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Pan J, Hu J, Meng D, Chen L, Wei X. Neuroinflammation in dementia: A meta-analysis of PET imaging studies. Medicine (Baltimore) 2024; 103:e38086. [PMID: 38701247 PMCID: PMC11062685 DOI: 10.1097/md.0000000000038086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/11/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Dementia is a major public health challenge for aging societies worldwide. Neuroinflammation is thought to be a key factor in dementia development. The aim of this study was to comprehensively assess translocator protein (TSPO) expression by positron emission tomography (PET) imaging to reveal the characteristics of neuroinflammation in dementia. METHODS We used a meta-analysis to retrieve literature on TSPO expression in dementia using PET imaging technology, including but not limited to the quality of the study design, sample size, and the type of TSPO ligand used in the study. For the included studies, we extracted key data, including TSPO expression levels, clinical characteristics of the study participants, and specific information on brain regions. Meta-analysis was performed using R software to assess the relationship between TSPO expression and dementia. RESULTS After screening, 12 studies that met the criteria were included. The results of the meta-analysis showed that the expression level of TSPO was significantly elevated in patients with dementia, especially in the hippocampal region. The OR in the hippocampus was 1.50 with a 95% CI of 1.09 to 1.25, indicating a significant increase in the expression of TSPO in this region compared to controls. Elevated levels of inflammation in the prefrontal lobe and cingulate gyrus are associated with cognitive impairment in patients. This was despite an OR of 1.00 in the anterior cingulate gyrus, indicating that TSPO expression in this region did not correlate significantly with the findings. The overall heterogeneity test showed I² = 51%, indicating moderate heterogeneity. CONCLUSION This study summarizes the existing literature on TSPO expression in specific regions of the brain in patients with dementia, and also provides some preliminary evidence on the possible association between neuroinflammation and dementia. However, the heterogeneity of results and limitations of the study suggest that we need to interpret these findings with caution. Future studies need to adopt a more rigorous and consistent methodological design to more accurately assess the role of neuroinflammation in dementia, thereby providing a more reliable evidence base for understanding pathological mechanisms and developing potential therapeutic strategies.
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Affiliation(s)
- Jie Pan
- Department of Neurology, The First Hospital of Jiaxing (Affiliated Hospital of Jiaxing University), Jiaxing City, Zhejiang Province, China
| | - Jin Hu
- Department of Neurology, The First Hospital of Jiaxing (Affiliated Hospital of Jiaxing University), Jiaxing City, Zhejiang Province, China
| | - Danyang Meng
- Department of Neurology, The First Hospital of Jiaxing (Affiliated Hospital of Jiaxing University), Jiaxing City, Zhejiang Province, China
| | - Liang Chen
- Department of Head and Neck Surgery, The First Hospital of Jiaxing (Affiliated Hospital of Jiaxing University), Jiaxing City, Zhejiang Province, China
| | - Xianling Wei
- Department of Nuclear Medicine, The First Hospital of Jiaxing (Affiliated Hospital of Jiaxing University), Jiaxing City, Zhejiang Province, China
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Ibanez A, Kringelbach ML, Deco G. A synergetic turn in cognitive neuroscience of brain diseases. Trends Cogn Sci 2024; 28:319-338. [PMID: 38246816 DOI: 10.1016/j.tics.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/15/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024]
Abstract
Despite significant improvements in our understanding of brain diseases, many barriers remain. Cognitive neuroscience faces four major challenges: complex structure-function associations; disease phenotype heterogeneity; the lack of transdiagnostic models; and oversimplified cognitive approaches restricted to the laboratory. Here, we propose a synergetics framework that can help to perform the necessary dimensionality reduction of complex interactions between the brain, body, and environment. The key solutions include low-dimensional spatiotemporal hierarchies for brain-structure associations, whole-brain modeling to handle phenotype diversity, model integration of shared transdiagnostic pathophysiological pathways, and naturalistic frameworks balancing experimental control and ecological validity. Creating whole-brain models with reduced manifolds combined with ecological measures can improve our understanding of brain disease and help identify novel interventions. Synergetics provides an integrated framework for future progress in clinical and cognitive neuroscience, pushing the boundaries of brain health and disease toward more mature, naturalistic approaches.
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Affiliation(s)
- Agustin Ibanez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile; Global Brain Health Institute (GBHI), University California San Francisco (UCSF), San Francisco, CA, USA; Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; Department of Psychiatry, University of Oxford, Oxford, UK.
| | - Morten L Kringelbach
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Centre for Eudaimonia and Human Flourishing, University of Oxford, Oxford, UK
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Roc Boronat 138, Barcelona 08018, Spain; Institució Catalana de la Recerca i Estudis Avançats (ICREA), Passeig Lluís Companys 23, Barcelona 08010, Spain.
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Ibanez A, Northoff G. Intrinsic timescales and predictive allostatic interoception in brain health and disease. Neurosci Biobehav Rev 2024; 157:105510. [PMID: 38104789 PMCID: PMC11184903 DOI: 10.1016/j.neubiorev.2023.105510] [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: 09/07/2023] [Revised: 11/29/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Abstract
The cognitive neuroscience of brain diseases faces challenges in understanding the complex relationship between brain structure and function, the heterogeneity of brain phenotypes, and the lack of dimensional and transnosological explanations. This perspective offers a framework combining the predictive coding theory of allostatic interoceptive overload (PAIO) and the intrinsic neural timescales (INT) theory to provide a more dynamic understanding of brain health in psychiatry and neurology. PAIO integrates allostasis and interoception to assess the interaction between internal patterns and environmental stressors, while INT shows that different brain regions operate on different intrinsic timescales. The allostatic overload can be understood as a failure of INT, which involves a breakdown of proper temporal integration and segregation. This can lead to dimensional disbalances between exteroceptive/interoceptive inputs across brain and whole-body levels (cardiometabolic, cardiovascular, inflammatory, immune). This approach offers new insights, presenting novel perspectives on brain spatiotemporal hierarchies and interactions. By integrating these theories, the paper opens innovative paths for studying brain health dynamics, which can inform future research in brain health and disease.
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Affiliation(s)
- Agustin Ibanez
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), CA, USA; Latin American Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; Trinity College Dublin, Dublin, Ireland.
| | - Georg Northoff
- Mental Health Center, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China; Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, People's Republic of China; Mind, Brain Imaging and Neuroethics, Institute of Mental Health Research, University of Ottawa, Ottawa, Canada.
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Assogna M, Premi E, Gazzina S, Benussi A, Ashton NJ, Zetterberg H, Blennow K, Gasparotti R, Padovani A, Tadayon E, Romanella S, Sprugnoli G, Pascual-Leone A, Di Lorenzo F, Koch G, Borroni B, Santarnecchi E. Association of Choroid Plexus Volume With Serum Biomarkers, Clinical Features, and Disease Severity in Patients With Frontotemporal Lobar Degeneration Spectrum. Neurology 2023; 101:e1218-e1230. [PMID: 37500561 PMCID: PMC10516270 DOI: 10.1212/wnl.0000000000207600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/15/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Choroid plexus (ChP) is emerging as a key brain structure in the pathophysiology of neurodegenerative disorders. In this observational study, we investigated ChP volume in a large cohort of patients with frontotemporal lobar degeneration (FTLD) spectrum to explore a possible link between ChP volume and other disease-specific biomarkers. METHODS Participants included patients meeting clinical criteria for a probable syndrome in the FTLD spectrum. Structural brain MRI imaging, serum neurofilament light (NfL), serum phosphorylated-Tau181 (p-Tau181), and cognitive and behavioral data were collected. MRI ChP volumes were obtained from an ad-hoc segmentation model based on a Gaussian Mixture Models algorithm. RESULTS Three-hundred and sixteen patients within FTLD spectrum were included in this study, specifically 135 patients diagnosed with behavioral variant frontotemporal dementia (bvFTD), 75 primary progressive aphasia, 46 progressive supranuclear palsy, and 60 corticobasal syndrome. In addition, 82 age-matched healthy participants were recruited as controls (HCs). ChP volume was significantly larger in patients with FTLD compared with HC, across the clinical subtype. Moreover, we found a significant difference in ChP volume between HC and patients stratified for disease-severity based on CDR plus NACC FTLD, including patients at very early stage of the disease. Interestingly, ChP volume correlated with serum NfL, cognitive/behavioral deficits, and with patterns of cortical atrophy. Finally, ChP volume seemed to discriminate HC from patients with FTLD better than other previously identified brain structure volumes. DISCUSSION Considering the clinical, pathologic, and genetic heterogeneity of the disease, ChP could represent a potential biomarker across the FTLD spectrum, especially at the early stage of disease. Further longitudinal studies are needed to establish its role in disease onset and progression. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that choroid plexus volume, as measured on MRI scan, can assist in differentiating patients with FTLD from healthy controls and in characterizing disease severity.
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Affiliation(s)
- Martina Assogna
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Enrico Premi
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Stefano Gazzina
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Alberto Benussi
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Nicholas J Ashton
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Henrik Zetterberg
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Kaj Blennow
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Roberto Gasparotti
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Alessandro Padovani
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Ehsan Tadayon
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Sara Romanella
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Giulia Sprugnoli
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Alvaro Pascual-Leone
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Francesco Di Lorenzo
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Giacomo Koch
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Barbara Borroni
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy
| | - Emiliano Santarnecchi
- From the Precision Neuroscience & Neuromodulation Program (M.A., S.R., G.S., E.S.), Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Non-Invasive Brain Stimulation Unit (M.A., F.D.L., G.K.), Department of Behavioural and Clinical Neurology, Santa Lucia Foundation IRCCS; Memory Clinic (M.A.), Department of Systems Medicine, University of Tor Vergata, Rome; Neurology Unit (E.P., S.G., A.B., A.P., B.B.), Department of Clinical and Experimental Sciences, University of Brescia, Italy; Institute of Neuroscience and Physiology (N.J.A.), Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg; Wallenberg Centre for Molecular and Translational Medicine (N.J.A.), University of Gothenburg, Mӧlndal, Sweden; King's College London (N.J.A.), Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute; NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation (N.J.A.), United Kingdom; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg; Clinical Neurochemistry Laboratory (H.Z., K.B.), Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease (H.Z.), UCL Institute of Neurology, Queen Square; UK Dementia Research Institute at UCL (H.Z.), London, United Kingdom; Hong Kong Center for Neurodegenerative Diseases (H.Z.), Clear Water Bay, Hong Kong, China; Neuroradiology Unit (R.G.), University of Brescia, Italy; Berenson-Allen Center for Noninvasive Brain Stimulation (E.T.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Medicine (G.S.), Surgery and Neuroscience, Siena Brain Investigation & Neuromodulation Laboratory, University of Siena, Siena, Italy; Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife (A.P.-L.); Department of Neurology (A.P.-L.), Harvard MedicalSchool, Boston, MA, USA; and Department of Neuroscience and Rehabilitation (G.K.), University of Ferrara, Italy.
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5
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De Marchi F, Tondo G, Corrado L, Menegon F, Aprile D, Anselmi M, D’Alfonso S, Comi C, Mazzini L. Neuroinflammatory Pathways in the ALS-FTD Continuum: A Focus on Genetic Variants. Genes (Basel) 2023; 14:1658. [PMID: 37628709 PMCID: PMC10454262 DOI: 10.3390/genes14081658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
Amyotrophic Lateral Sclerosis (ALS) and Frontotemporal dementia (FDT) are progressive neurodegenerative disorders that, in several cases, overlap in clinical presentation, and genetic and pathological disease mechanisms. About 10-15% of ALS cases and up to 40% of FTD are familial, usually with dominant traits. ALS and FTD, in several cases, share common gene mutations, such as in C9ORF72, TARDBP, SQSTM-1, FUS, VCP, CHCHD10, and TBK-1. Also, several mechanisms are involved in ALS and FTD pathogenesis, such as protein misfolding, oxidative stress, and impaired axonal transport. In addition, neuroinflammation and neuroinflammatory cells, such as astrocytes, oligodendrocytes, microglia, and lymphocytes and, overall, the cellular microenvironment, have been proposed as pivotal players in the pathogenesis the ALS-FTD spectrum disorders. This review overviews the current evidence regarding neuroinflammatory markers in the ALS/FTD continuum, focusing on the neuroinflammatory pathways involved in the genetic cases, moving from post-mortem reports to in vivo biofluid and neuroimaging data. We further discuss the potential link between genetic and autoimmune disorders and potential therapeutic implications.
