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Malhis M, Kaniyappan S, Aillaud I, Chandupatla RR, Ramirez LM, Zweckstetter M, Horn AHC, Mandelkow E, Sticht H, Funke SA. Potent Tau Aggregation Inhibitor D-Peptides Selected against Tau-Repeat 2 Using Mirror Image Phage Display. Chembiochem 2021; 22:3049-3059. [PMID: 34375027 PMCID: PMC8596876 DOI: 10.1002/cbic.202100287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/07/2021] [Indexed: 11/11/2022]
Abstract
Alzheimer's disease and other Tauopathies are associated with neurofibrillary tangles composed of Tau protein, as well as toxic Tau oligomers. Therefore, inhibitors of pathological Tau aggregation are potentially useful candidates for future therapies targeting Tauopathies. Two hexapeptides within Tau, designated PHF6* (275-VQIINK-280) and PHF6 (306-VQIVYK-311), are known to promote Tau aggregation. Recently, the PHF6* segment has been described as the more potent driver of Tau aggregation. We therefore employed mirror-image phage display with a large peptide library to identify PHF6* fibril binding peptides consisting of D-enantiomeric amino acids. The suitability of D-enantiomeric peptides for in vivo applications, which are protease stable and less immunogenic than L-peptides, has already been demonstrated. The identified D-enantiomeric peptide MMD3 and its retro-inverso form, designated MMD3rev, inhibited in vitro fibrillization of the PHF6* peptide, the repeat domain of Tau as well as full-length Tau. Dynamic light scattering, pelleting assays and atomic force microscopy demonstrated that MMD3 prevents the formation of tau β-sheet-rich fibrils by diverting Tau into large amorphous aggregates. NMR data suggest that the D-enantiomeric peptides bound to Tau monomers with rather low affinity, but ELISA (enzyme-linked immunosorbent assay) data demonstrated binding to PHF6* and full length Tau fibrils. In addition, molecular insight into the binding mode of MMD3 to PHF6* fibrils were gained by in silico modelling. The identified PHF6*-targeting peptides were able to penetrate cells. The study establishes PHF6* fibril binding peptides consisting of D-enantiomeric amino acids as potential molecules for therapeutic and diagnostic applications in AD research.
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Affiliation(s)
- Marwa Malhis
- Institut für BioanalytikHochschule für angewandte WissenschaftenCoburgGermany
| | - Senthilvelrajan Kaniyappan
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE)BonnGermany
- Department of Neurodegenerative Diseases and Geriatric PsychiatryUniversity of BonnBonnGermany
| | - Isabelle Aillaud
- Institut für BioanalytikHochschule für angewandte WissenschaftenCoburgGermany
| | | | - Lisa Marie Ramirez
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE)GöttingenGermany
| | | | - Anselm H. C. Horn
- Institut für BiochemieFriedrich-Alexander-Universität Erlangen-NürnbergErlangenGermany
- Institut für Medizinische GenetikUniversität Zürich SchlierenZürichSwitzerland
| | - Eckhard Mandelkow
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE)BonnGermany
- Department of Neurodegenerative Diseases and Geriatric PsychiatryUniversity of BonnBonnGermany
- CAESAR Research CenterBonnGermany
| | - Heinrich Sticht
- Institut für BiochemieFriedrich-Alexander-Universität Erlangen-NürnbergErlangenGermany
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El-Wahsh S, Finger EC, Piguet O, Mok V, Rohrer JD, Kiernan MC, Ahmed RM. Predictors of survival in frontotemporal lobar degeneration syndromes. J Neurol Neurosurg Psychiatry 2021; 92:jnnp-2020-324349. [PMID: 33441385 DOI: 10.1136/jnnp-2020-324349] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/26/2020] [Accepted: 12/14/2020] [Indexed: 12/11/2022]
Abstract
After decades of research, large-scale clinical trials in patients diagnosed with frontotemporal lobar degeneration (FTLD) are now underway across multiple centres worldwide. As such, refining the determinants of survival in FTLD represents a timely and important challenge. Specifically, disease outcome measures need greater clarity of definition to enable accurate tracking of therapeutic interventions in both clinical and research settings. Multiple factors potentially determine survival, including the clinical phenotype at presentation; radiological patterns of atrophy including markers on both structural and functional imaging; metabolic factors including eating behaviour and lipid metabolism; biomarkers including both serum and cerebrospinal fluid markers of underlying pathology; as well as genetic factors, including both dominantly inherited genes, but also genetic modifiers. The present review synthesises the effect of these factors on disease survival across the syndromes of frontotemporal dementia, with comparison to amyotrophic lateral sclerosis, progressive supranuclear palsy and corticobasal syndrome. A pathway is presented that outlines the utility of these varied survival factors for future clinical trials and drug development. Given the complexity of the FTLD spectrum, it seems unlikely that any single factor may predict overall survival in individual patients, further suggesting that a precision medicine approach will need to be developed in predicting disease survival in FTLD, to enhance drug target development and future clinical trial methodologies.
