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Abdelnour C, Young CB, Shahid-Besanti M, Smith A, Wilson EN, Ramos Benitez J, Vossler H, Plastini MJ, Winer JR, Kerchner GA, Cholerton B, Andreasson KI, Henderson VW, Yutsis M, Montine TJ, Tian L, Mormino EC, Poston KL. Plasma pTau181 Reveals a Pathological Signature that Predicts Cognitive Outcomes in Lewy Body Disease. Ann Neurol 2024. [PMID: 38888142 DOI: 10.1002/ana.27003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 05/22/2024] [Accepted: 05/25/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE To determine whether plasma phosphorylated-Tau181 (pTau181) could be used as a diagnostic biomarker of concurrent Alzheimer's disease neuropathologic change (ADNC) or amyloidosis alone, as well as a prognostic, monitoring, and susceptibility/risk biomarker for clinical outcomes in Lewy body disease (LBD). METHODS We studied 565 participants: 94 LBD with normal cognition, 83 LBD with abnormal cognition, 114 with Alzheimer's disease, and 274 cognitively normal. Plasma pTau181 levels were measured with the Lumipulse G platform. Diagnostic accuracy for concurrent ADNC and amyloidosis was assessed with Receiver Operating Characteristic curves in a subset of participants with CSF pTau181/Aβ42, and CSF Aβ42/Aβ40 or amyloid-β PET, respectively. Linear mixed effects models were used to examine the associations between baseline and longitudinal plasma pTau181 levels and clinical outcomes. RESULTS Plasma pTau181 predicted concurrent ADNC and amyloidosis in LBD with abnormal cognition with 87% and 72% accuracy, respectively. In LBD patients with abnormal cognition, higher baseline plasma pTau181 was associated with worse baseline MoCA and CDR-SB, as well as accelerated decline in CDR-SB. Additionally, in this group, rapid increases in plasma pTau181 over 3 years predicted a faster decline in CDR-SB and memory. In LBD patients with normal cognition, there was no association between baseline or longitudinal plasma pTau181 levels and clinical outcomes; however, elevated pTau181 at baseline increased the risk of conversion to cognitive impairment. INTERPRETATION Our findings suggest that plasma pTau181 is a promising biomarker for concurrent ADNC and amyloidosis in LBD. Furthermore, plasma pTau181 holds potential as a prognostic, monitoring, and susceptibility/risk biomarker, predicting disease progression in LBD. ANN NEUROL 2024.
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Affiliation(s)
- Carla Abdelnour
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Christina B Young
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Marian Shahid-Besanti
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Alena Smith
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Edward N Wilson
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Javier Ramos Benitez
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Hillary Vossler
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Melanie J Plastini
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Joseph R Winer
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Geoffrey A Kerchner
- Pharma Research and Early Development, F. Hoffmann-La Roche, Ltd., Basel, Switzerland
| | - Brenna Cholerton
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Katrin I Andreasson
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Victor W Henderson
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - Maya Yutsis
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Thomas J Montine
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Lu Tian
- Department of Biomedical Data Science, School of Medicine, Department of Statistics, School of Humanities and Sciences, Stanford University, Stanford, CA, USA
| | - Elizabeth C Mormino
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Kathleen L Poston
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
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2
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Lin J, Ou R, Li C, Hou Y, Zhang L, Wei Q, Liu K, Jiang Q, Yang T, Xiao Y, Pang D, Zhao B, Chen X, Yang J, Shang H. Evolution and Predictive Role of Plasma Alzheimer's Disease-related Pathological Biomarkers in Parkinson's Disease. J Gerontol A Biol Sci Med Sci 2023; 78:2203-2213. [PMID: 37560912 DOI: 10.1093/gerona/glad189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Indexed: 08/11/2023] Open
Abstract
