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Hoglund Z, Ruiz-Uribe N, Del Sastre E, Woost B, Bader E, Bailey J, Hyman BT, Zwang T, Bennett RE. Brain vasculature accumulates tau and is spatially related to tau tangle pathology in Alzheimer's disease. Acta Neuropathol 2024; 147:101. [PMID: 38884806 PMCID: PMC11182845 DOI: 10.1007/s00401-024-02751-9] [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: 04/02/2024] [Revised: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 06/18/2024]
Abstract
Insoluble pathogenic proteins accumulate along blood vessels in conditions of cerebral amyloid angiopathy (CAA), exerting a toxic effect on vascular cells and impacting cerebral homeostasis. In this work, we provide new evidence from three-dimensional human brain histology that tau protein, the main component of neurofibrillary tangles, can similarly accumulate along brain vascular segments. We quantitatively assessed n = 6 Alzheimer's disease (AD), and n = 6 normal aging control brains and saw that tau-positive blood vessel segments were present in all AD cases. Tau-positive vessels are enriched for tau at levels higher than the surrounding tissue and appear to affect arterioles across cortical layers (I-V). Further, vessels isolated from these AD tissues were enriched for N-terminal tau and tau phosphorylated at T181 and T217. Importantly, tau-positive vessels are associated with local areas of increased tau neurofibrillary tangles. This suggests that accumulation of tau around blood vessels may reflect a local clearance failure. In sum, these data indicate that tau, like amyloid beta, accumulates along blood vessels and may exert a significant influence on vasculature in the setting of AD.
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Affiliation(s)
- Zachary Hoglund
- Department of Neurology, Massachusetts General Hospital, 114 16Th Street, Charlestown, MA, USA
| | - Nancy Ruiz-Uribe
- Department of Neurology, Massachusetts General Hospital, 114 16Th Street, Charlestown, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Eric Del Sastre
- Department of Neurology, Massachusetts General Hospital, 114 16Th Street, Charlestown, MA, USA
| | - Benjamin Woost
- Department of Neurology, Massachusetts General Hospital, 114 16Th Street, Charlestown, MA, USA
| | - Elizabeth Bader
- Department of Neurology, Massachusetts General Hospital, 114 16Th Street, Charlestown, MA, USA
| | - Joshua Bailey
- Department of Neurology, Massachusetts General Hospital, 114 16Th Street, Charlestown, MA, USA
| | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital, 114 16Th Street, Charlestown, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Theodore Zwang
- Department of Neurology, Massachusetts General Hospital, 114 16Th Street, Charlestown, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Rachel E Bennett
- Department of Neurology, Massachusetts General Hospital, 114 16Th Street, Charlestown, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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2
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Kamagata K, Saito Y, Andica C, Uchida W, Takabayashi K, Yoshida S, Hagiwara A, Fujita S, Nakaya M, Akashi T, Wada A, Kamiya K, Hori M, Aoki S. Noninvasive Magnetic Resonance Imaging Measures of Glymphatic System Activity. J Magn Reson Imaging 2024; 59:1476-1493. [PMID: 37655849 DOI: 10.1002/jmri.28977] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/09/2023] [Accepted: 08/09/2023] [Indexed: 09/02/2023] Open
Abstract
The comprehension of the glymphatic system, a postulated mechanism responsible for the removal of interstitial solutes within the central nervous system (CNS), has witnessed substantial progress recently. While direct measurement techniques involving fluorescence and contrast agent tracers have demonstrated success in animal studies, their application in humans is invasive and presents challenges. Hence, exploring alternative noninvasive approaches that enable glymphatic research in humans is imperative. This review primarily focuses on several noninvasive magnetic resonance imaging (MRI) techniques, encompassing perivascular space (PVS) imaging, diffusion tensor image analysis along the PVS, arterial spin labeling, chemical exchange saturation transfer, and intravoxel incoherent motion. These methodologies provide valuable insights into the dynamics of interstitial fluid, water permeability across the blood-brain barrier, and cerebrospinal fluid flow within the cerebral parenchyma. Furthermore, the review elucidates the underlying concept and clinical applications of these noninvasive MRI techniques, highlighting their strengths and limitations. It addresses concerns about the relationship between glymphatic system activity and pathological alterations, emphasizing the necessity for further studies to establish correlations between noninvasive MRI measurements and pathological findings. Additionally, the challenges associated with conducting multisite studies, such as variability in MRI systems and acquisition parameters, are addressed, with a suggestion for the use of harmonization methods, such as the combined association test (COMBAT), to enhance standardization and statistical power. Current research gaps and future directions in noninvasive MRI techniques for assessing the glymphatic system are discussed, emphasizing the need for larger sample sizes, harmonization studies, and combined approaches. In conclusion, this review provides invaluable insights into the application of noninvasive MRI methods for monitoring glymphatic system activity in the CNS. It highlights their potential in advancing our understanding of the glymphatic system, facilitating clinical applications, and paving the way for future research endeavors in this field. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 5.
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Affiliation(s)
- Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuya Saito
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Christina Andica
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Faculty of Health Data Science, Juntendo University, Chiba, Japan
| | - Wataru Uchida
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kaito Takabayashi
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Seina Yoshida
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Akifumi Hagiwara
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shohei Fujita
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Radiology, The University of Tokyo, Tokyo, Japan
| | - Moto Nakaya
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Radiology, The University of Tokyo, Tokyo, Japan
| | - Toshiaki Akashi
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akihiko Wada
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kouhei Kamiya
- Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan
| | - Masaaki Hori
- Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan
| | - Shigeki Aoki
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Faculty of Health Data Science, Juntendo University, Chiba, Japan
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3
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Alghanimy A, Work LM, Holmes WM. The glymphatic system and multiple sclerosis: An evolving connection. Mult Scler Relat Disord 2024; 83:105456. [PMID: 38266608 DOI: 10.1016/j.msard.2024.105456] [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: 01/14/2024] [Accepted: 01/18/2024] [Indexed: 01/26/2024]
Abstract
Multiple sclerosis (MS) is a complex autoimmune disorder that affects the central nervous system, resulting in demyelination and an array of neurological manifestations. Recently, there has been significant scientific interest in the glymphatic system, which operates as a waste-clearance system for the brain. This article reviews the existing literature, and explores potential links between the glymphatic system and MS, shedding light on its evolving significance in the context of MS pathogenesis. The authors consider the pathophysiological implications of glymphatic dysfunction in MS, the impact of disrupted sleep on glymphatic function, and the bidirectional relationship between MS and sleep disturbances. By offering an understanding of the intricate interplay between the glymphatic system and MS, this review provides valuable insights which may lead to improved diagnostic techniques and more effective therapeutic interventions.
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Affiliation(s)
- Alaa Alghanimy
- School of Psychology and Neuroscience, College of Medicine, Veterinary and Life Science, University of Glasgow, Glasgow G61 1QH, United Kingdom; Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Lorraine M Work
- School of Cardiovascular and Metabolic Health, College of Medicine, Veterinary and Life Science, University of Glasgow, Glasgow G12 8TA, United Kingdom
| | - William M Holmes
- School of Psychology and Neuroscience, College of Medicine, Veterinary and Life Science, University of Glasgow, Glasgow G61 1QH, United Kingdom
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Astara K, Tsimpolis A, Kalafatakis K, Vavougios GD, Xiromerisiou G, Dardiotis E, Christodoulou NG, Samara MT, Lappas AS. Sleep disorders and Alzheimer's disease pathophysiology: The role of the Glymphatic System. A scoping review. Mech Ageing Dev 2024; 217:111899. [PMID: 38163471 DOI: 10.1016/j.mad.2023.111899] [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: 08/25/2023] [Revised: 12/14/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Alzheimer's disease (AD) is highly intertwined with sleep disturbances throughout its whole natural history. Sleep consists of a major compound of the functionality of the glymphatic system, as the synchronized slow-wave activity during NREM facilitates cerebrospinal and interstitial long-distance mixing. OBJECTIVE The present study undertakes a scoping review of research on the involvement of the glymphatic system in AD-related sleep disturbances. DESIGN we searched Medline, Embase, PsychInfo and HEAL-link databases, without limitations on date and language, along with reference lists of relevant reviews and all included studies. We included in vivo, in vitro and post-mortem studies examining glymphatic implications of sleep disturbances in human populations with AD spectrum pathology. A thematic synthesis of evidence based on the extracted content was applied and presented in a narrative way. RESULTS In total, 70 original research articles were included and were grouped as following: a) Protein aggregation and toxicity, after sleep deprivation, along with its effects on sleep architecture, b) Glymphatic Sequalae in SDB, yielding potential glymphatic markers c) Circadian Dysregulation, d) Possible Interventions. CONCLUSIONS this review sought to provide insight into the role of sleep disturbances in AD pathogenesis, in the context of the glymphatic disruption.
