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Oliveira FFD. Looking Behind the Curtain: Patient Stratification According to Genetic or Demographic Factors May Yield Unexpected Results in Studies of Neurodegenerative Diseases. J Alzheimers Dis 2023:JAD230561. [PMID: 37393510 DOI: 10.3233/jad-230561] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2023]
Abstract
Amyloid-PET studies of neurodegenerative diseases may yield inconclusive findings due to lacking stratification according to genetic or demographic variants. APOEɛ4 alleles are the major variants to increase disease susceptibility and cause earlier onset and more behavioral features in patients with late-onset Alzheimer's disease, but have no linear effects on cognitive or functional decline; thus, sample stratification according to APOEɛ4 carrier status may be the best option. Interactions among APOEɛ4 alleles, sex, and age on amyloid-β deposition may reveal even more innovative findings with sufficiently large samples, suggesting variable genomic effects of cognitive reserve, sex differences, and cerebrovascular risk on neurodegeneration.
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Hanon O, Vidal JS, Lehmann S, Bombois S, Allinquant B, Baret-Rose C, Tréluyer JM, Abdoul H, Gelé P, Delmaire C, Blanc F, Mangin JF, Buée L, Touchon J, Hugon J, Vellas B, Galbrun E, Benetos A, Berrut G, Paillaud E, Wallon D, Castelnovo G, Volpe-Gillot L, Paccalin M, Robert P, Godefroy O, Camus V, Belmin J, Vandel P, Novella JL, Duron E, Rigaud AS, Schraen-Maschke S, Gabelle A. Plasma amyloid beta predicts conversion to dementia in subjects with mild cognitive impairment: The BALTAZAR study. Alzheimers Dement 2022; 18:2537-2550. [PMID: 35187794 DOI: 10.1002/alz.12613] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/20/2021] [Accepted: 12/10/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Blood-based biomarkers are the next challenge for Alzheimer's disease (AD) diagnosis and prognosis. METHODS Mild cognitive impairment (MCI) participants (N = 485) of the BALTAZAR study, a large-scale longitudinal multicenter cohort, were followed-up for 3 years. A total of 165 of them converted to dementia (95% AD). Associations of conversion and plasma amyloid beta (Aβ)1-42 , Aβ1-40 , Aβ1-42 /Aβ1-40 ratio were analyzed with logistic and Cox models. RESULTS Converters to dementia had lower level of plasma Aβ1-42 (37.1 pg/mL [12.5] vs. 39.2 [11.1] , P value = .03) and lower Aβ1-42 /Aβ1-40 ratio than non-converters (0.148 [0.125] vs. 0.154 [0.076], P value = .02). MCI participants in the highest quartile of Aβ1-42 /Aβ1-40 ratio (>0.169) had a significant lower risk of conversion (hazard ratio adjusted for age, sex, education, apolipoprotein E ε4, hippocampus atrophy = 0.52 (95% confidence interval [0.31-0.86], P value = .01). DISCUSSION In this large cohort of MCI subjects we identified a threshold for plasma Aβ1-42 /Aβ1-40 ratio that may detect patients with a low risk of conversion to dementia within 3 years.