Plasma Alzheimer's disease-related pathological biomarkers' role in Parkinson's disease (PD) remains unknown. We aimed to determine whether plasma Alzheimer's disease-related biomarkers can predict PD progression. A total of 184 PD patients and 86 healthy controls were included and followed up for 5 years. Plasma phosphorylated tau181 (p-tau181), Aβ40, and Aβ42 were measured at baseline and the 1- and 2-year follow-ups using the Quanterix-single-molecule array. Global cognitive function and motor symptoms were assessed using the Montreal Cognitive Assessment and Unified Parkinson's Disease Rating Scale part III. Genetic analyses were conducted to identify APOE and MAPT genotypes. Plasma p-tau181 levels were higher in PD than healthy controls. APOE-ε4 carriers had lower plasma Aβ42 levels and Aβ42/Aβ40 ratio. The linear mixed-effects models showed that Montreal Cognitive Assessment scores were associated with plasma p-tau181/Aβ42 ratio (β -1.719 [-3.398 to -0.040], p = .045). Higher baseline plasma p-tau181 correlated with faster cognitive decline and motor symptoms deterioration in total patients (β -0.170 [-0.322 to -0.018], p = .029; β 0.329 [0.032 to 0.626], p = .030) and APOE-ε4 carriers (β -0.318 [-0.602 to -0.034], p = .030; β 0.632 [0.017 to 1.246], p = .046), but not in the noncarriers. Higher baseline plasma Aβ40 correlated with faster cognitive decline in total patients (β -0.007 [-0.015 to -0.0001], p = .047) and faster motor symptoms deterioration in total patients (β 0.026 [0.010 to 0.041], p = .001) and APOE-ε4 carriers (β 0.044 [-0.026 to 0.049], p = .020), but not in the noncarriers. The plasma p-tau181/Aβ2 ratio monitors the cognitive status of PD. Higher baseline plasma p-tau181 and Aβ40 predict faster cognitive decline and motor symptoms deterioration in PD, especially in APOE-ε4 carriers.
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Affiliation(s)
- Junyu Lin
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ruwei Ou
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chunyu Li
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yanbing Hou
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lingyu Zhang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qianqian Wei
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kuncheng Liu
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qirui Jiang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tianmi Yang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi Xiao
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dejiang Pang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bi Zhao
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xueping Chen
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Yang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huifang Shang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Liu T, Zuo H, Ma D, Song D, Zhao Y, Cheng O. Cerebrospinal fluid GFAP is a predictive biomarker for conversion to dementia and Alzheimer's disease-associated biomarkers alterations among de novo Parkinson's disease patients: a prospective cohort study. J Neuroinflammation 2023; 20:167. [PMID: 37475029 PMCID: PMC10357612 DOI: 10.1186/s12974-023-02843-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/27/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Dementia is a prevalent non-motor manifestation among individuals with advanced Parkinson's disease (PD). Glial fibrillary acidic protein (GFAP) is an inflammatory marker derived from astrocytes. Research has demonstrated the potential of plasma GFAP to forecast the progression to dementia in PD patients with mild cognitive impairment (PD-MCI). However, the predictive role of cerebrospinal fluid (CSF) GFAP on future cognitive transformation and alterations in Alzheimer's disease (AD)-associated CSF biomarkers in newly diagnosed PD patients has not been investigated. METHODS 210 de novo PD patients from the Parkinson's Progression Markers Initiative were recruited. Cognitive progression in PD participants was evaluated using Cox regression. Cross-sectional and longitudinal associations between baseline CSF GFAP and cognitive function and AD-related CSF biomarkers were evaluated using multiple linear regression and generalized linear mixed model. RESULTS At baseline, the mean age of PD participants was 60.85 ± 9.78 years, including 142 patients with normal cognition (PD-NC) and 68 PD-MCI patients. The average follow-up time was 6.42 ± 1.69 years. A positive correlation was observed between baseline CSF GFAP and age (β = 0.918, p < 0.001). There was no statistically significant difference in baseline CSF GFAP levels between PD-NC and PD-MCI groups. Higher baseline CSF GFAP predicted greater global cognitive decline over time in early PD patients (Montreal Cognitive Assessment, β = - 0.013, p = 0.014). Furthermore, Cox regression showed that high baseline CSF GFAP levels were associated with a high risk of developing dementia over an 8-year period in the PD-NC group (adjusted HR = 3.070, 95% CI 1.119-8.418, p = 0.029). In addition, the baseline CSF GFAP was positively correlated with the longitudinal changes of not only CSF α-synuclein (β = 0.313, p < 0.001), but also CSF biomarkers associated with AD, namely, amyloid-β 42 (β = 0.147, p = 0.034), total tau (β = 0.337, p < 0.001) and phosphorylated tau (β = 0.408, p < 0.001). CONCLUSIONS CSF GFAP may be a valuable prognostic tool that can predict the severity and progression of cognitive deterioration, accompanied with longitudinal changes in AD-associated pathological markers in early PD.
