women's Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States.,Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, MO, United States.,Hope Center for Neurological Disorders, Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
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17
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Freeze WM, Jacobs HIL, Gronenschild EH, Jansen JFA, Burgmans S, Aalten P, Clerx L, Vos SJ, van Buchem MA, Barkhof F, van der Flier WM, Verbeek MM, Rikkert MO, Backes WH, Verhey FR. White Matter Hyperintensities Potentiate Hippocampal Volume Reduction in Non-Demented Older Individuals with Abnormal Amyloid-β. J Alzheimers Dis 2018; 55:333-342. [PMID: 27662299 DOI: 10.3233/jad-160474] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Cerebral small vessel disease (cSVD) and amyloid-β (Aβ) deposition often co-exist in (prodromal) dementia, and both types of pathology have been associated with neurodegeneration. We examined whether cSVD and Aβ have independent or interactive effects on hippocampal volume (HV) in a memory clinic population. We included 87 individuals with clinical diagnoses of Alzheimer's disease (AD) (n = 24), mild cognitive impairment (MCI) (n = 26), and subjective cognitive complaints (SCC) (n = 37). cSVD magnetic resonance imaging markers included white matter hyperintensity (WMH) volume, lacunar infarct presence, and microbleed presence. Aβ pathology was assessed as cerebrospinal fluid-derived Aβ1 - 42 levels and dichotomized into normal or abnormal, and HV was determined by manual volumetric measurements. A linear hierarchical regression approach was applied for the detection of additive or interaction effects between cSVD and Aβ on HV in the total participant group (n = 87) and in the non-demented group (including SCC and MCI individuals only, n = 63). The results revealed that abnormal Aβ and lacunar infarct presence were independently associated with lower HV in the non-demented individuals. Interestingly, Aβ and WMH pathology interacted in the non-demented individuals, such that WMH had a negative effect on HV in individuals with abnormal CSF Aβ42 levels, but not in individuals with normal CSF Aβ42 levels. These associations were not present when individuals with AD were included in the analyses. Our observations suggest that relatively early on in the disease process older individuals with abnormal Aβ levels are at an increased risk of accelerated disease progression when concomitant cSVD is present.
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Affiliation(s)
- Whitney M Freeze
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, The Netherlands.,Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Heidi I L Jacobs
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, The Netherlands
| | - Ed H Gronenschild
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, The Netherlands
| | - Jacobus F A Jansen
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Saartje Burgmans
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, The Netherlands
| | - Pauline Aalten
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, The Netherlands
| | - Lies Clerx
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, The Netherlands
| | - Stephanie J Vos
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, The Netherlands
| | - Mark A van Buchem
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.,Institutes of Neurology and Healthcare Engineering, University College Lodon, London, UK
| | | | - Marcel M Verbeek
- Departments of Neurology and Laboratory Medicine, Radboud University Medical Center Nijmegen, Donders Institute for Brain, Cognition and Behaviour, and Radboud Alzheimer Center, Nijmegen, The Netherlands
| | - Marcel Olde Rikkert
- Department of Geriatric Medicine, Radboud University Medical Center Nijmegen, Donders Institute for Brain, Cognition and Behaviour, and Radboud UMC, Alzheimer Center, Nijmegen, The Netherlands
| | - Walter H Backes
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Frans R Verhey
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, The Netherlands
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18
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Tijms BM, Willemse EAJ, Zwan MD, Mulder SD, Visser PJ, van Berckel BNM, van der Flier WM, Scheltens P, Teunissen CE. Unbiased Approach to Counteract Upward Drift in Cerebrospinal Fluid Amyloid-β 1-42 Analysis Results. Clin Chem 2017; 64:576-585. [PMID: 29208658 DOI: 10.1373/clinchem.2017.281055] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 11/20/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Low cerebrospinal fluid (CSF) amyloid-β 1-42 (Aβ 1-42) concentrations indicate amyloid plaque accumulation in the brain, a pathological hallmark of Alzheimer disease (AD). Innotest assay values of Aβ 1-42 have gradually increased over the past 2 decades, which might lead to misclassification of AD when a single cutpoint for abnormality is used. We propose an unbiased approach to statistically correct for drift. METHODS We determined year-specific cutpoints with Gaussian mixture modeling, based on the cross-section of bimodal distributions of Aβ 1-42 concentrations in 4397 memory clinic patients. This allowed us to realign year-specific cutpoints as an unbiased method to remove drift from the data. Sensitivity and specificity to detect AD dementia were compared between corrected and uncorrected values. RESULTS Aβ 1-42 values increased 22 pg/mL annually, and this could not be explained by changes in cohort composition. Our approach removed time dependencies [β (SE) = 0.07 (0.59); P = 0.91]. Statistically correcting for drift improved the sensitivity to detect AD dementia to 0.90 (95% CI, 0.89-0.92) from at least 0.66 (95% CI, 0.64-0.69) based on uncorrected data. Specificity became lower (0.69; 95% CI, 0.67-0.70) vs at most 0.80 (95% CI, 0.79-0.82) for uncorrected data. CONCLUSIONS This approach may also be useful to standardize Aβ 1-42 CSF concentrations across different centers and/or platforms, and to optimize use of CSF biomarker data collected over a long period.
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Affiliation(s)
- Betty M Tijms
- Alzheimer Center and Department of Neurology, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands;
| | - Eline A J Willemse
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Marissa D Zwan
- Alzheimer Center and Department of Neurology, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Sandra D Mulder
- Alzheimer Center and Department of Neurology, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center and Department of Neurology, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands.,Department of Epidemiology and Biostatistics, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, VUmc, Amsterdam Neuroscience, Amsterdam, the Netherlands
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19
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Mathotaarachchi S, Pascoal TA, Shin M, Benedet AL, Kang MS, Beaudry T, Fonov VS, Gauthier S, Rosa-Neto P. Identifying incipient dementia individuals using machine learning and amyloid imaging. Neurobiol Aging 2017; 59:80-90. [DOI: 10.1016/j.neurobiolaging.2017.06.027] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 06/20/2017] [Accepted: 06/30/2017] [Indexed: 01/18/2023]
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20
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Caldwell JZK, Berg JL, Cummings JL, Banks SJ. Moderating effects of sex on the impact of diagnosis and amyloid positivity on verbal memory and hippocampal volume. ALZHEIMERS RESEARCH & THERAPY 2017; 9:72. [PMID: 28899422 PMCID: PMC5596932 DOI: 10.1186/s13195-017-0300-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 08/22/2017] [Indexed: 01/16/2023]
Abstract
Background Alzheimer’s disease (AD) impacts men and women differently, but the effect of sex on predementia stages is unclear. The objective of this study was to examine whether sex moderates the impact of florbetapir positron emission tomography (PET) amyloid positivity (A+) on verbal learning and memory performance and hippocampal volume (HV) in normal cognition (NC) and early mild cognitive impairment (eMCI). Methods Seven hundred forty-two participants with NC and participants with eMCI from the Alzheimer’s Disease Neuroimaging Initiative (second cohort [ADNI2] and Grand Opportunity Cohort [ADNI-GO]) were included. All had baseline florbetapir PET measured, and 526 had screening visit HV measured. Regression moderation models were used to examine whether A+ effects on Rey Auditory Verbal Learning Test learning and delayed recall and right and left HV (adjusted for total intracranial volume) were moderated by diagnosis and sex. Age, cognition at screening, education, and apolipoprotein E ε4 carrier status were controlled. Results Women with A+, but not those with florbetapir PET amyloid negative (A-),eMCI showed poorer learning. For women with NC, there was no relationship of A+ with learning. In contrast, A+ men trended toward poorer learning regardless of diagnosis. A similar trend was found for verbal delayed recall: Women with A+, but not A-, eMCI trended toward reduced delayed recall; no effects were observed for women with NC or for men. Hippocampal analyses indicated that women with A+, but not those with A−, eMCI, trended toward smaller right HV; no significant A+ effects were observed for women with NC. Men showed similar, though nonsignificant, patterns of smaller right HV in A+ eMCI, but not in men with A− eMCI or NC. No interactive effects of sex were noted for left HV. Conclusions Women with NC showed verbal learning and memory scores robust to A+, and women with A+ eMCI lost this advantage. In contrast, A+ impacted men’s scores less significantly or not at all, and comparably across those with NC and eMCI. Sex marginally moderated the relationship of A+ and diagnosis with right HV, such that women with NC showed no A+ effect and women with A+ eMCI lost that advantage in neural integrity; the pattern in men was less clear. These findings show that women with A+ eMCI (i.e., prodromal AD) have differential neural and cognitive decline, which has implications for considering sex in early detection of AD and development of therapeutics.