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Affiliation(s)
- Shadi El-Wahsh
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Elizabeth C Finger
- Department of Clinicial Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Olivier Piguet
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Vincent Mok
- Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Matthew C Kiernan
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebekah M Ahmed
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
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Current and future applications of induced pluripotent stem cell-based models to study pathological proteins in neurodegenerative disorders. Mol Psychiatry 2021; 26:2685-2706. [PMID: 33495544 PMCID: PMC8505258 DOI: 10.1038/s41380-020-00999-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/02/2020] [Accepted: 12/09/2020] [Indexed: 12/13/2022]
Abstract
Neurodegenerative disorders emerge from the failure of intricate cellular mechanisms, which ultimately lead to the loss of vulnerable neuronal populations. Research conducted across several laboratories has now provided compelling evidence that pathogenic proteins can also contribute to non-cell autonomous toxicity in several neurodegenerative contexts, including Alzheimer's, Parkinson's, and Huntington's diseases as well as Amyotrophic Lateral Sclerosis. Given the nearly ubiquitous nature of abnormal protein accumulation in such disorders, elucidating the mechanisms and routes underlying these processes is essential to the development of effective treatments. To this end, physiologically relevant human in vitro models are critical to understand the processes surrounding uptake, release and nucleation under physiological or pathological conditions. This review explores the use of human-induced pluripotent stem cells (iPSCs) to study prion-like protein propagation in neurodegenerative diseases, discusses advantages and limitations of this model, and presents emerging technologies that, combined with the use of iPSC-based models, will provide powerful model systems to propel fundamental research forward.
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Abstract
Frontotemporal dementia is a clinically and pathologically heterogeneous group of neurodegenerative disorders, with progressive impairment of behavior and language. They can be closely related to amyotrophic lateral sclerosis, clinically and through shared genetics and similar pathology. Approximately 40% of people with frontotemporal dementia report a family history of dementia, motor neuron disease or parkinsonism, and half of these familial cases are attributed to mutations in three genes (C9orf72, MAPT and PGRN). Akinetic-rigidity is a common feature in several types of frontotemporal dementia, particularly the behavioral variant and the non-fluent agrammatic variant of primary progressive aphasia, and the familial dementias. The majority of patients develop a degree of parkinsonism during the course of the illness, and signs may be present at the time of initial diagnosis. However, the parkinsonism of frontotemporal dementia is very different from that observed in idiopathic Parkinson's disease: it may be symmetric, axial, and poorly responsive to levodopa. Tremor is uncommon, and may be postural, action or occasionally rest tremor. The emergence of parkinsonism is often part of an evolving phenotype, in which frontotemporal dementia comes to resemble corticobasal syndrome or progressive supranuclear palsy. This chapter describes the prevalence and phenomenology of parkinsonism in each of the major syndromes, and according to the common genetic forms of frontotemporal dementia. We discuss the changing nosology and terminology surrounding the diagnoses, and the significance of parkinsonism as a core feature of frontotemporal dementia, relevant to clinical management and the design of future clinical trials.
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Affiliation(s)
- James B Rowe
- Cambridge University Centre for Frontotemporal Dementia and Cambridge University Centre for Parkinson-plus, Cambridge University, Cambridge, United Kingdom
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Lye JJ, Latorre E, Lee BP, Bandinelli S, Holley JE, Gutowski NJ, Ferrucci L, Harries LW. Astrocyte senescence may drive alterations in GFAPα, CDKN2A p14 ARF, and TAU3 transcript expression and contribute to cognitive decline. GeroScience 2019; 41:561-573. [PMID: 31654269 PMCID: PMC6885035 DOI: 10.1007/s11357-019-00100-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 09/10/2019] [Indexed: 12/11/2022] Open
Abstract
The accumulation of senescent cells in tissues is causally linked to the development of several age-related diseases; the removal of senescent glial cells in animal models prevents Tau accumulation and cognitive decline. Senescent cells can arise through several distinct mechanisms; one such mechanism is dysregulation of alternative splicing. In this study, we characterised the senescent cell phenotype in primary human astrocytes in terms of SA-β-Gal staining and SASP secretion, and then assessed splicing factor expression and candidate gene splicing patterns. Finally, we assessed associations between expression of dysregulated isoforms and premature cognitive decline in 197 samples from the InCHIANTI study of ageing, where expression was present in both blood and brain. We demonstrate here that senescent astrocytes secrete a modified SASP characterised by increased IL8, MMP3, MMP10, and TIMP2 but decreased IL10 levels. We identified significant changes in splicing factor expression for 10/20 splicing factors tested in senescent astrocytes compared with early passage cells, as well as dysregulation of isoform levels for 8/13 brain or senescence genes tested. Finally, associations were identified between peripheral blood GFAPα, TAU3, and CDKN2A (P14ARF) isoform levels and mild or severe cognitive decline over a 3–7-year period. Our data are suggestive that some of the features of cognitive decline may arise from dysregulated splicing of important genes in senescent brain support cells, and that defects in alternative splicing or splicing regulator expression deserve exploration as points of therapeutic intervention in the future.