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Affiliation(s)
- Tingting Liu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 China
| | - Hongzhou Zuo
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 China
| | - Di Ma
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 China
| | - Dan Song
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 China
| | - Yuying Zhao
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 China
| | - Oumei Cheng
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 China
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Gasser T. Genetic testing for Parkinson's disease in clinical practice. J Neural Transm (Vienna) 2023; 130:777-782. [PMID: 36929227 PMCID: PMC10199829 DOI: 10.1007/s00702-023-02612-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 02/21/2023] [Indexed: 03/18/2023]
Abstract
The identification of disease-causing mutations or strong risk factors for Parkinson's disease in genes encoding proteins such as α-synuclein (SNCA), leucine-rich repeat kinase-2 (LRRK2), or glucocerebrosidase (GBA1) has led to a better understanding of the different components of disease pathogenesis. Many gene and mutation-specific targeted disease-modifying treatments are under development and several studies are under way. It is, therefore, important to raise awareness among patients and their families and to offer genetic testing, at least to those patients who are considering to participate in innovative trials.
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5
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Clinical correlations of cerebrospinal fluid biomarkers including neuron-glia 2 and neurofilament light chain in patients with multiple system atrophy. Parkinsonism Relat Disord 2022; 102:30-35. [DOI: 10.1016/j.parkreldis.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 11/19/2022]
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Höglinger G, Schulte C, Jost WH, Storch A, Woitalla D, Krüger R, Falkenburger B, Brockmann K. GBA-associated PD: chances and obstacles for targeted treatment strategies. J Neural Transm (Vienna) 2022; 129:1219-1233. [PMID: 35639160 PMCID: PMC9463270 DOI: 10.1007/s00702-022-02511-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/01/2022] [Indexed: 11/08/2022]
Abstract
Given the clear role of GBA in the pathogenesis of Parkinson’s disease (PD) and its impact on phenotypical characteristics, this review provides an overview of the current knowledge of GBA-associated PD with a special focus on clinical trajectories and the underlying pathological mechanisms. Importantly, differences and characteristics based on mutation severity are recognized, and current as well as potential future treatment options are discussed. These findings will inform future strategies for patient stratification and cohort enrichment as well as suitable outcome measures when designing clinical trials.
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Affiliation(s)
- Günter Höglinger
- Department of Neurology, Hannover Medical School, 30625, Hannover, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Claudia Schulte
- Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, Center of Neurology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.,German Center for Neurodegenerative Disease (DZNE), Tuebingen, Germany
| | | | - Alexander Storch
- Department of Neurology, Rostock University, Gehlsheimer Str. 20, 18147, Rostock, Germany.,German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Gehlsheimer Str. 20, 18147, Rostock, Germany
| | - Dirk Woitalla
- Department of Neurology, St. Josef-Hospital, Katholische Kliniken Ruhrhalbinsel, Contilia Gruppe, Essen, Germany
| | - Rejko Krüger
- Transversal Translational Medicine, Luxembourg Institute of Health (LIH), Strassen, Luxembourg.,Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg.,Parkinson Research Clinic, Centre Hospitalier de Luxembourg (CHL), Luxembourg, Luxembourg
| | - Björn Falkenburger
- Department of Neurology, Faculty of Medicine, University Hospital Carl Gustav Carus and Carl Gustav Carus, Technische Universität Dresden, 01307, Dresden, Germany
| | - Kathrin Brockmann
- Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, Center of Neurology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany. .,German Center for Neurodegenerative Disease (DZNE), Tuebingen, Germany.