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Affiliation(s)
- Fabiola De Marchi
- ALS Center, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy;
| | - Giacomo Tondo
- Neurology Unit, Department of Translational Medicine, S. Andrea Hospital, University of Piemonte Orientale, 13100 Vercelli, Italy; (G.T.); (D.A.); (C.C.)
| | - Lucia Corrado
- Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.C.); (S.D.)
| | - Federico Menegon
- Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; (F.M.); (M.A.)
| | - Davide Aprile
- Neurology Unit, Department of Translational Medicine, S. Andrea Hospital, University of Piemonte Orientale, 13100 Vercelli, Italy; (G.T.); (D.A.); (C.C.)
| | - Matteo Anselmi
- Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy; (F.M.); (M.A.)
| | - Sandra D’Alfonso
- Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.C.); (S.D.)
| | - Cristoforo Comi
- Neurology Unit, Department of Translational Medicine, S. Andrea Hospital, University of Piemonte Orientale, 13100 Vercelli, Italy; (G.T.); (D.A.); (C.C.)
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, 28100 Novara, Italy
| | - Letizia Mazzini
- ALS Center, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy;
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Xia W, Singh N, Goel S, Shi S. Molecular Imaging of Innate Immunity and Immunotherapy. Adv Drug Deliv Rev 2023; 198:114865. [PMID: 37182699 DOI: 10.1016/j.addr.2023.114865] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/17/2023] [Accepted: 05/03/2023] [Indexed: 05/16/2023]
Abstract
The innate immune system plays a key role as the first line of defense in various human diseases including cancer, cardiovascular and inflammatory diseases. In contrast to tissue biopsies and blood biopsies, in vivo imaging of the innate immune system can provide whole body measurements of immune cell location and function and changes in response to disease progression and therapy. Rationally developed molecular imaging strategies can be used in evaluating the status and spatio-temporal distributions of the innate immune cells in near real-time, mapping the biodistribution of novel innate immunotherapies, monitoring their efficacy and potential toxicities, and eventually for stratifying patients that are likely to benefit from these immunotherapies. In this review, we will highlight the current state-of-the-art in noninvasive imaging techniques for preclinical imaging of the innate immune system particularly focusing on cell trafficking, biodistribution, as well as pharmacokinetics and dynamics of promising immunotherapies in cancer and other diseases; discuss the unmet needs and current challenges in integrating imaging modalities and immunology and suggest potential solutions to overcome these barriers.
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Affiliation(s)
- Wenxi Xia
- Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, UT 84112, United States
| | - Neetu Singh
- Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, UT 84112, United States
| | - Shreya Goel
- Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, UT 84112, United States; Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, United States; Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84112, United States
| | - Sixiang Shi
- Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, UT 84112, United States; Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT 84112, United States.
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7
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Raval NR, Wetherill RR, Wiers CE, Dubroff JG, Hillmer AT. Positron Emission Tomography of Neuroimmune Responses in Humans: Insights and Intricacies. Semin Nucl Med 2023; 53:213-229. [PMID: 36270830 PMCID: PMC11261531 DOI: 10.1053/j.semnuclmed.2022.08.008] [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: 08/15/2022] [Accepted: 08/30/2022] [Indexed: 11/06/2022]
Abstract
The brain's immune system plays a critical role in responding to immune challenges and maintaining homeostasis. However, dysregulated neuroimmune function contributes to neurodegenerative disease and neuropsychiatric conditions. In vivo positron emission tomography (PET) imaging of the neuroimmune system has facilitated a greater understanding of its physiology and the pathology of some neuropsychiatric conditions. This review presents an in-depth look at PET findings from human neuroimmune function studies, highlighting their importance in current neuropsychiatric research. Although the majority of human PET studies feature radiotracers targeting the translocator protein 18 kDa (TSPO), this review also considers studies with other neuroimmune targets, including monoamine oxidase B, cyclooxygenase-1 and cyclooxygenase-2, nitric oxide synthase, and the purinergic P2X7 receptor. Promising new targets, such as colony-stimulating factor 1, Sphingosine-1-phosphate receptor 1, and the purinergic P2Y12 receptor, are also discussed. The significance of validating neuroimmune targets and understanding their function and expression is emphasized in this review to better identify and interpret PET results.
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Affiliation(s)
- Nakul R Raval
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT; Yale PET Center, Yale University, New Haven, CT
| | - Reagan R Wetherill
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Corinde E Wiers
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jacob G Dubroff
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ansel T Hillmer
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT; Yale PET Center, Yale University, New Haven, CT; Department of Psychiatry, Yale University, New Haven, CT.
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8
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Dassanayake P, Anazodo UC, Liu L, Narciso L, Iacobelli M, Hicks J, Rusjan P, Finger E, St Lawrence K. Development of a minimally invasive simultaneous estimation method for quantifying translocator protein binding with [ 18F]FEPPA positron emission tomography. EJNMMI Res 2023; 13:1. [PMID: 36633702 PMCID: PMC9837356 DOI: 10.1186/s13550-023-00950-1] [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: 10/04/2022] [Accepted: 01/01/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The purpose of this study was to assess the feasibility of using a minimally invasive simultaneous estimation method (SIME) to quantify the binding of the 18-kDa translocator protein tracer [18F]FEPPA. Arterial sampling was avoided by extracting an image-derived input function (IDIF) that was metabolite-corrected using venous blood samples. The possibility of reducing scan duration to 90 min from the recommended 2-3 h was investigated by assuming a uniform non-displaceable distribution volume (VND) to simplify the SIME fitting. RESULTS SIME was applied to retrospective data from healthy volunteers and was comprised of both high-affinity binders (HABs) and mixed-affinity binders (MABs). Estimates of global VND and regional total distribution volume (VT) from SIME were not significantly different from values obtained using a two-tissue compartment model (2CTM). Regional VT estimates were greater for HABs compared to MABs for both the 2TCM and SIME, while the SIME estimates had lower inter-subject variability (41 ± 17% reduction). Binding potential (BPND) values calculated from regional VT and brain-wide VND estimates were also greater for HABs, and reducing the scan time from 120 to 90 min had no significant effect on BPND. The feasibility of using venous metabolite correction was evaluated in a large animal model involving a simultaneous collection of arterial and venous samples. Strong linear correlations were found between venous and arterial measurements of the blood-to-plasma ratio and the remaining [18F]FEPPA fraction. Lastly, estimates of BPND and the specific distribution volume (i.e., VS = VT - VND) from a separate group of healthy volunteers (90 min scan time, venous-scaled IDIFs) agreed with estimates from the retrospective data for both genotypes. CONCLUSIONS The results of this study demonstrate that accurate estimates of regional VT, BPND and VS can be obtained by applying SIME to [18F]FEPPA data. Furthermore, the application of SIME enabled the scan time to be reduced to 90 min, and the approach worked well with IDIFs that were scaled and metabolite-corrected using venous blood samples.
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Affiliation(s)
- Praveen Dassanayake
- grid.39381.300000 0004 1936 8884Department of Medical Biophysics, University of Western Ontario, London, ON Canada ,grid.415847.b0000 0001 0556 2414Lawson Health Research Institute, 268 Grosvenor St, London, ON N6A 4V2 Canada
| | - Udunna C. Anazodo
- grid.39381.300000 0004 1936 8884Department of Medical Biophysics, University of Western Ontario, London, ON Canada ,grid.415847.b0000 0001 0556 2414Lawson Health Research Institute, 268 Grosvenor St, London, ON N6A 4V2 Canada ,grid.14709.3b0000 0004 1936 8649Department of Neurology and Neurosurgery, McGill University, Montréal, QC Canada
| | - Linshan Liu
- grid.415847.b0000 0001 0556 2414Lawson Health Research Institute, 268 Grosvenor St, London, ON N6A 4V2 Canada
| | - Lucas Narciso
- grid.39381.300000 0004 1936 8884Department of Medical Biophysics, University of Western Ontario, London, ON Canada ,grid.415847.b0000 0001 0556 2414Lawson Health Research Institute, 268 Grosvenor St, London, ON N6A 4V2 Canada
| | - Maryssa Iacobelli
- grid.415847.b0000 0001 0556 2414Lawson Health Research Institute, 268 Grosvenor St, London, ON N6A 4V2 Canada
| | - Justin Hicks
- grid.39381.300000 0004 1936 8884Department of Medical Biophysics, University of Western Ontario, London, ON Canada ,grid.415847.b0000 0001 0556 2414Lawson Health Research Institute, 268 Grosvenor St, London, ON N6A 4V2 Canada
| | - Pablo Rusjan
- Douglas Research Centre, Human Neuroscience Division, Montréal, QC Canada ,grid.14709.3b0000 0004 1936 8649Department of Psychiatry, McGill University, Montréal, QC Canada
| | - Elizabeth Finger
- grid.415847.b0000 0001 0556 2414Lawson Health Research Institute, 268 Grosvenor St, London, ON N6A 4V2 Canada ,grid.39381.300000 0004 1936 8884Department of Clinical Neurological Sciences, University of Western Ontario, London, ON Canada
| | - Keith St Lawrence
- grid.39381.300000 0004 1936 8884Department of Medical Biophysics, University of Western Ontario, London, ON Canada ,grid.415847.b0000 0001 0556 2414Lawson Health Research Institute, 268 Grosvenor St, London, ON N6A 4V2 Canada
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9
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Migeot JA, Duran-Aniotz CA, Signorelli CM, Piguet O, Ibáñez A. A predictive coding framework of allostatic-interoceptive overload in frontotemporal dementia. Trends Neurosci 2022; 45:838-853. [PMID: 36057473 PMCID: PMC11286203 DOI: 10.1016/j.tins.2022.08.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/27/2022] [Accepted: 08/09/2022] [Indexed: 10/31/2022]
Abstract
Recent allostatic-interoceptive explanations using predictive coding models propose that efficient regulation of the body's internal milieu is necessary to correctly anticipate environmental needs. We review this framework applied to understanding behavioral variant frontotemporal dementia (bvFTD) considering both allostatic overload and interoceptive deficits. First, we show how this framework could explain divergent deficits in bvFTD (cognitive impairments, behavioral maladjustment, brain atrophy, fronto-insular-temporal network atypicality, aberrant interoceptive electrophysiological activity, and autonomic disbalance). We develop a set of theory-driven predictions based on levels of allostatic interoception associated with bvFTD phenomenology and related physiopathological mechanisms. This approach may help further understand the disparate behavioral and physiopathological dysregulations of bvFTD, suggesting targeted interventions and strengthening clinical models of neurological and psychiatric disorders.
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Affiliation(s)
- Joaquin A Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Claudia A Duran-Aniotz
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Camilo M Signorelli
- Department of Computer Science, University of Oxford, Oxford, UK; Physiology of Cognition, GIGA-CRC In Vivo Imaging, University of Liège, Liège, Belgium; Cognitive Neuroimaging Unit, INSERM, Saclay, France
| | - Olivier Piguet
- The University of Sydney, School of Psychology and Brain & Mind Centre, Sydney, Australia
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Global Brain Health Institute, University of California-San Francisco, San Francisco, CA, USA, and Trinity College Dublin, Dublin, Ireland.