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Affiliation(s)
- Kyriaki Astara
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece; Department of Neurology, 417 Army Equity Fund Hospital (NIMTS), Athens, Greece
| | - Alexandros Tsimpolis
- Department of Pharmacology, Medical School, University of Crete & Institute of Molecular Biology and Biotechnology, Foundation of Research and Technology Hellas, Heraklion, Crete, Greece
| | - Konstantinos Kalafatakis
- Faculty of Medicine & Dentistry (Malta campus), Queen Mary University of London, VCT 2520, Victoria, Gozo, Malta.
| | - George D Vavougios
- Department of Neurology, Faculty of Medicine, University of Cyprus, Lefkosia, Cyprus; Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece; Department of Neurology, Athens Naval Hospital, Athens, Greece
| | - Georgia Xiromerisiou
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
| | - Nikos G Christodoulou
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece; Medical School, University of Nottingham, Lenton, Nottingham, UK
| | - Myrto T Samara
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Andreas S Lappas
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece; Aneurin Bevan University Health Board, Wales, UK
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Voorter PHM, van Dinther M, Jansen WJ, Postma AA, Staals J, Jansen JFA, van Oostenbrugge RJ, van der Thiel MM, Backes WH. Blood-Brain Barrier Disruption and Perivascular Spaces in Small Vessel Disease and Neurodegenerative Diseases: A Review on MRI Methods and Insights. J Magn Reson Imaging 2024; 59:397-411. [PMID: 37658640 DOI: 10.1002/jmri.28989] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 09/03/2023] Open
Abstract
Perivascular spaces (PVS) and blood-brain barrier (BBB) disruption are two key features of cerebral small vessel disease (cSVD) and neurodegenerative diseases that have been linked to cognitive impairment and are involved in the cerebral waste clearance system. Magnetic resonance imaging (MRI) offers the possibility to study these pathophysiological processes noninvasively in vivo. This educational review provides an overview of the MRI techniques used to assess PVS functionality and BBB disruption. MRI-visible PVS can be scored on structural images by either (subjectively) counting or (automatically) delineating the PVS. We highlight emerging (diffusion) techniques to measure proxies of perivascular fluid and its movement, which may provide a more comprehensive understanding of the role of PVS in diseases. For the measurement of BBB disruption, we explain the most commonly used MRI technique, dynamic contrast-enhanced (DCE) MRI, as well as a more recently developed technique based on arterial spin labeling (ASL). DCE MRI and ASL are thought to measure complementary characteristics of the BBB. Furthermore, we describe clinical studies that have utilized these MRI techniques in cSVD and neurodegenerative diseases, particularly Alzheimer's disease (AD). These studies demonstrate the role of PVS and BBB dysfunction in these diseases and provide insight into the large overlap, but also into the differences between cSVD and AD. Overall, MRI techniques may provide valuable insights into the pathophysiological mechanisms underlying these diseases and have the potential to be used as markers for disease progression and treatment response. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Paulien H M Voorter
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Maud van Dinther
- School for Cardiovascular Disease, Maastricht University, Maastricht, the Netherlands
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Willemijn J Jansen
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Alida A Postma
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Julie Staals
- School for Cardiovascular Disease, Maastricht University, Maastricht, the Netherlands
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jacobus F A Jansen
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Robert J van Oostenbrugge
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- School for Cardiovascular Disease, Maastricht University, Maastricht, the Netherlands
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Merel M van der Thiel
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Walter H Backes
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- School for Cardiovascular Disease, Maastricht University, Maastricht, the Netherlands
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Hoglund Z, Ruiz-Uribe N, del Sastre E, Woost B, Bailey J, Hyman BT, Zwang T, Bennett RE. Brain Vasculature Accumulates Tau and Is Spatially Related to Tau Tangle Pathology in Alzheimer's Disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.27.577088. [PMID: 38328111 PMCID: PMC10849642 DOI: 10.1101/2024.01.27.577088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Insoluble pathogenic proteins accumulate along blood vessels in conditions of cerebral amyloid angiopathy (CAA), exerting a toxic effect on vascular cells and impacting cerebral homeostasis. In this work we provide new evidence from three-dimensional human brain histology that tau protein, the main component of neurofibrillary tangles, can similarly accumulate along brain vascular segments. We quantitatively assessed n=6 Alzheimer's disease (AD), and n=6 normal aging control brains and saw that tau-positive blood vessel segments were present in all AD cases. Tau-positive vessels are enriched for tau at levels higher than the surrounding tissue and appear to affect arterioles across cortical layers (I-V). Further, vessels isolated from these AD tissues were enriched for N-terminal tau and tau phosphorylated at T181 and T217. Importantly, tau-positive vessels are associated with local areas of increased tau neurofibrillary tangles. This suggests that accumulation of tau around blood vessels may reflect a local clearance failure. In sum, these data indicate tau, like amyloid beta, accumulates along blood vessels and may exert a significant influence on vasculature in the setting of AD.
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Affiliation(s)
- Zachary Hoglund
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Nancy Ruiz-Uribe
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Eric del Sastre
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Benjamin Woost
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Joshua Bailey
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Bradley T. Hyman
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Theodore Zwang
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Rachel E. Bennett
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, USA
- Harvard Medical School, Boston, MA, USA
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7
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Meng JC, Shen MQ, Lu YL, Feng HX, Chen XY, Xu DQ, Wu GH, Cheng QZ, Wang LH, Gui Q. Correlation of glymphatic system abnormalities with Parkinson's disease progression: a clinical study based on non-invasive fMRI. J Neurol 2024; 271:457-471. [PMID: 37755462 DOI: 10.1007/s00415-023-12004-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND The glymphatic system is reportedly involved in Parkinson's disease (PD). Based on previous studies, we aimed to confirm the correlation between the glymphatic system and PD progression by combining two imaging parameters, diffusion tensor image analysis along the perivascular space (DTI-ALPS), and enlarged perivascular spaces (EPVS). METHODS Fifty-one PD patients and fifty healthy control (HC) were included. Based on the Hoehn-Yahr scale, the PD group was divided into early-stage and medium-to late-stage. All PD patients were scored using the Unified PD Rating Scale (UPDRS). We assessed the DTI-ALPS indices in the bilateral hemispheres and EPVS numbers in bilateral centrum semiovale (CSO), basal ganglia (BG), and midbrain. RESULTS The DTI-ALPS indices were significantly lower bilaterally in PD patients than in the HC group, and EPVS numbers in any of the bilateral CSO, BG, and midbrain were significantly higher, especially for the medium- to late-stage group and the BG region. In PD patients, the DTI-ALPS index was significantly negatively correlated with age, while the BG-EPVS numbers were significantly positively correlated with age. Furthermore, the DTI-ALPS index was negatively correlated with UPDRS II and III scores, while the BG-EPVS numbers were positively correlated with UPDRS II and III scores. Similarly, the correlation was more pronounced in the medium- to late-stage group. CONCLUSION The DTI-ALPS index and EPVS numbers (especially in the BG region) are closely related to age and PD progression and can serve as non-invasive assessments for glymphatic dysfunction and its interventions in clinical studies.
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Affiliation(s)
- Jing-Cai Meng
- Department of Physiology and Neurobiology, Suzhou Medical College of Soochow University, Suzhou, 215123, Jiangsu, China
| | - Ming-Qiang Shen
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital), Suzhou, 215002, Jiangsu, China
| | - Yan-Li Lu
- Department of Radiology, Suzhou Hospital Affiliated to Nanjing Medical University(Suzhou Municipal Hospital), Suzhou, 215002, Jiangsu, China
| | - Hong-Xuan Feng
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital), Suzhou, 215002, Jiangsu, China
| | - Xin-Yi Chen
- Department of Physiology and Neurobiology, Suzhou Medical College of Soochow University, Suzhou, 215123, Jiangsu, China
| | - Da-Qiang Xu
- Department of Radiology, Suzhou Hospital Affiliated to Nanjing Medical University(Suzhou Municipal Hospital), Suzhou, 215002, Jiangsu, China
| | - Guan-Hui Wu
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital), Suzhou, 215002, Jiangsu, China
| | - Qing-Zhang Cheng
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital), Suzhou, 215002, Jiangsu, China
| | - Lin-Hui Wang
- Department of Physiology and Neurobiology, Suzhou Medical College of Soochow University, Suzhou, 215123, Jiangsu, China
| | - Qian Gui
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital), Suzhou, 215002, Jiangsu, China.
