1
|
Dallmeier JD, Gober R, Vontell RT, Barreda A, Dorfsman DA, Davis DA, Sun X, Brzostowicki D, Bennett I, Garamszegi SP, Wander CM, Cohen T, Scott WK. Corpora amylacea negatively correlate with hippocampal tau pathology in Alzheimer's disease. Front Neurosci 2024; 18:1286924. [PMID: 38486969 PMCID: PMC10937356 DOI: 10.3389/fnins.2024.1286924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
Introduction Severity and distribution of aggregated tau and neurofibrillary tangles (NFT) are strongly correlated with the clinical presentation of Alzheimer's disease (AD). Clearance of aggregated tau could decrease the rate of NFT formation and delay AD onset. Recent studies implicate corpora amylacea (CA) as a regulator of onset or accumulation of tau pathology. Normally, CA clear brain waste products by amassing cellular debris, which are then extruded into the cerebrospinal fluid to be phagocytosed. The proper functioning of CA may slow progression of AD-associated NFT pathology, and this relationship may be influenced by amount and distribution of phospho-tau (pTau) produced, age, sex, and genetic risk. Objective The goal of this study was to determine if CA size and number are associated with hippocampal location and local pTau severity while accounting for variations in age, sex, and genetic risk. Methods Postmortem brain hippocampal tissue sections from 40 AD and 38 unaffected donors were immunohistochemically stained with AT8 (pTau) and counter stained with periodic acid Schiff (PAS). Stained sections of the CA1 and CA3 regions of the hippocampus were analyzed. The percent area occupied (%AO) of CA, pTau, and NFT was calculated. Pairwise comparisons and regression modeling were used to analyze the influence of age, pTau %AO, and genetic risk on %AO by CA in each region, separately in donors with AD and unaffected donors. Results CA %AO was significantly higher in the CA3 region compared to CA1 in both groups. A significant negative correlation of CA %AO with both pTau %AO and neurofibrillary tangle %AO in the CA3 region of AD brain donors was found. Regression analysis in the CA3 region revealed a significant negative association between CA with both pTau and age. Conclusion We found an increase of CA in the CA3 region, compared to CA1 region, in AD and unaffected donors. This may suggest that the CA3 region is a hub for waste removal. Additionally, the negative correlation between %AO by CA and NFT in the CA3 region of the hippocampus in donors with AD suggests CA could play a role in AD pathologic progression by influencing tau clearance.
Collapse
Affiliation(s)
- Julian D. Dallmeier
- Brain Endowment Bank, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Ryan Gober
- Brain Endowment Bank, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Regina T. Vontell
- Brain Endowment Bank, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
- Department of Neurology, Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Ayled Barreda
- Brain Endowment Bank, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Daniel A. Dorfsman
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, United States
| | - David A. Davis
- Brain Endowment Bank, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
- Department of Neurology, Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Xiaoyan Sun
- Brain Endowment Bank, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
- Department of Neurology, Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Daniel Brzostowicki
- Brain Endowment Bank, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Illiana Bennett
- Brain Endowment Bank, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Susanna P. Garamszegi
- Brain Endowment Bank, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Connor M. Wander
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Todd Cohen
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - William K. Scott
- Brain Endowment Bank, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, United States
| |
Collapse
|
2
|
Robinson AC, Davidson YS, Roncaroli F, Minshull J, Tinkler P, Cairns M, Horan MA, Payton A, Mann DMA. Telephone Interview for Cognitive Status Scores Associate with Cognitive Impairment and Alzheimer's Disease Pathology at Death. J Alzheimers Dis 2021; 84:609-619. [PMID: 34602485 DOI: 10.3233/jad-215102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Early diagnosis of Alzheimer's disease (AD) provides an opportunity for early intervention. Cognitive testing has proven to be a reliable way to identify individuals who may be at risk of AD. The Telephone Assessment for Cognitive Screening (TICS) is proficient in screening for cognitive impairment. However, its ability to identify those at risk of developing AD pathology is unknown. OBJECTIVE We aim to investigate associations between TICS scores, collected over a period of 13 years, and the cognitive status of participants at death. We also examine relationships between TICS scores and neuropathological indices of AD (CERAD score, Thal phase, and Braak stage). METHODS Between 2004 and 2017, participants from The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age underwent cognitive assessment using TICS. Scores from four time points were available for analysis. Cognitive impairment and AD pathology at death was evaluated in 101 participants. RESULTS TICS scores at time points 2, 3, and 4 were significantly lower in those cognitively impaired at death compared to those considered cognitively normal. There were significant negative correlations between TICS scores and CERAD score and Braak stage at time points 2 and 4. No correlations between Thal phase and TICS were found. CONCLUSION Findings indicate that TICS could be used not only to screen for cognitive impairment, but also to identify individuals at risk of developing AD pathology, many years before any overt symptoms occur. Once identified, 'at risk' individuals could be targeted for early interventions which could attenuate the progression of the disease.