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10
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Masdeu JC, Pascual B, Fujita M. Imaging Neuroinflammation in Neurodegenerative Disorders. J Nucl Med 2022; 63:45S-52S. [PMID: 35649654 DOI: 10.2967/jnumed.121.263200] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 05/03/2022] [Indexed: 02/07/2023] Open
Abstract
Neuroinflammation plays a major role in the etiopathology of neurodegenerative diseases, including Alzheimer and Parkinson diseases, frontotemporal lobar degeneration, and amyotrophic lateral sclerosis. In vivo monitoring of neuroinflammation using PET is critical to understand this process, and data are accumulating in this regard, thus a review is useful. From PubMed, we retrieved publications using any of the available PET tracers to image neuroinflammation in humans as well as selected articles dealing with experimental animal models or the chemistry of currently used or potential radiotracers. We reviewed 280 articles. The most common PET neuroinflammation target, translocator protein (TSPO), has limitations, lacking cellular specificity and the ability to separate neuroprotective from neurotoxic inflammation. However, TSPO PET is useful to define the amount and location of inflammation in the brain of people with neurodegenerative disorders. We describe the characteristics of TSPO and other potential PET neuroinflammation targets and PET tracers available or in development. Despite target and tracer limitations, in recent years there has been a sharp increase in the number of reports of neuroinflammation PET in humans. The most studied has been Alzheimer disease, in which neuroinflammation seems initially neuroprotective and neurotoxic later in the progression of the disease. We describe the findings in all the major neurodegenerative disorders. Neuroinflammation PET is an indispensable tool to understand the process of neurodegeneration, particularly in humans, as well as to validate target engagement in therapeutic clinical trials.
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Affiliation(s)
- Joseph C Masdeu
- Nantz National Alzheimer Center, Stanley H. Appel Department of Neurology, Houston Methodist Neurological Institute, Houston Methodist Research Institute, Weill Cornell Medicine, Houston, Texas; and
| | - Belen Pascual
- Nantz National Alzheimer Center, Stanley H. Appel Department of Neurology, Houston Methodist Neurological Institute, Houston Methodist Research Institute, Weill Cornell Medicine, Houston, Texas; and
| | - Masahiro Fujita
- Nantz National Alzheimer Center, Stanley H. Appel Department of Neurology, Houston Methodist Neurological Institute, Houston Methodist Research Institute, Weill Cornell Medicine, Houston, Texas; and.,PET Core, Houston Methodist Research Institute, Weill Cornell Medicine, Houston, Texas
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11
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Ji B, Ono M, Yamasaki T, Fujinaga M, Zhang MR, Seki C, Aoki I, Kito S, Sawada M, Suhara T, Sahara N, Higuchi M. Detection of Alzheimer's disease-related neuroinflammation by a PET ligand selective for glial versus vascular translocator protein. J Cereb Blood Flow Metab 2021; 41:2076-2089. [PMID: 33557690 PMCID: PMC8327108 DOI: 10.1177/0271678x21992457] [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] [Indexed: 11/17/2022]
Abstract
A substantial and constitutive expression of translocator protein (TSPO) in cerebral blood vessels hampers the sensitive detection of neuroinflammation characterized by greatly induced TSPO expression in activated glia. Here, we conducted in vivo positron emission tomography (PET) and in vitro autoradiographic imaging of normal and TSPO-deficient mouse brains to compare the binding properties of 18F-FEBMP, a relatively novel TSPO radioligand developed for human studies based on its insensitivity to a common polymorphism, with 11C-PK11195, as well as other commonly used TSPO radioligands including 11C-PBR28, 11C-Ac5216 and 18F-FEDAA1106. TSPO in cerebral vessels of normal mice was found to provide a major binding site for 11C-PK11195, 11C-PBR28 and 18F-FEDAA1106, in contrast to no overt specific binding of 18F-FEBMP and 11C-Ac5216 to this vascular component. In addition, 18F-FEBMP yielded PET images of microglial TSPO with a higher contrast than 11C-PK11195 in a tau transgenic mouse modeling Alzheimer's disease (AD) and allied neurodegenerative tauopathies. Moreover, TSPO expression examined by immunoblotting was significantly increased in AD brains compared with healthy controls, and was well correlated with the autoradiographic binding of 18F-FEBMP but not 11C-PK11195. Our findings support the potential advantage of comparatively glial TSPO-selective radioligands such as 18F-FEBMP for PET imaging of inflammatory glial cells.
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Affiliation(s)
- Bin Ji
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Maiko Ono
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Tomoteru Yamasaki
- Department of Radiopharmaceuticals Development, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Masayuki Fujinaga
- Department of Radiopharmaceuticals Development, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Ming-Rong Zhang
- Department of Radiopharmaceuticals Development, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Chie Seki
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Ichio Aoki
- Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Seiji Kito
- Research, Development and Support Center, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Makoto Sawada
- Department of Brain Function, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Tetsuya Suhara
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Naruhiko Sahara
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Makoto Higuchi
- Department of Functional Brain Imaging Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
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12
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De Marchi F, Munitic I, Amedei A, Berry JD, Feldman EL, Aronica E, Nardo G, Van Weehaeghe D, Niccolai E, Prtenjaca N, Sakowski SA, Bendotti C, Mazzini L. Interplay between immunity and amyotrophic lateral sclerosis: Clinical impact. Neurosci Biobehav Rev 2021; 127:958-978. [PMID: 34153344 PMCID: PMC8428677 DOI: 10.1016/j.neubiorev.2021.06.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/07/2021] [Accepted: 06/17/2021] [Indexed: 12/12/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a debilitating and rapidly fatal neurodegenerative disease. Despite decades of research and many new insights into disease biology over the 150 years since the disease was first described, causative pathogenic mechanisms in ALS remain poorly understood, especially in sporadic cases. Our understanding of the role of the immune system in ALS pathophysiology, however, is rapidly expanding. The aim of this manuscript is to summarize the recent advances regarding the immune system involvement in ALS, with particular attention to clinical translation. We focus on the potential pathophysiologic mechanism of the immune system in ALS, discussing local and systemic factors (blood, cerebrospinal fluid, and microbiota) that influence ALS onset and progression in animal models and people. We also explore the potential of Positron Emission Tomography to detect neuroinflammation in vivo, and discuss ongoing clinical trials of therapies targeting the immune system. With validation in human patients, new evidence in this emerging field will serve to identify novel therapeutic targets and provide realistic hope for personalized treatment strategies.
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Affiliation(s)
- Fabiola De Marchi
- Department of Neurology and ALS Centre, University of Piemonte Orientale, Maggiore Della Carità Hospital, Corso Mazzini 18, Novara, 28100, Italy
| | - Ivana Munitic
- Laboratory for Molecular Immunology, Department of Biotechnology, University of Rijeka, R. Matejcic 2, 51000, Rijeka, Croatia
| | - Amedeo Amedei
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - James D Berry
- Sean M. Healey & AMG Center for ALS, Department of Neurology, Massachusetts General Hospital, 165 Cambridge Street, Suite 600, Boston, MA, 02114, USA
| | - Eva L Feldman
- Department of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Eleonora Aronica
- Amsterdam UMC, University of Amsterdam, Department of (Neuro) Pathology, Amsterdam Neuroscience, Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Giovanni Nardo
- Laboratory of Molecular Neurobiology, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milanm, 20156, Italy
| | - Donatienne Van Weehaeghe
- Division of Nuclear Medicine, Department of Imaging and Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Elena Niccolai
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Nikolina Prtenjaca
- Laboratory for Molecular Immunology, Department of Biotechnology, University of Rijeka, R. Matejcic 2, 51000, Rijeka, Croatia
| | - Stacey A Sakowski
- Department of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Caterina Bendotti
- Laboratory of Molecular Neurobiology, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milanm, 20156, Italy
| | - Letizia Mazzini
- Department of Neurology and ALS Centre, University of Piemonte Orientale, Maggiore Della Carità Hospital, Corso Mazzini 18, Novara, 28100, Italy.
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Duran-Aniotz C, Orellana P, Leon Rodriguez T, Henriquez F, Cabello V, Aguirre-Pinto MF, Escobedo T, Takada LT, Pina-Escudero SD, Lopez O, Yokoyama JS, Ibanez A, Parra MA, Slachevsky A. Systematic Review: Genetic, Neuroimaging, and Fluids Biomarkers for Frontotemporal Dementia Across Latin America Countries. Front Neurol 2021; 12:663407. [PMID: 34248820 PMCID: PMC8263937 DOI: 10.3389/fneur.2021.663407] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/27/2021] [Indexed: 11/13/2022] Open
Abstract
Frontotemporal dementia (FTD) includes a group of clinically, genetically, and pathologically heterogeneous neurodegenerative disorders, affecting the fronto-insular-temporal regions of the brain. Clinically, FTD is characterized by progressive deficits in behavior, executive function, and language and its diagnosis relies mainly on the clinical expertise of the physician/consensus group and the use of neuropsychological tests and/or structural/functional neuroimaging, depending on local availability. The modest correlation between clinical findings and FTD neuropathology makes the diagnosis difficult using clinical criteria and often leads to underdiagnosis or misdiagnosis, primarily due to lack of recognition or awareness of FTD as a disease and symptom overlap with psychiatric disorders. Despite advances in understanding the underlying neuropathology of FTD, accurate and sensitive diagnosis for this disease is still lacking. One of the major challenges is to improve diagnosis in FTD patients as early as possible. In this context, biomarkers have emerged as useful methods to provide and/or complement clinical diagnosis for this complex syndrome, although more evidence is needed to incorporate most of them into clinical practice. However, most biomarker studies have been performed using North American or European populations, with little representation of the Latin American and the Caribbean (LAC) region. In the LAC region, there are additional challenges, particularly the lack of awareness and knowledge about FTD, even in specialists. Also, LAC genetic heritage and cultures are complex, and both likely influence clinical presentations and may modify baseline biomarker levels. Even more, due to diagnostic delay, the clinical presentation might be further complicated by both neurological and psychiatric comorbidity, such as vascular brain damage, substance abuse, mood disorders, among others. This systematic review provides a brief update and an overview of the current knowledge on genetic, neuroimaging, and fluid biomarkers for FTD in LAC countries. Our review highlights the need for extensive research on biomarkers in FTD in LAC to contribute to a more comprehensive understanding of the disease and its associated biomarkers. Dementia research is certainly reduced in the LAC region, highlighting an urgent need for harmonized, innovative, and cross-regional studies with a global perspective across multiple areas of dementia knowledge.