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Affiliation(s)
- Olivier Hanon
- Memory Resource and Research Centre of de Paris-Broca-Ile de France, Université de Paris, EA 4468, APHP, Hopital Broca, Paris, France
| | - Jean-Sébastien Vidal
- Memory Resource and Research Centre of de Paris-Broca-Ile de France, Université de Paris, EA 4468, APHP, Hopital Broca, Paris, France
| | - Sylvain Lehmann
- CHU Montpellier, LBPC, Inserm, Université de Montpellier, Montpellier, France
| | - Stéphanie Bombois
- CHU Lille, U1172-LilNCog, LiCEND, LabEx DISTALZ, Université de Lille, Inserm, Lille, France
| | - Bernadette Allinquant
- UMR-S 1266, Université de Paris, Institute of Psychiatric and Neurosciences, Inserm, Paris, France
| | - Christiane Baret-Rose
- UMR-S 1266, Université de Paris, Institute of Psychiatric and Neurosciences, Inserm, Paris, France
| | - Jean-Marc Tréluyer
- Clinical Research Unit, Université de Paris, APHP, Hôpital Necker, Paris, France
| | - Hendy Abdoul
- Clinical Research Unit, Université de Paris, APHP, Hôpital Necker, Paris, France
| | - Patrick Gelé
- CHU Lille, CRB/CIC1403, Université de Lille, Inserm, Lille, France
| | - Christine Delmaire
- CHU Lille, U1172-LilNCog, LiCEND, LabEx DISTALZ, Université de Lille, Inserm, Lille, France
| | - Fredéric Blanc
- CM2R, pôle de Gériatrie, Laboratoire ICube, FMTS, CNRS, équipe IMIS, Université de Strasbourg, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Jean-François Mangin
- Neurospin, CEA, CNRS, cati-neuroimaging.com, CATI Multicenter Neuroimaging Platform, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Luc Buée
- CHU Lille, U1172-LilNCog, LiCEND, LabEx DISTALZ, Université de Lille, Inserm, Lille, France
| | - Jacques Touchon
- Department of Neurology, Memory Research and Resources Center of Montpellier, Inserm INM NeuroPEPs Team, Excellence Center of Neurodegenerative Disorders, Université de Montpellier, CHU Montpellier, Montpellier, France
| | - Jacques Hugon
- APHP, Groupe Hospitalier Saint Louis-Lariboisière Fernand Widal, Center of Cognitive Neurology, Université de Paris, Paris, France
| | - Bruno Vellas
- Memory Resource and Research Centre of Midi-Pyrénées, Université de Toulouse III, CHU La Grave-Casselardit, Toulouse, France
| | - Evelyne Galbrun
- Department of Gérontology 2, Sorbonne Université, APHP, Centre Hospitalier Dupuytren, Draveil, France
| | - Athanase Benetos
- Memory Resource and Research Centre of Lorraine, Université de Lorraine, CHRU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Gilles Berrut
- Department of Clinical Gerontology, Memory Research Resource Center of Nantes, Université de Nantes, EA 4334 Movement-Interactions-Performance, CHU Nantes, Nantes, France
| | - Elena Paillaud
- Service de Gériatrie, Université de Paris, APHP, Hôpital Europeen Georges Pompidou, Paris, France
| | - David Wallon
- CHU de Rouen, Department of Neurology and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, CIC-CRB1404, Normandie Univ, UNIROUEN, Inserm U1245, Rouen, France
| | | | - Lisette Volpe-Gillot
- Service de Neuro-Psycho-Gériatrie, Memory Clinic, Hôpital Léopold Bellan, Paris, France
| | - Marc Paccalin
- Memory Resource and Research Centre of Poitiers, CHU de Poitiers, Poitiers, France
| | - Philippe Robert
- Memory Research Resource Center of Nice, CoBTek lab, Université Côte d'Azur, CHU de Nice, Nice, France
| | - Olivier Godefroy
- Memory Resource and Research Centre of Amiens Picardie, CHU d'Amiens-Picardie, Amiens, France
| | - Vincent Camus
- CHRU de Tours, UMR Inserm U1253, Université François-Rabelais de Tours, Tours, France
| | - Joël Belmin
- Service de Gériatrie Ambulatoire, Sorbonne Université, APHP, Hôpitaux Universitaires Pitie-Salpêtrière-Charles Foix, Paris, France
| | - Pierre Vandel
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, CHU de Besançon, Memory Resource and Research Centre of Besançon Franche-Comté, Université Bourgogne Franche-Comté, Besançon, France
| | - Jean-Luc Novella
- Memory Resource and Research Centre of Champagne-Ardenne, Université de Reims Champagne-Ardenne, EA 3797, CHU de Reims, Reims, France
| | - Emmanuelle Duron
- Département de gériatrie, Équipe MOODS, Inserm 1178, Université Paris-Saclay, APHP, Hôpital Paul Brousse, Villejuif, France
| | - Anne-Sophie Rigaud
- Memory Resource and Research Centre of de Paris-Broca-Ile de France, Université de Paris, EA 4468, APHP, Hopital Broca, Paris, France
| | | | - Audrey Gabelle