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Affiliation(s)
- Jed J Lye
- Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Exeter, Devon, EX2 5DW, UK
| | - Eva Latorre
- Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Exeter, Devon, EX2 5DW, UK
| | - Ben P Lee
- Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Exeter, Devon, EX2 5DW, UK
| | | | - Janet E Holley
- University of Exeter Medical School & Neurology Department, Royal Devon & Exeter Hospital, Exeter, EX2 5DW, UK
| | - Nicholas J Gutowski
- University of Exeter Medical School & Neurology Department, Royal Devon & Exeter Hospital, Exeter, EX2 5DW, UK
| | - Luigi Ferrucci
- National Institute on Aging, Clinical Research Branch, Harbor Hospital, Baltimore, MD, 21225, USA
| | - Lorna W Harries
- Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Exeter, Devon, EX2 5DW, UK.
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Valachova B, Brezovakova V, Bugos O, Jadhav S, Smolek T, Novak P, Zilka N. A comparative study on pathological features of transgenic rat lines expressing either three or four repeat misfolded tau. J Comp Neurol 2018; 526:1777-1789. [DOI: 10.1002/cne.24447] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 03/08/2018] [Accepted: 03/08/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Bernadeta Valachova
- Centre of Excellence for Alzheimer's Disease and Related Disorders; Institute of Neuroimmunology, Slovak Academy of Sciences; Bratislava Slovak Republic
- Axon Neuroscience R&D Services SE; Bratislava Slovak Republic
| | - Veronika Brezovakova
- Centre of Excellence for Alzheimer's Disease and Related Disorders; Institute of Neuroimmunology, Slovak Academy of Sciences; Bratislava Slovak Republic
| | - Ondrej Bugos
- Centre of Excellence for Alzheimer's Disease and Related Disorders; Institute of Neuroimmunology, Slovak Academy of Sciences; Bratislava Slovak Republic
| | - Santosh Jadhav
- Centre of Excellence for Alzheimer's Disease and Related Disorders; Institute of Neuroimmunology, Slovak Academy of Sciences; Bratislava Slovak Republic
- Axon Neuroscience R&D Services SE; Bratislava Slovak Republic
| | - Tomas Smolek
- Centre of Excellence for Alzheimer's Disease and Related Disorders; Institute of Neuroimmunology, Slovak Academy of Sciences; Bratislava Slovak Republic
- Axon Neuroscience R&D Services SE; Bratislava Slovak Republic
| | - Petr Novak
- Centre of Excellence for Alzheimer's Disease and Related Disorders; Institute of Neuroimmunology, Slovak Academy of Sciences; Bratislava Slovak Republic
| | - Norbert Zilka
- Centre of Excellence for Alzheimer's Disease and Related Disorders; Institute of Neuroimmunology, Slovak Academy of Sciences; Bratislava Slovak Republic
- Axon Neuroscience R&D Services SE; Bratislava Slovak Republic
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Kobylecki C, Jones M, Thompson JC, Richardson AM, Neary D, Mann DMA, Snowden JS, Gerhard A. Cognitive-behavioural features of progressive supranuclear palsy syndrome overlap with frontotemporal dementia. J Neurol 2015; 262:916-22. [PMID: 25663411 DOI: 10.1007/s00415-015-7657-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 01/25/2015] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
Abstract
Cognitive impairment is common in patients with the neurodegenerative tauopathy progressive supranuclear palsy (PSP). Although a pattern of 'subcortical' cognitive impairment is considered prototypical in PSP, pathological and clinical observations suggest an overlap with frontotemporal dementia (FTD). Our objective was to evaluate behavioural and cognitive symptoms in a retrospective study of patients with PSP syndrome (PSPS) and their relationship to features seen in behavioural variant FTD. We reviewed the records of 62 patients (29 male, 33 female, median age 65.5 years) evaluated at a tertiary cognitive clinic who met NINDS-SPSP criteria for probable or possible PSP, and collected clinical details of their presenting history, cognitive and behavioural features. We also evaluated the proportion of patients fulfilling FTD Consensus criteria. Cognitive and behavioural symptoms were a predominant presenting feature in 58% of patients evaluated. Cognitive slowing, executive impairments, and inefficient memory recall, consistent with 'subcortical' impairment, were identified in the majority of patients. Twenty patients (32%) fulfilled cognitive and behavioural criteria for possible FTD at initial assessment, whereas behavioural changes not meeting formal diagnostic criteria were present in a greater proportion of the patients. Our findings support the existence of a spectrum of cognitive-behavioural features in PSPS, with significant clinical overlap with behavioural variant FTD. Cognitive and behavioural profiling should be an integral part of the assessment of patients with PSPS.