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7
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The Role of Tau beyond Alzheimer’s Disease: A Narrative Review. Biomedicines 2022; 10:biomedicines10040760. [PMID: 35453510 PMCID: PMC9026415 DOI: 10.3390/biomedicines10040760] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 02/01/2023] Open
Abstract
Nowadays, there is a need for reliable fluid biomarkers to improve differential diagnosis, prognosis, and the prediction of treatment response, particularly in the management of neurogenerative diseases that display an extreme variability in clinical phenotypes. In recent years, Tau protein has been progressively recognized as a valuable neuronal biomarker in several neurological conditions, not only Alzheimer’s disease (AD). Cerebrospinal fluid and serum Tau have been extensively investigated in several neurodegenerative disorders, from classically defined proteinopathy, e.g., amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), and Parkinson’s disease (PD), but also in inflammatory conditions such as multiple sclerosis (MS), as a marker of axonal damage. In MS, total Tau (t-Tau) may represent, along with other proteins, a marker with diagnostic and prognostic value. In ALS, t-Tau and, mainly, the phosphorylated-Tau/t-Tau ratio alone or integrated with transactive DNA binding protein of ~43 kDa (TDP-43), may represent a tool for both diagnosis and differential diagnosis of other motoneuron diseases or tauopathies. Evidence indicated the crucial role of the Tau protein in the pathogenesis of PD and other parkinsonian disorders. This narrative review summarizes current knowledge regarding non-AD neurodegenerative diseases and the Tau protein.
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8
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Pan L, Meng L, He M, Zhang Z. Tau in the Pathophysiology of Parkinson's Disease. J Mol Neurosci 2021; 71:2179-2191. [PMID: 33459970 PMCID: PMC8585831 DOI: 10.1007/s12031-020-01776-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/10/2020] [Indexed: 12/13/2022]
Abstract
The pathological hallmarks of Parkinson's disease (PD) are the progressive loss of dopaminergic neurons in the substantia nigra and the formation of Lewy bodies (LBs) in remaining neurons. LBs primarily consist of aggregated α-Synuclein (α-Syn). However, accumulating evidence suggests that Tau, which is associated with tauopathies such as Alzheimer's disease (AD), progressive supranuclear palsy (PSP), and argyrophilic grain disease, is also involved in the pathophysiology of PD. A genome-wide association study (GWAS) identified MAPT, the gene encoding the Tau protein, as a risk gene for PD. Autopsy of PD patients also revealed the colocalization of Tau and α-Syn in LBs. Experimental evidence has shown that Tau interacts with α-Syn and influences the pathology of α-Syn in PD. In this review, we discuss the structure and function of Tau and provide a summary of the current evidence supporting Tau's involvement as either an active or passive element in the pathophysiology of PD, which may provide novel targets for the early diagnosis and treatment of PD.
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Affiliation(s)
- Lina Pan
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Lanxia Meng
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Mingyang He
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Zhentao Zhang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
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Abstract
Parkinson's disease is a recognisable clinical syndrome with a range of causes and clinical presentations. Parkinson's disease represents a fast-growing neurodegenerative condition; the rising prevalence worldwide resembles the many characteristics typically observed during a pandemic, except for an infectious cause. In most populations, 3-5% of Parkinson's disease is explained by genetic causes linked to known Parkinson's disease genes, thus representing monogenic Parkinson's disease, whereas 90 genetic risk variants collectively explain 16-36% of the heritable risk of non-monogenic Parkinson's disease. Additional causal associations include having a relative with Parkinson's disease or tremor, constipation, and being a non-smoker, each at least doubling the risk of Parkinson's disease. The diagnosis is clinically based; ancillary testing is reserved for people with an atypical presentation. Current criteria define Parkinson's disease as the presence of bradykinesia combined with either rest tremor, rigidity, or both. However, the clinical presentation is multifaceted and includes many non-motor symptoms. Prognostic counselling is guided by awareness of disease subtypes. Clinically manifest Parkinson's disease is preceded by a potentially long prodromal period. Presently, establishment of prodromal symptoms has no clinical implications other than symptom suppression, although recognition of prodromal parkinsonism will probably have consequences when disease-modifying treatments become available. Treatment goals vary from person to person, emphasising the need for personalised management. There is no reason to postpone symptomatic treatment in people developing disability due to Parkinson's disease. Levodopa is the most common medication used as first-line therapy. Optimal management should start at diagnosis and requires a multidisciplinary team approach, including a growing repertoire of non-pharmacological interventions. At present, no therapy can slow down or arrest the progression of Parkinson's disease, but informed by new insights in genetic causes and mechanisms of neuronal death, several promising strategies are being tested for disease-modifying potential. With the perspective of people with Parkinson's disease as a so-called red thread throughout this Seminar, we will show how personalised management of Parkinson's disease can be optimised.
