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Saloner R, VandeVrede L, Asken BM, Paolillo EW, Gontrum EQ, Wolf A, Lario‐Lago A, Milà‐Alomà M, Triana‐Baltzer G, Kolb HC, Dubal DB, Rabinovici GD, Miller BL, Boxer AL, Casaletto KB, Kramer JH. Plasma phosphorylated tau-217 exhibits sex-specific prognostication of cognitive decline and brain atrophy in cognitively unimpaired adults. Alzheimers Dement 2024; 20:376-387. [PMID: 37639492 PMCID: PMC10843677 DOI: 10.1002/alz.13454] [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: 06/28/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Accumulating evidence indicates disproportionate tau burden and tau-related clinical progression in females. However, sex differences in plasma phosphorylated tau (p-tau)217 prediction of subclinical cognitive and brain changes are unknown. METHODS We measured baseline plasma p-tau217, glial fibrillary acidic protein (GFAP), and neurofilament light (NfL) in 163 participants (85 cognitively unimpaired [CU], 78 mild cognitive impairment [MCI]). In CU, linear mixed effects models examined sex differences in plasma biomarker prediction of longitudinal domain-specific cognitive decline and brain atrophy. Cognitive models were repeated in MCI. RESULTS In CU females, baseline plasma p-tau217 predicted verbal memory and medial temporal lobe trajectories such that trajectories significantly declined once p-tau217 concentrations surpassed 0.053 pg/ml, a threshold that corresponded to early levels of cortical amyloid aggregation in secondary amyloid positron emission tomography analyses. CU males exhibited similar rates of cognitive decline and brain atrophy, but these trajectories were not dependent on plasma p-tau217. Plasma GFAP and NfL exhibited similar female-specific prediction of medial temporal lobe atrophy in CU. Plasma p-tau217 exhibited comparable prediction of cognitive decline across sex in MCI. DISCUSSION Plasma p-tau217 may capture earlier Alzheimer's disease (AD)-related cognitive and brain atrophy hallmarks in females compared to males, possibly reflective of increased susceptibility to AD pathophysiology.
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Affiliation(s)
- Rowan Saloner
- Department of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Lawren VandeVrede
- Department of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Breton M. Asken
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
| | - Emily W. Paolillo
- Department of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Eva Q. Gontrum
- Department of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Amy Wolf
- Department of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Argentina Lario‐Lago
- Department of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Marta Milà‐Alomà
- Department of Radiology and Biomedical ImagingUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | | | - Hartmuth C. Kolb
- Neuroscience BiomarkersJanssen Research & Development, LLCSan DiegoCaliforniaUSA
| | - Dena B. Dubal
- Department of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Gil D. Rabinovici
- Department of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
- Department of Radiology and Biomedical ImagingUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Bruce L. Miller
- Department of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Adam L. Boxer
- Department of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Kaitlin B. Casaletto
- Department of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Joel H. Kramer
- Department of NeurologyWeill Institute for NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
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Digma LA, Litvan I, Del Ser T, Bayram E. Sex differences for cognitive decline in progressive supranuclear palsy. Parkinsonism Relat Disord 2023; 112:105454. [PMID: 37301014 PMCID: PMC10911684 DOI: 10.1016/j.parkreldis.2023.105454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/16/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Cognitive dysfunction is a core clinical feature of progressive supranuclear palsy (PSP), with executive function being most markedly affected. In other neurodegenerative conditions, such as Alzheimer's and Parkinson's diseases, there are a growing number of reports demonstrating that cognition is differentially impacted in men and women. In PSP, however, the sex differences in cognitive decline have yet to be fully characterized. METHODS Data were obtained from the TAUROS trial for 139 participants with mild-to-moderate PSP (62 women, 77 men). Sex differences in longitudinal change in cognitive performance were evaluated with linear mixed models. Exploratory subgroup analyses assessed whether sex differences varied by baseline executive dysfunction, PSP phenotype, or baseline age. RESULTS In the primary whole group analyses, there were no sex differences for change in cognitive performance. Among participants with normal executive function at baseline, men declined more severely on executive function and language tests. Among the PSP-Parkinsonism subgroup, men declined more severely on category fluency. Across people aged≥65, men had a worse decline on category fluency, whereas across people aged <65, women had a worse decline on DRS construction. CONCLUSION In people with mild-to-moderate PSP, there are no sex differences in cognitive decline. However, the rate of cognitive decline may differ for women and men based on the level of baseline executive dysfunction, PSP-phenotype and age. Further studies are needed to clarify how sex differences in PSP clinical progression vary by disease stage and to examine the contributions of co-pathology to these observed sex differences.