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Affiliation(s)
- Christopher Kobylecki
- Cerebral Function Unit, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK,
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Clerc MT, Deprez M, Leuba G, Lhermitte B, Lopez U, von Gunten A. Atypical association of semantic dementia, corticobasal syndrome, and 4R tauopathy. Neurocase 2015; 21:1-15. [PMID: 24156410 DOI: 10.1080/13554794.2013.841953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A 57-year-old male with no family history was diagnosed with semantic dementia. He also showed some unusual cognitive features such as episodic memory and executive dysfunctions, spatial disorientation, and dyscalculia. Rapidly progressive cognitive and physical decline occurred. About 1.5 years later, he developed clinical features of a corticobasal syndrome. He died at the age of 60. Brain autopsy revealed numerous 4R-tau-positive lesions in the frontal, parietal and temporal lobes, basal ganglia, and brainstem. Neuronal loss was severe in the temporal cortex. Such association of semantic dementia with tauopathy and corticobasal syndrome is highly unusual. These findings are discussed in the light of current knowledge about frontotemporal lobar degeneration.
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Affiliation(s)
- Marie-Therese Clerc
- a Service Universitaire de Psychiatrie de l'âge avancé, Département de Psychiatrie , Centre Hospitalier Universitaire Vaudois , Lausanne , Switzerland
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Ling H, Ling H, de Silva R, Massey LA, Courtney R, Hondhamuni G, Bajaj N, Lowe J, Holton JL, Lees A, Revesz T. Characteristics of progressive supranuclear palsy presenting with corticobasal syndrome: a cortical variant. Neuropathol Appl Neurobiol 2014; 40:149-63. [PMID: 23432126 PMCID: PMC4260147 DOI: 10.1111/nan.12037] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 02/15/2013] [Indexed: 12/11/2022]
Abstract
Aims Since the first description of the classical presentation of progressive supranuclear palsy (PSP) in 1963, now known as Richardson's syndrome (PSP-RS), several distinct clinical syndromes have been associated with PSP-tau pathology. Like other neurodegenerative disorders, the severity and distribution of phosphorylated tau pathology are closely associated with the clinical heterogeneity of PSP variants. PSP with corticobasal syndrome presentation (PSP-CBS) was reported to have more tau load in the mid-frontal and inferior-parietal cortices than in PSP-RS. However, it is uncertain if differences exist in the distribution of tau pathology in other brain regions or if the overall tau load is increased in the brains of PSP-CBS. Methods We sought to compare the clinical and pathological features of PSP-CBS and PSP-RS including quantitative assessment of tau load in 15 cortical, basal ganglia and cerebellar regions. Results In addition to the similar age of onset and disease duration, we demonstrated that the overall severity of tau pathology was the same between PSP-CBS and PSP-RS. We identified that there was a shift of tau burden towards the cortical regions away from the basal ganglia; supporting the notion that PSP-CBS is a ‘cortical’ PSP variant. PSP-CBS also had less severe neuronal loss in the dorsolateral and ventrolateral subregions of the substantia nigra and more severe microglial response in the corticospinal tract than in PSP-RS; however, neuronal loss in subthalamic nucleus was equally severe in both groups. Conclusions A better understanding of the factors that influence the selective pathological vulnerability in different PSP variants will provide further insights into the neurodegenerative process underlying tauopathies.
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Affiliation(s)
| | - H Ling
- Reta Lila Weston Institute of Neurological Studies, Institute of Neurology, University College London, London, UK; Queen Square Brain Bank for Neurological Disorders, Institute of Neurology, University College London, London, UK; Sara Koe PSP Research Centre, Institute of Neurology, University College London, London, UK
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Extraction and Analysis of Risk Elements for Korean Homecare Patients with Senile Dementia. J Behav Health Serv Res 2014; 43:116-26. [PMID: 25047103 DOI: 10.1007/s11414-014-9429-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this study is to provide information for the protection of Korean homecare patients with senile dementia by investigating accident cases using a survey. With the survey of accident cases, the caregivers of 55 Korean homecare patients with senile dementia (75.9 ± 7.0 years) were administered the short form of the Samsung Dementia Questionnaire (S-SDQ) and an activities of daily living (ADL) test. Twelve risk elements were extracted. The order of frequency of occurrence from highest to lowest was "egress," "fall," "violence," "collision," "gas accident," "slip," "faucet misuse," "overeating," "drop," "discharge," "weird eating," and "self-injury." The percentage of risk elements resulting in physical harm was 40.1% across all risk elements. The risk elements resulting in the most physical harm were "fall," "collision," "slip," and "drop," respectively. Regarding the location of occurrence of risk elements, risk elements resulting in physical harm showed no significant differences between indoors and outdoors. Some risk elements, such as "egress," "fall," and "gas accident" happened concurrently with more than four other elements, while "collision," "drop," and "violence" happened together with more than two other elements. "Slip" happened significantly more often in the low ADL score group, while "gas accident" happened significantly more often in the high ADL score group. This study provides basic information about monitoring factors to protect senior homecare patients with senile dementia.