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Affiliation(s)
- Claudia Duran-Aniotz
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Paulina Orellana
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Tomas Leon Rodriguez
- Trinity College, Global Brain Health Institute, Dublin, Ireland
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | - Fernando Henriquez
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Victoria Cabello
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | | | - Tamara Escobedo
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Leonel T. Takada
- Cognitive and Behavioral Neurology Unit - Department of Neurology, University of São Paulo, São Paulo, Brazil
| | - Stefanie D. Pina-Escudero
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA, United States
- UCSF Department of Neurology, Memory and Aging Center, UCSF, San Francisco, CA, United States
| | - Oscar Lopez
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jennifer S. Yokoyama
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA, United States
- UCSF Department of Neurology, Memory and Aging Center, UCSF, San Francisco, CA, United States
| | - Agustin Ibanez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
- Trinity College, Global Brain Health Institute, Dublin, Ireland
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA, United States
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, & National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Mario A. Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | - Andrea Slachevsky
- Memory and Neuropsychiatric Clinic (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Cognitive and Behavioral Neurology Unit - Department of Neurology, University of São Paulo, São Paulo, Brazil
- Department of Neurology and Psychiatry, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
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14
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Assogna M, Casula EP, Borghi I, Bonnì S, Samà D, Motta C, Di Lorenzo F, D'Acunto A, Porrazzini F, Minei M, Caltagirone C, Martorana A, Koch G. Effects of Palmitoylethanolamide Combined with Luteoline on Frontal Lobe Functions, High Frequency Oscillations, and GABAergic Transmission in Patients with Frontotemporal Dementia. J Alzheimers Dis 2021; 76:1297-1308. [PMID: 32623398 DOI: 10.3233/jad-200426] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Frontotemporal dementia (FTD) is a presenile neurodegenerative disease for which there is no effective pharmacological treatment. Recently, a link has been proposed between neuroinflammation and FTD. OBJECTIVE Here, we aim to investigate the effects of palmitoylethanolamide (PEA) combined with luteoline (PEA-LUT), an endocannabinoid with anti-inflammatory and neuroprotective effects, on behavior, cognition, and cortical activity in a sample of FTD patients. METHODS Seventeen patients with a diagnosis of probable FTD were enrolled. Cognitive and neurophysiological evaluations were performed at baseline and after 4 weeks of PEA-LUT 700 mg×2/day. Cognitive effects were assessed by Neuropsychiatric Inventory (NPI), Mini-Mental State Examination, Frontal Assessment Battery (FAB), Screening for Aphasia in Neurodegeneration, Activities of Daily Living-Instrumental Activities of Daily Living, and Frontotemporal Lobar Degeneration-modified Clinical Dementia Rating scale. To investigate in vivo neurophysiological effects of PEA-LUT, we used repetitive and paired-pulse transcranial magnetic stimulation (TMS) protocols assessing LTP-like cortical plasticity, short-interval intracortical inhibition, long-interval intracortical inhibition (LICI), and short-latency afferent inhibition. Moreover, we used TMS combined with EEG to evaluate the effects on frontal lobe cortical oscillatory activity. RESULTS Treatment with PEA-LUT was associated with an improvement in NPI and FAB scores. Neurophysiological evaluation showed a restoration of LICI, in particular at ISI 100 ms, suggesting a modulation of GABA(B) activity. TMS-EEG showed a remarkable increase of TMS-evoked frontal lobe activity and of high-frequency oscillations in the beta/gamma range. CONCLUSION PEA-LUT could reduce behavioral disturbances and improve frontal lobe functions in FTD patients through the modulation of cortical oscillatory activity and GABA(B)ergic transmission.
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Affiliation(s)
- Martina Assogna
- Santa Lucia Foundation, IRCCS, Rome, Italy.,Tor Vergata Policlinic, Rome, Italy
| | - Elias Paolo Casula
- Santa Lucia Foundation, IRCCS, Rome, Italy.,Department of Clinical and Movement Neurosciences, University College London, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | - Giacomo Koch
- Santa Lucia Foundation, IRCCS, Rome, Italy.,eCampus University, Novedrate, Italy
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15
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Schwarz AJ. The Use, Standardization, and Interpretation of Brain Imaging Data in Clinical Trials of Neurodegenerative Disorders. Neurotherapeutics 2021; 18:686-708. [PMID: 33846962 PMCID: PMC8423963 DOI: 10.1007/s13311-021-01027-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 12/11/2022] Open
Abstract
Imaging biomarkers play a wide-ranging role in clinical trials for neurological disorders. This includes selecting the appropriate trial participants, establishing target engagement and mechanism-related pharmacodynamic effect, monitoring safety, and providing evidence of disease modification. In the early stages of clinical drug development, evidence of target engagement and/or downstream pharmacodynamic effect-especially with a clear relationship to dose-can provide confidence that the therapeutic candidate should be advanced to larger and more expensive trials, and can inform the selection of the dose(s) to be further tested, i.e., to "de-risk" the drug development program. In these later-phase trials, evidence that the therapeutic candidate is altering disease-related biomarkers can provide important evidence that the clinical benefit of the compound (if observed) is grounded in meaningful biological changes. The interpretation of disease-related imaging markers, and comparability across different trials and imaging tools, is greatly improved when standardized outcome measures are defined. This standardization should not impinge on scientific advances in the imaging tools per se but provides a common language in which the results generated by these tools are expressed. PET markers of pathological protein aggregates and structural imaging of brain atrophy are common disease-related elements across many neurological disorders. However, PET tracers for pathologies beyond amyloid β and tau are needed, and the interpretability of structural imaging can be enhanced by some simple considerations to guard against the possible confound of pseudo-atrophy. Learnings from much-studied conditions such as Alzheimer's disease and multiple sclerosis will be beneficial as the field embraces rarer diseases.
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Affiliation(s)
- Adam J Schwarz
- Takeda Pharmaceuticals Ltd., 40 Landsdowne Street, Cambridge, MA, 02139, USA.
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16
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Maeda J, Minamihisamatsu T, Shimojo M, Zhou X, Ono M, Matsuba Y, Ji B, Ishii H, Ogawa M, Akatsu H, Kaneda D, Hashizume Y, Robinson JL, Lee VMY, Saito T, Saido TC, Trojanowski JQ, Zhang MR, Suhara T, Higuchi M, Sahara N. Distinct microglial response against Alzheimer's amyloid and tau pathologies characterized by P2Y12 receptor. Brain Commun 2021; 3:fcab011. [PMID: 33644757 PMCID: PMC7901060 DOI: 10.1093/braincomms/fcab011] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/11/2020] [Accepted: 12/21/2020] [Indexed: 02/07/2023] Open
Abstract
Microglia are the resident phagocytes of the central nervous system, and microglial activation is considered to play an important role in the pathogenesis of neurodegenerative diseases. Recent studies with single-cell RNA analysis of CNS cells in Alzheimer's disease and diverse other neurodegenerative conditions revealed that the transition from homeostatic microglia to disease-associated microglia was defined by changes of gene expression levels, including down-regulation of the P2Y12 receptor gene (P2Y12R). However, it is yet to be clarified in Alzheimer's disease brains whether and when this down-regulation occurs in response to amyloid-β and tau depositions, which are core pathological processes in the disease etiology. To further evaluate the significance of P2Y12 receptor alterations in the neurodegenerative pathway of Alzheimer's disease and allied disorders, we generated an anti-P2Y12 receptor antibody and examined P2Y12 receptor expressions in the brains of humans and model mice bearing amyloid-β and tau pathologies. We observed that the brains of both Alzheimer's disease and non-Alzheimer's disease tauopathy patients and tauopathy model mice (rTg4510 and PS19 mouse lines) displayed declined microglial P2Y12 receptor levels in regions enriched with tau inclusions, despite an increase in the total microglial population. Notably, diminution of microglial immunoreactivity with P2Y12 receptor was noticeable prior to massive accumulations of phosphorylated tau aggregates and neurodegeneration in rTg4510 mouse brains, despite a progressive increase of total microglial population. On the other hand, Iba1-positive microglia encompassing compact and dense-cored amyloid-β plaques expressed P2Y12 receptor at varying levels in amyloid precursor protein (APP) mouse models (APP23 and AppNL-F/NL-F mice). By contrast, neuritic plaques in Alzheimer's disease brains were associated with P2Y12 receptor-negative microglia. These data suggest that the down-regulation of microglia P2Y12 receptor, which is characteristic of disease-associated microglia, is intimately associated with tau rather than amyloid-β pathologies from an early stage and could be a sensitive index for neuroinflammatory responses to Alzheimer's disease-related neurodegenerative processes.
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Affiliation(s)
- Jun Maeda
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Takeharu Minamihisamatsu
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Masafumi Shimojo
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Xiaoyun Zhou
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Maiko Ono
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Yukio Matsuba
- Laboratory for Proteolytic Neuroscience, RIKEN Center for Brain Science, Saitama, Japan
| | - Bin Ji
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Hideki Ishii
- Department of Advanced Nuclear Medicine Science, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Masanao Ogawa
- Department of Advanced Nuclear Medicine Science, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Hiroyasu Akatsu
- Department of Neuropathology, Choju Medical Institute, Fukushimura Hospital, Aichi, Japan.,Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Daita Kaneda
- Department of Neuropathology, Choju Medical Institute, Fukushimura Hospital, Aichi, Japan
| | - Yoshio Hashizume
- Department of Neuropathology, Choju Medical Institute, Fukushimura Hospital, Aichi, Japan
| | - John L Robinson
- Center for Neurodegenerative Disease Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104-2674, USA
| | - Virginia M-Y Lee
- Center for Neurodegenerative Disease Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104-2674, USA
| | - Takashi Saito
- Department of Neurocognitive Science, Institute of Brain Science, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Takaomi C Saido
- Laboratory for Proteolytic Neuroscience, RIKEN Center for Brain Science, Saitama, Japan
| | - John Q Trojanowski
- Center for Neurodegenerative Disease Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104-2674, USA
| | - Ming-Rong Zhang
- Department of Advanced Nuclear Medicine Science, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Tetsuya Suhara
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Makoto Higuchi
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Naruhiko Sahara
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.,Laboratory for Proteolytic Neuroscience, RIKEN Center for Brain Science, Saitama, Japan.,Department of Advanced Nuclear Medicine Science, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.,Department of Neuropathology, Choju Medical Institute, Fukushimura Hospital, Aichi, Japan.,Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan.,Center for Neurodegenerative Disease Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104-2674, USA.,Department of Neurocognitive Science, Institute of Brain Science, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
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17
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Alarmins and c-Jun N-Terminal Kinase (JNK) Signaling in Neuroinflammation. Cells 2020; 9:cells9112350. [PMID: 33114371 PMCID: PMC7693759 DOI: 10.3390/cells9112350] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/08/2020] [Accepted: 10/21/2020] [Indexed: 02/07/2023] Open
Abstract
Neuroinflammation is involved in the progression or secondary injury of multiple brain conditions, including stroke and neurodegenerative diseases. Alarmins, also known as damage-associated molecular patterns, are released in the presence of neuroinflammation and in the acute phase of ischemia. Defensins, cathelicidin, high-mobility group box protein 1, S100 proteins, heat shock proteins, nucleic acids, histones, nucleosomes, and monosodium urate microcrystals are thought to be alarmins. They are released from damaged or dying cells and activate the innate immune system by interacting with pattern recognition receptors. Being principal sterile inflammation triggering agents, alarmins are considered biomarkers and therapeutic targets. They are recognized by host cells and prime the innate immune system toward cell death and distress. In stroke, alarmins act as mediators initiating the inflammatory response after the release from the cellular components of the infarct core and penumbra. Increased c-Jun N-terminal kinase (JNK) phosphorylation may be involved in the mechanism of stress-induced release of alarmins. Putative crosstalk between the alarmin-associated pathways and JNK signaling seems to be inherently interwoven. This review outlines the role of alarmins/JNK-signaling in cerebral neurovascular inflammation and summarizes the complex response of cells to alarmins. Emerging anti-JNK and anti-alarmin drug treatment strategies are discussed.
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18
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Berdyyeva T, Xia C, Taylor N, He Y, Chen G, Huang C, Zhang W, Kolb H, Letavic M, Bhattacharya A, Szardenings AK. PET Imaging of the P2X7 Ion Channel with a Novel Tracer [ 18F]JNJ-64413739 in a Rat Model of Neuroinflammation. Mol Imaging Biol 2020; 21:871-878. [PMID: 30632003 DOI: 10.1007/s11307-018-01313-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE The P2X7 receptor, an adenosine triphosphate (ATP)-gated purinoreceptor, has emerged as one of the key players in neuroinflammatory processes. Therefore, developing a positron emission tomography (PET) tracer for imaging of P2X7 receptors in vivo presents a promising approach to diagnose, monitor, and study neuroinflammation in a variety of brain disorders. To fulfill the goal of developing a P2X7 PET ligand as a biomarker of neuroinflammation, [18F]JNJ-64413739 has been recently disclosed. PROCEDURES We evaluated [18F]JNJ-64413739 in a rat model of neuroinflammation induced by an intracerebral injection of lipopolysaccharide (LPS). In vivo brain uptake was determined by PET imaging. Upregulation of neuroinflammatory biomarkers was determined by quantitative polymerase chain reaction (qPCR). Distribution of the tracer in the brain was determined by ex vivo autoradiography (ARG). The specificity of [18F]JNJ-64413739 was confirmed by performing blocking experiments with the P2X7 antagonist JNJ-54175446. RESULTS Brain regions of rats injected with LPS had a significantly increased uptake (34 % ± 3 % s.e.m., p = 0.036, t test, standardized uptake value measured over the entire scanning period) of [18F]JNJ-64413739 relative to the corresponding brain regions of control animals injected with phosphate-buffered saline (PBS). The uptake in the contralateral regions and cerebellum was not significantly different between the groups of animals. The increase in uptake of [18F]JNJ-64413739 at the LPS-injected site observed by PET imaging was concordant with ex vivo ARG, upregulation of neuroinflammatory biomarkers, and elevated P2X7 expression levels. CONCLUSIONS While further work is needed to study [18F]JNJ-64413739 in other types of neuroinflammation, the current results favorably characterize [18F]JNJ-64413739 as a potential PET tracer of central neuroinflammation.