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Affiliation(s)
- Leonardino A Digma
- Parkinson and Other Movement Disorder Center, Department of Neurosciences, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
| | - Irene Litvan
- Parkinson and Other Movement Disorder Center, Department of Neurosciences, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
| | - Teodoro Del Ser
- Alzheimer's Disease Investigation Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofia Foundation, Alzheimer Research Centre, C. de Valderrebollo, 5, 28031, Madrid, Spain.
| | - Ece Bayram
- Parkinson and Other Movement Disorder Center, Department of Neurosciences, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
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Mielke MM, Aggarwal NT, Vila‐Castelar C, Agarwal P, Arenaza‐Urquijo EM, Brett B, Brugulat‐Serrat A, DuBose LE, Eikelboom WS, Flatt J, Foldi NS, Franzen S, Gilsanz P, Li W, McManus AJ, van Lent DM, Milani SA, Shaaban CE, Stites SD, Sundermann E, Suryadevara V, Trani J, Turner AD, Vonk JMJ, Quiroz YT, Babulal GM. Consideration of sex and gender in Alzheimer's disease and related disorders from a global perspective. Alzheimers Dement 2022; 18:2707-2724. [PMID: 35394117 PMCID: PMC9547039 DOI: 10.1002/alz.12662] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/15/2022] [Accepted: 02/20/2022] [Indexed: 01/31/2023]
Abstract
Sex or gender differences in the risk of Alzheimer's disease and related dementias (ADRD) differ by world region, suggesting that there are potentially modifiable risk factors for intervention. However, few epidemiological or clinical ADRD studies examine sex differences; even fewer evaluate gender in the context of ADRD risk. The goals of this perspective are to: (1) provide definitions of gender, biologic sex, and sexual orientation. and the limitations of examining these as binary variables; (2) provide an overview of what is known with regard to sex and gender differences in the risk, prevention, and diagnosis of ADRD; and (3) discuss these sex and gender differences from a global, worldwide perspective. Identifying drivers of sex and gender differences in ADRD throughout the world is a first step in developing interventions unique to each geographical and sociocultural area to reduce these inequities and to ultimately reduce global ADRD risk. HIGHLIGHTS: The burden of dementia is unevenly distributed geographically and by sex and gender. Scientific advances in genetics and biomarkers challenge beliefs that sex is binary. Discrimination against women and sex and gender minority (SGM) populations contributes to cognitive decline. Sociocultural factors lead to gender inequities in Alzheimer's disease and related dementias (ADRD) worldwide.
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Affiliation(s)
- Michelle M. Mielke
- Division of Epidemiology, Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Neelum T. Aggarwal
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Clara Vila‐Castelar
- Department of Psychiatry, Harvard Medical SchoolMassachusetts General HospitalMassachusettsBostonUSA
| | - Puja Agarwal
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Internal MedicineRush University Medical CenterChicagoIllinoisUSA
| | - Eider M. Arenaza‐Urquijo
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES)MadridSpain
| | - Benjamin Brett
- Department of NeurosurgeryMedical College of WisconsinWisconsinMilwaukeeUSA
| | - Anna Brugulat‐Serrat
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES)MadridSpain
- Atlantic Fellow for Equity in Brain HealthThe University of California San FranciscoSan FranciscoCaliforniaUSA
| | - Lyndsey E. DuBose
- Department of Medicine, Division of GeriatricsUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Willem S. Eikelboom
- Department of NeurologyErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Jason Flatt
- Social and Behavioral Health Program, School of Public HealthUniversity of Nevada, Las VegasLas VegasNevadaUSA
| | - Nancy S. Foldi
- Department of Psychology, Queens College and The Graduate CenterCity University of New YorkNew YorkUSA
