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Shatalina E, Whitehurst TS, Onwordi EC, Gilbert BJ, Rizzo G, Whittington A, Mansur A, Tsukada H, Marques TR, Natesan S, Rabiner EA, Wall MB, Howes OD. Mitochondrial complex I density is associated with IQ and cognition in cognitively healthy adults: an in vivo [ 18F]BCPP-EF PET study. EJNMMI Res 2024; 14:41. [PMID: 38632153 PMCID: PMC11024075 DOI: 10.1186/s13550-024-01099-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/23/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Mitochondrial function plays a key role in regulating neurotransmission and may contribute to general intelligence. Mitochondrial complex I (MC-I) is the largest enzyme of the respiratory chain. Recently, it has become possible to measure MC-I distribution in vivo, using a novel positron emission tomography tracer [18F]BCPP-EF, thus, we set out to investigate the association between MC-I distribution and measures of cognitive function in the living healthy brain. RESULTS Analyses were performed in a voxel-wise manner and identified significant associations between [18F]BCPP-EF DVRCS-1 in the precentral gyrus and parietal lobes and WAIS-IV predicted IQ, WAIS-IV arithmetic and WAIS-IV symbol-digit substitution scores (voxel-wise Pearson's correlation coefficients transformed to Z-scores, thresholded at Z = 2.3 family-wise cluster correction at p < 0.05, n = 16). Arithmetic scores were associated with middle frontal and post-central gyri tracer uptake, symbol-digit substitution scores were associated with precentral gyrus tracer uptake. RAVLT recognition scores were associated with [18F]BCPP-EF DVRCS-1 in the middle frontal gyrus, post-central gyrus, occipital and parietal regions (n = 20). CONCLUSIONS Taken together, our findings support the theory that mitochondrial function may contribute to general intelligence and indicate that interindividual differences in MC-I should be a key consideration for research into mitochondrial dysfunction in conditions with cognitive impairment.
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Affiliation(s)
- Ekaterina Shatalina
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, Imperial College London, London, UK.
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Kings College London, London, UK.
| | - Thomas S Whitehurst
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, Imperial College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Kings College London, London, UK
| | - Ellis Chika Onwordi
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, Imperial College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Kings College London, London, UK
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | | | | | | | | | | | - Tiago Reis Marques
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Kings College London, London, UK
- Faculty of Medicine, Imperial College London, London, UK
| | - Sridhar Natesan
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, Imperial College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Kings College London, London, UK
| | - Eugenii A Rabiner
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Kings College London, London, UK
- Invicro, London, UK
| | - Matthew B Wall
- Faculty of Medicine, Imperial College London, London, UK
- Invicro, London, UK
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Oliver D Howes
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, Imperial College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), Kings College London, London, UK
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Mølstrøm S, Nielsen TH, Nordstrøm CH, Forsse A, Møller S, Venø S, Mamaev D, Tencer T, Theódórsdóttir Á, Krøigård T, Møller J, Hassager C, Kjærgaard J, Schmidt H, Toft P. A randomized, double-blind trial comparing the effect of two blood pressure targets on global brain metabolism after out-of-hospital cardiac arrest. Crit Care 2023; 27:73. [PMID: 36823636 PMCID: PMC9951410 DOI: 10.1186/s13054-023-04376-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
PURPOSE This study aimed to assess the effect of different blood pressure levels on global cerebral metabolism in comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA). METHODS In a double-blinded trial, we randomly assigned 60 comatose patients following OHCA to low (63 mmHg) or high (77 mmHg) mean arterial blood pressure (MAP). The trial was a sub-study in the Blood Pressure and Oxygenation Targets after Out-of-Hospital Cardiac Arrest-trial (BOX). Global cerebral metabolism utilizing jugular bulb microdialysis (JBM) and cerebral oxygenation (rSO2) was monitored continuously for 96 h. The lactate-to-pyruvate (LP) ratio is a marker of cellular redox status and increases during deficient oxygen delivery (ischemia, hypoxia) and mitochondrial dysfunction. The primary outcome was to compare time-averaged means of cerebral energy metabolites between MAP groups during post-resuscitation care. Secondary outcomes included metabolic patterns of cerebral ischemia, rSO2, plasma neuron-specific enolase level at 48 h and neurological outcome at hospital discharge (cerebral performance category). RESULTS We found a clear separation in MAP between the groups (15 mmHg, p < 0.001). Cerebral biochemical variables were not significantly different between MAP groups (LPR low MAP 19 (16-31) vs. high MAP 23 (16-33), p = 0.64). However, the LP ratio remained high (> 16) in both groups during the first 30 h. During the first 24 h, cerebral lactate > 2.5 mM, pyruvate levels > 110 µM, LP ratio > 30, and glycerol > 260 µM were highly predictive for poor neurological outcome and death with AUC 0.80. The median (IQR) rSO2 during the first 48 h was 69.5% (62.0-75.0%) in the low MAP group and 69.0% (61.3-75.5%) in the high MAP group, p = 0.16. CONCLUSIONS Among comatose patients resuscitated from OHCA, targeting a higher MAP 180 min after ROSC did not significantly improve cerebral energy metabolism within 96 h of post-resuscitation care. Patients with a poor clinical outcome exhibited significantly worse biochemical patterns, probably illustrating that insufficient tissue oxygenation and recirculation during the initial hours after ROSC were essential factors determining neurological outcome.