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Affiliation(s)
- Tamara Berdyyeva
- Janssen Research & Development LLC, 3210 Merryfield Row, San Diego, CA, 92121, USA.
| | - Chunfang Xia
- Janssen Research & Development LLC, 3210 Merryfield Row, San Diego, CA, 92121, USA
| | - Natalie Taylor
- Janssen Research & Development LLC, 3210 Merryfield Row, San Diego, CA, 92121, USA
| | - Yingbo He
- Janssen Research & Development LLC, 3210 Merryfield Row, San Diego, CA, 92121, USA
| | - Gang Chen
- Janssen Research & Development LLC, 3210 Merryfield Row, San Diego, CA, 92121, USA
| | - Chaofeng Huang
- Janssen Research & Development LLC, 3210 Merryfield Row, San Diego, CA, 92121, USA
| | - Wei Zhang
- Janssen Research & Development LLC, 3210 Merryfield Row, San Diego, CA, 92121, USA
| | - Hartmuth Kolb
- Janssen Research & Development LLC, 3210 Merryfield Row, San Diego, CA, 92121, USA
| | - Michael Letavic
- Janssen Research & Development LLC, 3210 Merryfield Row, San Diego, CA, 92121, USA
| | - Anindya Bhattacharya
- Janssen Research & Development LLC, 3210 Merryfield Row, San Diego, CA, 92121, USA
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19
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Hyperactive Innate Immunity Causes Degeneration of Dopamine Neurons upon Altering Activity of Cdk5. Cell Rep 2020; 26:131-144.e4. [PMID: 30605670 PMCID: PMC6442473 DOI: 10.1016/j.celrep.2018.12.025] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/10/2018] [Accepted: 12/05/2018] [Indexed: 11/23/2022] Open
Abstract
Innate immunity is central to the pathophysiology of neurodegenerative disorders, but it remains unclear why immunity is altered in the disease state and whether changes in immunity are a cause or a consequence of neuronal dysfunction. Here, we identify a molecular pathway that links innate immunity to age-dependent loss of dopaminergic neurons in Drosophila. We find, first, that altering the expression of the activating subunit of the Cdk5 protein kinase (Cdk5α) causes severe disruption of autophagy. Second, this disruption of autophagy is both necessary and sufficient to cause the hyperactivation of innate immunity, particularly expression of anti-microbial peptides. Finally, it is the upregulation of immunity that induces the age-dependent death of dopaminergic neurons. Given the dysregulation of Cdk5 and innate immunity in human neurodegeneration and the conserved role of the kinase in the regulation of autophagy, this sequence is likely to have direct application to the chain of events in human neurodegenerative disease. How can one disentangle the many pathologies of neurodegeneration from one another and from normal aging? Shukla et al. show that a mutation in Drosophila kills neurons by impairing autophagy, which in turn stimulates neurotoxic levels of innate immunity, and this acts synergistically with a parallel pathway that accelerates aging.
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20
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Bevan-Jones WR, Cope TE, Jones PS, Kaalund SS, Passamonti L, Allinson K, Green O, Hong YT, Fryer TD, Arnold R, Coles JP, Aigbirhio FI, Larner AJ, Patterson K, O’Brien JT, Rowe JB. Neuroinflammation and protein aggregation co-localize across the frontotemporal dementia spectrum. Brain 2020; 143:1010-1026. [PMID: 32179883 PMCID: PMC7089669 DOI: 10.1093/brain/awaa033] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 12/04/2019] [Accepted: 01/06/2020] [Indexed: 12/14/2022] Open
Abstract
The clinical syndromes of frontotemporal dementia are clinically and neuropathologically heterogeneous, but processes such as neuroinflammation may be common across the disease spectrum. We investigated how neuroinflammation relates to the localization of tau and TDP-43 pathology, and to the heterogeneity of clinical disease. We used PET in vivo with (i) 11C-PK-11195, a marker of activated microglia and a proxy index of neuroinflammation; and (ii) 18F-AV-1451, a radioligand with increased binding to pathologically affected regions in tauopathies and TDP-43-related disease, and which is used as a surrogate marker of non-amyloid-β protein aggregation. We assessed 31 patients with frontotemporal dementia (10 with behavioural variant, 11 with the semantic variant and 10 with the non-fluent variant), 28 of whom underwent both 18F-AV-1451 and 11C-PK-11195 PET, and matched control subjects (14 for 18F-AV-1451 and 15 for 11C-PK-11195). We used a univariate region of interest analysis, a paired correlation analysis of the regional relationship between binding distributions of the two ligands, a principal component analysis of the spatial distributions of binding, and a multivariate analysis of the distribution of binding that explicitly controls for individual differences in ligand affinity for TDP-43 and different tau isoforms. We found significant group-wise differences in 11C-PK-11195 binding between each patient group and controls in frontotemporal regions, in both a regions-of-interest analysis and in the comparison of principal spatial components of binding. 18F-AV-1451 binding was increased in semantic variant primary progressive aphasia compared to controls in the temporal regions, and both semantic variant primary progressive aphasia and behavioural variant frontotemporal dementia differed from controls in the expression of principal spatial components of binding, across temporal and frontotemporal cortex, respectively. There was a strong positive correlation between 11C-PK-11195 and 18F-AV-1451 uptake in all disease groups, across widespread cortical regions. We confirmed this association with post-mortem quantification in 12 brains, demonstrating strong associations between the regional densities of microglia and neuropathology in FTLD-TDP (A), FTLD-TDP (C), and FTLD-Pick's. This was driven by amoeboid (activated) microglia, with no change in the density of ramified (sessile) microglia. The multivariate distribution of 11C-PK-11195 binding related better to clinical heterogeneity than did 18F-AV-1451: distinct spatial modes of neuroinflammation were associated with different frontotemporal dementia syndromes and supported accurate classification of participants. These in vivo findings indicate a close association between neuroinflammation and protein aggregation in frontotemporal dementia. The inflammatory component may be important in shaping the clinical and neuropathological patterns of the diverse clinical syndromes of frontotemporal dementia.
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Affiliation(s)
| | - Thomas E Cope
- Cambridge University Department of Clinical Neurosciences and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - P Simon Jones
- Cambridge University Department of Clinical Neurosciences and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Sanne S Kaalund
- Cambridge University Department of Clinical Neurosciences and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Luca Passamonti
- Cambridge University Department of Clinical Neurosciences and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Istituto di Bioimmagini e Fisiologia Molecolare (IBFM), Consiglio Nazionale delle Ricerche (CNR), via Fratelli Cervi, Milano, Italy
| | - Kieren Allinson
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridge, UK
| | - Oliver Green
- Istituto di Bioimmagini e Fisiologia Molecolare (IBFM), Consiglio Nazionale delle Ricerche (CNR), via Fratelli Cervi, Milano, Italy
| | - Young T Hong
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Tim D Fryer
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Robert Arnold
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | | | | | - Karalyn Patterson
- Cambridge University Department of Clinical Neurosciences and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - John T O’Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - James B Rowe
- Cambridge University Department of Clinical Neurosciences and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
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21
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Fraga VG, Magalhães CA, Loures CDMG, de Souza LC, Guimarães HC, Zauli DAG, Carvalho MDG, Ferreira CN, Caramelli P, de Sousa LP, Gomes KB. Inflammatory and Pro-resolving Mediators in Frontotemporal Dementia and Alzheimer's Disease. Neuroscience 2019; 421:123-135. [PMID: 31654714 DOI: 10.1016/j.neuroscience.2019.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/07/2019] [Accepted: 09/10/2019] [Indexed: 01/06/2023]
Abstract
Chronic inflammation contributes to neuronal death in Alzheimer's disease (AD) and frontotemporal dementia (FTD). Here we evaluated inflammatory and pro-resolving mediators in AD and behavioural variant of FTD (bvFTD) patients compared with controls, since neuroinflamamtion is a common feature in both diseases. Ninety-eight subjects were included in this study, divided into AD (n = 32), bvFTD (n = 30), and control (n = 36) groups. The levels of hsCRP, IL-1β, IL-6, TNF, and TGF-β1, as well as annexin A1 (AnxA1) and lipoxin A4 (LXA4) were measured in blood and cerebrospinal fluid (CSF). The expression profile of AnxA1 was evaluated in peripheral blood mononuclear cells (PBMCs) as well the distribution of ANXA1 rs2611228 polymorphism. We found reduced peripheral levels of hsCRP and TNF in AD compared with bvFTD patients and controls, and increased levels of TGF-β1 in AD compared to controls. Moreover, reduced plasma levels of AnxA1 were observed in bvFTD compared to AD and controls. There was a significant cleavage of AnxA1 in PBMCs in both dementia groups. The results suggest differential regulation of inflammatory and pro-resolving mediators in bvFTD and AD, while AnxA1 cleavage may impair pro-resolving mechanisms in both groups.
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Affiliation(s)
- Vanêssa Gomes Fraga
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carolina Antunes Magalhães
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Cristina de Mello Gomide Loures
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leonardo Cruz de Souza
- Departamento de Clínca Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Henrique Cerqueira Guimarães
- Departamento de Clínca Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Maria das Graças Carvalho
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Paulo Caramelli
- Departamento de Clínca Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lirlândia Pires de Sousa
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Karina Braga Gomes
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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22
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Van Weehaeghe D, Van Schoor E, De Vocht J, Koole M, Attili B, Celen S, Declercq L, Thal DR, Van Damme P, Bormans G, Van Laere K. TSPO Versus P2X7 as a Target for Neuroinflammation: An In Vitro and In Vivo Study. J Nucl Med 2019; 61:604-607. [PMID: 31562223 DOI: 10.2967/jnumed.119.231985] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/26/2019] [Indexed: 12/12/2022] Open
Abstract
Neuroinflammation is important in amyotrophic lateral sclerosis (ALS). The P2X7 receptor (P2X7R) is a promising target for neuroinflammation. The objective of this study was to compare 18F-DPA714, a second-generation translocator protein tracer, with 11C-JNJ717, a novel P2X7R tracer, in vitro and in vivo in ALS. Methods: For the in vitro portion of the study, autoradiography with 18F-DPA714 and 11C-JNJ717 was performed on human ALS brain sections in comparison to immunofluorescence with Iba1 and GFAP. For the in vivo portion, 3 male patients with early-stage ALS (59.3 ± 7.2 y old) and 6 healthy volunteers (48.2 ± 16.5 y old, 2 men and 4 women) underwent dynamic PET/MR scanning with 18F-DPA714 and 11C-JNJ717. Volume-of-distribution images were calculated using Logan plots and analyzed on a volume-of-interest basis. Results: Autoradiography showed no difference in 11C-JNJ717 binding but did show increased 18F-DPA714 binding in the motor cortex correlating with Iba1 expression (glial cells). Similar findings were observed in vivo, with a 13% increase in 18F-DPA714 binding in the motor cortex. Conclusion: In symptomatic ALS patients, 18F-DPA714 showed increased signal whereas 11C-JNJ717 was not elevated.