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Coleman A, Langan MT, Verma G, Knights H, Sturrock A, Leavitt BR, Tabrizi SJ, Scahill RI, Hobbs NZ. Assessment of Perivascular Space Morphometry Across the White Matter in Huntington's Disease Using MRI. J Huntingtons Dis 2024; 13:91-101. [PMID: 38517798 DOI: 10.3233/jhd-231508] [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] [Indexed: 03/24/2024]
Abstract
Background Perivascular spaces (PVS) are fluid-filled cavities surrounding small cerebral blood vessels. There are limited reports of enlarged PVS across the grey matter in manifest Huntington's disease (HD). Little is known about how PVS morphometry in the white matter may contribute to HD. Enlarged PVS have the potential to both contribute to HD pathology and affect the distribution and success of intraparenchymal and intrathecally administered huntingtin-lowering therapies. Objective To investigate PVS morphometry in the global white matter across the spectrum of HD. Relationships between PVS morphometry and disease burden and severity measures were examined. Methods White matter PVS were segmented on 3T T2 W MRI brain scans of 33 healthy controls, 30 premanifest HD (pre-HD), and 32 early manifest HD (early-HD) participants from the Vancouver site of the TRACK-HD study. PVS count and total PVS volume were measured. Results PVS total count slightly increased in pre-HD (p = 0.004), and early-HD groups (p = 0.005), compared to healthy controls. PVS volume, as a percentage of white matter volume, increased subtly in pre-HD compared to healthy controls (p = 0.044), but not in early-HD. No associations between PVS measures and HD disease burden or severity were found. Conclusions This study reveals relatively preserved PVS morphometry across the global white matter of pre-HD and early-HD. Subtle morphometric abnormalities are implied but require confirmation in a larger cohort. However, in conjunction with previous publications, further investigation of PVS in HD and its potential impact on future treatments, with a focus on subcortical grey matter, is warranted.
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Affiliation(s)
- Annabelle Coleman
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Mackenzie T Langan
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Biomedical Engineering and Imaging Institute at Mount Sinai School of Medicine, New York, NY, USA
| | - Gaurav Verma
- Biomedical Engineering and Imaging Institute at Mount Sinai School of Medicine, New York, NY, USA
| | - Harry Knights
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Aaron Sturrock
- Department of Medical Genetics, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Blair R Leavitt
- Department of Medical Genetics, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Sarah J Tabrizi
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Rachael I Scahill
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Nicola Z Hobbs
- Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
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9
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Zhang J, Liu S, Wu Y, Tang Z, Wu Y, Qi Y, Dong F, Wang Y. Enlarged Perivascular Space and Index for Diffusivity Along the Perivascular Space as Emerging Neuroimaging Biomarkers of Neurological Diseases. Cell Mol Neurobiol 2023; 44:14. [PMID: 38158515 DOI: 10.1007/s10571-023-01440-7] [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: 03/06/2023] [Accepted: 11/12/2023] [Indexed: 01/03/2024]
Abstract
The existence of lymphatic vessels or similar clearance systems in the central nervous system (CNS) that transport nutrients and remove cellular waste is a neuroscientific question of great significance. As the brain is the most metabolically active organ in the body, there is likely to be a potential correlation between its clearance system and the pathological state of the CNS. Until recently the successive discoveries of the glymphatic system and the meningeal lymphatics solved this puzzle. This article reviews the basic anatomy and physiology of the glymphatic system. Imaging techniques to visualize the function of the glymphatic system mainly including post-contrast imaging techniques, indirect lymphatic assessment by detecting increased perivascular space, and diffusion tensor image analysis along the perivascular space (DTI-ALPS) are discussed. The pathological link between glymphatic system dysfunction and neurological disorders is the key point, focusing on the enlarged perivascular space (EPVS) and the index of diffusivity along the perivascular space (ALPS index), which may represent the activity of the glymphatic system as possible clinical neuroimaging biomarkers of neurological disorders. The pathological link between glymphatic system dysfunction and neurological disorders is the key point, focusing on the enlarged perivascular space (EPVS) and the index for of diffusivity along the perivascular space (ALPS index), which may represent the activity of the glymphatic system as possible clinical neuroimaging biomarkers of neurological disorders.
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Affiliation(s)
- Jun Zhang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shengwen Liu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yaqi Wu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Zhijian Tang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yasong Wu
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yiwei Qi
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Fangyong Dong
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yu Wang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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10
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Sosa MJ, Shih AY, Bonney SK. The elusive brain perivascular fibroblast: a potential role in vascular stability and homeostasis. Front Cardiovasc Med 2023; 10:1283434. [PMID: 38075961 PMCID: PMC10704358 DOI: 10.3389/fcvm.2023.1283434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/10/2023] [Indexed: 01/09/2024] Open
Abstract
In the brain, perivascular fibroblasts (PVFs) reside within the perivascular spaces (PVSs) of arterioles and large venules, however their physiological and pathophysiological roles remain largely unknown. PVFs express numerous extracellular matrix proteins that are found in the basement membrane and PVS surrounding large diameter vessels. PVFs are sandwiched between the mural cell layer and astrocytic endfeet, where they are poised to interact with mural cells, perivascular macrophages, and astrocytes. We draw connections between the more well-studied PVF pro-fibrotic response in ischemic injury and the less understood thickening of the vascular wall and enlargement of the PVS described in dementia and neurodegenerative diseases. We postulate that PVFs may be responsible for stability and homeostasis of the brain vasculature, and may also contribute to changes within the PVS during disease.
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Affiliation(s)
- Maria J. Sosa
- Center for Developmental Biology and Regenerative Medicine, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Andy Y. Shih
- Center for Developmental Biology and Regenerative Medicine, Seattle Children’s Research Institute, Seattle, WA, United States
- Department of Pediatrics, University of Washington, Seattle, WA, United States
- Department of Bioengineering, University of Washington, Seattle, WA, United States
| | - Stephanie K. Bonney
- Center for Developmental Biology and Regenerative Medicine, Seattle Children’s Research Institute, Seattle, WA, United States
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11
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Emmerson JT, Do Carmo S, Liu Y, Shalhoub A, Liu A, Bonomo Q, Malcolm JC, Breuillaud L, Cuello AC. Progressive human-like tauopathy with downstream neurodegeneration and neurovascular compromise in a transgenic rat model. Neurobiol Dis 2023; 184:106227. [PMID: 37454780 DOI: 10.1016/j.nbd.2023.106227] [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: 05/02/2023] [Revised: 06/27/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023] Open
Abstract
Tauopathies, including frontotemporal dementia (FTD) and Alzheimer's disease (AD), clinically present with progressive cognitive decline and the deposition of neurofibrillary tangles (NFTs) in the brain. Neurovascular compromise is also prevalent in AD and FTD however the relationship between tau and the neurovascular unit is less understood relative to other degenerative phenotypes. Current animal models confer the ability to recapitulate aspects of the CNS tauopathies, however, existing models either display overaggressive phenotypes, or do not develop neuronal loss or genuine neurofibrillary lesions. In this report, we communicate the longitudinal characterization of brain tauopathy in a novel transgenic rat model, coded McGill-R955-hTau. The model expresses the longest isoform of human P301S tau. Homozygous R955-hTau rats displayed a robust, progressive accumulation of mutated human tau leading to the detection of tau hyperphosphorylation and cognitive deficits accelerating from 14 months of age. This model features extensive tau hyperphosphorylation with endogenous tau recruitment, authentic neurofibrillary lesions, and tau-associated neuronal loss, ventricular dilation, decreased brain volume, and gliosis in aged rats. Further, we demonstrate how neurovascular integrity becomes compromised at aged life stages using a combination of electron microscopy, injection of the tracer horseradish peroxidase and immunohistochemical approaches.
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Affiliation(s)
- Joshua T Emmerson
- Department of Pharmacology & Therapeutics, McGill University, Montreal H3G1Y6, Canada
| | - Sonia Do Carmo
- Department of Pharmacology & Therapeutics, McGill University, Montreal H3G1Y6, Canada
| | - Yingying Liu
- Department of Pharmacology & Therapeutics, McGill University, Montreal H3G1Y6, Canada
| | - Ali Shalhoub
- Department of Biochemistry, McGill University, Montreal H3A 0C7, Canada
| | - Ai Liu
- Integrated Program in Neuroscience, McGill University, Montreal H3A 1A1, Canada
| | - Quentin Bonomo
- Integrated Program in Neuroscience, McGill University, Montreal H3A 1A1, Canada
| | - Janice C Malcolm
- Department of Anatomy and Cell Biology, McGill University, Montreal H3A 0C7, Canada
| | - Lionel Breuillaud
- Department of Pharmacology & Therapeutics, McGill University, Montreal H3G1Y6, Canada
| | - A Claudio Cuello
- Department of Pharmacology & Therapeutics, McGill University, Montreal H3G1Y6, Canada; Integrated Program in Neuroscience, McGill University, Montreal H3A 1A1, Canada; Department of Pharmacology, Oxford University, Oxford OX13QT, UK.