Collapse
Affiliation(s)
- Andrew C Robinson
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Yvonne S Davidson
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK
| | - Federico Roncaroli
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK.,Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - James Minshull
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK
| | - Phillip Tinkler
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK
| | - Margaret Cairns
- Department of Healthcare for Older People, Royal Devon and Exeter NHS Healthcare Trust, Exeter, UK
| | - Michael A Horan
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK
| | - Antony Payton
- Division of Informatics, Imaging & Data Sciences, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
| | - David M A Mann
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK
| |
Collapse
|
3
|
Robinson AC, Roncaroli F, Chew-Graham S, Davidson YS, Minshull J, Horan MA, Payton A, Pendleton N, Mann DMA. The Contribution of Vascular Pathology Toward Cognitive Impairment in Older Individuals with Intermediate Braak Stage Tau Pathology. J Alzheimers Dis 2021; 77:1005-1015. [PMID: 32804131 DOI: 10.3233/jad-200339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The pathological features of Alzheimer's disease (AD) are well described but little is known as to how both neurodegeneration and vascular changes might interact in causing cognitive impairment. OBJECTIVE The present study aims to investigate relationships between vascular and AD pathology in cognitively healthy and cognitively impaired individuals with a particular emphasis on those at intermediate Braak tau stages. METHODS We investigated the interplay between Braak tau stage and measures of vascular pathology as described by the vascular cognitive impairment neuropathology guidelines (VCING) in 185 brains from the Brains for Dementia Research programme and The University of Manchester Longitudinal Study of Cognition in Healthy Old Age. VCING asserts that at least one large (>10 mm) infarct, moderate/severe occipital leptomeningeal cerebral amyloid angiopathy, and moderate/severe arteriosclerosis in occipital white matter accurately predicts the contribution of cerebrovascular pathology to cognitive impairment. RESULTS We found that the extent of arteriosclerosis in the occipital white matter did not differ between cognitive groups at intermediate (III-IV) Braak stages whereas moderate/severe leptomeningeal occipital cerebral amyloid angiopathy was greater in cognitively impaired than normal individuals at Braak stage III-IV. This finding remained significant after controlling for effects of age, sex, CERAD score, Thal phase, presence/severity of primary age-related tauopathy, presence/severity of limbic-predominant age-related TDP43 encephalopathy and small vessel disease in basal ganglia. CONCLUSION Interventions targeting cerebral amyloid angiopathy may contribute to delay the onset of cognitive impairment in individuals with intermediate Alzheimer's type pathology.