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Affiliation(s)
- Jessica Z K Caldwell
- Cleveland Clinic Lou Ruvo Center for Brain Health, 888 West Bonneville Avenue, Las Vegas, NV, 89106, USA.
| | - Jody-Lynn Berg
- Cleveland Clinic Lou Ruvo Center for Brain Health, 888 West Bonneville Avenue, Las Vegas, NV, 89106, USA
| | - Jeffrey L Cummings
- Cleveland Clinic Lou Ruvo Center for Brain Health, 888 West Bonneville Avenue, Las Vegas, NV, 89106, USA
| | - Sarah J Banks
- Cleveland Clinic Lou Ruvo Center for Brain Health, 888 West Bonneville Avenue, Las Vegas, NV, 89106, USA
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21
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Takemaru M, Kimura N, Abe Y, Goto M, Matsubara E. The evaluation of brain perfusion SPECT using an easy Z-score imaging system in the mild cognitive impairment subjects with brain amyloid-β deposition. Clin Neurol Neurosurg 2017; 160:111-115. [PMID: 28715708 DOI: 10.1016/j.clineuro.2017.06.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 05/13/2017] [Accepted: 06/25/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The analysis of 99mTc-ECD single-photon emission computed tomography (SPECT) images using the easy Z-score imaging system (eZIS) program is useful for the diagnosis of early AD in daily medical practice. However, it remains unclear whether eZIS analysis can identify the amnestic mild cognitive impairment (MCI) subjects with brain amyloid-β deposition. The aim of this study was to evaluate the usefulness of an eZIS analysis for predicting amnestic MCI subjects with brain amyloid β deposition. PATIENTS AND METHODS Twenty-three subjects with MCI (10 men and 13 women, mean age; 74.2 years) underwent brain perfusion SPECT and 11C-Pittsburgh Compound B positron emission tomography (PiB-PET). MCI subjects were divided into PiB-positive and PiB-negative subgroups. SPECT data was analyzed using the Specific Volume of interest Analysis of the eZIS program. Three indicators (severity, extent, and ratio) were calculated automatically and compared between the two subgroups. RESULTS Five of 12 (41.7%) subjects in the PiB-positive subgroup and three of 11 (27.3%) subjects in the PiB-negative subgroup showed the abnormal value for each indicator. The frequency of subjects with abnormal ratio values was significantly higher in the PiB-positive subgroup compared to the PiB-negative subgroup (p=0.02), whereas that of subjects with abnormal values in severity and extent did not differ among the two subgroups. In particular, all subjects in the PiB-negative subgroup showed normal ratio values. Moreover, the subjects with abnormal values on two indicators, including ratio, or on all three indicators, showed PiB-positive. CONCLUSION The analysis of brain perfusion SPECT using an eZIS program cannot identify the amnestic MCI subjects with brain amyloid-β deposition. However, abnormal three indicators or normal ratio values may be helpful SPECT findings for predicting the results of PiB-PET in the amnestic MCI subjects.
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Affiliation(s)
- Makoto Takemaru
- Department of Neurology, Oita University, Faculty of Medicine, Idaigaoka 1-1, Hasama, Yufu, Oita, 879-5593, Japan
| | - Noriyuki Kimura
- Department of Neurology, Oita University, Faculty of Medicine, Idaigaoka 1-1, Hasama, Yufu, Oita, 879-5593, Japan.
| | - Yoshitake Abe
- Department of Neurology, Oita University, Faculty of Medicine, Idaigaoka 1-1, Hasama, Yufu, Oita, 879-5593, Japan
| | - Megumi Goto
- Department of Neurology, Oita University, Faculty of Medicine, Idaigaoka 1-1, Hasama, Yufu, Oita, 879-5593, Japan
| | - Etsuro Matsubara
- Department of Neurology, Oita University, Faculty of Medicine, Idaigaoka 1-1, Hasama, Yufu, Oita, 879-5593, Japan
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22
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Bangen KJ, Clark AL, Edmonds EC, Evangelista ND, Werhane ML, Thomas KR, Locano LE, Tran M, Zlatar ZZ, Nation DA, Bondi MW, Delano-Wood L. Cerebral Blood Flow and Amyloid-β Interact to Affect Memory Performance in Cognitively Normal Older Adults. Front Aging Neurosci 2017. [PMID: 28642699 PMCID: PMC5463038 DOI: 10.3389/fnagi.2017.00181] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cerebral blood flow (CBF) alterations and amyloid-β (Aβ) accumulation have been independently linked to cognitive deficits in older adults at risk for dementia. Less is known about how CBF and Aβ may interact to affect cognition in cognitively normal older adults. Therefore, we examined potential statistical interactions between CBF and Aβ status in regions typically affected in Alzheimer's disease (AD) within a sample of older adults from the Alzheimer's Disease Neuroimaging Initiative (ADNI) study. Sixty-two cognitively normal participants (mean age = 72 years) underwent neuroimaging and memory testing. Arterial spin labeling magnetic resonance imaging was used to quantify CBF and florbetapir PET amyloid imaging was used to measure Aβ deposition. Aβ status (i.e., positivity versus negativity) was determined based on established cutoffs (Landau et al., 2013). The Rey Auditory Verbal Learning Test was used to assess memory. Linear regression models adjusted for age, education, and sex, demonstrated significant interactions between CBF and Aβ status on memory performance. Among Aβ positive older adults, there were significant negative associations between higher CBF in hippocampus, posterior cingulate, and precuneus and poorer memory performance. In contrast, among Aβ negative older adults, there were no significant associations between CBF and cognition. Our findings extend previous CBF studies of dementia risk by reporting interactions between Aβ status and CBF on memory performance in a sample of well-characterized, cognitively normal older adults. Results suggest that differential CBF-cognition associations can be identified in healthy, asymptomatic Aβ positive older adults relative to Aβ negative individuals. Associations between higherCBF and poorer memory among Aβ positive older adults may reflect a cellular and/or vascular compensatory response to pathologic processes whereby higher CBF is needed to maintain normal memory abilities. Findings indicate that CBF and its associations with cognition may have utility as a reliable marker of brain function early in the AD process when interventions are likely to be beneficial.
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Affiliation(s)
- Katherine J Bangen
- Research Service, VA San Diego Healthcare System, San DiegoCA, United States.,Department of Psychiatry, University of California, San Diego, La JollaCA, United States
| | - Alexandra L Clark
- San Diego State University, University of California, San Diego Joint Doctoral Program in Clinical Psychology, San DiegoCA, United States
| | - Emily C Edmonds
- Research Service, VA San Diego Healthcare System, San DiegoCA, United States.,Department of Psychiatry, University of California, San Diego, La JollaCA, United States
| | | | - Madeleine L Werhane
- San Diego State University, University of California, San Diego Joint Doctoral Program in Clinical Psychology, San DiegoCA, United States
| | - Kelsey R Thomas
- Research Service, VA San Diego Healthcare System, San DiegoCA, United States.,Psychology Service, VA San Diego Healthcare System, San DiegoCA, United States
| | - Lyzette E Locano
- Department of Psychology, San Diego State University, San DiegoCA, United States
| | - My Tran
- Department of Psychology, San Diego State University, San DiegoCA, United States
| | - Zvinka Z Zlatar
- Department of Psychiatry, University of California, San Diego, La JollaCA, United States
| | - Daniel A Nation
- Department of Psychology, University of Southern California, Los AngelesCA, United States
| | - Mark W Bondi
- Department of Psychiatry, University of California, San Diego, La JollaCA, United States.,Psychology Service, VA San Diego Healthcare System, San DiegoCA, United States
| | - Lisa Delano-Wood
- Research Service, VA San Diego Healthcare System, San DiegoCA, United States.,Department of Psychiatry, University of California, San Diego, La JollaCA, United States
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23
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Mak E, Gabel S, Mirette H, Su L, Williams GB, Waldman A, Wells K, Ritchie K, Ritchie C, O’Brien J. Structural neuroimaging in preclinical dementia: From microstructural deficits and grey matter atrophy to macroscale connectomic changes. Ageing Res Rev 2017; 35:250-264. [PMID: 27777039 DOI: 10.1016/j.arr.2016.10.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 08/26/2016] [Accepted: 10/19/2016] [Indexed: 12/18/2022]
Abstract
The last decade has witnessed a proliferation of neuroimaging studies characterising brain changes associated with Alzheimer's disease (AD), where both widespread atrophy and 'signature' brain regions have been implicated. In parallel, a prolonged latency period has been established in AD, with abnormal cerebral changes beginning many years before symptom onset. This raises the possibility of early therapeutic intervention, even before symptoms, when treatments could have the greatest effect on disease-course modification. Two important prerequisites of this endeavour are (1) accurate characterisation or risk stratification and (2) monitoring of progression using neuroimaging outcomes as a surrogate biomarker in those without symptoms but who will develop AD, here referred to as preclinical AD. Structural neuroimaging modalities have been used to identify brain changes related to risk factors for AD, such as familial genetic mutations, risk genes (for example apolipoprotein epsilon-4 allele), and/or family history. In this review, we summarise structural imaging findings in preclinical AD. Overall, the literature suggests early vulnerability in characteristic regions, such as the medial temporal lobe structures and the precuneus, as well as white matter tracts in the fornix, cingulum and corpus callosum. We conclude that while structural markers are promising, more research and validation studies are needed before future secondary prevention trials can adopt structural imaging biomarkers as either stratification or surrogate biomarkers.
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24
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Ben Bouallègue F, Mariano-Goulart D, Payoux P. Comparison of CSF markers and semi-quantitative amyloid PET in Alzheimer's disease diagnosis and in cognitive impairment prognosis using the ADNI-2 database. Alzheimers Res Ther 2017; 9:32. [PMID: 28441967 PMCID: PMC5405503 DOI: 10.1186/s13195-017-0260-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 03/24/2017] [Indexed: 11/13/2022]
Abstract
BACKGROUND The relative performance of semi-quantitative amyloid positron emission tomography (PET) and cerebrospinal fluid (CSF) markers in diagnosing Alzheimer's disease (AD) and predicting the cognitive evolution of patients with mild cognitive impairment (MCI) is still debated. METHODS Subjects from the Alzheimer's Disease Neuroimaging Initiative 2 with complete baseline cognitive assessment (Mini Mental State Examination, Clinical Dementia Rating [CDR] and Alzheimer's Disease Assessment Scale-Cognitive Subscale [ADAS-cog] scores), CSF collection (amyloid-β1-42 [Aβ], tau and phosphorylated tau) and 18F-florbetapir scans were included in our cross-sectional cohort. Among these, patients with MCI or substantial memory complaints constituted our longitudinal cohort and were followed for 30 ± 16 months. PET amyloid deposition was quantified using relative retention indices (standardised uptake value ratio [SUVr]) with respect to pontine, cerebellar and composite reference regions. Diagnostic and prognostic performance based on PET and CSF was evaluated using ROC analysis, multivariate linear regression and survival analysis with the Cox proportional hazards model. RESULTS The cross-sectional study included 677 participants and revealed that pontine and composite SUVr values were better classifiers (AUC 0.88, diagnostic accuracy 85%) than CSF markers (AUC 0.83 and 0.85, accuracy 80% and 75%, for Aβ and tau, respectively). SUVr was a strong independent determinant of cognition in multivariate regression, whereas Aβ was not; tau was also a determinant, but to a lesser degree. Among the 396 patients from the longitudinal study, 82 (21%) converted to AD within 22 ± 13 months. Optimal SUVr thresholds to differentiate AD converters were quite similar to those of the cross-sectional study. Composite SUVr was the best AD classifier (AUC 0.86, sensitivity 88%, specificity 81%). In multivariate regression, baseline cognition (CDR and ADAS-cog) was the main predictor of subsequent cognitive decline. Pontine and composite SUVr were moderate but independent predictors of final status and CDR/ADAS-cog progression rate, whereas baseline CSF markers had a marginal influence. The adjusted HRs for AD conversion were 3.8 (p = 0.01) for PET profile, 1.2 (p = ns) for Aβ profile and 1.8 (p = 0.03) for tau profile. CONCLUSIONS Semi-quantitative amyloid PET appears more powerful than CSF markers for AD grading and MCI prognosis in terms of cognitive decline and AD conversion.