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Affiliation(s)
- Simon Mølstrøm
- Department of Anesthesiology and Intensive Care, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense, Denmark.
| | - Troels Halfeld Nielsen
- grid.7143.10000 0004 0512 5013Department of Neurosurgery, Odense University Hospital, Odense, Denmark
| | - Carl-Henrik Nordstrøm
- grid.7143.10000 0004 0512 5013Department of Neurosurgery, Odense University Hospital, Odense, Denmark
| | - Axel Forsse
- grid.4973.90000 0004 0646 7373Department of Neurosurgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Søren Møller
- grid.7143.10000 0004 0512 5013OPEN, Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark ,grid.10825.3e0000 0001 0728 0170Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Søren Venø
- grid.7143.10000 0004 0512 5013Department of Anesthesiology and Intensive Care, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense, Denmark
| | - Dmitry Mamaev
- grid.7143.10000 0004 0512 5013Department of Anesthesiology and Intensive Care, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense, Denmark
| | - Tomas Tencer
- grid.7143.10000 0004 0512 5013Department of Anesthesiology and Intensive Care, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense, Denmark
| | - Ásta Theódórsdóttir
- grid.7143.10000 0004 0512 5013Department of Neurology, Odense University Hospital, Odense, Denmark
| | - Thomas Krøigård
- grid.7143.10000 0004 0512 5013Department of Neurology, Odense University Hospital, Odense, Denmark
| | - Jacob Møller
- grid.4973.90000 0004 0646 7373The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark ,grid.7143.10000 0004 0512 5013Department of Cardiology, Odense University Hospital, Odense, Denmark ,grid.10825.3e0000 0001 0728 0170Department of Clinical Medicine, University of Southern, Odense, Denmark
| | - Christian Hassager
- grid.4973.90000 0004 0646 7373The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jesper Kjærgaard
- grid.4973.90000 0004 0646 7373The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark
| | - Henrik Schmidt
- grid.7143.10000 0004 0512 5013Department of Anesthesiology and Intensive Care, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense, Denmark
| | - Palle Toft
- grid.7143.10000 0004 0512 5013Department of Anesthesiology and Intensive Care, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense, Denmark
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Kato Y, Yokokura M, Iwabuchi T, Murayama C, Harada T, Goto T, Tamayama T, Kameno Y, Wakuda T, Kuwabara H, Benner S, Senju A, Tsukada H, Nishizawa S, Ouchi Y, Yamasue H. Lower Availability of Mitochondrial Complex I in Anterior Cingulate Cortex in Autism: A Positron Emission Tomography Study. Am J Psychiatry 2022; 180:277-284. [PMID: 36069020 DOI: 10.1176/appi.ajp.22010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Mitochondrial dysfunction has been implicated in the pathophysiology of autism spectrum disorder (ASD) in previous studies of postmortem brain or peripheral samples. The authors investigated whether and where mitochondrial dysfunction occurs in the living brains of individuals with ASD and to identify the clinical correlates of detected mitochondrial dysfunction. METHODS This case-control study used positron emission tomography (PET) with 2-tert-butyl-4-chloro-5-{6-[2-(2-[18F]fluoroethoxy)-ethoxy]-pyridin-3-ylmethoxy}-2H-pyridazin-3-one ([18F]BCPP-EF), a radioligand that binds to the mitochondrial electron transport chain complex I, to examine the topographical distribution of mitochondrial dysfunction in living brains of individuals with ASD. Twenty-three adult males with high-functioning ASD, with no psychiatric comorbidities and free of psychotropic medication, and 24 typically developed males with no psychiatric diagnoses, matched with the ASD group on age, parental socioeconomic background, and IQ, underwent [18F]BCPP-EF PET measurements. Individuals with mitochondrial disease were excluded by clinical evaluation and blood tests for abnormalities in lactate and pyruvate levels. RESULTS Among the brain regions in which mitochondrial dysfunction has been reported in postmortem studies of autistic brains, participants with ASD had significantly decreased [18F]BCPP-EF availability specifically in the anterior cingulate cortex compared with typically developed participants. The regional specificity was revealed by a significant interaction between diagnosis and brain regions. Moreover, the lower [18F]BCPP-EF availability in the anterior cingulate cortex was significantly correlated with the more severe ASD core symptom of social communication deficits. CONCLUSIONS This study provides direct evidence to link in vivo brain mitochondrial dysfunction with ASD pathophysiology and its communicational deficits. The findings support the possibility that mitochondrial electron transport chain complex I is a novel therapeutic target for ASD core symptoms.