- Department of Neurology, Memory Research and Resources Center of Montpellier, Inserm INM NeuroPEPs Team, Excellence Center of Neurodegenerative Disorders, Université de Montpellier, CHU Montpellier, Montpellier, France
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Fontaine D, Santucci S. Deep brain stimulation in Alzheimer's disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2021; 159:69-87. [PMID: 34446251 DOI: 10.1016/bs.irn.2021.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Benefits from symptomatic and etiologic treatments in Alzheimer's Disease (AD), the most frequent dementia, are still insufficient. During the last decade, several studies showed that electrical stimulation of memory circuits could enhance memory in humans without memory impairment. First, improvement of verbal recollection was reported after deep brain stimulation (DBS) of the fornix in the hypothalamus in a patient treated for morbid obesity. Several studies in epileptic patients explored by deep electrodes reported that visuo-spatial memorization was facilitated by electrical stimulation of the entorhinal cortex or theta burst stimulation of the fornix. Recent studies suggested that DBS could be useful to modulate memory circuits in patients with cognitive decline. Phase I and II studies (about 50 patients) showed that chronic fornix DBS was safe and could achieved to stabilize or slow the memory decline of some patients with mild to moderate AD, especially older ones with less severe and/or advanced disease. DBS of the cholinergic nucleus of Meynert also has been explored in phase I studies in AD and Parkinson-related dementia. Growing experimental data suggest several mechanisms of action: restoration of hippocampal theta rhythms, enhanced long term potentiation, increase of hippocampal neurogenesis, neuroprotection by release of neurotrophic factors, diffuse reactivation of hypoactive neocortical associative regions. However, DBS in AD is still investigational and numerous issues remain to be solved before envisaging its use in clinical practice, including optimal anatomical DBS target, stimulation modalities (continuous, intermittent, theta-bursts, closed loop stimulation), best candidate patients, relevant targeted symptoms, ethical considerations.
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Affiliation(s)
- Denys Fontaine
- Department of Neurosurgery, Université Côte d'Azur, CHU de Nice, Nice, France.
| | - Serena Santucci
- Department of Neurosurgery, Université Côte d'Azur, CHU de Nice, Nice, France
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Spengler M, Adler M, Niemeyer CM. Highly sensitive ligand-binding assays in pre-clinical and clinical applications: immuno-PCR and other emerging techniques. Analyst 2016. [PMID: 26196036 DOI: 10.1039/c5an00822k] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Recombinant DNA technology and corresponding innovations in molecular biology, chemistry and medicine have led to novel therapeutic biomacromolecules as lead candidates in the pharmaceutical drug development pipelines. While monoclonal antibodies and other proteins provide therapeutic potential beyond the possibilities of small molecule drugs, the concomitant demand for supportive bioanalytical sample testing creates multiple novel challenges. For example, intact macromolecules can usually not be quantified by mass-spectrometry without enzymatic digestion and isotopically labeled internal standards are costly and/or difficult to prepare. Classical ELISA-type immunoassays, on the other hand, often lack the sensitivity required to obtain pharmacokinetics of low dosed drugs or pharmacodynamics of suitable biomarkers. Here we summarize emerging state-of-the-art ligand-binding assay technologies for pharmaceutical sample testing, which reveal enhanced analytical sensitivity over classical ELISA formats. We focus on immuno-PCR, which combines antibody specificity with the extremely sensitive detection of a tethered DNA marker by quantitative PCR, and alternative nucleic acid-based technologies as well as methods based on electrochemiluminescence or single-molecule counting. Using case studies, we discuss advantages and drawbacks of these methods for preclinical and clinical sample testing.
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Affiliation(s)
- Mark Spengler
- Chimera Biotec GmbH, Emil-Figge-Str. 76 A, D-44227 Dortmund, Germany.