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Affiliation(s)
- Fayçal Ben Bouallègue
- Toulouse NeuroImaging Centre (ToNIC), Université de Toulouse, Inserm/UPS, Toulouse, France
- Nuclear Medicine Department, Purpan University Hospital, Toulouse, France
- Nuclear Medicine Department, Lapeyronie University Hospital, Montpellier, France
| | | | - Pierre Payoux
- Toulouse NeuroImaging Centre (ToNIC), Université de Toulouse, Inserm/UPS, Toulouse, France
- Nuclear Medicine Department, Purpan University Hospital, Toulouse, France
| | - the Alzheimer’s Disease Neuroimaging Initiative (ADNI)
- Toulouse NeuroImaging Centre (ToNIC), Université de Toulouse, Inserm/UPS, Toulouse, France
- Nuclear Medicine Department, Purpan University Hospital, Toulouse, France
- Nuclear Medicine Department, Lapeyronie University Hospital, Montpellier, France
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25
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Chiotis K, Saint-Aubert L, Boccardi M, Gietl A, Picco A, Varrone A, Garibotto V, Herholz K, Nobili F, Nordberg A, Frisoni GB, Winblad B, Jack CR. Clinical validity of increased cortical uptake of amyloid ligands on PET as a biomarker for Alzheimer's disease in the context of a structured 5-phase development framework. Neurobiol Aging 2017; 52:214-227. [DOI: 10.1016/j.neurobiolaging.2016.07.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 06/10/2016] [Accepted: 07/06/2016] [Indexed: 12/31/2022]
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26
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Abe Y, Kimura N, Takahashi R, Gotou M, Mizukami K, Uchida H, Matsubara E. Relationship between cytokine levels in the cerebrospinal fluid and 11C-Pittsburgh compound B retention in patients with mild cognitive impairment. Geriatr Gerontol Int 2017; 17:1907-1913. [PMID: 28261965 DOI: 10.1111/ggi.12991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 11/01/2016] [Accepted: 11/22/2016] [Indexed: 01/05/2023]
Abstract
AIM In the present study, we examined the relationship between cytokine levels in the cerebrospinal fluid (CSF) and 11 C-Pittsburgh compound B (PiB) retention in patients with mild cognitive impairment. METHODS A total of 33 participants (12 men and 21 women; mean age 76.5 years) with mild cognitive impairment underwent neuropsychological assessments, PiB positron emission tomography and analysis of cytokine levels in the CSF. The CSF levels of 48 cytokines and growth factors were measured using multiplex immunoassays. PiB retention was assessed based on a standardized uptake value ratio. Mild cognitive impairment participants were classified as PiB-positive and PiB-negative, with a cut-off level of 1.4. We compared the CSF cytokine levels and Alzheimer's disease biomarkers, including β-amyloid 1-42, total tau and tau phosphorylated at threonine 181, between the two subgroups, and evaluated the correlation between PiB retention or CSF Alzheimer's disease biomarkers and CSF cytokine levels. RESULTS Cytokine levels in the CSF did not differ between the two subgroups. Macrophage inflammatory protein-1β levels in the CSF significantly correlated with PiB retention only in the PiB-positive subgroup, whereas stem cell growth factor-β levels significantly correlated with PiB retention in the PiB-negative subgroup. Furthermore, stem cell growth factor-β levels significantly correlated with total tau and tau phosphorylated at threonine 181 levels in only the PiB-negative subgroup. CONCLUSION The present findings suggest that macrophage inflammatory protein-1β and stem cell growth factor-β are associated with chronic inflammatory processes accompanied by amyloid deposition or AD pathophysiology. Geriatr Gerontol Int 2017; 17: 1907-1913.
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Affiliation(s)
- Yoshitake Abe
- Department of Neurology, Oita University, Faculty of Medicine, Oita, Japan
| | - Noriyuki Kimura
- Department of Neurology, Oita University, Faculty of Medicine, Oita, Japan
| | - Ryuichi Takahashi
- Department of Neurology, Oita University, Faculty of Medicine, Oita, Japan.,Department of Neurology, Hyogo Prefectural Rehabilitation Hospital, Hyougo, Japan
| | - Megumi Gotou
- Department of Neurology, Oita University, Faculty of Medicine, Oita, Japan
| | - Ken Mizukami
- Department of Neurology, Oita University, Faculty of Medicine, Oita, Japan
| | - Hirotatsu Uchida
- Department of Neurology, Oita University, Faculty of Medicine, Oita, Japan
| | - Etsuro Matsubara
- Department of Neurology, Oita University, Faculty of Medicine, Oita, Japan
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27
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Safety of disclosing amyloid status in cognitively normal older adults. Alzheimers Dement 2017; 13:1024-1030. [PMID: 28263740 DOI: 10.1016/j.jalz.2017.01.022] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 01/24/2017] [Accepted: 01/26/2017] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Disclosing amyloid status to cognitively normal individuals remains controversial given our lack of understanding the test's clinical significance and unknown psychological risk. METHODS We assessed the effect of amyloid status disclosure on anxiety and depression before disclosure, at disclosure, and 6 weeks and 6 months postdisclosure and test-related distress after disclosure. RESULTS Clinicians disclosed amyloid status to 97 cognitively normal older adults (27 had elevated cerebral amyloid). There was no difference in depressive symptoms across groups over time. There was a significant group by time interaction in anxiety, although post hoc analyses revealed no group differences at any time point, suggesting a minimal nonsustained increase in anxiety symptoms immediately postdisclosure in the elevated group. Slight but measureable increases in test-related distress were present after disclosure and were related to greater baseline levels of anxiety and depression. DISCUSSION Disclosing amyloid imaging results to cognitively normal adults in the clinical research setting with pre- and postdisclosure counseling has a low risk of psychological harm.
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28
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Machulda MM, Hagen CE, Wiste HJ, Mielke MM, Knopman DS, Roberts RO, Vemuri P, Lowe VJ, Jack CR, Petersen RC. [Formula: see text]Practice effects and longitudinal cognitive change in clinically normal older adults differ by Alzheimer imaging biomarker status. Clin Neuropsychol 2017; 31:99-117. [PMID: 27724156 PMCID: PMC5408356 DOI: 10.1080/13854046.2016.1241303] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 09/18/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of this study was to examine practice effects and longitudinal cognitive change in 190 clinically normal elderly classified according to a two-feature biomarker model for Alzheimer's disease. METHODS All participants completed neuropsychological testing, MRI, FDG-PET, and PiB-PET at their baseline evaluation. We divided participants into four groups based on neuroimaging measures of amyloid (A+ or A-) and neurodegeneration (N+ or N-) and reexamined cognition at 15- and 30-month intervals. RESULTS The A-N- group showed significant improvements in the memory and global scores. The A+N- group also showed significant improvements in the memory and global scores as well as attention. The A-N+ group showed a significant decline in attention at 30 months. The A+N+ group showed significant improvements in memory and the global score at 15 months followed by a significant decline in the global score at 30 months. CONCLUSION Amyloidosis in the absence of neurodegeneration did not have an adverse impact on practice effects or the 30-month cognitive trajectories. In contrast, participants with neurodegeneration (either A-N+ or A+N+) had worse performance at the 30-month follow-up. Our results show that neurodegeneration has a more deleterious effect on cognition than amyloidosis in clinically normal individuals.