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Affiliation(s)
- Bastiaan R Bloem
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Nijmegen, Netherlands.
| | - Michael S Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Christine Klein
- Institute of Neurogenetics and Department of Neurology, University of Lübeck and University Hospital Schleswig-Holstein, Lübeck, Germany
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Liepelt-Scarfone I, Gräber S, Kalbe E, Riedel O, Ringendahl H, Schmidt N, Witt K, Roeske S. [Guidelines for the Neuropsychological Assessment of Patients with Parkinson's Disease]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 89:363-373. [PMID: 33561875 DOI: 10.1055/a-1099-9332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Presence of mild cognitive impairment is currently the best predictor for the development of Parkinson's disease dementia. Diagnostic criteria for both Parkinson's with mild cognitive impairment and Parkinson's disease dementia have been suggested by the Movement Disorder Society. However, not all cognitive tests recommended are available in the German language with proper standard values. OBJECTIVES To define evidence-based guidelines for neuropsychological assessment of patients with Parkinson's disease in German. METHODS Two systematic literature searches were conducted. First, articles that presented international guidelines (consensus papers or reviews) for the application of standardized neuropsychological assessments for the diagnosis of cognitive impairment in Parkinson's disease were selected. Of those, only neuropsychological assessments in German language with normative values referring either to a German, Austrian, or Swiss population were considered. Second, articles comparing test performances of healthy controls vs. Parkinson's disease and/or different cognitive Parkinson's disease subtypes (e.g. no cognitive impairment, Parkinson's with mild cognitive impairment, Parkinson's disease dementia) were selected. Effect sizes for group differentiation were calculated. RESULTS Out of 127 full-text articles reviewed, 48 tests were identified during the first literature search. In the second search, 1716 articles were reviewed and 23 papers selected. The strongest effect sizes for group discrimination were revealed for tests assessing executive function, attention, and visuo-cognitive abilities. Based on the results of the two literature searches, consensus guidelines were defined by the authors, allowing for Level-II diagnosis for Parkinson's with mild cognitive impairment and Parkinson's disease dementia. CONCLUSIONS The presented guidelines may have the potential to standardize and improve the neuropsychological assessment of Parkinson's disease patients in German speaking countries.
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Affiliation(s)
- Inga Liepelt-Scarfone
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Standort Tübingen, Deutschland.,Abteilung Neurodegeneration, Hertie Institut für Klinische Forschung, Tübingen, Deutschland
| | - Susanne Gräber
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Standort Tübingen, Deutschland.,Zentrum für ambulante Rehabilitation am Universitätsklinikum Tübingen, Deutschland
| | - Elke Kalbe
- Medizinische Psychologie: Neuropsychologie und Genderforschung & Center für Neuropsychologische Diagnostik und Intervention, Universitätsklinikum Köln, Köln, Deutschland
| | - Oliver Riedel
- Abteilung Klinische Epidemiologie, Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS GmbH, Bremen, Deutschland
| | - Hubert Ringendahl
- Klinik für Neurologie und klinische Neurophysiologie, Helios Universitätsklinikum Wuppertal, Universitäts Witten/Herdecke, Wuppertal, Deutschland
| | - Nele Schmidt
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel, Deutschland
| | - Karsten Witt
- Forschungszentrum Neurosensorik, Carl von Ossietzy Universität Oldenburg, Universitätsklinik für Neurologie, Oldenburg, Deutschland
| | - Sandra Roeske
- Deutsches Zentrum für Neurodegenerative Erkrankungen, Bonn, Deutschland
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11
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Becker S, Granert O, Timmers M, Pilotto A, Van Nueten L, Roeben B, Salvadore G, Galpern WR, Streffer J, Scheffler K, Maetzler W, Berg D, Liepelt-Scarfone I. Association of Hippocampal Subfields, CSF Biomarkers, and Cognition in Patients With Parkinson Disease Without Dementia. Neurology 2020; 96:e904-e915. [PMID: 33219138 DOI: 10.1212/wnl.0000000000011224] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 10/02/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To examine whether hippocampal volume loss is primarily associated with cognitive status or pathologic β-amyloid 1-42 (Aβ42) levels, this study compared hippocampal subfield volumes between patients with Parkinson disease (PD) with mild cognitive impairment (PD-MCI) and without cognitive impairment (PD-CN) and between patients with low and high Aβ42 levels, in addition exploring the relationship among hippocampal subfield volumes, CSF biomarkers (Aβ42, phosphorylated and total tau), neuropsychological tests, and activities of daily living. METHODS Forty-five patients with PD without dementia underwent CSF analyses and MRI as well as comprehensive motor and neuropsychological examinations. Hippocampal segmentation was conducted using FreeSurfer image analysis suite 6.0. Regression models were used to compare hippocampal subfield volumes between groups, and partial correlations defined the association between variables while controlling for intracranial volume (ICV). RESULTS Linear regressions revealed cognitive group as a statistically significant predictor of both the hippocampal-amygdaloid transition area (HATA; β = -0.23, 95% CI -0.44 to -0.02) and the cornu ammonis 1 region (CA1; β = -0.28, 95% confidence interval [CI] -0.56 to -0.02), independent of disease duration and ICV, with patients with PD-MCI showing significantly smaller volumes than PD-CN. In contrast, no subfields were predicted by Aβ42 levels. Smaller hippocampal volumes were associated with worse performance on memory, language, spatial working memory, and executive functioning tests. The subiculum was negatively correlated with total tau levels (r = -0.37, 95% CI -0.60 to -0.09). CONCLUSION Cognitive status, but not CSF Aβ42, predicted hippocampal volumes, specifically the CA1 and HATA. Hippocampal subfields were associated with various cognitive domains, as well as with tau pathology.