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Irwin DJ, McMillan CT, Suh E, Powers J, Rascovsky K, Wood EM, Toledo JB, Arnold SE, Lee VMY, Van Deerlin VM, Trojanowski JQ, Grossman M. Myelin oligodendrocyte basic protein and prognosis in behavioral-variant frontotemporal dementia. Neurology 2014; 83:502-9. [PMID: 24994843 DOI: 10.1212/wnl.0000000000000668] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To determine the prognostic utility of tauopathy-associated single nucleotide polymorphisms (SNPs) in sporadic behavioral-variant frontotemporal dementia (bvFTD). METHODS Eighty-one patients with sporadic bvFTD were genotyped for tauopathy-associated SNPs at rs8070723 (microtubule-associated protein tau [MAPT]) and rs1768208 (myelin-associated oligodendrocyte basic protein [MOBP]). We performed a retrospective case-control study comparing age at onset and disease duration between carriers of ≥1 polymorphism allele and noncarriers for these SNPs. Subanalyses were performed for autopsied subgroups with tauopathy (n = 20) and TDP-43 proteinopathy (n = 12). To identify a potential biological basis for disease duration, neuroimaging measures of white matter integrity were evaluated (n = 37). RESULTS Carriers of risk allele (T) in rs1768208 (i.e., MOBP RA+) had a shorter median disease duration (TC/TT = 5.5 years, CC = 9.5 years; p = 0.02). This was also found in the subset of cases with autopsy-confirmed tauopathies (p = 0.04) but not with TDP-43 proteinopathies (p > 0.1). By comparison, polymorphisms at rs8070723 (MAPT) had no effect on disease duration (p > 0.1), although carriers of protective allele (G) in rs8070723 had a younger median age at onset (AG/GG = 54.5 years, AA = 58 years; p < 0.01). MOBP RA+ patients had increased radial diffusivity in the superior corona radiata and midbrain, and reduced fractional anisotropy in the superior corona radiata as well as superior and inferior longitudinal fasciculi compared with noncarriers (p < 0.01). CONCLUSIONS The rs1768208 risk polymorphism in MOBP may have prognostic value in bvFTD. MOBP RA+ patients have more severe white matter degeneration in bvFTD that may contribute to shorter disease duration. Future studies are needed to help confirm these findings.
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Affiliation(s)
- David J Irwin
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (D.J.I., C.T.M., J.P., K.R., E.M.W., M.G.); Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, Alzheimer's Disease Core Center (D.J.I., C.T.M., E.S., E.M.W., J.B.T., S.E.A., V.M.-Y.L., V.M.V.D., J.Q.T., M.G.); Penn Memory Center, Department of Neurology (S.E.A.); and Brain-Behavior Laboratory, Departments of Psychiatry, Perelman School of Medicine (S.E.A.), University of Pennsylvania, Philadelphia.
| | - Corey T McMillan
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (D.J.I., C.T.M., J.P., K.R., E.M.W., M.G.); Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, Alzheimer's Disease Core Center (D.J.I., C.T.M., E.S., E.M.W., J.B.T., S.E.A., V.M.-Y.L., V.M.V.D., J.Q.T., M.G.); Penn Memory Center, Department of Neurology (S.E.A.); and Brain-Behavior Laboratory, Departments of Psychiatry, Perelman School of Medicine (S.E.A.), University of Pennsylvania, Philadelphia
| | - EunRan Suh
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (D.J.I., C.T.M., J.P., K.R., E.M.W., M.G.); Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, Alzheimer's Disease Core Center (D.J.I., C.T.M., E.S., E.M.W., J.B.T., S.E.A., V.M.-Y.L., V.M.V.D., J.Q.T., M.G.); Penn Memory Center, Department of Neurology (S.E.A.); and Brain-Behavior Laboratory, Departments of Psychiatry, Perelman School of Medicine (S.E.A.), University of Pennsylvania, Philadelphia
| | - John Powers
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (D.J.I., C.T.M., J.P., K.R., E.M.W., M.G.); Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, Alzheimer's Disease Core Center (D.J.I., C.T.M., E.S., E.M.W., J.B.T., S.E.A., V.M.-Y.L., V.M.V.D., J.Q.T., M.G.); Penn Memory Center, Department of Neurology (S.E.A.); and Brain-Behavior Laboratory, Departments of Psychiatry, Perelman School of Medicine (S.E.A.), University of Pennsylvania, Philadelphia
| | - Katya Rascovsky
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (D.J.I., C.T.M., J.P., K.R., E.M.W., M.G.); Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, Alzheimer's Disease Core Center (D.J.I., C.T.M., E.S., E.M.W., J.B.T., S.E.A., V.M.-Y.L., V.M.V.D., J.Q.T., M.G.); Penn Memory Center, Department of Neurology (S.E.A.); and Brain-Behavior Laboratory, Departments of Psychiatry, Perelman School of Medicine (S.E.A.), University of Pennsylvania, Philadelphia
| | - Elisabeth M Wood