- Department of PsychiatryNew York University Long Island School of MedicineNew YorkUSA
| | - Sanne Franzen
- Department of NeurologyErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Paola Gilsanz
- Kaiser Permanente Division of ResearchOaklandCaliforniaUSA
| | - Wei Li
- Department of Clinical and Diagnostic SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Alison J. McManus
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Debora Melo van Lent
- UT Health San AntonioGlenn Biggs Institute for Alzheimer's and Neurodegenerative diseasesSan AntonioTexasUSA
- Framingham Heart StudyFraminghamMassachusettsUSA
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
| | - Sadaf Arefi Milani
- Division of Geriatrics & Palliative Medicine, Department of Internal MedicineUniversity of Texas Medical BranchGalvestonTexasUSA
| | - C. Elizabeth Shaaban
- Department of EpidemiologyGraduate School of Public HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Shana D. Stites
- Department of PsychiatryPerlman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Erin Sundermann
- Department of PsychiatryUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Vidyani Suryadevara
- Department of Orthopedic SurgeryRush University Medical CenterChicagoIllinoisUSA
| | - Jean‐Francoise Trani
- Department of Public HealthWashington University in St. LouisSt. LouisMissouriUSA
| | - Arlener D. Turner
- Department of Psychiatry & Behavioral SciencesUniversity of Miami Miller School of MedicineMiamiFloridaUSA
| | - Jet M. J. Vonk
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
- Julius Center for Health Sciences and Primary CareDepartment of EpidemiologyUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Yakeel T. Quiroz
- Department of Psychiatry, Harvard Medical SchoolMassachusetts General HospitalMassachusettsBostonUSA
- Grupo de Neurociencias de Antioquia of Universidad de AntioquiaMedellinColumbiaUSA
| | - Ganesh M. Babulal
- Department of NeurologyWashington University in St. LouisSt. LouisMississippiUSA
- Department of Clinical Research and LeadershipThe George Washington University School of Medicine and Health SciencesWashingtonDCUSA
- Department of Psychology, Faculty of HumanitiesUniversity of JohannesburgJohannesburgSouth Africa
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Vila-Castelar C, Tariot PN, Sink KM, Clayton D, Langbaum JB, Thomas RG, Chen Y, Su Y, Chen K, Hu N, Giraldo-Chica M, Tobón C, Acosta-Baena N, Luna E, Londoño M, Ospina P, Tirado V, Muñoz C, Henao E, Bocanegra Y, Alvarez S, Rios-Romenets S, Ghisays V, Goradia D, Lee W, Luo J, Malek-Ahmadi MH, Protas HD, Lopera F, Reiman EM, Quiroz YT. Sex differences in cognitive resilience in preclinical autosomal-dominant Alzheimer's disease carriers and non-carriers: Baseline findings from the API ADAD Colombia Trial. Alzheimers Dement 2022; 18:2272-2282. [PMID: 35103388 PMCID: PMC9339586 DOI: 10.1002/alz.12552] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Females may have greater susceptibility to Alzheimer's disease (AD)-pathology. We examined the effect of sex on pathology, neurodegeneration, and memory in cognitively-unimpaired Presenilin-1 (PSEN1) E280A mutation carriers and non-carriers. METHODS We analyzed baseline data from 167 mutation carriers and 75 non-carriers (ages 30 to 53) from the Alzheimer's Prevention Initiative Autosomal Dominant AD Trial, including florbetapir- and fludeoxyglucose-PET, MRI based hippocampal volume and cognitive testing. RESULTS Females exhibited better delayed recall than males, controlling for age, precuneus glucose metabolism, and mutation status, although the effect was not significant among PSEN1 mutation carriers only. APOE ε4 did not modify the effect of sex on AD biomarkers and memory. DISCUSSION Our findings suggest that, among cognitively-unimpaired individuals at genetic risk for autosomal-dominant AD, females may have greater cognitive resilience to AD pathology and neurodegeneration than males. Further investigation of sex-specific differences in autosomal-dominant AD is key to elucidating mechanisms of AD risk and resilience.