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Affiliation(s)
- Mary M. Machulda
- Division of Neurocognitive Disorders, Department of Psychiatry and Psychology
| | - Clint E. Hagen
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research
| | - Heather J. Wiste
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research
| | - Michelle M. Mielke
- Division of Epidemiology, Department of Health Sciences Research
- Department of Neurology, College of Medicine, Mayo Clinic, 200 1 Street SW, Rochester, MN 55905
| | - David S. Knopman
- Department of Neurology, College of Medicine, Mayo Clinic, 200 1 Street SW, Rochester, MN 55905
| | - Rosebud O. Roberts
- Division of Epidemiology, Department of Health Sciences Research
- Department of Neurology, College of Medicine, Mayo Clinic, 200 1 Street SW, Rochester, MN 55905
| | - Prashanthi Vemuri
- Department of Radiology, College of Medicine, Mayo Clinic, 200 1 Street SW, Rochester, MN 55905
| | - Val J. Lowe
- Department of Radiology, College of Medicine, Mayo Clinic, 200 1 Street SW, Rochester, MN 55905
| | - Clifford R. Jack
- Department of Radiology, College of Medicine, Mayo Clinic, 200 1 Street SW, Rochester, MN 55905
| | - Ronald C. Petersen
- Department of Neurology, College of Medicine, Mayo Clinic, 200 1 Street SW, Rochester, MN 55905
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29
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Ruthirakuhan M, Herrmann N, Suridjan I, Abraham EH, Farber I, Lanctôt KL. Beyond immunotherapy: new approaches for disease modifying treatments for early Alzheimer’s disease. Expert Opin Pharmacother 2016; 17:2417-2429. [DOI: 10.1080/14656566.2016.1258060] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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30
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Araque Caballero MÁ, Klöppel S, Dichgans M, Ewers M. Spatial Patterns of Longitudinal Gray Matter Change as Predictors of Concurrent Cognitive Decline in Amyloid Positive Healthy Subjects. J Alzheimers Dis 2016; 55:343-358. [DOI: 10.3233/jad-160327] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Miguel Ángel Araque Caballero
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Stefan Klöppel
- Freiburg Brain Imaging, Departments of Neurology and Psychiatry, University Medical Center Freiburg, Freiburg, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
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31
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Baker JE, Lim YY, Pietrzak RH, Hassenstab J, Snyder PJ, Masters CL, Maruff P. Cognitive impairment and decline in cognitively normal older adults with high amyloid-β: A meta-analysis. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2016; 6:108-121. [PMID: 28239636 PMCID: PMC5315443 DOI: 10.1016/j.dadm.2016.09.002] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This meta-analysis aimed to characterize the nature and magnitude of amyloid (Aβ)-related cognitive impairment and decline in cognitively normal (CN) older individuals. METHOD MEDLINE Ovid was searched from 2012 to June 2016 for studies reporting relationships between cerebrospinal fluid or positron emission tomography (PET) Aβ levels and cognitive impairment (cross-sectional) and decline (longitudinal) in CN older adults. Neuropsychological data were classified into domains of episodic memory, executive function, working memory, processing speed, visuospatial function, semantic memory, and global cognition. Type of Aβ measure, how Aβ burden was analyzed, inclusion of control variables, and clinical criteria used to exclude participants, were considered as moderators. Random-effects models were used for analyses with effect sizes expressed as Cohen's d. RESULTS A total of 38 studies met inclusion criteria contributing 30 cross-sectional (N = 5005) and 14 longitudinal (N = 2584) samples. Aβ-related cognitive impairment was observed for global cognition (d = 0.32), visuospatial function (d = 0.25), processing speed (d = 0.18), episodic memory, and executive function (both d's = 0.15), with decline observed for global cognition (d = 0.30), semantic memory (d = 0.28), visuospatial function (d = 0.25), and episodic memory (d = 0.24). Aβ-related impairment was moderated by age, amyloid measure, type of analysis, and inclusion of control variables and decline moderated by amyloid measure, type of analysis, inclusion of control variables, and exclusion criteria used. DISCUSSION CN older adults with high Aβ show a small general cognitive impairment and small to moderate decline in episodic memory, visuospatial function, semantic memory, and global cognition.
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Affiliation(s)
- Jenalle E. Baker
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
- CRC for Mental Health, Carlton South, Victoria, Australia
| | - Yen Ying Lim
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
- Cogstate Ltd., Melbourne, Victoria, Australia
| | - Robert H. Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Peter J. Snyder
- Department of Neurology, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Neurology, Rhode Island Hospital & Alpert Medical School of Brown University, Providence, RI, USA
| | - Colin L. Masters
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Paul Maruff
- The Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
- CRC for Mental Health, Carlton South, Victoria, Australia
- Cogstate Ltd., Melbourne, Victoria, Australia
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32
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Knopman DS, Jack CR, Lundt ES, Weigand SD, Vemuri P, Lowe VJ, Kantarci K, Gunter JL, Senjem ML, Mielke MM, Machulda MM, Roberts RO, Boeve BF, Jones DT, Petersen RC. Evolution of neurodegeneration-imaging biomarkers from clinically normal to dementia in the Alzheimer disease spectrum. Neurobiol Aging 2016; 46:32-42. [PMID: 27460147 PMCID: PMC5018437 DOI: 10.1016/j.neurobiolaging.2016.06.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/20/2016] [Accepted: 06/08/2016] [Indexed: 12/11/2022]
Abstract
The availability of antemortem biomarkers for Alzheimer's disease (AD) enables monitoring the evolution of neurodegenerative processes in real time. Pittsburgh compound B (PIB) positron emission tomography (PET) was used to select participants in the Mayo Clinic Study of Aging and the Mayo Alzheimer's Disease Research Center with elevated β-amyloid, designated as "A+," and hippocampal volume and (18)fluorodeoxyglucose (FDG) positron emission tomography were used to characterize participants as having evidence of neurodegeneration ("N+") at the baseline evaluation. There were 145 clinically normal (CN) A+ individuals, 62 persons with mild cognitive impairment (MCI) who were A+ and 20 with A+ AD dementia. Over a period of 1-6 years, MCI A+N+ individuals showed declines in medial temporal, lateral temporal, lateral parietal, and to a lesser extent, medial parietal regions for both FDG standardized uptake value ratio and gray matter volume that exceeded declines seen in the CN A+N+ group. The AD dementia group showed declines in the same regions on FDG standardized uptake value ratio and gray matter volume with rates that exceeded that in MCI A+N+. Expansion of regional involvement and faster rate of neurodegeneration characterizes progression in the AD pathway.
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Affiliation(s)
- David S Knopman
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA.
| | - Clifford R Jack
- Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Emily S Lundt
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Stephen D Weigand
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Prashanthi Vemuri
- Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Val J Lowe
- Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Kejal Kantarci
- Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Jeffrey L Gunter
- Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Information Technology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Matthew L Senjem
- Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Information Technology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Michelle M Mielke
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Mary M Machulda
- Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Psychiatry, Division of Psychology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Rosebud O Roberts
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA
| | - David T Jones
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA
| | - Ronald C Petersen
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA; Mayo Clinic Alzheimer's Disease Research Center, Mayo Clinic and Foundation, Rochester, MN, USA; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN, USA
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Longitudinal brain structural changes in preclinical Alzheimer's disease. Alzheimers Dement 2016; 13:499-509. [DOI: 10.1016/j.jalz.2016.08.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 08/22/2016] [Accepted: 08/23/2016] [Indexed: 01/30/2023]
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Alzheimer's disease--subcortical vascular disease spectrum in a hospital-based setting: Overview of results from the Gothenburg MCI and dementia studies. J Cereb Blood Flow Metab 2016; 36. [PMID: 26219595 PMCID: PMC4702291 DOI: 10.1038/jcbfm.2015.148] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The ability to discriminate between Alzheimer's disease (AD), subcortical vascular disease, and other cognitive disorders is crucial for diagnostic purposes and clinical trial outcomes. Patients with primarily subcortical vascular disease are unlikely to benefit from treatments targeting the AD pathogenic mechanisms and vice versa. The Gothenburg mild cognitive impairment (MCI) and dementia studies are prospective, observational, single-center cohort studies suitable for both cross-sectional and longitudinal analysis that outline the cognitive profiles and biomarker characteristics of patients with AD, subcortical vascular disease, and other cognitive disorders. The studies, the first of which started in 1987, comprise inpatients with manifest dementia and patients seeking care for cognitive disorders at an outpatient memory clinic. This article gives an overview of the major published papers (neuropsychological, imaging/physiology, and neurochemical) of the studies including the ongoing Gothenburg MCI study. The main findings suggest that subcortical vascular disease with or without dementia exhibit a characteristic neuropsychological pattern of mental slowness and executive dysfunction and neurochemical deviations typical of white matter changes and disturbed blood-brain barrier function. Our findings may contribute to better healthcare for this underrecognized group of patients. The Gothenburg MCI study has also published papers on multimodal prediction of dementia, and cognitive reserve.
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Jagust W. Is amyloid-β harmful to the brain? Insights from human imaging studies. Brain 2015; 139:23-30. [PMID: 26614753 DOI: 10.1093/brain/awv326] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 09/22/2015] [Indexed: 11/14/2022] Open
Abstract
Although the amyloid-β protein associated with the Alzheimer's disease plaque has been detectable in living people for over a decade, its importance in the pathogenesis of Alzheimer's disease is still debated. The frequent presence of amyloid-β in the brains of cognitively healthy older people has been interpreted as evidence against a causative role. If amyloid-β is crucial to the development of Alzheimer's disease, it should be associated with other Alzheimer's disease-like neurological changes. This review examines whether amyloid-β is associated with other biomarkers indicative of early Alzheimer's disease in normal older people. The preponderance of evidence links amyloid-β to functional change, progressive brain atrophy, and cognitive decline. Individuals at greatest risk of decline seem to be those with evidence of both amyloid-β and findings suggestive of neurodegeneration. The crucial question is thus how amyloid-β is related to brain degeneration and how these two processes interact to cause cognitive decline and dementia.
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Affiliation(s)
- William Jagust
- School of Public Health and Helen Wills Neuroscience Institute, University of California, Berkeley, USA
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36
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Araque Caballero MÁ, Brendel M, Delker A, Ren J, Rominger A, Bartenstein P, Dichgans M, Weiner MW, Ewers M. Mapping 3-year changes in gray matter and metabolism in Aβ-positive nondemented subjects. Neurobiol Aging 2015; 36:2913-2924. [PMID: 26476234 PMCID: PMC5862042 DOI: 10.1016/j.neurobiolaging.2015.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 08/07/2015] [Accepted: 08/08/2015] [Indexed: 01/13/2023]
Abstract
Gray matter (GM) atrophy and brain glucose hypometabolism are already detected in the predementia stages of Alzheimer's disease (AD), but the regional and longitudinal associations between the two are not well understood. Here, we analyzed the patterns of longitudinal atrophy (magnetic resonance imaging [MRI]) and (18)F-Fluorodeoxyglucose-positron emission tomography ([18F]FDG-PET) metabolism decline in 40 cognitively healthy control (HC) and 52 mildly impaired (mild cognitive impairment [MCI]) subjects during 3 years. Based on cerebrospinal fluid and brain amyloid-PET, the subjects were divided into amyloid-beta (Aβ)- and Aβ+ subgroups. In voxel-based and region of interest analyses, we compared the 3-year rates of change in GM and glucose metabolism between Aβ-subgroups, within each diagnostic group. In joint-independent component analyses, we assessed the patterns of covariation between longitudinal change in GM volume and glucose metabolism. MCI-Aβ+ showed faster atrophy than MCI-Aβ- within the temporal, medial temporal, and medial parietal lobes. HC-Aβ+ showed faster atrophy within the precuneus than HC-Aβ-. For FDG-PET metabolism, MCI-Aβ+ exhibited faster decline than MCI-Aβ- in temporoparietal regions, whereas no differences between HC subgroups were observed. Joint-independent component analysis showed that accelerated atrophy and metabolism decline correlated across distant brain regions for MCI-Aβ+. In conclusion, abnormally increased levels of Aβ in nondemented subjects were associated with accelerated decline in both GM and glucose metabolism, where both types of neurodegeneration progress in spatially divergent patterns.