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12
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Kapoor A, Gaubert A, Yew B, Jang JY, Dutt S, Li Y, Alitin JPM, Nguyen A, Ho JK, Blanken AE, Sible IJ, Marshall A, Shenasa F, Rodgers KE, Martini AC, Head E, Nation DA. Enlarged perivascular spaces and plasma Aβ42/Aβ40 ratio in older adults without dementia. Neurobiol Aging 2023; 128:43-48. [PMID: 37156179 PMCID: PMC10852216 DOI: 10.1016/j.neurobiolaging.2023.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 03/30/2023] [Accepted: 04/10/2023] [Indexed: 05/10/2023]
Abstract
Dilation of perivascular spaces (PVS) in the brain may indicate poor fluid drainage due to the accumulation of perivascular cell debris, waste, and proteins, including amyloid-beta (Aβ). No prior study has assessed whether plasma Aβ levels are related to PVS in older adults without dementia. Independently living older adults (N = 56, mean age = 68.2 years; Standard deviation (SD) = 6.5; 30.4% male) free of dementia or clinical stroke were recruited from the community and underwent brain MRI and venipuncture. PVS were qualitatively scored and dichotomized to low PVS burden (scores 0-1,) or high PVS burden (score>1). Plasma was assayed using a Quanterix Simoa Kit to quantify Aβ42 and Aβ40 levels. A significant difference was observed in plasma Aβ42/Aβ40 ratio between low and high PVS burden, controlling for age (F[1, 53] = 5.59, p = 0.022, η2 = 0.10), with lower Aβ42/Aβ40 ratio in the high PVS burden group. Dilation of PVS is associated with a lower plasma Aβ42/Aβ40 ratio, which may indicate higher cortical amyloid deposition. Future longitudinal studies examining PVS changes, and the pathogenesis of AD are warranted.
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Affiliation(s)
- Arunima Kapoor
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Aimée Gaubert
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Belinda Yew
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Jung Yun Jang
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Shubir Dutt
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Yanrong Li
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - John Paul M Alitin
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Amy Nguyen
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Jean K Ho
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Anna E Blanken
- San Francisco Veterans Affairs Health Care System & Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Anisa Marshall
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Fatemah Shenasa
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Kathleen E Rodgers
- Center for Innovations in Brain Science, Department of Pharmacology, University of Arizona, Tucson, AZ, USA
| | - Alessandra C Martini
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA, USA
| | - Elizabeth Head
- Department of Pathology and Laboratory Medicine, University of California, Irvine, Irvine, CA, USA
| | - Daniel A Nation
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA; Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA.
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13
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Sacchi L, Arcaro M, Carandini T, Pietroboni AM, Fumagalli GG, Fenoglio C, Serpente M, Sorrentino F, Visconte C, Pintus M, Conte G, Contarino VE, Scarpini E, Triulzi F, Galimberti D, Arighi A. Association between enlarged perivascular spaces and cerebrospinal fluid aquaporin-4 and tau levels: report from a memory clinic. Front Aging Neurosci 2023; 15:1191714. [PMID: 37547746 PMCID: PMC10399743 DOI: 10.3389/fnagi.2023.1191714] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
Background Perivascular spaces (PVS) are fluid-filled compartments that dilate in response to many different conditions. A high burden of enlarged PVS (EPVS) in the centrum semiovale (CSO) has been linked to neurodegeneration. Moreover, an increase in cerebrospinal fluid (CSF) levels of aquaporin-4 (AQP4), a water channel expressed on PVS-bounding astrocytes, has been described in patients with neurodegenerative dementia. Our aim was to investigate the relationship between neurodegenerative diseases and two putative glymphatic system biomarkers: AQP4 and EPVS. Methods We included 70 individuals, 54 patients with neurodegenerative diseases and 16 subjects with non-degenerative conditions. EPVS were visually quantified on MRI-scans applying Paradise's scale. All subjects underwent lumbar puncture for the measurement of AQP4 levels in the cerebrospinal fluid (CSF). CSF levels of amyloid-β-1-42, phosphorylated and total tau (tTau) were also measured. Linear regression analyses were adjusted for age, sex, education and disease duration, after excluding outliers. Results Cerebrospinal fluid (CSF)-AQP4 levels were independent predictors of total (β = 0.28, standard error [SE] = 0.08, p = 0.001), basal ganglia (β = 0.20, SE = 0.08, p = 0.009) and centrum semiovale EPVS (β = 0.37, SE = 0.12, p = 0.003). tTau levels predicted CSO-EPVS (β = 0.30, SE = 0.15, p = 0.046). Moreover, increased levels of AQP4 were strongly associated with higher levels of tTau in the CSF (β = 0.35, SE = 0.13, p = 0.008). Conclusion We provide evidence that CSO-EPVS and CSF-AQP4 might be clinically meaningful biomarkers of glymphatic dysfunction and associated neurodegeneration.
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Affiliation(s)
- Luca Sacchi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marina Arcaro
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Tiziana Carandini
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Margherita Pietroboni
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Chiara Fenoglio
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Maria Serpente
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Sorrentino
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Caterina Visconte
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Manuela Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giorgio Conte
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Neuroradiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valeria Elisa Contarino
- Neuroradiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elio Scarpini
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio Triulzi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Neuroradiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Arighi
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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14
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Raicevic N, Forer JM, Ladrón-de-Guevara A, Du T, Nedergaard M, Kelley DH, Boster K. Sizes and shapes of perivascular spaces surrounding murine pial arteries. Fluids Barriers CNS 2023; 20:56. [PMID: 37461047 PMCID: PMC10351203 DOI: 10.1186/s12987-023-00454-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/21/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Flow of cerebrospinal fluid (CSF) through brain perivascular spaces (PVSs) is essential for the clearance of interstitial metabolic waste products whose accumulation and aggregation is a key mechanism of pathogenesis in many diseases. The PVS geometry has important implications for CSF flow as it affects CSF and solute transport rates. Thus, the size and shape of the perivascular spaces are essential parameters for models of CSF transport in the brain and require accurate quantification. METHODS We segmented two-photon images of pial (surface) PVSs and the adjacent arteries and characterized their sizes and shapes of cross sections from 14 PVS segments in 9 mice. Based on the analysis, we propose an idealized model that approximates the cross-sectional size and shape of pial PVSs, closely matching their area ratios and hydraulic resistances. RESULTS The ratio of PVS-to-vessel area varies widely across the cross sections analyzed. The hydraulic resistance per unit length of the PVS scales with the PVS cross-sectional area, and we found a power-law fit that predicts resistance as a function of the area. Three idealized geometric models were compared to PVSs imaged in vivo, and their accuracy in reproducing hydraulic resistances and PVS-to-vessel area ratios were evaluated. The area ratio was obtained across different cross sections, and we found that the distribution peaks for the original PVS and its closest idealized fit (polynomial fit) were 1.12 and 1.21, respectively. The peak of the hydraulic resistance distribution is [Formula: see text] Pa s/m[Formula: see text] and [Formula: see text] Pa s/m[Formula: see text] for the segmentation and its closest idealized fit, respectively. CONCLUSIONS PVS hydraulic resistance can be reasonably predicted as a function of the PVS area. The proposed polynomial-based fit most closely captures the shape of the PVS with respect to area ratio and hydraulic resistance. Idealized PVS shapes are convenient for modeling, which can be used to better understand how anatomical variations affect clearance and drug transport.
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Affiliation(s)
- Nikola Raicevic
- Department of Mechanical Engineering, University of Rochester, Rochester, USA
| | - Jarod M Forer
- Department of Mechanical Engineering, University of Rochester, Rochester, USA
| | - Antonio Ladrón-de-Guevara
- Center for Translational Neuromedicine and Department of Neuroscience, University of Rochester Medical Center, Rochester, USA
- Department of Biomedical Engineering, University of Rochester, Rochester, USA
| | - Ting Du
- Center for Translational Neuromedicine and Department of Neuroscience, University of Rochester Medical Center, Rochester, USA
- School of Pharmacy, China Medical University, Shenyang, Liaoning, China
| | - Maiken Nedergaard
- Center for Translational Neuromedicine and Department of Neuroscience, University of Rochester Medical Center, Rochester, USA
| | - Douglas H Kelley
- Department of Mechanical Engineering, University of Rochester, Rochester, USA
| | - Kimberly Boster
- Department of Mechanical Engineering, University of Rochester, Rochester, USA.