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Affiliation(s)
- Sara Becker
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany.
| | - Oliver Granert
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Maarten Timmers
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Andrea Pilotto
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Luc Van Nueten
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Benjamin Roeben
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Giacomo Salvadore
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Wendy R Galpern
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Johannes Streffer
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Klaus Scheffler
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Walter Maetzler
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Daniela Berg
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
| | - Inga Liepelt-Scarfone
- From the Department of Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Hertie Institute for Clinical Brain Research; German Center for Neurodegenerative Diseases (S.B., B.R., I.L.-S.), Tübingen; Department of Neurology (O.G., W.M., D.B.), Christian-Albrechts-University, Kiel, Germany; Janssen Research and Development, a Division of Janssen Pharmaceutica N.V. (M.T., L.V.N., J.S.), Beerse; Reference Center for Biological Markers of Dementia (M.T.), Institute Born-Bunge, University of Antwerp, Belgium; Department of Clinical and Experimental Sciences (A.P.), University of Brescia; Parkinson's Disease Rehabilitation Centre (A.P.), FERB ONLUS Sant'Isidoro Hospital, Trescore Balneario, Italy; Janssen Research and Development LLC (G.S., W.R.G.), Titusville, NJ; Translational Medicine Neuroscience (J.S.), UCB Biopharma SPRK, Braine-l'Alleud, Belgium; Magnetic Resonance Center (K.S.), Max Planck Institute for Biological Cybernetics; and Department of Biomedical Magnetic Resonance (K.S.), University Hospital Tübingen, Germany
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12
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Brockmann K. GBA-Associated Synucleinopathies: Prime Candidates for Alpha-Synuclein Targeting Compounds. Front Cell Dev Biol 2020; 8:562522. [PMID: 33102473 PMCID: PMC7545538 DOI: 10.3389/fcell.2020.562522] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/09/2020] [Indexed: 12/13/2022] Open
Abstract
With disease-modifying compounds targeting alpha-synuclein available in clinical trials, patient stratification according to alpha-synuclein-specific enrichment strategies is a much-needed prerequisite. Such a scenario will be exemplified for GBA, one major genetic risk factor that is specifically associated with the alpha-synucleinopathies: Parkinson's disease and dementia with Lewy bodies.