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Affiliation(s)
- Miguel Ángel Araque Caballero
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilian-University (LMU), Munich, Germany.
| | - Matthias Brendel
- Department of Nuclear Medicine, Klinikum der Universität München, Ludwig-Maximilian-University (LMU), Munich, Germany
| | - Andreas Delker
- Department of Nuclear Medicine, Klinikum der Universität München, Ludwig-Maximilian-University (LMU), Munich, Germany
| | - Jinyi Ren
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilian-University (LMU), Munich, Germany
| | - Axel Rominger
- Department of Nuclear Medicine, Klinikum der Universität München, Ludwig-Maximilian-University (LMU), Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, Klinikum der Universität München, Ludwig-Maximilian-University (LMU), Munich, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilian-University (LMU), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Michael W Weiner
- Department of Radiology, VA Medical Center, Center for Imaging of Neurodegenerative Diseases, University of California, SanFrancisco, CA, USA
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilian-University (LMU), Munich, Germany
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Patterson BW, Elbert DL, Mawuenyega KG, Kasten T, Ovod V, Ma S, Xiong C, Chott R, Yarasheski K, Sigurdson W, Zhang L, Goate A, Benzinger T, Morris JC, Holtzman D, Bateman RJ. Age and amyloid effects on human central nervous system amyloid-beta kinetics. Ann Neurol 2015; 78:439-53. [PMID: 26040676 PMCID: PMC4546566 DOI: 10.1002/ana.24454] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 05/20/2015] [Accepted: 05/31/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Age is the single greatest risk factor for Alzheimer's disease (AD), with the incidence doubling every 5 years after age 65. However, our understanding of the mechanistic relationship between increasing age and the risk for AD is currently limited. We therefore sought to determine the relationship between age, amyloidosis, and amyloid-beta (Aβ) kinetics in the central nervous system (CNS) of humans. METHODS Aβ kinetics were analyzed in 112 participants and compared to the ages of participants and the amount of amyloid deposition. RESULTS We found a highly significant correlation between increasing age and slowed Aβ turnover rates (2.5-fold longer half-life over five decades of age). In addition, we found independent effects on Aβ42 kinetics specifically in participants with amyloid deposition. Amyloidosis was associated with a higher (>50%) irreversible loss of soluble Aβ42 and a 10-fold higher Aβ42 reversible exchange rate. INTERPRETATION These findings reveal a mechanistic link between human aging and the risk of amyloidosis, which may be owing to a dramatic slowing of Aβ turnover, increasing the likelihood of protein misfolding that leads to deposition. Alterations in Aβ kinetics associated with aging and amyloidosis suggest opportunities for diagnostic and therapeutic strategies. More generally, this study provides an example of how changes in protein turnover kinetics can be used to detect physiological and pathophysiological changes and may be applicable to other proteinopathies.
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Affiliation(s)
- Bruce W Patterson
- Department of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Donald L Elbert
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO
| | - Kwasi G Mawuenyega
- Department of Neurology, Washington University in St. Louis, St. Louis, MO
| | - Tom Kasten
- Department of Neurology, Washington University in St. Louis, St. Louis, MO
| | - Vitaliy Ovod
- Department of Neurology, Washington University in St. Louis, St. Louis, MO
| | - Shengmei Ma
- Department of Biostatistics, Washington University in St. Louis, St. Louis, MO
| | - Chengjie Xiong
- Department of Biostatistics, Washington University in St. Louis, St. Louis, MO
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University in St. Louis, St. Louis, MO
| | - Robert Chott
- Department of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Kevin Yarasheski
- Department of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Wendy Sigurdson
- Department of Neurology, Washington University in St. Louis, St. Louis, MO
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University in St. Louis, St. Louis, MO
| | - Lily Zhang
- Hope Center for Neurological Disorders, Department of Neurology, Washington University in St. Louis, St. Louis, MO
| | - Alison Goate
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO
- Hope Center for Neurological Disorders, Department of Neurology, Washington University in St. Louis, St. Louis, MO
| | - Tammie Benzinger
- Department of Radiology, Washington University in St. Louis, St. Louis, MO
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University in St. Louis, St. Louis, MO
| | - John C Morris
- Department of Neurology, Washington University in St. Louis, St. Louis, MO
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University in St. Louis, St. Louis, MO
| | - David Holtzman
- Department of Neurology, Washington University in St. Louis, St. Louis, MO
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University in St. Louis, St. Louis, MO
- Hope Center for Neurological Disorders, Department of Neurology, Washington University in St. Louis, St. Louis, MO
| | - Randall J Bateman
- Department of Neurology, Washington University in St. Louis, St. Louis, MO
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University in St. Louis, St. Louis, MO
- Hope Center for Neurological Disorders, Department of Neurology, Washington University in St. Louis, St. Louis, MO
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Wang F, Gordon BA, Ryman DC, Ma S, Xiong C, Hassenstab J, Goate A, Fagan AM, Cairns NJ, Marcus DS, McDade E, Ringman JM, Graff-Radford NR, Ghetti B, Farlow MR, Sperling R, Salloway S, Schofield PR, Masters CL, Martins RN, Rossor MN, Jucker M, Danek A, Förster S, Lane CAS, Morris JC, Benzinger TLS, Bateman RJ. Cerebral amyloidosis associated with cognitive decline in autosomal dominant Alzheimer disease. Neurology 2015; 85:790-8. [PMID: 26245925 PMCID: PMC4553024 DOI: 10.1212/wnl.0000000000001903] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 04/23/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the associations of cerebral amyloidosis with concurrent cognitive performance and with longitudinal cognitive decline in asymptomatic and symptomatic stages of autosomal dominant Alzheimer disease (ADAD). METHODS Two hundred sixty-three participants enrolled in the Dominantly Inherited Alzheimer Network observational study underwent neuropsychological evaluation as well as PET scans with Pittsburgh compound B. One hundred twenty-one participants completed at least 1 follow-up neuropsychological evaluation. Four composite cognitive measures representing global cognition, episodic memory, language, and working memory were generated using z scores from a battery of 13 standard neuropsychological tests. General linear mixed-effects models were used to investigate the relationship between baseline cerebral amyloidosis and baseline cognitive performance and whether baseline cerebral amyloidosis predicts cognitive change over time (mean follow-up 2.32 years ± 0.92, range 0.89-4.19) after controlling for estimated years from expected symptom onset, APOE ε4 allelic status, and education. RESULTS In asymptomatic mutation carriers, amyloid burden was not associated with baseline cognitive functioning but was significantly predictive of longitudinal decline in episodic memory. In symptomatic mutation carriers, cerebral amyloidosis was correlated with worse baseline performance in multiple cognitive composites and predicted greater decline over time in global cognition, working memory, and Mini-Mental State Examination. CONCLUSIONS Cerebral amyloidosis predicts longitudinal episodic memory decline in presymptomatic ADAD and multidomain cognitive decline in symptomatic ADAD. These findings imply that amyloidosis in the brain is an indicator of early cognitive decline and provides a useful outcome measure for early assessment and prevention treatment trials.
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Affiliation(s)
- Fen Wang
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Brian A Gordon
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Davis C Ryman
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Shengmei Ma
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Chengjie Xiong
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Jason Hassenstab
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Alison Goate
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Anne M Fagan
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Nigel J Cairns
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Daniel S Marcus
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Eric McDade
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - John M Ringman
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Neill R Graff-Radford
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Bernardino Ghetti
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Martin R Farlow
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Reisa Sperling
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Steve Salloway
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Peter R Schofield
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Colin L Masters
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Ralph N Martins
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Martin N Rossor
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Mathias Jucker
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Adrian Danek
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Stefan Förster
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Christopher A S Lane
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - John C Morris
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Tammie L S Benzinger
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China.