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Affiliation(s)
| | | | | | | | | | | | | | - Yi Su
- Banner Alzheimer’s Institute, Phoenix, AZ, USA
| | - Kewei Chen
- Banner Alzheimer’s Institute, Phoenix, AZ, USA
| | - Nan Hu
- Genentech Inc., South San Francisco, CA, USA
| | | | - Carlos Tobón
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellin, CO
| | | | - Ernesto Luna
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellin, CO
| | - Marisol Londoño
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellin, CO
| | - Paula Ospina
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellin, CO
| | - Victoria Tirado
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellin, CO
| | - Claudia Muñoz
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellin, CO
| | - Eliana Henao
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellin, CO
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellin, CO
| | | | | | | | | | - Wendy Lee
- Banner Alzheimer’s Institute, Phoenix, AZ, USA
| | - Ji Luo
- Banner Alzheimer’s Institute, Phoenix, AZ, USA
| | | | | | - Francisco Lopera
- Grupo de Neurociencias de Antioquia of Universidad de Antioquia, Medellin, CO
| | | | - Yakeel T. Quiroz
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Banner Alzheimer’s Institute, Phoenix, AZ, USA
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Shiravandi A, Yari F, Tofigh N, Kazemi Ashtiani M, Shahpasand K, Ghanian MH, Shekari F, Faridbod F. Earlier Detection of Alzheimer's Disease Based on a Novel Biomarker cis P-tau by a Label-Free Electrochemical Immunosensor. BIOSENSORS 2022; 12:879. [PMID: 36291017 PMCID: PMC9599477 DOI: 10.3390/bios12100879] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/01/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Early detection of cis phosphorylated tau (cis P-tau) may help as an effective treatment to control the progression of Alzheimer's disease (AD). Recently, we introduced for the first time a monoclonal antibody (mAb) with high affinity against cis P-tau. In this study, the cis P-tau mAb was utilized to develop a label-free immunosensor. The antibody was immobilized onto a gold electrode and the electrochemical responses to the analyte were acquired by electrochemical impedance spectroscopy (EIS), cyclic voltammetry (CV), and differential pulse voltammetry (DPV). The immunosensor was capable of selective detection of cis P-tau among non-specific targets like trans P-tau and major plasma proteins. A wide concentration range (10 × 10-14 M-3.0 × 10-9 M) of cis P-tau was measured in PBS and human serum matrices with a limit of detection of 0.02 and 0.05 pM, respectively. Clinical applicability of the immunosensor was suggested by its long-term storage stability and successful detection of cis P-tau in real samples of cerebrospinal fluid (CSF) and blood serum collected from human patients at different stages of AD. These results suggest that this simple immunosensor may find great application in clinical settings for early detection of AD which is an unmet urgent need in today's healthcare services.
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Affiliation(s)
- Ayoub Shiravandi
- Department of Cell Engineering, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, Academic Center for Education, Culture and Research (ACECR), Tehran 1665659911, Iran
| | - Farzaneh Yari
- Center of Excellence in Electrochemistry, School of Chemistry, College of Science, University of Tehran, Tehran P.O. Box 14155-6455, Iran
| | - Nahid Tofigh
- Laboratory of Neuro-Organic Chemistry, Institute of Biochemistry and Biophysics (IBB), University of Tehran, Tehran 1417935840, Iran
| | - Mohammad Kazemi Ashtiani
- Department of Cell Engineering, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, Academic Center for Education, Culture and Research (ACECR), Tehran 1665659911, Iran
| | - Koorosh Shahpasand
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, Academic Center for Education, Culture and Research (ACECR), Tehran 1665659911, Iran
| | - Mohammad-Hossein Ghanian
- Department of Cell Engineering, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, Academic Center for Education, Culture and Research (ACECR), Tehran 1665659911, Iran
| | - Faezeh Shekari
- Advanced Therapy Medicinal Product Technology Development Center, Royan Institute for Stem Cell Biology and Technology, Academic Center for Education, Culture and Research (ACECR), Tehran 1665659911, Iran
| | - Farnoush Faridbod
- Center of Excellence in Electrochemistry, School of Chemistry, College of Science, University of Tehran, Tehran P.O. Box 14155-6455, Iran