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15
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Peters ME, Lyketsos CG. The glymphatic system's role in traumatic brain injury-related neurodegeneration. Mol Psychiatry 2023; 28:2707-2715. [PMID: 37185960 DOI: 10.1038/s41380-023-02070-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 05/17/2023]
Abstract
In at least some individuals who suffer a traumatic brain injury (TBI), there exists a risk of future neurodegenerative illness. This review focuses on the association between the brain-based paravascular drainage pathway known as the "glymphatic system" and TBI-related neurodegeneration. The glymphatic system is composed of cerebrospinal fluid (CSF) flowing into the brain parenchyma along paravascular spaces surrounding penetrating arterioles where it mixes with interstitial fluid (ISF) before being cleared along paravenous drainage pathways. Aquaporin-4 (AQP4) water channels on astrocytic end-feet appear essential for the functioning of this system. The current literature linking glymphatic system disruption and TBI-related neurodegeneration is largely based on murine models with existing human research focused on the need for biomarkers of glymphatic system function (e.g., neuroimaging modalities). Key findings from the existing literature include evidence of glymphatic system flow disruption following TBI, mechanisms of this decreased flow (i.e., AQP4 depolarization), and evidence of protein accumulation and deposition (e.g., amyloid β, tau). The same studies suggest that glymphatic dysfunction leads to subsequent neurodegeneration, cognitive decline, and/or behavioral change although replication in humans is needed. Identified emerging topics from the literature are as follows: link between TBI, sleep, and glymphatic system dysfunction; influence of glymphatic system disruption on TBI biomarkers; and development of novel treatments for glymphatic system disruption following TBI. Although a burgeoning field, more research is needed to elucidate the role of glymphatic system disruption in TBI-related neurodegeneration.
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Affiliation(s)
- Matthew E Peters
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Constantine G Lyketsos
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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16
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Johnson SC, Suárez-Calvet M, Suridjan I, Minguillón C, Gispert JD, Jonaitis E, Michna A, Carboni M, Bittner T, Rabe C, Kollmorgen G, Zetterberg H, Blennow K. Identifying clinically useful biomarkers in neurodegenerative disease through a collaborative approach: the NeuroToolKit. Alzheimers Res Ther 2023; 15:25. [PMID: 36709293 PMCID: PMC9883877 DOI: 10.1186/s13195-023-01168-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 01/15/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is a complex and heterogeneous disease, which requires reliable biomarkers for diagnosis and monitoring disease activity. Preanalytical protocol and technical variability associated with biomarker immunoassays makes comparability of biomarker data across multiple cohorts difficult. This study aimed to compare cerebrospinal fluid (CSF) biomarker results across independent cohorts, including participants spanning the AD continuum. METHODS Measured on the NeuroToolKit (NTK) prototype panel of immunoassays, 12 CSF biomarkers were evaluated from three cohorts (ALFA+, Wisconsin, and Abby/Blaze). A correction factor was applied to biomarkers found to be affected by preanalytical procedures (amyloid-β1-42, amyloid-β1-40, and alpha-synuclein), and results between cohorts for each disease stage were compared. The relationship between CSF biomarker concentration and cognitive scores was evaluated. RESULTS Biomarker distributions were comparable across cohorts following correction. Correlations of biomarker values were consistent across cohorts, regardless of disease stage. Disease stage differentiation was highest for neurofilament light (NfL), phosphorylated tau, and total tau, regardless of the cohort. Correlation between biomarker concentration and cognitive scores was comparable across cohorts, and strongest for NfL, chitinase-3-like protein-1 (YKL40), and glial fibrillary acidic protein. DISCUSSION The precision of the NTK enables merging of biomarker datasets, after correction for preanalytical confounders. Assessment of multiple cohorts is crucial to increase power in future studies into AD pathogenesis.
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Affiliation(s)
- Sterling C Johnson
- University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Geriatric Research Education and Clinical Center of the William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.
- Centre for Biomedical Research Network on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
- Neurology Service, Hospital del Mar, Barcelona, Spain.
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | | | - Carolina Minguillón
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain
- Centre for Biomedical Research Network on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centre for Biomedical Research in Network Bioengineering, Biomaterials and Nanomedicine, Instituto de Salud Carlos III, Madrid, Spain
| | - Erin Jonaitis
- University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | - Tobias Bittner
- F. Hoffmann-La Roche AG, Basel, Switzerland
- Genentech, A Member of the Roche Group, San Francisco, CA, USA
| | - Christina Rabe
- Genentech, A Member of the Roche Group, San Francisco, CA, USA
| | | | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
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17
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Na HK, Kim HK, Lee HS, Park M, Lee JH, Ryu YH, Cho H, Lyoo CH. Role of Enlarged Perivascular Space in the Temporal Lobe in Cerebral Amyloidosis. Ann Neurol 2023; 93:965-978. [PMID: 36651566 DOI: 10.1002/ana.26601] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 12/01/2022] [Accepted: 01/07/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Although growing evidence suggests that perivascular space (PVS) serves as a clearance route for amyloid and tau, the association between enlarged PVS (EPVS) and Alzheimer disease is highly inconsistent across studies. As the conventional visual rating systems for EPVS were insufficient to predict amyloid/tau/neurodegeneration (A/T/N) status, we developed a new rating scale for EPVS located in the temporal lobe (T-EPVS). METHODS EPVS located in the basal ganglia (BG-EPVS), centrum semiovale (CS-EPVS), and T-EPVS was visually rated in 272 individuals (healthy controls, n = 96; mild cognitive impairment, n = 106; dementia, n = 70) who underwent structural magnetic resonance imaging (MRI) and dual positron emission tomography scans (18 F-flortaucipir and 18 F-florbetaben). T-EPVS and BG-EPVS were defined as high degree when the counts in any hemisphere were >10, and the CS-EPVS cutoff was >20. Logistic regression models were constructed to investigate whether the regional EPVS burden was predictive of A/T/N status. The derived models were externally validated in a temporal validation cohort (n = 195) that underwent MRI studies using a different scanner. RESULTS Compared with those with low-degree T-EPVS (23/136, 16.9%), individuals with high-degree T-EPVS/CS-EPVS but low-degree BG-EPVS were more likely to exhibit amyloid positivity (46/56, 82.1%). High-degree T-EPVS burden (odds ratio [OR] = 7.251, 95% confidence interval [CI] = 3.296-15.952) and low-degree BG-EPVS (OR = 0.241, 95% CI = 0.109-0.530) were predictive of amyloid positivity. Although high-degree T-EPVS was associated with tau positivity, the association was no longer significant after adjusting for amyloid and neurodegeneration status. INTERPRETATION Investigating the burden and topographic distribution of EPVS including T-EPVS may be useful for predicting amyloid status, indicating that impaired perivascular drainage may contribute to cerebral amyloidosis. ANN NEUROL 2023.
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Affiliation(s)
- Han Kyu Na
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.,Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Han-Kyeol Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Sun Lee
- Biostatics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Mina Park
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae Hoon Lee
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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18
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Evans TE, Knol MJ, Schwingenschuh P, Wittfeld K, Hilal S, Ikram MA, Dubost F, van Wijnen KMH, Katschnig P, Yilmaz P, de Bruijne M, Habes M, Chen C, Langer S, Völzke H, Ikram MK, Grabe HJ, Schmidt R, Adams HHH, Vernooij MW. Determinants of Perivascular Spaces in the General Population: A Pooled Cohort Analysis of Individual Participant Data. Neurology 2023; 100:e107-e122. [PMID: 36253103 PMCID: PMC9841448 DOI: 10.1212/wnl.0000000000201349] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 08/19/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Perivascular spaces (PVS) are emerging markers of cerebral small vessel disease (CSVD), but research on their determinants has been hampered by conflicting results from small single studies using heterogeneous rating methods. In this study, we therefore aimed to identify determinants of PVS burden in a pooled analysis of multiple cohort studies using 1 harmonized PVS rating method. METHODS Individuals from 10 population-based cohort studies with adult participants from the Uniform Neuro-Imaging of Virchow-Robin Spaces Enlargement consortium and the UK Biobank were included. On MRI scans, we counted PVS in 4 brain regions (mesencephalon, hippocampus, basal ganglia, and centrum semiovale) according to a uniform and validated rating protocol, both manually and automated using a deep learning algorithm. As potential determinants, we considered demographics, cardiovascular risk factors, APOE genotypes, and other imaging markers of CSVD. Negative binomial regression models were used to examine the association between these determinants and PVS counts. RESULTS In total, 39,976 individuals were included (age range 20-96 years). The average count of PVS in the 4 regions increased from the age 20 years (0-1 PVS) to 90 years (2-7 PVS). Men had more mesencephalic PVS (OR [95% CI] = 1.13 [1.08-1.18] compared with women), but less hippocampal PVS (0.82 [0.81-0.83]). Higher blood pressure, particularly diastolic pressure, was associated with more PVS in all regions (ORs between 1.04-1.05). Hippocampal PVS showed higher counts with higher high-density lipoprotein cholesterol levels (1.02 [1.01-1.02]), glucose levels (1.02 [1.01-1.03]), and APOE ε4-alleles (1.02 [1.01-1.04]). Furthermore, white matter hyperintensity volume and presence of lacunes were associated with PVS in multiple regions, but most strongly with the basal ganglia (1.13 [1.12-1.14] and 1.10 [1.09-1.12], respectively). DISCUSSION Various factors are associated with the burden of PVS, in part regionally specific, which points toward a multifactorial origin beyond what can be expected from PVS-related risk factor profiles. This study highlights the power of collaborative efforts in population neuroimaging research.