| | - Randall J Bateman
- From the Departments of Neurology (F.W., D.C.R., S.M., A.M.F., N.J.C., J.C.M., R.J.B.), Radiology (B.A.G., D.S.M., T.L.S.B.), Biostatistics (C.X.), Psychology (J.H.), Neurological Surgery (T.L.S.B.), and Psychiatry (A.G.), Washington University School of Medicine, Saint Louis, MO; Department of Neurology (E.M.), University of Pittsburgh, PA; Mary S. Easton Center for Alzheimer's Disease Research at UCLA (J.M.R.), Los Angeles, CA; Department of Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; Department of Pathology and Laboratory Medicine (B.G.) and Department of Neurology (M.R.F.), Indiana University School of Medicine, Indianapolis; Center for Alzheimer Research and Treatment (R.S.), Brigham and Women's Hospital and Massachusetts General Hospital, Boston, MA; Department of Neurology (S.S.), Butler Hospital and Warren Alpert Medical School, Brown University, Providence, RI; Neuroscience Research Australia (P.R.S.) and University of New South Wales, Sydney, Australia; Mental Health Research Institute (C.L.M.), University of Melbourne, Parkville, Australia; Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Perth, Australia; Dementia Research Centre (M.N.R., C.A.S.L.), UCL Institute of Neurology, London, UK; German Center for Neurodegenerative Diseases (M.J.) and Hertie Institute for Clinical Brain Research, Tübingen, Germany; Neurologische Klinik Ludwig-Maximilians-Universität Munich (A.D.) and German Center for Neurodegenerative Diseases (S.F.), Klinik und Poliklinik für Nuklearmedizin & TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and Department of Neurology (F.W.), Xuan Wu Hospital, Capital Medical University, Beijing, China
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Alzheimer Disease Cerebrospinal Fluid Biomarkers Moderate Baseline Differences and Predict Longitudinal Change in Attentional Control and Episodic Memory Composites in the Adult Children Study. J Int Neuropsychol Soc 2015; 21:573-83. [PMID: 26416094 PMCID: PMC4610253 DOI: 10.1017/s1355617715000776] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Cognitive measures that are sensitive to biological markers of Alzheimer disease (AD) pathology are needed to (a) facilitate preclinical staging, (b) identify individuals who are at the highest risk for developing clinical symptoms, and (c) serve as endpoints for evaluating the efficacy of interventions. The present study assesses the utility of two cognitive composite scores of attentional control and episodic memory as markers for preclinical AD pathology in a group of cognitively normal older adults (N = 238), as part of the Adult Children Study. All participants were given a baseline cognitive assessment and follow-up assessments every 3 years over an 8-year period, as well as a lumbar puncture within 2 years of the initial assessment to collect cerebrospinal fluid (CSF) and amyloid tracer Pittsburgh compound-B scan for amyloid imaging. Results indicated that attentional control was correlated with levels of Aβ42 at the initial assessment whereas episodic memory was not. Longitudinally, individuals with high CSF tau exhibited a decline in both attention and episodic memory over the course of the study. These results indicate that measures of attentional control and episodic memory can be used to evaluate cognitive decline in preclinical AD and provide support that CSF tau may be a key mechanism driving longitudinal cognitive change.
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Daianu M, Jahanshad N, Nir TM, Jack CR, Weiner MW, Bernstein MA, Thompson PM. Rich club analysis in the Alzheimer's disease connectome reveals a relatively undisturbed structural core network. Hum Brain Mapp 2015; 36:3087-103. [PMID: 26037224 PMCID: PMC4504816 DOI: 10.1002/hbm.22830] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 02/04/2015] [Accepted: 04/21/2015] [Indexed: 11/11/2022] Open
Abstract
Diffusion imaging can assess the white matter connections within the brain, revealing how neural pathways break down in Alzheimer's disease (AD). We analyzed 3-Tesla whole-brain diffusion-weighted images from 202 participants scanned by the Alzheimer's Disease Neuroimaging Initiative-50 healthy controls, 110 with mild cognitive impairment (MCI) and 42 AD patients. From whole-brain tractography, we reconstructed structural brain connectivity networks to map connections between cortical regions. We tested whether AD disrupts the "rich club" - a network property where high-degree network nodes are more interconnected than expected by chance. We calculated the rich club properties at a range of degree thresholds, as well as other network topology measures including global degree, clustering coefficient, path length, and efficiency. Network disruptions predominated in the low-degree regions of the connectome in patients, relative to controls. The other metrics also showed alterations, suggesting a distinctive pattern of disruption in AD, less pronounced in MCI, targeting global brain connectivity, and focusing on more remotely connected nodes rather than the central core of the network. AD involves severely reduced structural connectivity; our step-wise rich club coefficients analyze points to disruptions predominantly in the peripheral network components; other modalities of data are needed to know if this indicates impaired communication among non rich club regions. The highly connected core was relatively preserved, offering new evidence on the neural basis of progressive risk for cognitive decline.
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Affiliation(s)
- Madelaine Daianu
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, California
| | - Neda Jahanshad
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, California
| | - Talia M Nir
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, California
| | | | - Michael W Weiner
- Department of Radiology, Medicine, and Psychiatry, University of California San Francisco, California
- Department of Veterans Affairs Medical Center, San Francisco, California
| | | | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging & Informatics, University of Southern California, Marina del Rey, California
- Departments of Neurology, Psychiatry, Radiology, Engineering, Pediatrics, and Ophthalmology, University of Southern California, Los Angeles, California
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Gu Y, Razlighi QR, Zahodne LB, Janicki SC, Ichise M, Manly JJ, Devanand DP, Brickman AM, Schupf N, Mayeux R, Stern Y. Brain Amyloid Deposition and Longitudinal Cognitive Decline in Nondemented Older Subjects: Results from a Multi-Ethnic Population. PLoS One 2015. [PMID: 26221954 PMCID: PMC4519341 DOI: 10.1371/journal.pone.0123743] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective We aimed to whether the abnormally high amyloid-β (Aβ) level in the brain among apparently healthy elders is related with subtle cognitive deficits and/or accelerated cognitive decline. Methods A total of 116 dementia-free participants (mean age 84.5 years) of the Washington Heights Inwood Columbia Aging Project completed 18F-Florbetaben PET imaging. Positive or negative cerebral Aβ deposition was assessed visually. Quantitative cerebral Aβ burden was calculated as the standardized uptake value ratio in pre-established regions of interest using cerebellar cortex as the reference region. Cognition was determined using a neuropsychological battery and selected tests scores were combined into four composite scores (memory, language, executive/speed, and visuospatial) using exploratory factor analysis. We examined the relationship between cerebral Aβ level and longitudinal cognition change up to 20 years before the PET scan using latent growth curve models, controlling for age, education, ethnicity, and Apolipoprotein E (APOE) genotype. Results Positive reading of Aβ was found in 41 of 116 (35%) individuals. Cognitive scores at scan time was not related with Aβ. All cognitive scores declined over time. Aβ positive reading (B = -0.034, p = 0.02) and higher Aβ burden in temporal region (B = -0.080, p = 0.02) were associated with faster decline in executive/speed. Stratified analyses showed that higher Aβ deposition was associated with faster longitudinal declines in mean cognition, language, and executive/speed in African-Americans or in APOE ε4 carriers, and with faster memory decline in APOE ε4 carriers. The associations remained significant after excluding mild cognitive impairment participants. Conclusions High Aβ deposition in healthy elders was associated with decline in executive/speed in the decade before neuroimaging, and the association was observed primarily in African-Americans and APOE ε4 carriers. Our results suggest that measuring cerebral Aβ may give us important insights into the cognitive profile in the years prior to the scan in cognitively normal elders.
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Affiliation(s)
- Yian Gu
- The Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York, United States of America
- * E-mail:
| | - Qolamreza R. Razlighi
- The Department of Neurology, Columbia University, New York, New York, United States of America
| | - Laura B. Zahodne
- The Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York, United States of America
| | - Sarah C. Janicki
- The Gertrude H. Sergievsky Center, Columbia University, New York, New York, United States of America
| | - Masanori Ichise
- Department of Radiology, Columbia University Medical College, New York, New York, United States of America
| | - Jennifer J. Manly
- The Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York, United States of America
- The Department of Neurology, Columbia University, New York, New York, United States of America
- The Gertrude H. Sergievsky Center, Columbia University, New York, New York, United States of America
| | - D. P. Devanand
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York, United States of America
| | - Adam M. Brickman
- The Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York, United States of America
- The Department of Neurology, Columbia University, New York, New York, United States of America
- The Gertrude H. Sergievsky Center, Columbia University, New York, New York, United States of America
| | - Nicole Schupf
- The Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York, United States of America
- The Department of Neurology, Columbia University, New York, New York, United States of America
- The Division of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Richard Mayeux
- The Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York, United States of America
- The Department of Neurology, Columbia University, New York, New York, United States of America
- The Gertrude H. Sergievsky Center, Columbia University, New York, New York, United States of America
- The Division of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Yaakov Stern
- The Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York, United States of America
- The Department of Neurology, Columbia University, New York, New York, United States of America
- The Gertrude H. Sergievsky Center, Columbia University, New York, New York, United States of America
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Amyloid PET in European and North American cohorts; and exploring age as a limit to clinical use of amyloid imaging. Eur J Nucl Med Mol Imaging 2015; 42:1492-506. [PMID: 26130168 PMCID: PMC4521094 DOI: 10.1007/s00259-015-3115-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 06/10/2015] [Indexed: 12/20/2022]
Abstract
Purpose Several radiotracers that bind to fibrillar amyloid-beta in the brain have been developed and used in various patient cohorts. This study aimed to investigate the comparability of two amyloid positron emission tomography (PET) tracers as well as examine how age affects the discriminative properties of amyloid PET imaging. Methods Fifty-one healthy controls (HCs), 72 patients with mild cognitive impairment (MCI) and 90 patients with Alzheimer’s disease (AD) from a European cohort were scanned with [11C]Pittsburgh compound-B (PIB) and compared with an age-, sex- and disease severity-matched population of 51 HC, 72 MCI and 84 AD patients from a North American cohort who were scanned with [18F]Florbetapir. An additional North American population of 246 HC, 342 MCI and 138 AD patients with a Florbetapir scan was split by age (55–75 vs 76–93 y) into groups matched for gender and disease severity. PET template-based analyses were used to quantify regional tracer uptake. Results The mean regional uptake patterns were similar and strong correlations were found between the two tracers across the regions of interest in HC (ρ = 0.671, p = 0.02), amyloid-positive MCI (ρ = 0.902, p < 0.001) and AD patients (ρ = 0.853, p < 0.001). The application of the Florbetapir cut-off point resulted in a higher proportion of amyloid-positive HC and a lower proportion of amyloid-positive AD patients in the older group (28 and 30 %, respectively) than in the younger group (19 and 20 %, respectively). Conclusions These results illustrate the comparability of Florbetapir and PIB in unrelated but matched patient populations. The role of amyloid PET imaging becomes increasingly important with increasing age in the diagnostic assessment of clinically impaired patients. Electronic supplementary material The online version of this article (doi:10.1007/s00259-015-3115-5) contains supplementary material, which is available to authorized users.