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Affiliation(s)
- Donatienne Van Weehaeghe
- Division of Nuclear Medicine, Department of Imaging and Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Evelien Van Schoor
- Department of Neurology, University Hospitals Leuven, and Laboratory of Neurobiology, Center for Brain and Disease Research, VIB, KU Leuven, Leuven, Belgium.,Leuven Brain Institute, KU Leuven, Leuven, Belgium.,Laboratory for Neuropathology, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Joke De Vocht
- Department of Neurology, University Hospitals Leuven, and Laboratory of Neurobiology, Center for Brain and Disease Research, VIB, KU Leuven, Leuven, Belgium
| | - Michel Koole
- Division of Nuclear Medicine, Department of Imaging and Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Bala Attili
- Laboratory for Radiopharmaceutical Research, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium; and
| | - Sofie Celen
- Laboratory for Radiopharmaceutical Research, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium; and
| | - Lieven Declercq
- Laboratory for Radiopharmaceutical Research, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium; and
| | - Dietmar R Thal
- Leuven Brain Institute, KU Leuven, Leuven, Belgium.,Laboratory for Neuropathology, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.,Department of Pathology, UZ Leuven, Leuven, Belgium
| | - Philip Van Damme
- Department of Neurology, University Hospitals Leuven, and Laboratory of Neurobiology, Center for Brain and Disease Research, VIB, KU Leuven, Leuven, Belgium
| | - Guy Bormans
- Laboratory for Radiopharmaceutical Research, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium; and
| | - Koen Van Laere
- Division of Nuclear Medicine, Department of Imaging and Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
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23
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Guzman-Martinez L, Maccioni RB, Andrade V, Navarrete LP, Pastor MG, Ramos-Escobar N. Neuroinflammation as a Common Feature of Neurodegenerative Disorders. Front Pharmacol 2019; 10:1008. [PMID: 31572186 PMCID: PMC6751310 DOI: 10.3389/fphar.2019.01008] [Citation(s) in RCA: 405] [Impact Index Per Article: 81.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 08/08/2019] [Indexed: 12/26/2022] Open
Abstract
Neurodegenerative diseases share the fact that they derive from altered proteins that undergo an unfolding process followed by formation of β-structures and a pathological tendency to self-aggregate in neuronal cells. This is a characteristic of tau protein in Alzheimer’s disease and several tauopathies associated with tau unfolding, α-synuclein in Parkinson’s disease, and huntingtin in Huntington disease. Usually, the self-aggregation products are toxic to these cells, and toxicity spreads all over different brain areas. We have postulated that these protein unfolding events are the molecular alterations that trigger several neurodegenerative disorders. Most interestingly, these events occur as a result of neuroinflammatory cascades involving alterations in the cross-talks between glial cells and neurons as a consequence of the activation of microglia and astrocytes. The model we have hypothesized for Alzheimer’s disease involves damage signals that promote glial activation, followed by nuclear factor NF-kβ activation, synthesis, and release of proinflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, IL-6, and IL-12 that affect neuronal receptors with an overactivation of protein kinases. These patterns of pathological events can be applied to several neurodegenerative disorders. In this context, the involvement of innate immunity seems to be a major paradigm in the pathogenesis of these diseases. This is an important element for the search for potential therapeutic approaches for all these brain disorders.
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Affiliation(s)
- Leonardo Guzman-Martinez
- Laboratory of Neuroscience, Faculty of Sciences, University of Chile & International Center for Biomedicine (ICC), Santiago, Chile
| | - Ricardo B Maccioni
- Laboratory of Neuroscience, Faculty of Sciences, University of Chile & International Center for Biomedicine (ICC), Santiago, Chile.,Department of Neurological Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Víctor Andrade
- Laboratory of Neuroscience, Faculty of Sciences, University of Chile & International Center for Biomedicine (ICC), Santiago, Chile
| | - Leonardo Patricio Navarrete
- Laboratory of Neuroscience, Faculty of Sciences, University of Chile & International Center for Biomedicine (ICC), Santiago, Chile
| | - María Gabriela Pastor
- Laboratory of Neuroscience, Faculty of Sciences, University of Chile & International Center for Biomedicine (ICC), Santiago, Chile.,Departamento de Biología, Facultad de Química y Biología, Universidad de Santiago de Chile, Santiago, Chile
| | - Nicolas Ramos-Escobar
- Laboratory of Neuroscience, Faculty of Sciences, University of Chile & International Center for Biomedicine (ICC), Santiago, Chile
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24
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Gefen T, Kim G, Bolbolan K, Geoly A, Ohm D, Oboudiyat C, Shahidehpour R, Rademaker A, Weintraub S, Bigio EH, Mesulam MM, Rogalski E, Geula C. Activated Microglia in Cortical White Matter Across Cognitive Aging Trajectories. Front Aging Neurosci 2019; 11:94. [PMID: 31139072 PMCID: PMC6527736 DOI: 10.3389/fnagi.2019.00094] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 04/05/2019] [Indexed: 11/29/2022] Open
Abstract
Activation of microglia, the primary mediators of inflammation in the brain, is a major component of gliosis and neuronal loss in a number of age-related neurodegenerative disorders, such as Alzheimer’s disease (AD). The role of activated microglia in white matter, and its relationship with cognitive decline during aging are unknown. The current study evaluated microglia densities in the white matter of postmortem specimens from cognitively normal young adults, cognitively normal older adults, and cognitive “SuperAgers,” a unique group of individuals over age 80 whose memory test scores are at a level equal to or better than scores of 50-to-65-year-olds. Whole hemisphere sections from cognitively normal old, young, and “SuperAgers” were used to quantify densities of human leukocyte antigen-D related (HLA-DR)-positive activated microglia underlying five cortical regions. Statistical findings showed a significant main effect of group on differences in microglia density where cognitively normal old showed highest densities. No difference between SuperAgers and young specimens were detected. In two autopsied SuperAgers with MRI FLAIR scans available, prominent hyperintensities in periventricular regions were observed, and interestingly, examination of corresponding postmortem sections showed only sparse microglia densities. In conclusion, activated microglia appear to respond to age-related pathologic changes in cortical white matter, and this phenomenon is largely spared in SuperAgers. Findings offer insights into the relationship between white matter neuroinflammatory changes and cognitive integrity during aging.
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Affiliation(s)
- Tamar Gefen
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Garam Kim
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kabriya Bolbolan
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Andrew Geoly
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Daniel Ohm
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Carly Oboudiyat
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Ryan Shahidehpour
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Alfred Rademaker
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Eileen H Bigio
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - M-Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Emily Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Changiz Geula
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Department of Cell and Molecular Biology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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25
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Aiello M, Cavaliere C, Fiorenza D, Duggento A, Passamonti L, Toschi N. Neuroinflammation in Neurodegenerative Diseases: Current Multi-modal Imaging Studies and Future Opportunities for Hybrid PET/MRI. Neuroscience 2019; 403:125-135. [DOI: 10.1016/j.neuroscience.2018.07.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 07/18/2018] [Accepted: 07/19/2018] [Indexed: 12/28/2022]
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26
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Wei YC, Huang LY, Chen CK, Lin C, Shyu YC, Chen YL, Huang WY, Lin CP. Subjective Cognitive Decline in the Community Is Affected at Multiple Aspects of Mental Health and Life Quality: A Cross-Sectional Study of the Community Medicine of Keelung Chang Gung Memorial Hospital. Dement Geriatr Cogn Dis Extra 2019; 9:152-162. [PMID: 31011329 PMCID: PMC6465714 DOI: 10.1159/000497222] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 01/22/2019] [Indexed: 02/02/2023] Open
Abstract
Background Subjective cognitive decline (SCD) is one of the early warning signs of objective cognition impairment and dementia. Methods This cross-sectional study screened SCD and studied multiple domains of mental health, lifestyle, and life quality of the community-dwelling people in the northern coastal region of Taiwan. Results Among 426 valid AD8 questionnaires, a cutoff of score 2 divided subjects into 115 with SCD (SCD+) and 311 without SCD (SCD–). Analysis of age, sex, body compositions, and blood tests revealed an older age (60.7 ± 10.9 years) of the SCD+ group than the SCD– group (57.6 ± 12.0 years, p < 0.05). Further exclusion of subjects younger than 50 years eliminated age differences and left 100 with SCD (SCD+_50) and 229 without (SCD–_50). Multidomain comparisons of the SCD+_50 group over the SCD–_50 group were made: the Taiwanese Depression Questionnaire found a higher likelihood of depression; the Pittsburgh Sleep Quality Index revealed suboptimal sleep quality; the SF-36 showed inferior function of all 8 aspects of quality of life; the Health-Promoting Lifestyle Profile documented a less health-seeking lifestyle of nutrition, self-actualization, and stress management. Conclusions Aging increased the SCD risk. People with SCD had suboptimal performance in mental health and life quality in addition to subjective cognition problems.
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Affiliation(s)
- Yi-Chia Wei
- Department of Neurology, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan.,Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan.,Community Medicine Research Center, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan
| | - Li-Yuan Huang
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.,Department of Nursing, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chih-Ken Chen
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan.,Department of Psychiatry, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan
| | - Chemin Lin
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan.,Department of Psychiatry, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan
| | - Yu-Chiau Shyu
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan
| | - Yao-Liang Chen
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan.,Department of Radiology, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan
| | - Wen-Yi Huang
- Department of Neurology, Keelung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
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27
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Wilson H, Pagano G, Politis M. Dementia spectrum disorders: lessons learnt from decades with PET research. J Neural Transm (Vienna) 2019; 126:233-251. [PMID: 30762136 PMCID: PMC6449308 DOI: 10.1007/s00702-019-01975-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 01/21/2019] [Indexed: 02/07/2023]
Abstract
The dementia spectrum encompasses a range of disorders with complex diagnosis, pathophysiology and limited treatment options. Positron emission tomography (PET) imaging provides insights into specific neurodegenerative processes underlying dementia disorders in vivo. Here we focus on some of the most common dementias: Alzheimer's disease, Parkinsonism dementias including Parkinson's disease with dementia, dementia with Lewy bodies, progressive supranuclear palsy and corticobasal syndrome, and frontotemporal lobe degeneration. PET tracers have been developed to target specific proteinopathies (amyloid, tau and α-synuclein), glucose metabolism, cholinergic system and neuroinflammation. Studies have shown distinct imaging abnormalities can be detected early, in some cases prior to symptom onset, allowing disease progression to be monitored and providing the potential to predict symptom onset. Furthermore, advances in PET imaging have identified potential therapeutic targets and novel methods to accurately discriminate between different types of dementias in vivo. There are promising imaging markers with a clinical application on the horizon, however, further studies are required before they can be implantation into clinical practice.
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Affiliation(s)
- Heather Wilson
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK
| | - Gennaro Pagano
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK
| | - Marios Politis
- Neurodegeneration Imaging Group, Maurice Wohl Clinical Neuroscience Institute, 125 Coldharbour Lane, Camberwell, London, SE5 9NU, UK.
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28
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Vucic S. Differences in inflammatory profiles between ALS and FTD. J Neurol Neurosurg Psychiatry 2019; 90:1. [PMID: 30224547 DOI: 10.1136/jnnp-2018-319377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 08/15/2018] [Accepted: 08/20/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Steve Vucic
- Western Clinical School, University of Sydney, Sydney, NSW 2145, Australia
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29
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Bachiller S, Jiménez-Ferrer I, Paulus A, Yang Y, Swanberg M, Deierborg T, Boza-Serrano A. Microglia in Neurological Diseases: A Road Map to Brain-Disease Dependent-Inflammatory Response. Front Cell Neurosci 2018; 12:488. [PMID: 30618635 PMCID: PMC6305407 DOI: 10.3389/fncel.2018.00488] [Citation(s) in RCA: 428] [Impact Index Per Article: 71.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 11/29/2018] [Indexed: 12/12/2022] Open
Abstract
Microglia represent a specialized population of macrophages-like cells in the central nervous system (CNS) considered immune sentinels that are capable of orchestrating a potent inflammatory response. Microglia are also involved in synaptic organization, trophic neuronal support during development, phagocytosis of apoptotic cells in the developing brain, myelin turnover, control of neuronal excitability, phagocytic debris removal as well as brain protection and repair. Microglial response is pathology dependent and affects to immune, metabolic. In this review, we will shed light on microglial activation depending on the disease context and the influence of factors such as aging, environment or cell-to-cell interaction.