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Affiliation(s)
- Tavia E Evans
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Maria J Knol
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Petra Schwingenschuh
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Katharina Wittfeld
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Saima Hilal
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - M Arfan Ikram
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Florian Dubost
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Kimberlin M H van Wijnen
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Petra Katschnig
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Pinar Yilmaz
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Marleen de Bruijne
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Mohamad Habes
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Christopher Chen
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Sönke Langer
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Henry Völzke
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - M Kamran Ikram
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Hans J Grabe
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Reinhold Schmidt
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Hieab H H Adams
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile.
| | - Meike W Vernooij
- From the Departments of Clinical Genetics (T.E.E., M.J.K., H.H.H.A.), Radiology and Nuclear Medicine (T.E.E., F.D., K.M.H.W., P.Y., M.B., H.H.H.A., M.W.V.), Epidemiology (M.J.K., M.A.I., P.Y., M.K.I., M.W.V.), and Neurology (M.K.I.), Erasmus MC, Rotterdam, the Netherlands; Department of Neurology (P.S., P.K., R.S.), Medical University of Graz, Austria; German Center for Neurodegenerative Diseases (DZNE) (K.W., M.H., H.J.G.), Site Rostock/Greifswald; Department of Psychiatry and Psychotherapy (K.W., H.J.G.) and Institute of Diagnostic Radiology and Neuroradiology (S.L.), University Medicine Greifswald, Germany; Department of Pharmacology (S.H., C.C.), National University of Singapore; Memory Aging & Cognition Centre (MACC) (S.H., C.C., M.K.I.), National University Health System, Singapore; Saw Swee Hock School of Public Health (S.H.), National University of Singapore; Department of Biomedical Data Sciences (F.D.), Stanford University, CA; J. Philip Kistler Stroke Research Center (P.Y.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; The Machine Learning Section (M.B.), Department of Computer Science, University of Copenhagen, Denmark; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC) (M.H.), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), TX; and Latin American Brain Health (BrainLat) (H.H.H.A.), Universidad Adolfo Ibáñez, Santiago, Chile
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Fu H, Li J, Du P, Jin W, Gao G, Cui D. Senile plaques in Alzheimer's disease arise from Aβ- and Cathepsin D-enriched mixtures leaking out during intravascular haemolysis and microaneurysm rupture. FEBS Lett 2022; 597:1007-1040. [PMID: 36448495 DOI: 10.1002/1873-3468.14549] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/12/2022] [Accepted: 11/15/2022] [Indexed: 12/05/2022]
Abstract
Senile plaques are a pathological hallmark of Alzheimer's disease (AD), yet the mechanism underlying their generation remains unknown. Beta-amyloid peptide (Aβ) is a major component of senile plaques. We analysed AD brain tissues with histochemistry, immunohistochemistry and fluorescence imaging to examine the neural, vascular or blood Aβ contribution to senile plaque development. We found little neural marker co-expression with plaque Aβ, while co-expression of blood markers, such as Haemin and ApoE, was abundant. The plaque cores were structured with vascular and glial proteins outside and blood metabolites inside, co-localizing with a characteristic of Hoechst staining-independent blue autofluorescence. Erythrocyte-interacting Aβ is linked to coagulation, elevated calcium and blue autofluorescence, and it is associated with intravascular haemolysis, atherosclerosis, cerebral amyloid angiopathy, microaneurysm, and often with Cathepsin D co-expression. We identified microaneurysms as major sites of amyloid formation. Our data suggest that senile plaques arise from Aβ- and Cathepsin D-enriched mixtures leaking out during intravascular haemolysis and microaneurysm rupture.
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Affiliation(s)
- Hualin Fu
- Institute of Nano Biomedicine and Engineering, School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, China.,National Center for Translational Medicine, Shanghai Jiao Tong University, China
| | - Jilong Li
- Institute of Nano Biomedicine and Engineering, School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, China
| | - Peng Du
- Department of Colorectal Surgery, School of Medicine, Xinhua Hospital, Shanghai Jiao Tong University, China
| | - Weilin Jin
- Institute of Nano Biomedicine and Engineering, School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, China.,National Center for Translational Medicine, Shanghai Jiao Tong University, China
| | - Guo Gao
- Institute of Nano Biomedicine and Engineering, School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, China.,National Center for Translational Medicine, Shanghai Jiao Tong University, China
| | - Daxiang Cui
- Institute of Nano Biomedicine and Engineering, School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, China.,National Center for Translational Medicine, Shanghai Jiao Tong University, China
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20
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Moses J, Sinclair B, Schwartz DL, Silbert LC, O’Brien TJ, Law M, Vivash L. Perivascular spaces as a marker of disease severity and neurodegeneration in patients with behavioral variant frontotemporal dementia. Front Neurosci 2022; 16:1003522. [PMID: 36340772 PMCID: PMC9633276 DOI: 10.3389/fnins.2022.1003522] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/06/2022] [Indexed: 11/19/2022] Open
Abstract
Background Behavioural Variant Frontotemporal Dementia (bvFTD) is a rapidly progressing neurodegenerative proteinopathy. Perivascular spaces (PVS) form a part of the brain’s glymphatic clearance system. When enlarged due to poor glymphatic clearance of toxic proteins, PVS become larger and more conspicuous on MRI. Therefore, enlarged PVS may be a useful biomarker of disease severity and progression in neurodegenerative proteinopathies such as bvFTD. This study aimed to determine the utility of PVS as a biomarker of disease progression in patients with bvFTD. Materials and methods Serial baseline and week 52 MRIs acquired from ten patients with bvFTD prospectively recruited and followed in a Phase 1b open label trial of sodium selenate for bvFTD were used in this study. An automated algorithm quantified PVS on MRI, which was visually inspected and validated by a member of the study team. The number and volume of PVS were extracted and mixed models used to assess the relationship between PVS burden and other measures of disease (cognition, carer burden scale, protein biomarkers). Additional exploratory analysis investigated PVS burden in patients who appeared to not progress over the 12 months of selenate treatment (i.e., “non-progressors”). Results Overall, PVS cluster number (ß = −3.27, CI [−7.80 – 1.27], p = 0.267) and PVS volume (ß = −36.8, CI [−84.9 – 11.3], p = 0.171) did not change over the paired MRI scans 12 months apart. There was association between cognition total composite scores and the PVS burden (PVS cluster ß = −0.802e–3, CI [9.45e–3 – −6.60e–3, p ≤ 0.001; PVS volume ß = −1.30e–3, CI [−1.55e–3 – −1.05e–3], p ≤ 0.001), as well as between the change in the cognition total composite score and the change in PVS volume (ß = 4.36e–3, CI [1.33e–3 – 7.40e–3], p = 0.046) over the trial period. There was a significant association between CSF t-tau and the number of PVS clusters (ß = 2.845, CI [0.630 – 5.06], p = 0.036). Additionally, there was a significant relationship between the change in CSF t-tau and the change in the number of PVS (ß = 1.54, CI [0.918 – 2.16], p < 0.001) and PVS volume (ß = 13.8, CI [6.37 – 21.1], p = 0.003) over the trial period. An association was found between the change in NfL and the change in PVS volume (ß = 1.40, CI [0.272 – 2.52], p = 0.045) over time. Within the “non-progressor” group (n = 7), there was a significant relationship between the change in the CSF total-tau (t-tau) levels and the change in the PVS burden (PVS cluster (ß = 1.46, CI [0.577 – 2.34], p = 0.014; PVS volume ß = 14.6, CI [3.86 – 25.4], p = 0.032) over the trial period. Additionally, there was evidence of a significant relationship between the change in NfL levels and the change in the PVS burden over time (PVS cluster ß = 0.296, CI [0.229 – 0.361], p ≤ 0.001; PVS volume ß = 3.67, CI [2.42 – 4.92], p = 0.002). Conclusion Analysis of serial MRI scans 12 months apart in patients with bvFTD demonstrated a relationship between PVS burden and disease severity as measured by the total cognitive composite score and CSF t-tau. Further studies are needed to confirm PVS as a robust marker of neurodegeneration in proteinopathies.