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Kaffashian S, Tzourio C, Soumaré A, Dufouil C, Mazoyer B, Schraen-Maschke S, Buée L, Debette S. Association of plasma β-amyloid with MRI markers of structural brain aging the 3-City Dijon study. Neurobiol Aging 2015; 36:2663-70. [PMID: 26242707 DOI: 10.1016/j.neurobiolaging.2015.03.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 03/14/2015] [Accepted: 03/19/2015] [Indexed: 12/23/2022]
Abstract
Cerebral β-amyloid (Aβ) deposition and atrophy are central features of Alzheimer disease. Studies of Alzheimer disease biomarkers have largely focused on Aβ in cerebrospinal fluid (CSF), and there is uncertainty as to what plasma Aβ may be a marker. We examined the association of Aβ levels in the plasma with magnetic resonance imaging (MRI)-markers of brain aging, including longitudinal changes in global and regional brain volumes, in dementia-free persons. We studied 1530 participants of the Three-City-Dijon cohort, aged 65-80 years. Plasma Aβ measurement and magnetic resonance imaging were performed at baseline and after a 4-year follow up. Total brain, gray matter, and hippocampal volume were estimated using voxel-based morphometry, and annualized change in brain volumes was calculated. Increased plasma Aβ1-40 was associated with lower baseline hippocampal volume. Although baseline plasma Aβ levels were not associated with longitudinal change in brain volumes, consistently high plasma Aβ1-40 levels were associated with faster total brain atrophy and consistently low plasma Aβ1-42/Aβ1-40 ratio, with increased total brain atrophy and gray matter atrophy. In dementia-free older adults, high plasma Aβ1-40 and low plasma Aβ1-42/Aβ1-40 ratio were associated with smaller hippocampal volume and accelerated global and regional brain atrophy respectively.
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Affiliation(s)
| | | | - Aïcha Soumaré
- INSERM U897, University of Bordeaux, Bordeaux, France
| | | | | | | | - Luc Buée
- CHRU de Lille, Lille, France; INSERM U837, Lille, France
| | - Stéphanie Debette
- INSERM U897, University of Bordeaux, Bordeaux, France; Department of Neurology, Bordeaux University Hospital, Bordeaux, France; Department of Neurology, Framingham Heart Study, Boston University School of Medicine, Boston MA, USA
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Hancock SE, Friedrich MG, Mitchell TW, Truscott RJW, Else PL. Decreases in Phospholipids Containing Adrenic and Arachidonic Acids Occur in the Human Hippocampus over the Adult Lifespan. Lipids 2015; 50:861-72. [PMID: 26001986 DOI: 10.1007/s11745-015-4030-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 04/28/2015] [Indexed: 10/23/2022]
Abstract
One of the biggest risk factors for developing Alzheimer's disease is advanced age. Despite several studies examining changes to phospholipids in the hippocampus during the pathogenesis of Alzheimer's disease, little is known regarding changes to phospholipids in this region during normal adult aging. This study examined the phospholipid composition of the mitochondrial and microsomal membranes of the human hippocampus from post-mortem tissue of neurologically normal subjects aged between 18 and 104 years. Many of the age-related changes found were in low-to-moderately abundant phospholipids in both membrane fractions, with decreases with age being seen in many phospholipids containing either adrenic or arachidonic acid. The most abundant phospholipid of this type was phosphatidylethanolamine 18:0_22:4, which decreased in both the mitochondrial and microsomal membranes by approximately 20% from ages 20 to 100. Subsequent decreases with age were seen in total adrenic and arachidonic acid in the phospholipids of both membrane fractions, but not in either fatty acid specifically within the phosphatidylethanolamine class. Increases with age were seen in the hippocampus for mitochondrial phosphatidylserine 18:0_22:6. This is the first report of changes to molecular phospholipids of the human hippocampus over the adult lifespan, with this study also providing a comprehensive profile of the phosphatidylcholine, phosphatidylethanolamine and phosphatidylserine phospholipids of the human hippocampus.
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Affiliation(s)
- Sarah E Hancock
- Illawarra Health and Medical Research Institute, Wollongong, Australia,
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Hake A, Trzepacz PT, Wang S, Yu P, Case M, Hochstetler H, Witte MM, Degenhardt EK, Dean RA. Florbetapir positron emission tomography and cerebrospinal fluid biomarkers. Alzheimers Dement 2015; 11:986-93. [PMID: 25916563 DOI: 10.1016/j.jalz.2015.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 01/16/2015] [Accepted: 03/06/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND We evaluated the relationship between florbetapir-F18 positron emission tomography (FBP PET) and cerebrospinal fluid (CSF) biomarkers. METHODS Alzheimer's Disease Neuroimaging Initiative-Grand Opportunity and Alzheimer's Disease Neuroimaging Initiative 2 (GO/2) healthy control (HC), mild cognitive impairment (MCI), and Alzheimer's disease (AD) dementia subjects with clinical measures and CSF collected ±90 days of FBP PET data were analyzed using correlation and logistic regression. RESULTS In HC and MCI subjects, FBP PET anterior and posterior cingulate and composite standard uptake value ratios correlated with CSF amyloid beta (Aβ1-42) and tau/Aβ1-42 ratios. Using logistic regression, Aβ1-42, total tau (t-tau), phosphorylated tau181P (p-tau), and FBP PET composite each differentiated HC versus AD. Aβ1-42 and t-tau distinguished MCI versus AD, without additional contribution by FBP PET. Total tau and p-tau added discriminative power to FBP PET when classifying HC versus AD. CONCLUSION Based on cross-sectional diagnostic groups, both amyloid and tau measures distinguish healthy from demented subjects. Longitudinal analyses are needed.
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Affiliation(s)
- Ann Hake
- Eli Lilly and Company, Indianapolis, IN, USA; Department of Neurology Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Paula T Trzepacz
- Eli Lilly and Company, Indianapolis, IN, USA; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Peng Yu
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | | | | | - Elisabeth K Degenhardt
- Eli Lilly and Company, Indianapolis, IN, USA; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana University Health Physicians Group, Indiana University Health, Indianapolis, IN, USA
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Mattsson N, Insel PS, Aisen PS, Jagust W, Mackin S, Weiner M. Brain structure and function as mediators of the effects of amyloid on memory. Neurology 2015; 84:1136-44. [PMID: 25681451 DOI: 10.1212/wnl.0000000000001375] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The objective of this study was to test whether effects of β-amyloid (Aβ) pathology on episodic memory were mediated by metabolism and gray matter volume in the early stages of Alzheimer disease. METHODS This was a prospective cohort study. We measured baseline Aβ (using florbetapir-PET), brain function (using fluorodeoxyglucose-PET), and brain structure (using MRI). A mediation analysis was performed to test whether statistical effects of Aβ positivity on cross-sectional and longitudinal episodic memory were mediated by hypometabolism or regional gray matter volume in cognitively healthy controls (CN, n = 280) and mild cognitive impairment (MCI, n = 463). RESULTS Lower memory scores were associated with Aβ positivity (CN, mildly; MCI, strongly), smaller gray matter volumes (CN, few regions, including hippocampus; MCI, widespread), and hypometabolism. Smaller volumes and hypometabolism mediated effects of Aβ in MCI but not in CN. The strongest individual regions mediated up to approximately 25%. A combination of brain structure and function mediated up to approximately 40%. In several regions, gray matter atrophy and hypometabolism predicted episodic memory without being associated (at p < 0.05) with Aβ positivity. CONCLUSIONS Changes in brain structure and function appear to be, in part, downstream events from Aβ pathology, ultimately resulting in episodic memory deficits. However, Aβ pathology is also strongly related to memory deficits through mechanisms that are not quantified by these imaging measurements, and episodic memory decline is partly caused by Alzheimer disease-like brain changes independently of Aβ pathology.
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Affiliation(s)
- Niklas Mattsson
- From the Department of Veterans Affairs Medical Center (N.M., P.S.I., S.M., M.W.), Center for Imaging of Neurodegenerative Diseases, San Francisco, CA; Clinical Neurochemistry Laboratory (N.M.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Radiology and Biomedical Imaging (N.M., P.S.I., M.W.), University of California, San Francisco; Alzheimer's Disease Cooperative Study (P.S.A.), Department of Neurosciences, University of California, San Diego, La Jolla; Helen Wills Neuroscience Institute and School of Public Health (W.J.), University of California, Berkeley; and Department of Psychiatry (S.M.), University of California, San Francisco.