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (D.J.I., C.T.M., J.P., K.R., E.M.W., M.G.); Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, Alzheimer's Disease Core Center (D.J.I., C.T.M., E.S., E.M.W., J.B.T., S.E.A., V.M.-Y.L., V.M.V.D., J.Q.T., M.G.); Penn Memory Center, Department of Neurology (S.E.A.); and Brain-Behavior Laboratory, Departments of Psychiatry, Perelman School of Medicine (S.E.A.), University of Pennsylvania, Philadelphia
| | - Jon B Toledo
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (D.J.I., C.T.M., J.P., K.R., E.M.W., M.G.); Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, Alzheimer's Disease Core Center (D.J.I., C.T.M., E.S., E.M.W., J.B.T., S.E.A., V.M.-Y.L., V.M.V.D., J.Q.T., M.G.); Penn Memory Center, Department of Neurology (S.E.A.); and Brain-Behavior Laboratory, Departments of Psychiatry, Perelman School of Medicine (S.E.A.), University of Pennsylvania, Philadelphia
| | - Steven E Arnold
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (D.J.I., C.T.M., J.P., K.R., E.M.W., M.G.); Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, Alzheimer's Disease Core Center (D.J.I., C.T.M., E.S., E.M.W., J.B.T., S.E.A., V.M.-Y.L., V.M.V.D., J.Q.T., M.G.); Penn Memory Center, Department of Neurology (S.E.A.); and Brain-Behavior Laboratory, Departments of Psychiatry, Perelman School of Medicine (S.E.A.), University of Pennsylvania, Philadelphia
| | - Virginia M-Y Lee
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (D.J.I., C.T.M., J.P., K.R., E.M.W., M.G.); Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, Alzheimer's Disease Core Center (D.J.I., C.T.M., E.S., E.M.W., J.B.T., S.E.A., V.M.-Y.L., V.M.V.D., J.Q.T., M.G.); Penn Memory Center, Department of Neurology (S.E.A.); and Brain-Behavior Laboratory, Departments of Psychiatry, Perelman School of Medicine (S.E.A.), University of Pennsylvania, Philadelphia
| | - Vivianna M Van Deerlin
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (D.J.I., C.T.M., J.P., K.R., E.M.W., M.G.); Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, Alzheimer's Disease Core Center (D.J.I., C.T.M., E.S., E.M.W., J.B.T., S.E.A., V.M.-Y.L., V.M.V.D., J.Q.T., M.G.); Penn Memory Center, Department of Neurology (S.E.A.); and Brain-Behavior Laboratory, Departments of Psychiatry, Perelman School of Medicine (S.E.A.), University of Pennsylvania, Philadelphia
| | - John Q Trojanowski
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (D.J.I., C.T.M., J.P., K.R., E.M.W., M.G.); Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, Alzheimer's Disease Core Center (D.J.I., C.T.M., E.S., E.M.W., J.B.T., S.E.A., V.M.-Y.L., V.M.V.D., J.Q.T., M.G.); Penn Memory Center, Department of Neurology (S.E.A.); and Brain-Behavior Laboratory, Departments of Psychiatry, Perelman School of Medicine (S.E.A.), University of Pennsylvania, Philadelphia
| | - Murray Grossman
- From the Penn Frontotemporal Degeneration Center, Department of Neurology (D.J.I., C.T.M., J.P., K.R., E.M.W., M.G.); Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, Alzheimer's Disease Core Center (D.J.I., C.T.M., E.S., E.M.W., J.B.T., S.E.A., V.M.-Y.L., V.M.V.D., J.Q.T., M.G.); Penn Memory Center, Department of Neurology (S.E.A.); and Brain-Behavior Laboratory, Departments of Psychiatry, Perelman School of Medicine (S.E.A.), University of Pennsylvania, Philadelphia
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Dementia time to death: a systematic literature review on survival time and years of life lost in people with dementia. Int Psychogeriatr 2012; 24:1034-45. [PMID: 22325331 DOI: 10.1017/s1041610211002924] [Citation(s) in RCA: 170] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Life expectancy with dementia directly influences rates of prevalence and service needs and is a common question posed by families and patients. As well as years of survival, it is useful to consider years of life lost after a diagnosis of dementia. METHODS We systematically reviewed the literature on mortality and survival with dementia which were compared to estimated life expectancies in the general population. Both were then compared by age (under 65 years vs. 65+ years), gender, dementia type, severity, and two epochs (prior to and after introduction of cholinesterase inhibitors in 1997). RESULTS Survival after a diagnosis of dementia varies considerably and depends on numerous factors and their complex interaction. Relative loss of life expectancy decreases with age at diagnosis across varying gender, dementia subtypes (except for frontotemporal dementia and dementia with Lewy bodies), and severity stages. Numerous study deficiencies precluded a meta-analysis of survival in dementia. CONCLUSION Estimates of years of life lost through dementia may be helpful for patients and their families. Recommendations for future research methods are proposed.