Collapse
Affiliation(s)
- Andrew C Robinson
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK
| | - Federico Roncaroli
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK.,Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Stephen Chew-Graham
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK
| | - Yvonne S Davidson
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK
| | - James Minshull
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK
| | - Michael A Horan
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK
| | - Antony Payton
- Division of Informatics, Imaging & Data Sciences, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Neil Pendleton
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK
| | - David M A Mann
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, School of Biological Sciences, The University of Manchester, Salford Royal Hospital, Salford, UK
| |
Collapse
|
4
|
Hossain MF, Wang N, Chen R, Li S, Roy J, Uddin MG, Li Z, Lim LW, Song YQ. Exploring the multifunctional role of melatonin in regulating autophagy and sleep to mitigate Alzheimer's disease neuropathology. Ageing Res Rev 2021; 67:101304. [PMID: 33610813 DOI: 10.1016/j.arr.2021.101304] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 12/12/2022]
Abstract
Melatonin (MLT) is a neurohormone that is regulated by the circadian clock and plays multifunctional roles in numerous neurodegenerative disorders, such as Alzheimer's disease (AD). AD is the most common form of dementia and is associated with the degradation of axons and synapses resulting in memory loss and cognitive impairment. Despite extensive research, there is still no effective cure or specific treatment to prevent the progression of AD. The pathogenesis of AD involves atrophic alterations in the brain that also result in circadian alterations, sleep disruption, and autophagic dysfunction. In this scenario, MLT and autophagy play a central role in removing the misfolded protein aggregations. MLT also promotes autophagy through inhibiting methamphetamine toxicity to protect against neuronal cell death in AD brain. Besides, MLT plays critical roles as either a pro-autophagic indicator or anti-autophagic regulator depending on the phase of autophagy. MLT also has antioxidant properties that can counteract mitochondrial damage, oxidative stress, and apoptosis. Aging, a major risk factor for AD, can change sleep patterns and sleep quality, and MLT can improve sleep quality through regulating sleep cycles. The primary purpose of this review is to explore the putative mechanisms of the beneficial effects of MLT in AD patients. Furthermore, we also summarize the findings from preclinical and clinical studies on the multifunctional roles of MLT on autophagic regulation, the control of the circadian clock-associated genes, and sleep regulation.
Collapse
|
5
|
Robinson AC, Roncaroli F, Davidson YS, Minshull J, Heal C, Montaldi D, Payton A, Horan MA, Pendleton N, Mann DM. Mid to late-life scores of depression in the cognitively healthy are associated with cognitive status and Alzheimer's disease pathology at death. Int J Geriatr Psychiatry 2021; 36:713-721. [PMID: 33176024 PMCID: PMC8048934 DOI: 10.1002/gps.5470] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 11/07/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Early diagnosis of Alzheimer's disease (AD) is essential for early interventions. Symptoms of depression could represent a prodromal stage of AD. Very early mood alterations may help to stratify those at highest risk of late-life AD. We aim to investigate associations between baseline/longitudinal scores for depression, presence of cognitive impairment and/or AD pathology at death. METHODS/DESIGN Between 1991 and 2015, participants from The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age underwent 10 waves of assessment using the Geriatric Depression Scale (GDS). AD pathology at death was evaluated in 106 eligible cases. Analyses aimed to examine associations between GDS scores, cognitive status and AD pathology (as measured by Braak stage, Thal phase and CERAD). RESULTS Baseline GDS scores were significantly higher for those cognitively impaired at death than those cognitively normal. Significantly higher baseline GDS scores were found for those with greater Consortium to Establish a Registry for Alzheimer's Disease (CERAD) scores than those with lower CERAD scores. Similarly, significantly higher baseline GDS scores were found for those with a greater Braak stage than those with lower tau burden. These correlations remained after controlling for age at death, education and APOE ε4, but were less robust. Mean longitudinal GDS scores associated with cognition but not pathology. CONCLUSIONS GDS scores collected approximately 20 years before death were associated with cognitive status and AD pathology at death. We postulate that early AD-related pathological change produces raised GDS scores due to an overlapping neural basis with depression, and that this may be considered as an early diagnostic marker for AD.