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Affiliation(s)
- Kathrin Brockmann
- Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Disease (DZNE), Bonn, Germany
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13
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Irwin DJ, Fedler J, Coffey CS, Caspell-Garcia C, Kang JH, Simuni T, Foroud T, Toga AW, Tanner CM, Kieburtz K, Chahine LM, Reimer A, Hutten S, Weintraub D, Mollenhauer B, Galasko DR, Siderowf A, Marek K, Trojanowski JQ, Shaw LM. Evolution of Alzheimer's Disease Cerebrospinal Fluid Biomarkers in Early Parkinson's Disease. Ann Neurol 2020; 88:574-587. [PMID: 32542885 PMCID: PMC7497251 DOI: 10.1002/ana.25811] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We analyzed the longitudinal profile of Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers in early Parkinson's disease (PD) compared with healthy controls (HCs) and tested baseline CSF biomarkers for prediction of clinical decline in PD. METHODS Amyloid-β 1 to 42 (Aβ42 ), total tau (t-tau) and phosphorylated tau (p-tau) at the threonine 181 position were measured using the high-precision Roche Elecsys electrochemiluminescence immunoassay in all available CSF samples from longitudinally studied patients with PD (n = 416) and HCs (n = 192) followed for up to 3 years in the Parkinson's Progression Markers Initiative (PPMI). Longitudinal CSF and clinical data were analyzed with linear-mixed effects models. RESULTS We found patients with PD had lower CSF t-tau (median = 157.7 pg/mL; range = 80.9-467.0); p-tau (median = 13.4 pg/mL; range = 8.0-40.1), and Aβ42 (median = 846.2 pg/mL; range = 238.8-3,707.0) than HCs at baseline (CSF t-tau median = 173.5 pg/mL; range = 82.0-580.8; p-tau median = 15.4 pg/mL; range = 8.1-73.6; and Aβ42 median = 926.5 pg/mL; range = 239.1-3,297.0; p < 0.05-0.001) and a moderate-to-strong correlation among these biomarkers in both patients with PD and HCs (Rho = 0.50-0.97; p < 0.001). Of the patients with PD, 31.5% had pathologically low levels of CSF Aβ42 at baseline and these patients with PD had lower p-tau levels (median = 10.8 pg/mL; range = 8.0-32.8) compared with 27.7% of HCs with pathologically low CSF Aβ42 (CSF p-tau median = 12.8 pg/mL; range 8.2-73.6; p < 0.03). In longitudinal CSF analysis, we found patients with PD had greater decline in CSF Aβ42 (mean difference = -41.83 pg/mL; p = 0.03) and CSF p-tau (mean difference = -0.38 pg/mL; p = 0.03) at year 3 compared with HCs. Baseline CSF Aβ42 values predicted small but measurable decline on cognitive, autonomic, and motor function in early PD. INTERPRETATION Our data suggest baseline CSF AD biomarkers may have prognostic value in early PD and that the dynamic change of these markers, although modest over a 3-year period, suggest biomarker profiles in PD may deviate from healthy aging. ANN NEUROL 2020;88:574-587.
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Affiliation(s)
- David J Irwin
- Department of Neurology, School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Janel Fedler
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Christopher S Coffey
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Chelsea Caspell-Garcia
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Ju Hee Kang
- Department of Pharmacology & Clinical Pharmacology, Inha University, Incheon, South Korea
| | - Tanya Simuni
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN, USA
| | - Arthur W Toga
- Laboratory of Neuro Imaging, University of Southern California, Los Angeles, CA, USA
| | - Caroline M Tanner
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Karl Kieburtz
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - Lana M Chahine
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Daniel Weintraub
- Department of Neurology, School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Department of Psychiatry Perelman, School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Michael J. Crescenz VA Medical Center, Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA, USA
| | - Brit Mollenhauer
- Department of Neurology, University Medical Center, Göttingen Paracelsus-Elena-Klinik, Kassel, Germany
| | - Douglas R Galasko
- Department of Neurology, University of San Diego, San Diego, CA, USA
| | - Andrew Siderowf
- Department of Neurology, School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Kenneth Marek
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Center for Neurodegenerative Disease Research, School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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14
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Wurster I, Lerche S, Hauser AK, Schulte C, Lachmann I, Beschorner R, Neumann M, Brockmann K. Do longitudinal cerebrospinal fluid profiles correspond to postmortem brain pathology in LRRK2 Parkinson's disease? Eur J Neurol 2019; 27:e5-e6. [PMID: 31420996 DOI: 10.1111/ene.14060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 08/05/2019] [Indexed: 11/29/2022]
Affiliation(s)
- I Wurster
- Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.,German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - S Lerche
- Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.,German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - A-K Hauser
- German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - C Schulte
- Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | | | - R Beschorner
- Department of Neuropathology, University of Tuebingen, Tuebingen, Germany
| | - M Neumann
- German Center for Neurodegenerative Diseases, Tuebingen, Germany.,Department of Neuropathology, University of Tuebingen, Tuebingen, Germany
| | - K Brockmann
- Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.,German Center for Neurodegenerative Diseases, Tuebingen, Germany
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