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Tan Z, Wang Y, Lu H, Tian W, Xu K, Fan M, Zhao X, Jin L, Cui M, Jiang Y, Chen X. The Effects of Brain Magnetic Resonance Imaging Indices in the Association of Olfactory Identification and Cognition in Chinese Older Adults. Front Aging Neurosci 2022; 14:873032. [PMID: 35865748 PMCID: PMC9294318 DOI: 10.3389/fnagi.2022.873032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Olfactory identification dysfunction frequently occurs in individuals with cognitive decline; however, a pathological mechanism linking the two has not been discovered. We aimed to study the association between olfactory identification and cognitive function, and determine the effects of brain regions atrophy therein. Methods A total of 645 individuals (57.5% were female) from the Taizhou Imaging Study, who underwent cognitive and olfactory identification measurements, were included. A subsample of participants underwent brain magnetic resonance imaging (n = 622). Cognition was assessed with a neuropsychological battery. Olfactory identification was measured using a 12-item Sniffin’ Sticks test. Beta and logistic regressions were used to elucidate the association between olfactory identification and cognition, and the effects of brain regions atrophy in this association. Results Dementia was diagnosed in 41 (6.4%) individuals (mean age = 64.8 years), and mild cognitive impairment (MCI) in 157 (24.3%) individuals (mean age = 64.4 years). Olfactory identification was associated with MMSE and MoCA (both P < 0.001) and specific cognitive domains (memory, executive function, visuospatial function, and language; all P < 0.05). Higher olfactory identification was associated with lower likelihood of MCI and dementia (P < 0.05). The amygdala volume was significantly related to olfactory identification, MMSE, MoCA, and language, and could attenuate the association between olfactory identification and cognitive function. Conclusion The association between olfactory identification and cognition can be partly attributable to differences in amygdala volume, suggesting that the amygdala could be a shared neural substrate that links olfactory identification and cognitive function. Limitations of this study include that all these results were based on a cross-sectional study.
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Cieri F, Zhuang X, Cordes D, Kaplan N, Cummings J, Caldwell J. Relationship of sex differences in cortical thickness and memory among cognitively healthy subjects and individuals with mild cognitive impairment and Alzheimer disease. Alzheimers Res Ther 2022; 14:36. [PMID: 35193682 PMCID: PMC8864917 DOI: 10.1186/s13195-022-00973-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 01/27/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND An aging society has increased rates of late onset Alzheimer disease dementia (ADD), the most common form of age-related dementia. This neurodegenerative disease disproportionately affects women. METHODS We use data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) to examine sex differences in cortical thickness (CT) and memory performance. Analyses of covariance (ANCOVA) models were used to examine effects of sex and diagnosis (DX) on CT and verbal memory. For regions demonstrating significant interaction effects of sex and DX, we tested whether sex moderated cognition-thickness relationships. We used machine learning as a complementary method to explore multivariate CT differences between women and men. RESULTS Women demonstrated greater CT in many brain regions. More specifically, men showed relatively consistent CT declines in all stages, from normal control (NC) to ADD in the bilateral cingulate cortex, bilateral temporal regions, and left precuneus; women had more stable CT in these regions between NC and mild cognitive impairment (MCI) stages, but sharper declines from MCI to ADD. Similarly, for the Rey Auditory Verbal Learning Test (RAVLT), ANCOVA analyses showed that women had significantly better immediate and delayed recall scores than men, at NC and MCI stages, but greater differences, cross-sectionally, from MCI to ADD than men. We found significant sex moderation effects between RAVLT-immediate scores and CT of right isthmus-cingulate for all subjects across DX. Partial correlation analyses revealed that increased CT of right isthmus-cingulate was associated with better verbal learning in women, driven by positron emission tomography defined amyloid positive (Aβ+) subjects. Significant sex-moderation effects in cognition-thickness relationships were further found in the right middle-temporal, left precuneus, and left superior temporal regions in Aβ+ subjects. Using a machine learning approach, we investigated multivariate CT differences between women and men, showing an accuracy in classification of 75% for Aβ+ cognitively NC participants. CONCLUSIONS Sex differences in memory and CT can play a key role in the different vulnerability and progression of ADD in women compared to men. Machine learning indicates sex differences in CT are most relevant early in the ADD neurodegeneration.
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Affiliation(s)
- Filippo Cieri
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Xiaowei Zhuang
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA.,Interdisciplinary Neuroscience Program, University of Nevada Las Vegas (UNLV), Las Vegas, NV, USA
| | - Dietmar Cordes
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA.,University of Colorado Boulder, Boulder, CO, USA
| | - Nikki Kaplan
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Jeffery Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas (UNLV), Las Vegas, NV, USA
| | - Jessica Caldwell
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA.