Collapse
Affiliation(s)
- Andrew C. Robinson
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
- Geoffrey Jefferson Brain Research CentreManchester Academic Health Science Centre (MAHSC)ManchesterUK
| | - Federico Roncaroli
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
- Geoffrey Jefferson Brain Research CentreManchester Academic Health Science Centre (MAHSC)ManchesterUK
| | - Yvonne S. Davidson
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
| | - James Minshull
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
| | - Calvin Heal
- Centre for BiostatisticsFaculty of Biology, Medicine and HealthSchool of Health SciencesThe University of ManchesterManchesterUK
| | - Daniela Montaldi
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterManchesterUK
| | - Antony Payton
- Division of Informatics, Imaging & Data SciencesFaculty of Biology, Medicine and HealthSchool of Health SciencesThe University of ManchesterManchesterUK
| | - Michael A. Horan
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
| | - Neil Pendleton
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
| | - David M.A. Mann
- Division of Neuroscience & Experimental PsychologyFaculty of Biology, Medicine and HealthSchool of Biological SciencesThe University of ManchesterSalford Royal HospitalSalfordUK
| |
Collapse
|
6
|
Nichols JB, Malek-Ahmadi M, Tariot PN, Serrano GE, Sue LI, Beach TG. Vascular Lesions, APOE ε4, and Tau Pathology in Alzheimer Disease. J Neuropathol Exp Neurol 2021; 80:240-246. [PMID: 33617650 PMCID: PMC7899190 DOI: 10.1093/jnen/nlaa160] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
We sought to determine the associations among cerebral amyloid angiopathy (CAA), white matter rarefaction (WMR), circle of Willis atherosclerosis (CWA), and total microinfarct number with Braak neurofibrillary stage in postmortem individuals with and without Alzheimer disease (AD). Data from 355 cases of autopsied individuals with Braak stage I-VI who had antemortem consensus diagnoses of cognitively unimpaired (n = 183), amnestic mild cognitive impairment (n = 31), and AD dementia (n = 141) were used. The association between Braak stage and vascular lesions were individually assessed using multivariable linear regression that adjusted for age at death, APOE ε4 carrier status, sex, education, and neuritic plaque density. CAA (p = 0.007) and WMR (p < 0.001) were associated with Braak stage, independent of amyloid load; microinfarct number and CWA showed no association. Analyses of the interactions between APOE ε4 carrier status and vascular lesions found that greater WMR and positive ε4 carrier status were associated with higher Braak stages. These results suggest that CAA and WMR are statistically linked to the severity of AD-related NFT pathology. The statistical link between WMR and NFT load may be strengthened by the presence of APOE ε4 carrier status. An additional finding was that Lewy body pathology was most prevalent in higher Braak stages.
Collapse
Affiliation(s)
- Jodie B Nichols
- From the Arizona College of Osteopathic Medicine, Midwestern University, Glendale, Arizona, USA
| | | | | | - Geidy E Serrano
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Lucia I Sue
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Thomas G Beach
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| |
Collapse
|
7
|
Malek-Ahmadi M, Perez SE, Chen K, Mufson EJ. Braak Stage, Cerebral Amyloid Angiopathy, and Cognitive Decline in Early Alzheimer's Disease. J Alzheimers Dis 2020; 74:189-197. [PMID: 31985469 PMCID: PMC10026689 DOI: 10.3233/jad-191151] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The aim of this study was to determine the interaction between cerebral amyloid angiopathy (CAA) and Braak staging on cognition in the elderly. The study used a total of 141 subjects consisting of 72 non-cognitively impaired (NCI), 33 mild cognitive impairment (MCI), 36 Alzheimer's disease (AD) cases displaying Braak stages 0-II and III from the Rush Religious Order Study cohort. The association between Braak stage and CAA status and cognition was evaluated using a series of regression models that adjusted for age at death, sex, education, APOEɛ4 status, and Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropathological diagnosis. Individuals with CAA were more likely to be classified as Braak stage III relative to those without CAA [OR = 2.33, 95% CI (1.06, 5.14), p = 0.04]. A significant interaction was found between Braak stage and CAA status on a global cognitive score (β = -0.58, SE = 0.25, p = 0.02). Episodic memory also showed a significant association between Braak stage and CAA (β= -0.75, SE = 0.35, p = 0.03). These data suggest that there is a significant interaction between tau pathology and cerebrovascular lesions on cognition within the AD clinical spectrum.