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Affiliation(s)
- Jasmine Moses
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Daniel L. Schwartz
- NIA-Layton Oregon Aging and Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, OR, United States
- Advanced Imaging Research Center, Oregon Health and Science University, Portland, OR, United States
| | - Lisa C. Silbert
- NIA-Layton Oregon Aging and Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, OR, United States
- Department of Neurology, Portland Veterans Affairs Health Care System, Portland, OR, United States
| | - Terence J. O’Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Meng Law
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Radiology, Alfred Health, Melbourne, VIC, Australia
- Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, VIC, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- *Correspondence: Lucy Vivash,
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21
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Lynch M, Pham W, Sinclair B, O’Brien TJ, Law M, Vivash L. Perivascular spaces as a potential biomarker of Alzheimer's disease. Front Neurosci 2022; 16:1021131. [PMID: 36330347 PMCID: PMC9623161 DOI: 10.3389/fnins.2022.1021131] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/23/2022] [Indexed: 07/20/2023] Open
Abstract
Alzheimer's disease (AD) is a highly damaging disease that affects one's cognition and memory and presents an increasing societal and economic burden globally. Considerable research has gone into understanding AD; however, there is still a lack of effective biomarkers that aid in early diagnosis and intervention. The recent discovery of the glymphatic system and associated Perivascular Spaces (PVS) has led to the theory that enlarged PVS (ePVS) may be an indicator of AD progression and act as an early diagnostic marker. Visible on Magnetic Resonance Imaging (MRI), PVS appear to enlarge when known biomarkers of AD, amyloid-β and tau, accumulate. The central goal of ePVS and AD research is to determine when ePVS occurs in AD progression and if ePVS are causal or epiphenomena. Furthermore, if ePVS are indeed causative, interventions promoting glymphatic clearance are an attractive target for research. However, it is necessary first to ascertain where on the pathological progression of AD ePVS occurs. This review aims to examine the knowledge gap that exists in understanding the contribution of ePVS to AD. It is essential to understand whether ePVS in the brain correlate with increased regional tau distribution and global or regional Amyloid-β distribution and to determine if these spaces increase proportionally over time as individuals experience neurodegeneration. This review demonstrates that ePVS are associated with reduced glymphatic clearance and that this reduced clearance is associated with an increase in amyloid-β. However, it is not yet understood if ePVS are the outcome or driver of protein accumulation. Further, it is not yet clear if ePVS volume and number change longitudinally. Ultimately, it is vital to determine early diagnostic criteria and early interventions for AD to ease the burden it presents to the world; ePVS may be able to fulfill this role and therefore merit further research.
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Affiliation(s)
- Miranda Lynch
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - William Pham
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Terence J. O’Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Meng Law
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Radiology, Alfred Health, Melbourne, VIC, Australia
- Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, VIC, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
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22
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Jeong SH, Cha J, Park M, Jung JH, Ye BS, Sohn YH, Chung SJ, Lee PH. Association of Enlarged Perivascular Spaces With Amyloid Burden and Cognitive Decline in Alzheimer Disease Continuum. Neurology 2022; 99:e1791-e1802. [PMID: 35985826 DOI: 10.1212/wnl.0000000000200989] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 06/03/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To investigate the effects of enlarged perivascular space (EPVS) on amyloid burden and cognitive function in Alzheimer disease (AD) continuum. METHODS We retrospectively reviewed 208 patients with AD across the cognitive continuum (preclinical, prodromal, and AD dementia) who showed amyloid deposition on 18F-florbetaben PET scans and 82 healthy controls. EPVSs were counted for each patient in the basal ganglia (BG), centrum semiovale (CSO), and hippocampus (HP) on axial T2-weighted images. Patients were then classified according to the number of EPVSs into the EPVS+ (>10 EPVSs) and EPVS- (0-10 EPVSs) groups for the BG and CSO, respectively. In terms of HP-EPVS, equal or more than 7 EPVSs on bilateral hemisphere were regarded as the presence of HP-EPVS. After adjusting for markers of small vessel disease (SVD), multiple linear regression analyses were performed to determine the intergroup differences in global and regional amyloid deposition and cognitive function at the time of diagnosis of AD continuum. A linear mixed model was used to assess the effects of EPVSs on the longitudinal changes in the Mini-Mental State Examination (MMSE) scores. RESULTS Amyloid burden at the time of diagnosis of AD continuum was not associated with the degree of BG-, CSO-, or HP-EPVS. BG-EPVS affected language and frontal/executive function via SVD markers, and HP-EPVS was associated with general cognition via SVD markers. However, CSO-EPVS was not associated with baseline cognition. A higher number of CSO-EPVS was significantly associated with a more rapid decline in MMSE scores (β = -0.58, standard error = 0.23, p = 0.011) independent of the amyloid burden. In terms of BG and HP, there was no difference between the EPVS+ and EPVS- groups in the rate of longitudinal decreases in MMSE scores. DISCUSSION Our findings suggest that BG-, CSO-, and HP-EPVS are not associated with baseline β-amyloid burden or cognitive function independently of SVD at the diagnosis of AD continuum. However, CSO-EPVS appears to be associated with the progression of cognitive decline in an amyloid-independent manner. Further studies are needed to investigate whether CSO-EPVS is a potential therapeutic target in patients with AD continuum.
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Affiliation(s)
- Seong Ho Jeong
- From the Department of Neurology (S.H.J., M.P., B.S.Y., Y.H.S., S.J.C., P.H.L.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.H.J.), Inje University Sanggye Paik Hospital, Seoul, South Korea; Nash Family Center for Advanced Circuit Therapeutics (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.H.J.), Busan Paik Hospital, Inje University College of Medicine, Seoul, South Korea; Department of Neurology (S.J.C.), Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea; Yonsei Beyond Lab (S.J.C.), Yongin, South Korea; and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea
| | - Jungho Cha
- From the Department of Neurology (S.H.J., M.P., B.S.Y., Y.H.S., S.J.C., P.H.L.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.H.J.), Inje University Sanggye Paik Hospital, Seoul, South Korea; Nash Family Center for Advanced Circuit Therapeutics (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.H.J.), Busan Paik Hospital, Inje University College of Medicine, Seoul, South Korea; Department of Neurology (S.J.C.), Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea; Yonsei Beyond Lab (S.J.C.), Yongin, South Korea; and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea
| | - Mincheol Park
- From the Department of Neurology (S.H.J., M.P., B.S.Y., Y.H.S., S.J.C., P.H.L.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.H.J.), Inje University Sanggye Paik Hospital, Seoul, South Korea; Nash Family Center for Advanced Circuit Therapeutics (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.H.J.), Busan Paik Hospital, Inje University College of Medicine, Seoul, South Korea; Department of Neurology (S.J.C.), Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea; Yonsei Beyond Lab (S.J.C.), Yongin, South Korea; and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Ho Jung
- From the Department of Neurology (S.H.J., M.P., B.S.Y., Y.H.S., S.J.C., P.H.L.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.H.J.), Inje University Sanggye Paik Hospital, Seoul, South Korea; Nash Family Center for Advanced Circuit Therapeutics (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.H.J.), Busan Paik Hospital, Inje University College of Medicine, Seoul, South Korea; Department of Neurology (S.J.C.), Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea; Yonsei Beyond Lab (S.J.C.), Yongin, South Korea; and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Seok Ye
- From the Department of Neurology (S.H.J., M.P., B.S.Y., Y.H.S., S.J.C., P.H.L.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.H.J.), Inje University Sanggye Paik Hospital, Seoul, South Korea; Nash Family Center for Advanced Circuit Therapeutics (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.H.J.), Busan Paik Hospital, Inje University College of Medicine, Seoul, South Korea; Department of Neurology (S.J.C.), Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea; Yonsei Beyond Lab (S.J.C.), Yongin, South Korea; and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- From the Department of Neurology (S.H.J., M.P., B.S.Y., Y.H.S., S.J.C., P.H.L.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.H.J.), Inje University Sanggye Paik Hospital, Seoul, South Korea; Nash Family Center for Advanced Circuit Therapeutics (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.H.J.), Busan Paik Hospital, Inje University College of Medicine, Seoul, South Korea; Department of Neurology (S.J.C.), Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea; Yonsei Beyond Lab (S.J.C.), Yongin, South Korea; and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea
| | - Seok Jong Chung
- From the Department of Neurology (S.H.J., M.P., B.S.Y., Y.H.S., S.J.C., P.H.L.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.H.J.), Inje University Sanggye Paik Hospital, Seoul, South Korea; Nash Family Center for Advanced Circuit Therapeutics (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.H.J.), Busan Paik Hospital, Inje University College of Medicine, Seoul, South Korea; Department of Neurology (S.J.C.), Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea; Yonsei Beyond Lab (S.J.C.), Yongin, South Korea; and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea
| | - Phil Hyu Lee
- From the Department of Neurology (S.H.J., M.P., B.S.Y., Y.H.S., S.J.C., P.H.L.), Yonsei University College of Medicine, Seoul, South Korea; Department of Neurology (S.H.J.), Inje University Sanggye Paik Hospital, Seoul, South Korea; Nash Family Center for Advanced Circuit Therapeutics (J.C.), Icahn School of Medicine at Mount Sinai, New York, NY; Department of Neurology (J.H.J.), Busan Paik Hospital, Inje University College of Medicine, Seoul, South Korea; Department of Neurology (S.J.C.), Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea; Yonsei Beyond Lab (S.J.C.), Yongin, South Korea; and Severance Biomedical Science Institute (P.H.L.), Yonsei University College of Medicine, Seoul, South Korea.