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Kamath V, Senjem ML, Spychalla AJ, Chen H, Palta P, Mosley TH, Windham BG, Griswold M, Knopman DS, Gottesman RF, Jack CR, Sharrett AR, Schneider AL. The Neuroanatomic Correlates of Olfactory Identification Impairment in Healthy Older Adults and in Persons with Mild Cognitive Impairment. J Alzheimers Dis 2022; 89:233-245. [PMID: 35871337 PMCID: PMC10134400 DOI: 10.3233/jad-220228] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Olfactory identification (OI) impairment appears early in the course of Alzheimer's disease dementia (AD), prior to detectable cognitive impairment. However, the neuroanatomical correlates of impaired OI in cognitively normal older adults (CN) and persons with mild cognitive impairment (MCI) are not fully understood. OBJECTIVE We examined the neuroanatomic correlates of OI impairment in older adults from the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS). METHODS Our sample included 1,600 older adults without dementia who completed clinical assessment and structural brain imaging from 2011 to 2013. We characterized OI impairment using the 12-item Sniffin' Sticks odor identification test (score ≤6). We used voxel-based morphometry (VBM) and region of interest (ROI) analyses to examine the neuroanatomic correlates of impaired OI in CN and MCI, after adjusting for potential confounders. Analyses were also separately stratified by race and sex. RESULTS In CN, OI impairment was associated with smaller amygdala gray matter (GM) volume (p < 0.05). In MCI, OI impairment was associated with smaller GM volumes of the olfactory cortex, amygdala, entorhinal cortex, hippocampus, and insula (ps < 0.05). Differential associations were observed by sex in MCI; OI impairment was associated with lower insular GM volumes among men but not among women (p-interaction = 0.04). There were no meaningful interactions by race. CONCLUSION The brain regions associated with OI impairment in individuals without dementia are specifically those regions known to be the primary targets of AD pathogenic processes. These findings highlight the potential utility of olfactory assessment in the identification and stratification of older adults at risk for AD.
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Affiliation(s)
- Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Matthew L. Senjem
- Department of Radiology, Mayo Clinic, Rochester, MN
- Department of Information Technology, Mayo Clinic, Rochester, MN
| | | | - Honglei Chen
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI
| | - Priya Palta
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Thomas H. Mosley
- The MIND Center, Department of Medicine, The University of Mississippi School of Medicine, Jackson, MI
| | - B. Gwen Windham
- The MIND Center, Department of Medicine, The University of Mississippi School of Medicine, Jackson, MI
| | - Michael Griswold
- The MIND Center, Department of Medicine, The University of Mississippi School of Medicine, Jackson, MI
| | | | - Rebecca F. Gottesman
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD
| | | | - A. Richey Sharrett
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health; Baltimore, MD
| | - Andrea L.C. Schneider
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
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Sundermann EE, Barnes LL, Bondi MW, Bennett DA, Salmon DP, Maki PM. Improving Detection of Amnestic Mild Cognitive Impairment with Sex-Specific Cognitive Norms. J Alzheimers Dis 2021; 84:1763-1770. [PMID: 34719502 DOI: 10.3233/jad-215260] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BackgroundDespite a female advantage in verbal memory, normative data for verbal memory tests used to diagnose Alzheimer's disease (AD) dementia and amnestic mild cognitive impairment (aMCI) often are not sex-adjusted.ObjectiveTo determine whether sex-adjusted norms improve aMCI diagnostic accuracy when accuracy was evaluated by progression to AD dementia over time.MethodsNon-sex-specific and sex-specific verbal memory test norms were incorporated into Jak/Bondi aMCI criteria and applied to older (age 65-90) non-demented women (N = 1,036) and men (N = 355) from the Rush Memory and Aging Project. Using sex-specific aMCI diagnosis as the "true" condition versus non-sex-specific aMCI diagnosis as the "predicted" condition, we identified True Positives, False Positives, True Negatives, and False Negatives and compared AD dementia risk over 10 years among groups.ResultsRates of aMCI were higher in men versus women (χ2 = 15.39, p < 0.001) when determined based on typical diagnostic criteria, but this difference reversed when using sex-specific diagnostic criteria (χ2 = 8.38, p = 0.004). We identified 8%of women as False Negatives and 12%of men as False Positives. Risk of incident AD dementia in False Positive men was significantly lower than in True Positive men (HR = 0.26, 95%CI = 0.12-0.58, p = 0.001). Risk of incident AD dementia in False Negative women was substantially higher than in True Negative women (HR = 3.11, 95%CI = 2.09-4.63, p < 0.001).ConclusionResults suggest that previous reports of higher aMCI rates in men versus women may be an artifact of non-sex-adjusted norms/cut-scores. Incorporation of sex-specific norms/cut-scores for verbal memory impairment into aMCI diagnostic criteria may improve diagnostic accuracy and avoid diagnostic errors in approximately 20%.