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Cai Z, Yan LJ, Li K, Quazi SH, Zhao B. Roles of AMP-activated protein kinase in Alzheimer's disease. Neuromolecular Med 2012; 14:1-14. [PMID: 22367557 DOI: 10.1007/s12017-012-8173-2] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Accepted: 02/04/2012] [Indexed: 12/22/2022]
Abstract
AMP-activated protein kinase (AMPK), a master regulator of cellular energy homeostasis and a central player in glucose and lipid metabolism, is potentially implicated in the pathogenesis of Alzheimer's disease (AD). AMPK activity decreases in AD brain, indicating decreased mitochondrial biogenesis and function. Emerging evidence demonstrates that AMPK activation is a potential target for improving perturbed brain energy metabolism that is involved in the pathogenesis of AD. The roles of AMPK in the pathogenesis of AD include β-amyloid protein (Aβ) generation and tau phosphorylation. In particular, AMPK may regulate Aβ generation through modulating neuronal cholesterol and sphingomyelin levels and through regulating APP distribution in the lipid rafts. AMPK is activated by phosphorylation of Thr-172 by LKB1 complex in response to increase in the AMP/ATP ratio and by calmodulin-dependent protein kinase kinase-beta in response to elevated Ca(2+) levels, which contributes to regulating Aβ generation. AMPK is a physiological tau kinase and can increase the phosphorylation of tau at Ser-262. AMPK can also directly phosphorylate tau at Thr-231 and Ser-396/404. Furthermore, AMPK activation decreases mTOR signaling activity to facilitate autophagy and promotes lysosomal degradation of Aβ. However, AMPK activation has non-neuroprotective property and may lead to detrimental outcomes, including Aβ generation and tau phosphorylation. Therefore, it is still unclear whether AMPK could serve a potential therapeutic target for AD, and hence, further studies will be needed to clarify the role of AMPK in AD.
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Affiliation(s)
- Zhiyou Cai
- Department of Neurology, The Affiliated Hospital of Guangdong Medical College, District of Xiashan, Zhanjiang 524001, Guangdong, People's Republic of China
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Tack GR, Choi MH, Lee SJ, Yang JW, Kim JH, Choi JS, Jun JH, Lee JW, Park JY, Moon SW, Chung SC. Prioritizing problem features in Korean patients with senile dementia for implementation of monitoring technologies. Psychiatry Res 2011; 187:418-23. [PMID: 20659771 DOI: 10.1016/j.psychres.2010.06.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Revised: 05/10/2010] [Accepted: 06/29/2010] [Indexed: 10/19/2022]
Abstract
The purpose of this study was to investigate the central problem features of Korean patients with senile dementia and to prioritize the features according to risk to the patient with a view to the implementation of remote monitoring technologies. Twenty central problem features were extracted using factorial analysis. The frequency of violent language and confabulation, gathering, and repetition was significantly greater in female than in male patients with senile dementia. All central features, with the exception of abnormal sexual behavior and audiovisual deficits, differed in frequency between the normal elderly and the senile dementia patients and between patients with dementias of different severity. Judgment disorder was the greatest differentiating factor between the normal elderly and the patients with senile dementia. For dementia severity, memory disorder was the greatest differentiating factor of severe versus mild dementia. When risk to the patient was analyzed, problems of perception were identified as the problem features of highest priority.
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Affiliation(s)
- Gye-Rae Tack
- Department of Biomedical Engineering, Research Institute of Biomedical Engineering, College of Biomedical & Health Science, Konkuk University, Chungju, South Korea
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Behavioural variant frontotemporal dementia--defining genetic and pathological subtypes. J Mol Neurosci 2011; 45:583-8. [PMID: 21559874 DOI: 10.1007/s12031-011-9542-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 04/28/2011] [Indexed: 12/12/2022]
Abstract
Behavioural variant frontotemporal dementia (bvFTD) is a clinically, genetically and pathologically heterogeneous neurodegenerative disorder caused by FTLD-tau, FTLD-TDP and FTLD-FUS pathologies. Clinically, patients present with behavioural symptoms that may include one or more of disinhibition, apathy/inertia, loss of sympathy/empathy, perseverative, stereotyped and compulsive/ritualistic behaviour or hyperorality/dietary changes. Cognitive deficits, particularly executive dysfunction, are also seen. Neuroanatomically, patients have frontal and/or temporal lobe atrophy on neuroimaging. However, there is currently no clear correlation between the clinical and neuroanatomical phenotype in life and the underlying pathogenetics. With the advent of clinical trials in bvFTD, establishing the underlying pathology accurately during life will become increasingly important. This review therefore investigates current and future biomarkers that may help make a pathological diagnosis in life, i.e. bvFTD-tau, bvFTD-TDP and bvFTD-FUS, including clinical and neuropsychological data, neuroimaging, blood and CSF markers.