Collapse
Affiliation(s)
| | - Sylvia E. Perez
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Kewei Chen
- Banner Alzheimer’s Institute, Phoenix, AZ, USA
| | - Elliott J. Mufson
- Department of Neurobiology, Barrow Neurological Institute, Phoenix, AZ, USA
- Correspondence to: Elliott Mufson, PhD, Director, Alzheimer’s Disease Research Laboratory, Professor, Department of Neurobiology, Barrow Neurological Institute, 350 W. Thomas Rd., Phoenix, AZ 85013, USA. Tel.: +1 602 406 8525; Fax: +1 602 406 8520;
| |
Collapse
|
8
|
Terada T, Yokokura M, Obi T, Bunai T, Yoshikawa E, Ando I, Shimada H, Suhara T, Higuchi M, Ouchi Y. In vivo direct relation of tau pathology with neuroinflammation in early Alzheimer's disease. J Neurol 2019; 266:2186-2196. [PMID: 31139959 DOI: 10.1007/s00415-019-09400-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/21/2019] [Accepted: 05/23/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Neuronal damage and neuroinflammation are important events occurring in the brain of Alzheimer's disease (AD). The purpose of this study was to clarify in vivo mutual relationships among abnormal tau deposition, neuroinflammation and cognitive impairment in patients with early AD using positron emission tomography (PET) with [11C]PBB3 and [11C]DPA713. METHODS Twenty patients with early AD and 20 age-matched normal control (NC) subjects underwent a series of PET measurements with [11C]PBB3 for tau aggregation and [11C]DPA713 for microglial activation (neuroinflammation). Inter- and intrasubject comparisons were performed regarding the levels of [11C]PBB3 binding potential (BPND) and [11C]DPA713 BPND in the light of cognitive functions using statistical parametric mapping (SPM) and regions of interest (ROIs) method. RESULTS The [11C]PBB3 BPND was greater in the temporo-parietal regions of AD patents than NC subjects, and a similar increasing pattern of [11C]DPA713 BPND was observed in the same patients. Correlation analyses within the AD group showed a positive direct correlation between [11C]PBB3 BPND and [11C]DPA713 BPND in the parahippocampus. Pass analysis revealed that cognitive impairment was more likely linked to the level of the parahippocampal [11C]PBB3 BPND than that of [11C]DPA713 BPND. CONCLUSIONS The pattern of abnormal tau deposition was very similar to that of neuroinflammation in patients with early-stage AD. Specifically, the direct positive correlation of tau pathology with neuroinflammation in the parahippocampus suggests that neuronal damage in this region is closely associated with microglial activation. Consistently, tau aggregation in this region matters more than neuroinflammation regarding the cognitive deterioration in AD.
Collapse
Affiliation(s)
- Tatsuhiro Terada
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education and Research Center, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, 431-3192, Japan
- Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka, 420-8688, Japan
| | - Masamichi Yokokura
- Department of Psychiatry, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Tomokazu Obi
- Department of Neurology, Shizuoka Institute of Epilepsy and Neurological Disorders, Urushiyama 886, Aoi-ku, Shizuoka, 420-8688, Japan
| | - Tomoyasu Bunai
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education and Research Center, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Etsuji Yoshikawa
- Central Research Laboratory, Hamamatsu Photonics KK, 5000 Hirakuchi, Hamakita-ku, Hamamatsu, 4434-0041, Japan
| | - Ichiro Ando
- Hamamatsu PET Imaging Center, Hamamatsu Medical Photonics Foundation, Hirakuchi, Hamakita-ku, Hamamatsu, 434-0041, Japan
| | - Hitoshi Shimada
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Tetsuya Suhara
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Makoto Higuchi
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Yasuomi Ouchi
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education and Research Center, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, 431-3192, Japan.