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Affiliation(s)
- Erin E Sundermann
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Mark W Bondi
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - David P Salmon
- Department of Neuroscience, University of California, San Diego, La Jolla, CA, USA
| | - Pauline M Maki
- Department of Psychiatry, Psychology and OBGYN, University of Illinois at Chicago, Chicago, IL, USA
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10
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Caldwell JZK, Kinney JW, Ritter A, Salazar A, Wong CG, Cordes D, Slavich GM. Inflammatory cytokine levels implicated in Alzheimer's disease moderate the effects of sex on verbal memory performance. Brain Behav Immun 2021; 95:27-35. [PMID: 33301871 PMCID: PMC8793982 DOI: 10.1016/j.bbi.2020.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/24/2020] [Accepted: 12/04/2020] [Indexed: 12/01/2022] Open
Abstract
Despite having an initial verbal memory advantage over men, women have greater rates of Alzheimer's disease and more rapid cognitive decline once diagnosed. Moreover, although Alzheimer's disease is influenced by inflammation, which itself has known sex differences, no study has investigated whether sex differences in memory are moderated by peripheral inflammatory activity. To address this issue, we analyzed data from 109 individuals (50 women, Mage = 71.62, range = 55-87) diagnosed as cognitively normal, or having mild cognitive impairment or Alzheimer's disease dementia. We then followed the sample for 12 months, as part of a longitudinal study of aging and Alzheimer's disease. At baseline, we assessed levels of the inflammatory cytokines interleukin (IL)-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) in plasma. At baseline and 12 months, we assessed verbal memory using the Rey Auditory Verbal Learning Test and nonverbal memory using the Brief Visuospatial Memory Test-Revised. As hypothesized, for the full sample, women exhibited stronger verbal (but not nonverbal) memory than men. In women, but not men, higher IL-1β at baseline related to poorer verbal learning across both time points and delayed recall at 12 months. The effect of sex on memory also differed by IL-1β level, with women exhibiting a memory advantage both at baseline and 12 months, but only for those with low-to-moderate IL-1β levels. Therefore, high peripheral inflammation levels may lead to a sex-specific memory vulnerability relevant for Alzheimer's disease.
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Affiliation(s)
| | | | - Aaron Ritter
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Arnold Salazar
- Department of Brain Health, University of Nevada, Las Vegas, NV, USA
| | - Christina G Wong
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Dietmar Cordes
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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11
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Shan G, Bernick C, Caldwell JZK, Ritter A. Machine learning methods to predict amyloid positivity using domain scores from cognitive tests. Sci Rep 2021; 11:4822. [PMID: 33649452 PMCID: PMC7921140 DOI: 10.1038/s41598-021-83911-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/09/2021] [Indexed: 01/31/2023] Open
Abstract
Amyloid-[Formula: see text] (A[Formula: see text]) is the target in many clinical trials for Alzheimer's disease (AD). Preclinical AD patients are heterogeneous with regards to different backgrounds and diagnosis. Accurately predicting A[Formula: see text] status of participants by using machine learning (ML) models based on easily accessible data, could improve the effectiveness of AD clinical trials. We will develop optimal ML models for each subpopulation stratified by sex and disease stages using sub scores from screening neurological tests. Data from the AD Neuroimaging Initiative (ADNI) were used to build the ML models, for three groups: individuals with significant memory concern, early mild cognitive impairment (MCI), and late MCI. Data were further separated into 6 groups by disease stage (3 levels) and sex (2 categories). The outcome was defined as the A[Formula: see text] status confirmed by the PET imaging, and the features include demographic data, newly identified risk factors, screening tests, and the domain scores from screening tests. Monte Carlo simulation studies were used together with k-fold cross-validation technique to compute model performance metric. We also develop a new feature selection method based on the stochastic ordering to avoiding searching all possible combinations of features. Accuracy of the identified optimal model for SMC male was over 90% by using domain scores, and accuracy for LMCI female was above 86%. Domain scores can improve the ML model prediction as compared to the total scores. Accurate ML prediction models can identify the proper population for AD clinical trials.