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Affiliation(s)
- Sara Bachiller
- Experimental Neuroinflammation Laboratory, Lund University, Lund, Sweden
| | - Itzia Jiménez-Ferrer
- Translational Neurogenetics Unit, Wallenberg Neuroscience Center, Lund University, Lund, Sweden
| | - Agnes Paulus
- Experimental Neuroinflammation Laboratory, Lund University, Lund, Sweden
| | - Yiyi Yang
- Experimental Neuroinflammation Laboratory, Lund University, Lund, Sweden
| | - Maria Swanberg
- Translational Neurogenetics Unit, Wallenberg Neuroscience Center, Lund University, Lund, Sweden
| | - Tomas Deierborg
- Experimental Neuroinflammation Laboratory, Lund University, Lund, Sweden
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30
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Pantaleão L, Rocha GHO, Reutelingsperger C, Tiago M, Maria-Engler SS, Solito E, Farsky SP. Connections of annexin A1 and translocator protein-18 kDa on toll like receptor stimulated BV-2 cells. Exp Cell Res 2018; 367:282-290. [DOI: 10.1016/j.yexcr.2018.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 04/06/2018] [Accepted: 04/07/2018] [Indexed: 01/27/2023]
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31
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Neuroimmune Tau Mechanisms: Their Role in the Progression of Neuronal Degeneration. Int J Mol Sci 2018; 19:ijms19040956. [PMID: 29570615 PMCID: PMC5979395 DOI: 10.3390/ijms19040956] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/05/2018] [Accepted: 03/08/2018] [Indexed: 12/15/2022] Open
Abstract
Progressive neurodegenerative pathologies in aged populations are an issue of major concern worldwide. The microtubule-associated protein tau is able to self-aggregate to form abnormal supramolecular structures that include small oligomers up to complex polymers. Tauopathies correspond to a group of diseases that share tau pathology as a common etiological agent. Since microglial cells play a preponderant role in innate immunity and are the main source of proinflammatory factors in the central nervous system (CNS), the alterations in the cross-talks between microglia and neuronal cells are the main focus of studies concerning the origins of tauopathies. According to evidence from a series of studies, these changes generate a feedback mechanism reactivating microglia and provoking constant cellular damage. Thus, the previously summarized mechanisms could explain the onset and progression of different tauopathies and their functional/behavioral effects, opening the window towards an understanding of the molecular basis of anomalous tau interactions. Despite clinical and pathological differences, increasing experimental evidence indicates an overlap between tauopathies and synucleinopathies, considering that neuroinflammatory events are involved and the existence of protein misfolding. Neurofibrillary tangles of pathological tau (NFT) and Lewy bodies appear to coexist in certain brain areas. Thus, the co-occurrence of synucleinopathies with tauopathies is evidenced by several investigations, in which NFT were found in the substantia nigra of patients with Parkinson’s disease, suggesting that the pathologies share some common features at the level of neuroinflammatory events.
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32
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Raj D, Yin Z, Breur M, Doorduin J, Holtman IR, Olah M, Mantingh-Otter IJ, Van Dam D, De Deyn PP, den Dunnen W, Eggen BJL, Amor S, Boddeke E. Increased White Matter Inflammation in Aging- and Alzheimer's Disease Brain. Front Mol Neurosci 2017; 10:206. [PMID: 28713239 PMCID: PMC5492660 DOI: 10.3389/fnmol.2017.00206] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 06/12/2017] [Indexed: 11/13/2022] Open
Abstract
Chronic neuroinflammation, which is primarily mediated by microglia, plays an essential role in aging and neurodegeneration. It is still unclear whether this microglia-induced neuroinflammation occurs globally or is confined to distinct brain regions. In this study, we investigated microglia activity in various brain regions upon healthy aging and Alzheimer's disease (AD)-related pathology in both human and mouse samples. In purified microglia isolated from aging mouse brains, we found a profound gene expression pattern related to pro-inflammatory processes, phagocytosis, and lipid homeostasis. Particularly in white matter microglia of 24-month-old mice, abundant expression of phagocytic markers including Mac-2, Axl, CD16/32, Dectin1, CD11c, and CD36 was detected. Interestingly, in white matter of human brain tissue the first signs of inflammatory activity were already detected during middle age. Thus quantification of microglial proteins, such as CD68 (commonly associated with phagocytosis) and HLA-DR (associated with antigen presentation), in postmortem human white matter brain tissue showed an age-dependent increase in immunoreactivity already in middle-aged people (53.2 ± 2.0 years). This early inflammation was also detectable by non-invasive positron emission tomography imaging using [11C]-(R)-PK11195, a ligand that binds to activated microglia. Increased microglia activity was also prominently present in the white matter of human postmortem early-onset AD (EOAD) brain tissue. Interestingly, microglia activity in the white matter of late-onset AD (LOAD) CNS was similar to that of the aged clinically silent AD cases. These data indicate that microglia-induced neuroinflammation is predominant in the white matter of aging mice and humans as well as in EOAD brains. This white matter inflammation may contribute to the progression of neurodegeneration, and have prognostic value for detecting the onset and progression of aging and neurodegeneration.
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Affiliation(s)
- Divya Raj
- Department of Neuroscience, Section Medical Physiology, University Medical Center Groningen, University of GroningenGroningen, Netherlands
| | - Zhuoran Yin
- Department of Neuroscience, Section Medical Physiology, University Medical Center Groningen, University of GroningenGroningen, Netherlands.,Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Marjolein Breur
- Department of Pathology, VU University Medical CenterAmsterdam, Netherlands
| | - Janine Doorduin
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of GroningenGroningen, Netherlands
| | - Inge R Holtman
- Department of Neuroscience, Section Medical Physiology, University Medical Center Groningen, University of GroningenGroningen, Netherlands
| | - Marta Olah
- Department of Neuroscience, Section Medical Physiology, University Medical Center Groningen, University of GroningenGroningen, Netherlands
| | - Ietje J Mantingh-Otter
- Department of Neuroscience, Section Medical Physiology, University Medical Center Groningen, University of GroningenGroningen, Netherlands
| | - Debby Van Dam
- Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of AntwerpWilrijk, Belgium.,Department of Neurology and Alzheimer Research Center, University Medical Center Groningen, University of GroningenGroningen, Netherlands
| | - Peter P De Deyn
- Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of AntwerpWilrijk, Belgium.,Department of Neurology and Alzheimer Research Center, University Medical Center Groningen, University of GroningenGroningen, Netherlands.,Biobank, Institute Born-BungeWilrijk, Belgium
| | - Wilfred den Dunnen
- Department of Pathology, University Medical Center Groningen, University of GroningenGroningen, Netherlands
| | - Bart J L Eggen
- Department of Neuroscience, Section Medical Physiology, University Medical Center Groningen, University of GroningenGroningen, Netherlands
| | - Sandra Amor
- Department of Pathology, VU University Medical CenterAmsterdam, Netherlands.,Neuroimmunology Unit, Blizard Institute of Cell and Molecular Science, Barts and The London School of Medicine and DentistryLondon, United Kingdom
| | - Erik Boddeke
- Department of Neuroscience, Section Medical Physiology, University Medical Center Groningen, University of GroningenGroningen, Netherlands
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33
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Leyns CEG, Holtzman DM. Glial contributions to neurodegeneration in tauopathies. Mol Neurodegener 2017; 12:50. [PMID: 28662669 PMCID: PMC5492997 DOI: 10.1186/s13024-017-0192-x] [Citation(s) in RCA: 264] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 06/20/2017] [Indexed: 01/09/2023] Open
Abstract
Tauopathies are a broad set of neurodegenerative dementias characterized by aggregation of the tau protein into filamentous inclusions that can be found in neurons and glial cells. Activated microglia, astrocytes and elevated levels of proinflammatory molecules are also pathological hallmarks that are found in brain regions affected by tau pathology. There has been abundant research in recent years to understand the role of gliosis and neuroinflammation in neurodegenerative diseases, particularly in Alzheimer's disease (AD) which is the most common form of dementia. AD is a tauopathy characterized by both extracellular amyloid-β plaques in addition to intracellular neurofibrillary tangles and neuropil threads containing aggregated tau protein. Accumulating evidence suggests that neuroinflammation offers a possible mechanistic link between these pathologies. Additionally, there appears to be a role for neuroinflammation in aggravating tau pathology and neurodegeneration in tauopathies featuring tau deposits as the predominant pathological signature. In this review, we survey the literature regarding inflammatory mechanisms that may impact neurodegeneration in AD and related tauopathies. We consider a physical role for microglia in the spread of tau pathology as well as the non-cell autonomous effects of secreted proinflammatory cytokines, specifically interleukin 1 beta, interleukin 6, tumor necrosis factor alpha and complement proteins. These molecules appear to have direct effects on tau pathophysiology and overall neuronal health. They also indirectly impact neuronal homeostasis by altering glial function. We conclude by proposing a complex role for gliosis and neuroinflammation in accelerating the progression of AD and other tauopathies.
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Affiliation(s)
- Cheryl E. G. Leyns
- Department of Neurology, Washington University, Hope Center for Neurological Disorders, Knight Alzheimer’s Disease Research Center, 660 S. Euclid Ave, St. Louis, MO 63110 USA
| | - David M. Holtzman
- Department of Neurology, Washington University, Hope Center for Neurological Disorders, Knight Alzheimer’s Disease Research Center, 660 S. Euclid Ave, St. Louis, MO 63110 USA
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34
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Lagarde J, Sarazin M, Bottlaender M. In vivo PET imaging of neuroinflammation in Alzheimer's disease. J Neural Transm (Vienna) 2017; 125:847-867. [PMID: 28516240 DOI: 10.1007/s00702-017-1731-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/01/2017] [Indexed: 12/15/2022]
Abstract
Increasing evidence suggests that neuroinflammation contributes to the pathophysiology of many neurodegenerative diseases, especially Alzheimer's disease (AD). Molecular imaging by PET may be a useful tool to assess neuroinflammation in vivo, thus helping to decipher the complex role of inflammatory processes in the pathophysiology of neurodegenerative diseases and providing a potential means of monitoring the effect of new therapeutic approaches. For this objective, the main target of PET studies is the 18 kDa translocator protein (TSPO), as it is overexpressed by activated microglia. In the present review, we describe the most widely used PET tracers targeting the TSPO, the methodological issues in tracer quantification and summarize the results obtained by TSPO PET imaging in AD, as well as in neurodegenerative disorders associated with AD, in psychiatric disorders and ageing. We also briefly describe alternative PET targets and imaging modalities to study neuroinflammation. Lastly, we question the meaning of PET imaging data in the context of a highly complex and multifaceted role of neuroinflammation in neurodegenerative diseases. This overview leads to the conclusion that PET imaging of neuroinflammation is a promising way of deciphering the enigma of the pathophysiology of AD and of monitoring the effect of new therapies.