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Dubois B, Feldman HH, Jacova C, Hampel H, Molinuevo JL, Blennow K, DeKosky ST, Gauthier S, Selkoe D, Bateman R, Cappa S, Crutch S, Engelborghs S, Frisoni GB, Fox NC, Galasko D, Habert MO, Jicha GA, Nordberg A, Pasquier F, Rabinovici G, Robert P, Rowe C, Salloway S, Sarazin M, Epelbaum S, de Souza LC, Vellas B, Visser PJ, Schneider L, Stern Y, Scheltens P, Cummings JL. Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria. Lancet Neurol 2014; 13:614-29. [PMID: 24849862 DOI: 10.1016/s1474-4422(14)70090-0] [Citation(s) in RCA: 2227] [Impact Index Per Article: 222.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In the past 8 years, both the International Working Group (IWG) and the US National Institute on Aging-Alzheimer's Association have contributed criteria for the diagnosis of Alzheimer's disease (AD) that better define clinical phenotypes and integrate biomarkers into the diagnostic process, covering the full staging of the disease. This Position Paper considers the strengths and limitations of the IWG research diagnostic criteria and proposes advances to improve the diagnostic framework. On the basis of these refinements, the diagnosis of AD can be simplified, requiring the presence of an appropriate clinical AD phenotype (typical or atypical) and a pathophysiological biomarker consistent with the presence of Alzheimer's pathology. We propose that downstream topographical biomarkers of the disease, such as volumetric MRI and fluorodeoxyglucose PET, might better serve in the measurement and monitoring of the course of disease. This paper also elaborates on the specific diagnostic criteria for atypical forms of AD, for mixed AD, and for the preclinical states of AD.
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Affiliation(s)
- Bruno Dubois
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France.
| | - Howard H Feldman
- Division of Neurology, University of British Columbia and Vancouver Coastal Health, Vancouver, BC, Canada
| | - Claudia Jacova
- UBC Division of Neurology, S152 UBC Hospital, BC, Canada
| | - Harald Hampel
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France
| | - José Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, IDIBAPS Hospital Clinici Universitari, Barcelona, Spain; BarcelonaBeta Brain Research Centre, Fundació Pasqual Maragall, Barcelona, Spain
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Steven T DeKosky
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Serge Gauthier
- McGill Center for Studies in Aging, Douglas Hospital, Montreal, Quebec, QC, Canada
| | - Dennis Selkoe
- Harvard Medical School Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Randall Bateman
- Washington University School of Medicine, St Louis, Missouri, MO, USA
| | - Stefano Cappa
- Vita-Salute San Raffaele University, Milan, Italy; Department of Clinical Neurosciences, Cognitive Neurorehabilitation, Milan, Italy
| | - Sebastian Crutch
- Dementia Research Centre, Department of Neurodegeneration, Institute of Neurology, University College London, London, UK; Dementia Research Centre, National Hospital, London, UK
| | - Sebastiaan Engelborghs
- Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA), Middelheim and Hoge Beuken, Antwerp, Belgium; Reference Centre for Biological Markers of Dementia, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Giovanni B Frisoni
- Hopitaux Universitaires et Université de Genève, Geneva, Switzerland; IRCCS Fatebenefratelli, Brescia, Italy; HUG Belle-Idée, bâtiment les Voirons, Chêne-Bourg, France
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegeneration, Institute of Neurology, University College London, London, UK
| | - Douglas Galasko
- Department of Neurosciences, -University of California, San Diego, CA, USA
| | - Marie-Odile Habert
- INSERM UMR, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Médecine Nucléaire, Paris, France
| | - Gregory A Jicha
- University of Kentucky Alzheimer's Disease Center, Lexington, KY, USA
| | - Agneta Nordberg
- Karolinska Institutet, Karolinska University Hospital Huddinge, Alzheimer Neurobiology Center, Stockholm, Sweden
| | - Florence Pasquier
- Université Lille Nord de France, Lille, France; CHRU, Clinique Neurologique, Hôpital Roger Salengro, Lille, France
| | - Gil Rabinovici
- UCSF Memory & Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Philippe Robert
- EA CoBTeK and Memory Center, CHU University of Nice, UNSA, Hôpital de Cimiez 4 av Victoria, Nice, France
| | - Christopher Rowe