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Affiliation(s)
- Guogen Shan
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada Las Vegas, Las Vegas, NV, 89154, USA.
| | - Charles Bernick
- Cleveland Clinic Lou Ruvo Center for Brain Health, 888 W. Bonneville Avenue, Las Vegas, NV, 89106, USA
| | - Jessica Z K Caldwell
- Cleveland Clinic Lou Ruvo Center for Brain Health, 888 W. Bonneville Avenue, Las Vegas, NV, 89106, USA
| | - Aaron Ritter
- Cleveland Clinic Lou Ruvo Center for Brain Health, 888 W. Bonneville Avenue, Las Vegas, NV, 89106, USA
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12
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Vila-Castelar C, Guzmán-Vélez E, Pardilla-Delgado E, Buckley RF, Bocanegra Y, Baena A, Fox-Fuller JT, Tirado V, Muñoz C, Giraldo M, Acosta-Baena N, Rios-Romenets S, Langbaum JB, Tariot PN, Lopera F, Reiman EM, Quiroz YT. Examining Sex Differences in Markers of Cognition and Neurodegeneration in Autosomal Dominant Alzheimer's Disease: Preliminary Findings from the Colombian Alzheimer's Prevention Initiative Biomarker Study. J Alzheimers Dis 2020; 77:1743-1753. [PMID: 32925067 PMCID: PMC8075106 DOI: 10.3233/jad-200723] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Growing evidence suggests that there may be a sex-specific biological risk for Alzheimer's disease (AD). Individuals with autosomal dominant AD due to a mutation (E280A) in Presenilin-1 (PSEN1) are genetically determined to develop early-onset dementia and thus, have few age-related risk factors for AD that are known to vary by sex (i.e., cardiovascular disease, menopause, life expectancy). OBJECTIVE Investigate sex differences in markers of cognition and neurodegeneration in autosomal dominant AD. METHODS We conducted a retrospective study in 19 cognitively-unimpaired PSEN1 mutation carriers (age range 20-44; 11 females), 11 symptomatic carriers (age range 42-56; 8 females), and 23 matched non-carriers family members (age range 20-50; 13 females). We examined hippocampal volume ratio, CERAD Total Score, and CERAD Word List (i.e., Learning, Delayed Recall, and Recognition). Mann-Whitney U tests, Spearman correlations and regression models were conducted. RESULTS There were no differential associations between age, CERAD Total Score, CERAD Word List-Learning, Delayed Recall, Recognition, and hippocampal volume ratio in male and female carriers and non-carriers. Cognitively-unimpaired female carriers showed better CERAD Total scores and CERAD Word List-Learning than cognitively-unimpaired male carriers, despite having similar hippocampal volume ratios. The interaction of sex and hippocampal volume ratio did not predict cognitive performance across groups. CONCLUSION Our preliminary findings suggest that cognitively-unimpaired female carriers showed a verbal memory reserve, and as disease progresses, female carriers did not exhibit a cognitive susceptibility to AD-related neurodegeneration. Future studies with larger samples of autosomal dominant AD are warranted to further understand sex differences in AD-related clinical and pathological markers.
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Affiliation(s)
- Clara Vila-Castelar
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Edmarie Guzmán-Vélez
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | | | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Yamile Bocanegra
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Ana Baena
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Joshua T Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - Victoria Tirado
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Claudia Muñoz
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Margarita Giraldo
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Natalia Acosta-Baena
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Silvia Rios-Romenets
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | | | | | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | | | - Yakeel T Quiroz
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
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