| |
Collapse
|
9
|
Robinson AC, McNamee R, Davidson YS, Horan MA, Snowden JS, McInnes L, Pendleton N, Mann DMA. Scores Obtained from a Simple Cognitive Test of Visuospatial Episodic Memory Performed Decades before Death Are Associated with the Ultimate Presence of Alzheimer Disease Pathology. Dement Geriatr Cogn Disord 2018; 45:79-90. [PMID: 29694971 DOI: 10.1159/000486827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 01/13/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Community- or population-based longitudinal studies of cognitive ability with a brain donation end point offer an opportunity to examine relationships between pathology and cognitive state prior to death. Discriminating the earliest signs of dementing disorders, such as Alzheimer disease (AD), is necessary to undertake early interventions and treatments. METHODS The neuropathological profile of brains donated from The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age, including CERAD (Consortium to Establish a Registry for Alzheimer's Disease) and Braak stage, was assessed by immunohistochemistry. Cognitive test scores collected 20 years prior to death were correlated with the extent of AD pathology present at death. RESULTS Baseline scores from the Memory Circle test had the ability to distinguish between individuals who developed substantial AD pathology and those with no, or low, AD pathology. Predicted test scores at the age of 65 years also discriminated between these pathology groups. The addition of APOE genotype further improved the discriminatory ability of the model. CONCLUSIONS The results raise the possibility of identifying individuals at future risk of the neuropathological changes associated with AD over 20 years before death using a simple cognitive test. This work may facilitate early interventions, therapeutics and treatments for AD by identifying at-risk and minimally affected (in pathological terms) individuals.
Collapse
Affiliation(s)
- Andrew C Robinson
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience and Experimental Psychology, University of Manchester, Salford Royal Hospital, Salford, United Kingdom
| | - Roseanne McNamee
- Faculty of Biology, Medicine and Health, School of Health Sciences, Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom
| | - Yvonne S Davidson
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience and Experimental Psychology, University of Manchester, Salford Royal Hospital, Salford, United Kingdom
| | - Michael A Horan
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience and Experimental Psychology, University of Manchester, Salford Royal Hospital, Salford, United Kingdom
| | - Julie S Snowden
- Cerebral Function Unit, Greater Manchester Neuroscience Centre, Salford Royal Foundation Trust, Salford, United Kingdom
| | - Lynn McInnes
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Neil Pendleton
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience and Experimental Psychology, University of Manchester, Salford Royal Hospital, Salford, United Kingdom
| | - David M A Mann
- Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience and Experimental Psychology, University of Manchester, Salford Royal Hospital, Salford, United Kingdom
| |
Collapse
|
10
|
Royall DR, Al-Rubaye S, Bishnoi R, Palmer RF. Few serum proteins mediate APOE's association with dementia. PLoS One 2017; 12:e0172268. [PMID: 28291794 PMCID: PMC5349443 DOI: 10.1371/journal.pone.0172268] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 02/02/2017] [Indexed: 02/08/2023] Open
Abstract
The latent variable "δ" (for "dementia") appears to be uniquely responsible for the dementing aspects of cognitive impairment. Age, depression, gender and the apolipoprotein E (APOE) e4 allele are independently associated with δ. In this analysis, we explore serum proteins as potential mediators of APOE's specific association with δ in a large, ethnically diverse longitudinal cohort, the Texas Alzheimer's Research and Care Consortium (TARCC). APOE was associated only with C-Reactive Protein (CRP), Adiponectin (APN) and Amphiregulin (AREG), although the latter two's associations did not survive Bonferroni correction for multiple comparisons. All three proteins were associated with δ and had weak potential mediation effects on APOE's association with that construct. Our findings suggest that APOE's association with cognitive performance is specific to δ and partially mediated by serum inflammatory proteins. The majority of APOE's significant unadjusted effect on δ is unexplained. It may instead arise from direct central nervous system effects, possibly on native intelligence. If so, then APOE may exert a life-long influence over δ and therefore all-cause dementia risk.