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Liu X, Sun P, Yang J, Fan Y. Biomarkers involved in the pathogenesis of cerebral small-vessel disease. Front Neurol 2022; 13:969185. [PMID: 36119691 PMCID: PMC9475115 DOI: 10.3389/fneur.2022.969185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
Cerebral small-vessel disease (CSVD) has been found to have a strong association with vascular cognitive impairment (VCI) and functional loss in elderly patients. At present, the diagnosis of CSVD mainly relies on brain neuroimaging markers, but they cannot fully reflect the overall picture of the disease. Currently, some biomarkers were found to be related to CSVD, but the underlying mechanisms remain unclear. We aimed to systematically review and summarize studies on the progress of biomarkers related to the pathogenesis of CSVD, which is mainly the relationship between these indicators and neuroimaging markers of CSVD. Concerning the pathophysiological mechanism of CSVD, the biomarkers of CSVD have been described as several categories related to sporadic and genetic factors. Monitoring of biomarkers might contribute to the early diagnosis and progression prediction of CSVD, thus providing ideas for better diagnosis and treatment of CSVD.
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Wang ML, Sun Z, Li WB, Zou QQ, Li PY, Wu X, Li YH. Enlarged perivascular spaces and white matter hyperintensities in patients with frontotemporal lobar degeneration syndromes. Front Aging Neurosci 2022; 14:923193. [PMID: 35966773 PMCID: PMC9366845 DOI: 10.3389/fnagi.2022.923193] [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: 04/19/2022] [Accepted: 07/06/2022] [Indexed: 11/27/2022] Open
Abstract
Objective The aim of this study was to investigate the distribution characteristics of enlarged perivascular spaces (EPVS) and white matter hyperintensities (WMH) and their associations with disease severity across the frontotemporal lobar degeneration (FTLD) syndromes spectrum. Methods This study included 73 controls, 39 progressive supranuclear palsy Richardson’s syndrome (PSP-RS), 31 corticobasal syndrome (CBS), 47 behavioral variant frontotemporal dementia (bvFTD), 36 non-fluent variant primary progressive aphasia (nfvPPA), and 50 semantic variant primary progressive aphasia (svPPA). All subjects had brain magnetic resonance imaging (MRI) and neuropsychological tests, including progressive supranuclear palsy rating scale (PSPRS) and FTLD modified clinical dementia rating sum of boxes (FTLD-CDR). EPVS number and grade were rated on MRI in the centrum semiovale (CSO-EPVS), basal ganglia (BG-EPVS), and brain stem (BS-EPVS). Periventricular (PWMH) and deep (DWMH) were also graded on MRI. The distribution characteristics of EPVS and WMH were compared between control and disease groups. Multivariable linear regression analysis was performed to evaluate the association of EPVS and WMH with disease severity. Results Compared with control subjects, PSP-RS and CBS had more BS-EPVS; CBS, bvFTD, and nfvPPA had less CSO-EPVS; all disease groups except CBS had higher PWMH (p < 0.05). BS-EPVS was associated with PSPRS in PSP-RS (β = 2.395, 95% CI 0.888–3.901) and CBS (β = 3.115, 95% CI 1.584–4.647). PWMH was associated with FTLD-CDR in bvFTD (β = 1.823, 95% CI 0.752–2.895), nfvPPA (β = 0.971, 95% CI 0.030–1.912), and svPPA (OR: 1.330, 95% CI 0.457–2.204). Conclusion BS-EPVS could be a promising indicator of disease severity in PSP-RS and CBS, while PWMH could reflect the severity of bvFTD, nfvPPA, and svPPA.
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Affiliation(s)
- Ming-Liang Wang
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Zheng Sun
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Wen-Bin Li
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Qiao-Qiao Zou
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Peng-Yang Li
- Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, United States
| | - Xue Wu
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Yue-Hua Li
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Yue-Hua Li,
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Wang ML, Yang DX, Sun Z, Li WB, Zou QQ, Li PY, Wu X, Li YH. MRI-Visible Perivascular Spaces Associated With Cognitive Impairment in Military Veterans With Traumatic Brain Injury Mediated by CSF P-Tau. Front Psychiatry 2022; 13:921203. [PMID: 35873253 PMCID: PMC9299379 DOI: 10.3389/fpsyt.2022.921203] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/14/2022] [Indexed: 12/05/2022] Open
Abstract
Objective To investigate the association of MRI-visible perivascular spaces (PVS) with cognitive impairment in military veterans with traumatic brain injury (TBI), and whether cerebrospinal fluid (CSF) p-tau and Aβ mediate this effect. Materials and Methods We included 55 Vietnam War veterans with a history of TBI and 52 non-TBI Vietnam War veterans from the Department of Defense Alzheimer's Disease Neuroimaging Initiative (ADNI) database. All the subjects had brain MRI, CSF p-tau, Aβ, and neuropsychological examinations. MRI-visible PVS number and grade were rated on MRI in the centrum semiovale (CSO-PVS) and basal ganglia (BG-PVS). Multiple linear regression was performed to assess the association between MRI-visible PVS and cognitive impairment and the interaction effect of TBI. Additionally, mediation effect of CSF biomarkers on the relationship between MRI-visible PVS and cognitive impairment was explored in TBI group. Results Compared with military control, TBI group had higher CSO-PVS number (p = 0.001), CSF p-tau (p = 0.022) and poorer performance in verbal memory (p = 0.022). High CSO-PVS number was associated with poor verbal memory in TBI group (β = -0.039, 95% CI -0.062, -0.016), but not in military control group (β = 0.019, 95% CI -0.004, 0.043) (p-interaction = 0.003). Further mediation analysis revealed that CSF p-tau had a significant indirect effect (β = -0.009, 95% CI: -0.022 -0.001, p = 0.001) and mediated 18.75% effect for the relationship between CSO-PVS and verbal memory in TBI group. Conclusion MRI-visible CSO-PVS was more common in Vietnam War veterans with a history of TBI and was associated with poor verbal memory, mediated partially by CSF p-tau.
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Affiliation(s)
- Ming-Liang Wang
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Dian-Xu Yang
- Department of Neurosurgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Zheng Sun
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Wen-Bin Li
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Qiao-Qiao Zou
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Peng-Yang Li
- Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, United States
| | - Xue Wu
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Yue-Hua Li
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
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Rundek T, Del Brutto V, Goryawala M, Dong C, Agudelo C, Saporta AS, Merritt S, Camargo C, Ariko T, Loewenstein DA, Duara R, Haq I. Associations Between Vascular Risk Factors and Perivascular Spaces in Adults with Intact Cognition, Mild Cognitive Impairment, and Dementia. J Alzheimers Dis 2022; 89:437-448. [PMID: 35871327 PMCID: PMC10410400 DOI: 10.3233/jad-215585] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Perivascular spaces (PVS) are fluid-filled compartments surrounding small intracerebral vessels that transport fluid and clear waste. OBJECTIVE We examined associations between PVS count, vascular and neurodegenerative risk factors, and cognitive status among the predominantly Hispanic participants of the FL-VIP Study of Alzheimer's Disease Risk. METHODS Using brain MRI (n = 228), we counted PVS in single axial image through the basal ganglia (BG) and centrum semiovale (CSO). PVS per region were scored as 0 (none), 1 (<10), 2 (11-20), 3 (21-40), and 4 (>40). Generalized linear models examined PVS associations with vascular risk factors and a composite vascular comorbidity risk (VASCom) score. RESULTS Our sample (mean age 72±8 years, 61% women, 60% Hispanic, mean education 15±4 years, 33% APOE4 carriers) was 59% hypertensive, 21% diabetic, 66% hypercholesteremic, and 30% obese. Mean VASCom score was 2.3±1.6. PVS scores ranged from 0-4 in the BG (mean 1.3±0.7) and CSO (mean 1.2±0.9), and 0-7 combined (mean 2.5±1.4). In multivariable regression models, BG PVS was associated with age (β= 0.03/year, p < 0.0001), Hispanic ethnicity (β= 0.29, p = 0.01), education (β= 0.04/year, p = 0.04), and coronary bypass surgery (β= 0.93, p = 0.02). CSO PVS only associated with age (β= 0.03/year, p < 0.01). APOE4 and amyloid-β were not associated with PVS. CONCLUSION BG PVS may be a marker of subclinical cerebrovascular disease. Further research is needed to validate associations and identify mechanisms linking BG PVS and cerebrovascular disease markers. PVS may be a marker of neurodegeneration despite our negative preliminary findings and more research is warranted. The association between BG PVS and Hispanic ethnicity also requires further investigation.
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Affiliation(s)
- Tatjana Rundek
- The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Victor Del Brutto
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mohammed Goryawala
- The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Chuanhui Dong
- The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Christian Agudelo
- The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Anita Seixas Saporta
- The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Stacy Merritt
- The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Christian Camargo
- The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Taylor Ariko
- The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - David A. Loewenstein
- The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
- The Center for Neurocognitive Sciences and Aging, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ranjan Duara
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Ihtsham Haq
- The Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
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