| | - Philip S Insel
- From the Department of Veterans Affairs Medical Center (N.M., P.S.I., S.M., M.W.), Center for Imaging of Neurodegenerative Diseases, San Francisco, CA; Clinical Neurochemistry Laboratory (N.M.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Radiology and Biomedical Imaging (N.M., P.S.I., M.W.), University of California, San Francisco; Alzheimer's Disease Cooperative Study (P.S.A.), Department of Neurosciences, University of California, San Diego, La Jolla; Helen Wills Neuroscience Institute and School of Public Health (W.J.), University of California, Berkeley; and Department of Psychiatry (S.M.), University of California, San Francisco
| | - Paul S Aisen
- From the Department of Veterans Affairs Medical Center (N.M., P.S.I., S.M., M.W.), Center for Imaging of Neurodegenerative Diseases, San Francisco, CA; Clinical Neurochemistry Laboratory (N.M.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Radiology and Biomedical Imaging (N.M., P.S.I., M.W.), University of California, San Francisco; Alzheimer's Disease Cooperative Study (P.S.A.), Department of Neurosciences, University of California, San Diego, La Jolla; Helen Wills Neuroscience Institute and School of Public Health (W.J.), University of California, Berkeley; and Department of Psychiatry (S.M.), University of California, San Francisco
| | - William Jagust
- From the Department of Veterans Affairs Medical Center (N.M., P.S.I., S.M., M.W.), Center for Imaging of Neurodegenerative Diseases, San Francisco, CA; Clinical Neurochemistry Laboratory (N.M.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Radiology and Biomedical Imaging (N.M., P.S.I., M.W.), University of California, San Francisco; Alzheimer's Disease Cooperative Study (P.S.A.), Department of Neurosciences, University of California, San Diego, La Jolla; Helen Wills Neuroscience Institute and School of Public Health (W.J.), University of California, Berkeley; and Department of Psychiatry (S.M.), University of California, San Francisco
| | - Scott Mackin
- From the Department of Veterans Affairs Medical Center (N.M., P.S.I., S.M., M.W.), Center for Imaging of Neurodegenerative Diseases, San Francisco, CA; Clinical Neurochemistry Laboratory (N.M.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Radiology and Biomedical Imaging (N.M., P.S.I., M.W.), University of California, San Francisco; Alzheimer's Disease Cooperative Study (P.S.A.), Department of Neurosciences, University of California, San Diego, La Jolla; Helen Wills Neuroscience Institute and School of Public Health (W.J.), University of California, Berkeley; and Department of Psychiatry (S.M.), University of California, San Francisco
| | - Michael Weiner
- From the Department of Veterans Affairs Medical Center (N.M., P.S.I., S.M., M.W.), Center for Imaging of Neurodegenerative Diseases, San Francisco, CA; Clinical Neurochemistry Laboratory (N.M.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Department of Radiology and Biomedical Imaging (N.M., P.S.I., M.W.), University of California, San Francisco; Alzheimer's Disease Cooperative Study (P.S.A.), Department of Neurosciences, University of California, San Diego, La Jolla; Helen Wills Neuroscience Institute and School of Public Health (W.J.), University of California, Berkeley; and Department of Psychiatry (S.M.), University of California, San Francisco
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47
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Cortical hypermetabolism in MCI subjects: a compensatory mechanism? Eur J Nucl Med Mol Imaging 2014; 42:447-58. [DOI: 10.1007/s00259-014-2919-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 09/17/2014] [Indexed: 01/25/2023]
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Bertens D, Knol DL, Scheltens P, Visser PJ. Temporal evolution of biomarkers and cognitive markers in the asymptomatic, MCI, and dementia stage of Alzheimer's disease. Alzheimers Dement 2014; 11:511-22. [PMID: 25150730 DOI: 10.1016/j.jalz.2014.05.1754] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 05/10/2014] [Accepted: 05/30/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND We investigated the pattern of disease progression in the asymptomatic, mild cognitive impairment (MCI), and dementia stage of Alzheimer's disease (AD). METHODS We selected 284 subjects with AD pathology, defined as abnormal levels of amyloid beta 1-42 (Aβ1-42) in cerebrospinal fluid (CSF). Disease outcome measures included six biomarkers and five cognitive markers. We compared differences in baseline measures and decline over 4 years between the AD stages and tested whether these changes differed from subjects, without AD pathology (N = 132). RESULTS CSF Aβ1-42 reached the maximum abnormality level in the asymptomatic stage and tau in the MCI stage. The imaging and cognitive markers started to decline in the asymptomatic stage, and decline accelerated with advancing clinical stage. CONCLUSION This study provides further evidence for a temporal evolution of AD biomarkers. Our findings may be helpful to determine stage specific outcome measures for clinical trials.
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Affiliation(s)
- Daniela Bertens
- Department of Neurology/Alzheimer Centre, VU Medical Centre, Amsterdam, The Netherlands.
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology/Alzheimer Centre, VU Medical Centre, Amsterdam, The Netherlands
| | - Pieter Jelle Visser
- Department of Neurology/Alzheimer Centre, VU Medical Centre, Amsterdam, The Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centre Limburg, University Medical Centre, Maastricht, The Netherlands
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Li G, Millard SP, Peskind ER, Zhang J, Yu CE, Leverenz JB, Mayer C, Shofer JS, Raskind MA, Quinn JF, Galasko DR, Montine TJ. Cross-sectional and longitudinal relationships between cerebrospinal fluid biomarkers and cognitive function in people without cognitive impairment from across the adult life span. JAMA Neurol 2014; 71:742-51. [PMID: 24756381 DOI: 10.1001/jamaneurol.2014.445] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Age-related cognitive decline among older individuals with normal cognition is a complex trait that potentially derives from processes of aging, inherited vulnerabilities, environmental factors, and common latent diseases that can progress to cause dementia, such as Alzheimer disease and vascular brain injury. OBJECTIVE To use cerebrospinal fluid (CSF) biomarkers to gain insight into this complex trait. DESIGN, SETTING, AND PARTICIPANTS Secondary analyses of an academic multicenter cross-sectional (n = 315) and longitudinal (n = 158) study of 5 neuropsychological tests (Immediate Recall, Delayed Recall, Trail Making Test Parts A and B, and Category Fluency) in cognitively normal individuals aged 21 to 100 years. MAIN OUTCOMES AND MEASURES To investigate the association of these cognitive function test results with age, sex, educational level, inheritance of the ε4 allele of the apolipoprotein E gene, and CSF concentrations of β-amyloid 42 (Aβ42) and tau (biomarkers of Alzheimer disease) as well as F2-isoprostanes (measures of free radical injury). RESULTS Age and educational level were broadly predictive of cross-sectional cognitive performance; of the genetic and CSF measures, only greater CSF F2-isoprostane concentration was significantly associated with poorer executive function (adjusted R2 ≤0.31). Longitudinal measures of cognitive abilities, except Category Fluency, also were associated broadly with age; of the genetic and CSF measures, only lower baseline CSF Aβ42 concentration was associated with longitudinal measures of immediate and delayed recall (marginal R2 ≤0.31). CONCLUSIONS AND RELEVANCE Our results suggest that age and educational level accounted for a substantial minority of variance in cross-sectional or longitudinal cognitive test performance in this large group of cognitively normal adults. Latent Alzheimer disease and other diseases that produce free radical injury, such as vascular brain injury, accounted for a small amount of variation in cognitive test performance across the adult human life span. Additional genetic and environmental factors likely contribute substantially to age-related cognitive decline.
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Affiliation(s)
- Ge Li
- School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | - Steven P Millard
- Veterans Affairs (VA) Northwest Network Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington
| | - Elaine R Peskind
- School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle2Veterans Affairs (VA) Northwest Network Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington
| | - Jing Zhang
- Department of Pathology, School of Medicine, University of Washington, Seattle
| | - Chang-En Yu
- Department of Medicine, School of Medicine, University of Washington, Seattle5Geriatric Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington
| | - James B Leverenz
- School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle6Department of Neurology, School of Medicine, University of Washington, Seattle
| | - Cynthia Mayer
- Veterans Affairs (VA) Northwest Network Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington
| | - Jane S Shofer
- School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | - Murray A Raskind
- School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle2Veterans Affairs (VA) Northwest Network Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington
| | - Joseph F Quinn
- Department of Neurology, School of Medicine, Oregon Health and Science University, Portland8VA Parkinson's Disease Research, Education, and Clinical Centers, Portland, Oregon
| | - Douglas R Galasko
- School of Medicine, Department of Neurosciences, University of California, San Diego, La Jolla
| | - Thomas J Montine
- Department of Pathology, School of Medicine, University of Washington, Seattle
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50
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Hurtz S, Woo E, Kebets V, Green AE, Zoumalan C, Wang B, Ringman JM, Thompson PM, Apostolova LG. Age effects on cortical thickness in cognitively normal elderly individuals. Dement Geriatr Cogn Dis Extra 2014; 4:221-7. [PMID: 25177330 PMCID: PMC4132234 DOI: 10.1159/000362872] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aims Atrophy in both grey and white matter is found in normal aging. The prefrontal cortex and the frontal lobe white matter are thought to be the most affected regions. Our aim was to examine the effects of normal aging on cortical grey matter using a 3D quantitative cortical mapping method. Methods We analyzed 1.5-tesla brain magnetic resonance imaging data from 44 cognitively normal elderly subjects using cortical pattern matching and cortical thickness analyses. Linear regression analysis was used to study the effect of age on cortical thickness. 3D map-wide correction for multiple comparisons was conducted with permutation analyses using a threshold of p < 0.01. Results We found a significant negative association between age and cortical thickness in the right hemisphere (pcorrected = 0.009) and a trend level association in the left hemisphere (pcorrected = 0.081). Age-related changes were greatest in the sensorimotor, bilateral dorsal anterior cingulate and supplementary motor cortices, and the right posterior middle and inferior frontal gyri. Age effects greater in the medial than lateral visual association cortices were also seen bilaterally. Conclusion Our novel method further validates that normal aging results in diffuse cortical thinning that is most pronounced in the frontal and visual association cortices.
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Affiliation(s)
- Sona Hurtz
- Department of Neurology, University of California Los Angeles, Calif., USA
| | - Ellen Woo
- Department of Neurology, University of California Los Angeles, Calif., USA
| | | | - Amity E Green
- Department of Psychology and Psychiatry, Monash University, Melbourne, Vic., Australia
| | - Charleen Zoumalan
- Department of Neurology, University of California Los Angeles, Calif., USA
| | - Benjamin Wang
- Department of Neurology, University of California Los Angeles, Calif., USA
| | - John M Ringman
- Department of Neurology, University of California Los Angeles, Calif., USA
| | - Paul M Thompson
- Department of Neurology, University of California Los Angeles, Calif., USA ; Laboratory of Neuro Imaging, University of Southern California, Los Angeles, Calif., USA
| | - Liana G Apostolova
- Department of Neurology, University of California Los Angeles, Calif., USA
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