Collapse
Affiliation(s)
- Donald R. Royall
- Department of Psychiatry, the University of Texas Health Science Center, San Antonio, Texas, United States of America
- Department of Medicine, the University of Texas Health Science Center, San Antonio, Texas, United States of America
- Department of Family and Community Medicine, the University of Texas Health Science Center, San Antonio, Texas, United States of America
- South Texas Veterans’ Health System Audie L. Murphy Division Geriatric Research Education and Clinical Care Center, San Antonio, Texas, United States of America
| | - Safa Al-Rubaye
- Department of Psychiatry, the University of Texas Health Science Center, San Antonio, Texas, United States of America
| | - Ram Bishnoi
- Department of Psychiatry, the Medical College of Georgia, Augusta, Georgia, United States of America
| | - Raymond F. Palmer
- Department of Family and Community Medicine, the University of Texas Health Science Center, San Antonio, Texas, United States of America
| |
Collapse
|
11
|
Tanskanen M, Mäkelä M, Notkola IL, Myllykangas L, Rastas S, Oinas M, Lindsberg PJ, Polvikoski T, Tienari PJ, Paetau A. Population-based analysis of pathological correlates of dementia in the oldest old. Ann Clin Transl Neurol 2017; 4:154-165. [PMID: 28275649 PMCID: PMC5338150 DOI: 10.1002/acn3.389] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 11/13/2016] [Accepted: 12/16/2016] [Indexed: 12/12/2022] Open
Abstract
Objective The aim of this study was to analyze brain pathologies which cause dementia in the oldest old population. Methods All 601 persons aged ≥85 years living in the city of Vantaa (Finland), on April 1st, 1991 formed the study population of the Vantaa85 + study, 300 of whom were autopsied during follow‐up (79.5% females, mean age‐at‐death 92 ± 3.7 years). Alzheimer's disease (AD) pathology (tau and beta‐amyloid [Aβ]), cerebral amyloid angiopathy (CAA) and Lewy‐related pathologies were analyzed. Brain infarcts were categorized by size (<2 mm, 2–15 mm, >15 mm) and by location. Brain hemorrhages were classified as microscopic (<2 mm) and macroscopic. Results 195/300 (65%) were demented. 194/195 (99%) of the demented had at least one neuropathology. Three independent contributors to dementia were identified: AD‐type tau‐pathology (Braak stage V‐VI), neocortical Lewy‐related pathology, and cortical anterior 2–15 mm infarcts. These were found in 34%, 21%, and 21% of the demented, respectively, with the multivariate odds ratios (OR) for dementia 5.5, 4.5, and 3.4. Factor analysis investigating the relationships between different pathologies identified three separate factors: (1) AD‐spectrum, which included neurofibrillary tau, Aβ plaque, and neocortical Lewy‐related pathologies and CAA (2) >2 mm cortical and subcortical infarcts, and (3) <2 mm cortical microinfarcts and microhemorrhages. Multipathology was common and increased the risk of dementia significantly. Interpretation These results indicate that AD‐type neurodegenerative processes play the most prominent role in twilight cognitive decline. The high prevalence of both neurodegenerative and vascular pathologies indicates that multiple preventive and therapeutic approaches are needed to protect the brains of the oldest old.
Collapse
Affiliation(s)
- Maarit Tanskanen
- Department of Pathology Huslab Helsinki University Hospital and Medicum University of Helsinki Helsinki Finland
| | - Mira Mäkelä
- Department of Pathology Huslab Helsinki University Hospital and Medicum University of Helsinki Helsinki Finland
| | | | - Liisa Myllykangas
- Department of Pathology Huslab Helsinki University Hospital and Medicum University of Helsinki Helsinki Finland
| | | | - Minna Oinas
- Neurosurgery Clinical Neurosciences Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - Perttu J Lindsberg
- Neurology Clinical Neurosciences Helsinki University Hospital and University of Helsinki Helsinki Finland; Biomedicum Helsinki University of Helsinki Helsinki Finland
| | - Tuomo Polvikoski
- Institute of Neuroscience Newcastle University Newcastle upon Tyne United Kingdom
| | - Pentti J Tienari
- Neurology Clinical Neurosciences Helsinki University Hospital and University of Helsinki Helsinki Finland; Biomedicum Helsinki University of Helsinki Helsinki Finland
| | - Anders Paetau
- Department of Pathology Huslab Helsinki University Hospital and Medicum University of Helsinki Helsinki Finland
| |
Collapse
|