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Chen KL, Yuan RY, Hu CJ, Hsu CY. Amyloid-β peptide alteration of tau exon-10 splicing via the GSK3β-SC35 pathway. Neurobiol Dis 2010; 40:378-85. [PMID: 20615469 DOI: 10.1016/j.nbd.2010.06.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 06/11/2010] [Accepted: 06/26/2010] [Indexed: 10/19/2022] Open
Abstract
Amyloid-beta peptide (Aβ) and Tau protein are the lead constituents in the pathogenesis of Alzheimer's disease (AD). However, their inter-relationship in the disease process remains to be established. Tauopathy refers to a characteristic neurodegenerative process in AD. In tauopathy, Tau accumulates as a consequence of altered pre-mRNA splicing of tau exon 10, resulting in 3R (without exon 10)/4R (with exon 10) imbalance. We studied Aβ effects on tau exon 10 pre-mRNA splicing and relevant signaling events. This is the first demonstration of Aβ alteration of tau exon 10 splicing with an increase in 3R/4R ratio caused by reduced 4R expression. This Aβ action is causally related to its activation of GSK-3β which in turn phosphorylates SC35, an enhancer in tau exon 10 splicing. The establishment of the Aβ-GSK-3β-SC35 cascade broadens insight into development of novel strategies to modulate Aβ action on tau exon 10 splicing for possible prevention of tauopathy.
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Affiliation(s)
- Kun-Lin Chen
- The Department of Medical Education and Research, Shih Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
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Whitwell JL, Przybelski SA, Weigand SD, Ivnik RJ, Vemuri P, Gunter JL, Senjem ML, Shiung MM, Boeve BF, Knopman DS, Parisi JE, Dickson DW, Petersen RC, Jack CR, Josephs KA. Distinct anatomical subtypes of the behavioural variant of frontotemporal dementia: a cluster analysis study. Brain 2009; 132:2932-46. [PMID: 19762452 DOI: 10.1093/brain/awp232] [Citation(s) in RCA: 225] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The behavioural variant of frontotemporal dementia is a progressive neurodegenerative syndrome characterized by changes in personality and behaviour. It is typically associated with frontal lobe atrophy, although patterns of atrophy are heterogeneous. The objective of this study was to examine case-by-case variability in patterns of grey matter atrophy in subjects with the behavioural variant of frontotemporal dementia and to investigate whether behavioural variant of frontotemporal dementia can be divided into distinct anatomical subtypes. Sixty-six subjects that fulfilled clinical criteria for a diagnosis of the behavioural variant of frontotemporal dementia with a volumetric magnetic resonance imaging scan were identified. Grey matter volumes were obtained for 26 regions of interest, covering frontal, temporal and parietal lobes, striatum, insula and supplemental motor area, using the automated anatomical labelling atlas. Regional volumes were divided by total grey matter volume. A hierarchical agglomerative cluster analysis using Ward's clustering linkage method was performed to cluster the behavioural variant of frontotemporal dementia subjects into different anatomical clusters. Voxel-based morphometry was used to assess patterns of grey matter loss in each identified cluster of subjects compared to an age and gender-matched control group at P < 0.05 (family-wise error corrected). We identified four potentially useful clusters with distinct patterns of grey matter loss, which we posit represent anatomical subtypes of the behavioural variant of frontotemporal dementia. Two of these subtypes were associated with temporal lobe volume loss, with one subtype showing loss restricted to temporal lobe regions (temporal-dominant subtype) and the other showing grey matter loss in the temporal lobes as well as frontal and parietal lobes (temporofrontoparietal subtype). Another two subtypes were characterized by a large amount of frontal lobe volume loss, with one subtype showing grey matter loss in the frontal lobes as well as loss of the temporal lobes (frontotemporal subtype) and the other subtype showing loss relatively restricted to the frontal lobes (frontal-dominant subtype). These four subtypes differed on clinical measures of executive function, episodic memory and confrontation naming. There were also associations between the four subtypes and genetic or pathological diagnoses which were obtained in 48% of the cohort. The clusters did not differ in behavioural severity as measured by the Neuropsychiatric Inventory; supporting the original classification of the behavioural variant of frontotemporal dementia in these subjects. Our findings suggest behavioural variant of frontotemporal dementia can therefore be subdivided into four different anatomical subtypes.
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Affiliation(s)
- Jennifer L Whitwell
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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Current world literature. Trauma and rehabilitation. Curr Opin Neurol 2008; 21:762-4. [PMID: 18989123 DOI: 10.1097/wco.0b013e32831cbb85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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