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Affiliation(s)
- Yasuhiko Kato
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Masamichi Yokokura
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Toshiki Iwabuchi
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Chihiro Murayama
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Taeko Harada
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Takafumi Goto
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Taishi Tamayama
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Yosuke Kameno
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Tomoyasu Wakuda
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Hitoshi Kuwabara
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Seico Benner
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Atsushi Senju
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Hideo Tsukada
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Sadahiko Nishizawa
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Yasuomi Ouchi
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
| | - Hidenori Yamasue
- Department of Psychiatry (Kato, Yokokura, Murayama, Goto, Tamayama, Kameno, Wakuda, Kuwabara, Benner, Yamasue), United Graduate School of Child Development (Yokokura, Iwabuchi, Harada, Kameno, Kuwabara, Senju, Yamasue), Research Center for Child Mental Development (Iwabuchi, Harada, Senju), and Department of Biofunctional Imaging (Ouchi), Hamamatsu University School of Medicine, Hamamatsu, Japan; Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan (Tsukada); Hamamatsu Medical Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan (Nishizawa, Ouchi)
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Venkataraman AV, Mansur A, Rizzo G, Bishop C, Lewis Y, Kocagoncu E, Lingford-Hughes A, Huiban M, Passchier J, Rowe JB, Tsukada H, Brooks DJ, Martarello L, Comley RA, Chen L, Schwarz AJ, Hargreaves R, Gunn RN, Rabiner EA, Matthews PM. Widespread cell stress and mitochondrial dysfunction occur in patients with early Alzheimer's disease. Sci Transl Med 2022; 14:eabk1051. [PMID: 35976998 DOI: 10.1126/scitranslmed.abk1051] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Cell stress and impaired oxidative phosphorylation are central to mechanisms of synaptic loss and neurodegeneration in the cellular pathology of Alzheimer's disease (AD). In this study, we quantified the in vivo expression of the endoplasmic reticulum stress marker, sigma 1 receptor (S1R), using [11C]SA4503 positron emission tomography (PET), the mitochondrial complex I (MC1) with [18F]BCPP-EF, and the presynaptic vesicular protein SV2A with [11C]UCB-J in 12 patients with early AD and in 16 cognitively normal controls. We integrated these molecular measures with assessments of regional brain volumes and cerebral blood flow (CBF) measured with magnetic resonance imaging arterial spin labeling. Eight patients with AD were followed longitudinally to estimate the rate of change of the physiological and structural pathology markers with disease progression. The patients showed widespread increases in S1R (≤ 27%) and regional reduction in MC1 (≥ -28%) and SV2A (≥ -25%) radioligand binding, brain volume (≥ -23%), and CBF (≥ -26%). [18F]BCPP-EF PET MC1 binding (≥ -12%) and brain volumes (≥ -5%) showed progressive reductions over 12 to 18 months, suggesting that they both could be used as pharmacodynamic indicators in early-stage therapeutics trials. Associations of reduced MC1 and SV2A and increased S1R radioligand binding with reduced cognitive performance in AD, although exploratory, suggested a loss of metabolic functional reserve with disease. Our study thus provides in vivo evidence for widespread, clinically relevant cellular stress and bioenergetic abnormalities in early AD.
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Affiliation(s)
- Ashwin V Venkataraman
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK.,UK Dementia Research Institute at Imperial College London, London W12 0NN, UK
| | | | - Gaia Rizzo
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK.,Invicro LLC, London W12 0NN, UK
| | | | | | | | | | | | | | | | - Hideo Tsukada
- Hamamatsu Photonics, Hamakita, Hamamatsu, Shizuoka 4348601, Japan
| | - David J Brooks
- University of Newcastle upon Tyne, Newcastle NE2 4HH, UK.,Department of Clinical Medicine, Aarhus University, Aarhus 8200, Denmark
| | | | | | | | | | | | - Roger N Gunn
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK.,Invicro LLC, London W12 0NN, UK
| | - Eugenii A Rabiner
- Invicro LLC, London W12 0NN, UK.,King's College London, London SE5 8AF, UK
| | - Paul M Matthews
- Department of Brain Sciences, Imperial College London, London W12 0NN, UK.,UK Dementia Research Institute at Imperial College London, London W12 0NN, UK
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