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Affiliation(s)
- Julien Lagarde
- Unit of Neurology of Memory and Language, Centre de Psychiatrie et Neurosciences, INSERM UMR S894, Centre Hospitalier Sainte-Anne and Université Paris Descartes, Sorbonne Paris Cité, 75014, Paris, France
| | - Marie Sarazin
- Unit of Neurology of Memory and Language, Centre de Psychiatrie et Neurosciences, INSERM UMR S894, Centre Hospitalier Sainte-Anne and Université Paris Descartes, Sorbonne Paris Cité, 75014, Paris, France
| | - Michel Bottlaender
- UNIACT, NeuroSpin, Institut d'Imagerie Biomédicale, Direction de la Recherche Fondamentale, Commissariat à l'Energie Atomique, 91191, Gif-sur-Yvette, France. .,Laboratoire Imagerie Moléculaire in Vivo, UMR 1023, Service Hospitalier Frédéric Joliot, Institut d'Imagerie Biomédicale, Direction de la Recherche Fondamentale, Commissariat à l'Energie Atomique, 91400, Orsay, France.
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35
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Baldacci F, Lista S, Cavedo E, Bonuccelli U, Hampel H. Diagnostic function of the neuroinflammatory biomarker YKL-40 in Alzheimer’s disease and other neurodegenerative diseases. Expert Rev Proteomics 2017; 14:285-299. [DOI: 10.1080/14789450.2017.1304217] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Filippo Baldacci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- AXA Research Fund UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Boulevard de l’hôpital, Paris, France
| | - Simone Lista
- AXA Research Fund UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Boulevard de l’hôpital, Paris, France
| | - Enrica Cavedo
- AXA Research Fund UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Boulevard de l’hôpital, Paris, France
- IRCCS Istituto Centro San Giovanni di Dio-Fatebenefratelli, Brescia, Italy
| | - Ubaldo Bonuccelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Harald Hampel
- AXA Research Fund UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du cerveau et de la moelle (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Boulevard de l’hôpital, Paris, France
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36
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Alam MM, Lee J, Lee SY. Recent Progress in the Development of TSPO PET Ligands for Neuroinflammation Imaging in Neurological Diseases. Nucl Med Mol Imaging 2017; 51:283-296. [PMID: 29242722 DOI: 10.1007/s13139-017-0475-8] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/08/2016] [Accepted: 02/06/2017] [Indexed: 12/13/2022] Open
Abstract
Neuroinflammation is heavily associated with various neurological diseases including Alzheimer's disease, Parkinson's disease, multiple sclerosis, and stroke. It is strongly characterized by the activation of microglia which can be visualized using position emission tomography (PET). Traditionally, translocator protein 18 kDa (TSPO) has been the preferred target for imaging the inflammatory progression of the microglial component. TSPO is expressed in the outer mitochondrial membrane and present in very low concentrations in the healthy human brain, but is markedly upregulated in response to brain injury and inflammation. Due to its value as a marker of microglial activation and subsequent utility for evaluating neuroinflammation in CNS disorders, several classes of TSPO radioligands have been developed and evaluated. However, the application of these second-generation TSPO radiotracers has been subject to several limiting factors, including a polymorphism that affects TSPO binding. This review focuses on recent developments in TSPO imaging, as well as current limitations and suggestions for future directions from a medical imaging perspective.
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Affiliation(s)
- Md Maqusood Alam
- Neuroscience Research Institute, Gachon University, Incheon, 20565 South Korea
| | - Jihye Lee
- Neuroscience Research Institute, Gachon University, Incheon, 20565 South Korea
| | - Sang-Yoon Lee
- Neuroscience Research Institute, Gachon University, Incheon, 20565 South Korea.,Department of Neuroscience, College of Medicine, Gachon University, Incheon, 21936 South Korea
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37
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Age-related hearing loss and dementia: a 10-year national population-based study. Eur Arch Otorhinolaryngol 2017; 274:2327-2334. [DOI: 10.1007/s00405-017-4471-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 01/18/2017] [Indexed: 11/26/2022]
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38
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Bevan-Jones WR, Surendranathan A, Passamonti L, Vázquez Rodríguez P, Arnold R, Mak E, Su L, Coles JP, Fryer TD, Hong YT, Williams G, Aigbirhio F, Rowe JB, O'Brien JT. Neuroimaging of Inflammation in Memory and Related Other Disorders (NIMROD) study protocol: a deep phenotyping cohort study of the role of brain inflammation in dementia, depression and other neurological illnesses. BMJ Open 2017; 7:e013187. [PMID: 28064175 PMCID: PMC5223666 DOI: 10.1136/bmjopen-2016-013187] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Inflammation of the central nervous system is increasingly regarded as having a role in cognitive disorders such as dementia and depression, but it is not clear how such inflammation relates to other aspects of neuropathology, structural and functional changes in the brain and symptoms (as assessed via clinical and neuropsychological assessment and MRI). This study will explore these pathophysiological mechanisms using positron emission tomography (PET) which allows in vivo imaging of inflammation, amyloid and τ deposition, together with neuropsychological profiling, MRI and peripheral biomarker analysis. METHODS AND ANALYSIS Using PET imaging of the ligand [11C]PK11195, we will test for increased neuroinflammation in vivo in patients with Alzheimer's disease, Lewy body dementia, frontotemporal dementia, progressive supranuclear palsy, late-onset depression and mild cognitive impairment, when compared to healthy controls. We will assess whether areas of inflammatory change are associated with amyloid and τ deposition (assessed using 11C-labelled Pittsburgh Compound B ([11C]PiB) and 18F-labelled AV-1451, respectively), as well as structural and connectivity markers found on MRI. Inflammatory biomarker analysis and immune-phenotyping of peripheral blood monocytes will determine the correlation between central inflammation and peripheral inflammation. Finally, we will examine whether central inflammatory markers seen on PET imaging are associated with global and domain specific cognitive impairments or predict cognitive decline over 12 months. ETHICS AND DISSEMINATION The study protocol was approved by the local ethics committee, East of England-Cambridge Central Research Ethics Committee (reference: 13/EE/0104). The study is also Administration of Radioactive Substances Advisory Committee (ARSAC) approved as part of this process. Data will be disseminated by presentation at national and international conferences and by publication, predominantly in journals of clinical neuroscience, neurology and psychiatry.
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Affiliation(s)
| | | | - Luca Passamonti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - Robert Arnold
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Elijah Mak
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Li Su
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Jonathan P Coles
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, UK
| | - Tim D Fryer
- Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Young T Hong
- Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Guy Williams
- Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Franklin Aigbirhio
- Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Lauterbach EC. Repurposing psychiatric medicines to target activated microglia in anxious mild cognitive impairment and early Parkinson's disease. AMERICAN JOURNAL OF NEURODEGENERATIVE DISEASE 2016; 5:29-51. [PMID: 27073741 PMCID: PMC4788730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 01/19/2016] [Indexed: 06/05/2023]
Abstract
Anxiety is common in the Mild Cognitive Impairment (MCI) stage of Alzheimer's disease (AD) and the pre-motor stages of Parkinson's disease (PD). A concomitant and possible cause of this anxiety is microglial activation, also considered a key promoter of neurodegeneration in MCI and early PD via inflammatory mechanisms and the generation of degenerative proinflammatory cytokines. Psychiatric disorders, prevalent in AD and PD, are often treated with psychiatric drugs (psychotropics), raising the question of whether psychotropics might therapeutically affect microglial activation, MCI, and PD. The literature of common psychotropics used in treating psychiatric disorders was reviewed for preclinical and clinical findings regarding microglial activation. Findings potentially compatible with reduced microglial activation or reduced microglial inflammogen release were evident for: antipsychotics including neuroleptics (chlorpromazine, thioridazine, loxapine) and atypicals (aripiprazole, olanzapine, quetiapine, risperidone, ziprasidone); mood stabilizers (carbamazepine, valproate, lithium); antidepressants including tricyclics (amitriptyline, clomipramine, imipramine, nortriptyline), SSRIs (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline), venlafaxine, and bupropion; benzodiazepine anxiolytics (clonazepam, diazepam); cognitive enhancers (donepezil, galantamine, memantine); and other drugs (dextromethorphan, quinidine, amantadine). In contrast, pramipexole and methylphenidate might promote microglial activation. The most promising replicated findings of reduced microglial activation are for quetiapine, valproate, lithium, fluoxetine, donepezil, and memantine but further study is needed and translation of their microglial effects to human disease still requires investigation. In AD-relevant models, risperidone, valproate, lithium, fluoxetine, bupropion, donepezil, and memantine have therapeutic microglial effects in need of replication. Limited clinical data suggest some support for lithium and donepezil in reducing MCI progression, but other drugs have not been studied. In PD-relevant models, lamotrigine, valproate, fluoxetine, dextromethorphan, and amantadine have therapeutic microglial effects whereas methylphenidate induced microglial activation and pramipexole promoted NO release. Clinical data limited to pramipexole do not as of yet indicate faster progression of early PD while the other drugs remain to be investigated. These tantalizing psychotropic neuroprotective findings now invite replication and evidence in AD-and PD-specific models under chronic administration, followed by consideration for clinical trials in MCI and early stage PD. Psychiatric features in early disease may provide opportunities for clinical studies that also employ microglial PET biomarkers.
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Affiliation(s)
- Edward C Lauterbach
- Department of Psychiatry and Behavioral Sciences, Mercer University School of Medicine 655 First Street, Macon, Georgia, 31201, USA
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Abstract
Frontotemporal dementia (FTD) refers to a group of clinically and genetically heterogeneous neurodegenerative disorders that are a common cause of adult-onset behavioural and cognitive impairment. FTD often presents in combination with various hyperkinetic or hypokinetic movement disorders, and evidence suggests that various genetic mutations underlie these different presentations. Here, we review the known syndromatic-genetic correlations in FTD. Although no direct genotype-phenotype correlations have been identified, mutations in multiple genes have been associated with various presentations. Mutations in the genes that encode microtubule-associated protein tau (MAPT) and progranulin (PGRN) can manifest as symmetrical parkinsonism, including the phenotypes of Richardson syndrome and corticobasal syndrome (CBS). Expansions in the C9orf72 gene are most frequently associated with familial FTD, typically combined with motor neuron disease, but other manifestations, such as symmetrical parkinsonism, CBS and multiple system atrophy-like presentations, have been described in patients with these mutations. Less common gene mutations, such as those in TARDBP, CHMP2B, VCP, FUS and TREM2, can also present as atypical parkinsonism. The most common hyperkinetic movement disorders in FTD are motor and vocal stereotypies, which have been observed in up to 78% of patients with autopsy-proven FTD. Other hyperkinetic movements, such as chorea, orofacial dyskinesias, myoclonus and dystonia, are also observed in some patients with FTD.
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Magnetic Resonance Spectroscopy discriminates the response to microglial stimulation of wild type and Alzheimer's disease models. Sci Rep 2016; 6:19880. [PMID: 26813748 PMCID: PMC4728482 DOI: 10.1038/srep19880] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 12/18/2015] [Indexed: 11/26/2022] Open
Abstract
Microglia activation has emerged as a potential key factor in the pathogenesis of Alzheimer’s disease. Metabolite levels assessed by magnetic resonance spectroscopy (MRS) are used as markers of neuroinflammation in neurodegenerative diseases, but how they relate to microglial activation in health and chronic disease is incompletely understood. Using MRS, we monitored the brain metabolic response to lipopolysaccharides (LPS)-induced microglia activation in vivo in a transgenic mouse model of Alzheimer’s disease (APP/PS1) and healthy controls (wild-type (WT) littermates) over 4 hours. We assessed reactive gliosis by immunohistochemistry and correlated metabolic and histological measures. In WT mice, LPS induced a microglial phenotype consistent with activation, associated with a sustained increase in macromolecule and lipid levels (ML9). This effect was not seen in APP/PS1 mice, where LPS did not lead to a microglial response measured by histology, but induced a late increase in the putative inflammation marker myoinositol (mI) and metabolic changes in total creatine and taurine previously reported to be associated with amyloid load. We argue that ML9 and mI distinguish the response of WT and APP/PS1 mice to immune mediators. Lipid and macromolecule levels may represent a biomarker of activation of healthy microglia, while mI may not be a glial marker.
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