- FRACP, Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Melbourne, VIC, Australia
| | - Stephen Salloway
- Neurology and the Memory and Aging Program, Butler Hospital, Department of Neurology and Psychiatry, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Marie Sarazin
- Neurologie de la Mémoire et du Langage, Centre Hospitalier Sainte-Anne, Paris Cedex, France; Université Paris 5, Paris, France
| | - Stéphane Epelbaum
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France
| | - Leonardo C de Souza
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France; Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Bruno Vellas
- Gerontopole, Pavillon Junod, University Toulouse 3, Toulouse, France
| | - Pieter J Visser
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, Netherlands; Department of Neurology and Alzheimer Center, Amsterdam, Netherlands
| | - Lon Schneider
- Department of Psychiatry, Neurology, and Gerontology, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Yaakov Stern
- Cognitive Neuroscience Division of the Taub Institute, Presbyterian Hospital, New York, NY, USA
| | - Philip Scheltens
- Alzheimer Centrum Vrije Universiteit Medical Center, VU University, Amsterdam, Netherlands
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Souza LCD, Sarazin M, Teixeira Júnior AL, Caramelli P, Santos AED, Dubois B. Biological markers of Alzheimer?s disease. ARQUIVOS DE NEURO-PSIQUIATRIA 2014; 72:227-31. [DOI: 10.1590/0004-282x20130233] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 10/10/2013] [Indexed: 11/22/2022]
Abstract
The challenges for establishing an early diagnosis of Alzheimer’s disease (AD) have created a need for biomarkers that reflect the core pathology of the disease. The cerebrospinal fluid (CSF) levels of total Tau (T-tau), phosphorylated Tau (P-Tau) and beta-amyloid peptide (Aβ42) reflect, respectively, neurofibrillary tangle and amyloid pathologies and are considered as surrogate markers of AD pathophysiology. The combination of low Aβ42 and high levels of T-tau and P-Tau can accurately identify patients with AD at early stages, even before the development of dementia. The combined analysis of the CSF biomarkers is also helpful for the differential diagnosis between AD and other degenerative dementias. The development of these CSF biomarkers has evolved to a novel diagnostic definition of the disease. The identification of a specific clinical phenotype combined with the in vivo evidence of pathophysiological markers offers the possibility to make a diagnosis of AD before the dementia stage with high specificity.
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Affiliation(s)
| | - Marie Sarazin
- Hôpital de la Pitié-Salpêtrière, France; Université Paris Descartes, France
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Petersen RC, Aisen P, Boeve BF, Geda YE, Ivnik RJ, Knopman DS, Mielke M, Pankratz VS, Roberts R, Rocca WA, Weigand S, Weiner M, Wiste H, Jack CR. Mild cognitive impairment due to Alzheimer disease in the community. Ann Neurol 2013; 74:199-208. [PMID: 23686697 PMCID: PMC3804562 DOI: 10.1002/ana.23931] [Citation(s) in RCA: 194] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 04/26/2013] [Accepted: 05/01/2013] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The newly proposed National Institute on Aging-Alzheimer's Association (NIA-AA) criteria for mild cognitive impairment (MCI) due to Alzheimer disease (AD) suggest a combination of clinical features and biomarker measures, but their performance in the community is not known. METHODS The Mayo Clinic Study of Aging (MCSA) is a population-based longitudinal study of nondemented subjects in Olmsted County, Minnesota. A sample of 154 MCI subjects from the MCSA was compared to a sample of 58 amnestic MCI subjects from the Alzheimer's Disease Neuroimaging Initiative 1 (ADNI-1) to assess the applicability of the criteria in both settings and to assess their outcomes. RESULTS Fourteen percent of MCSA and 16% of ADNI-1 of subjects were biomarker negative. In addition, 14% of MCSA and 12% of ADNI-1 subjects had evidence for amyloid deposition only, whereas 43% of MCSA and 55% of ADNI-1 subjects had evidence for amyloid deposition plus neurodegeneration (magnetic resonance imaging atrophy, fluorodeoxyglucose positron emission tomography hypometabolism, or both). However, a considerable number of subjects had biomarkers inconsistent with the proposed AD model; for example, 29% of MCSA subjects and 17% of ADNI-1 subjects had evidence for neurodegeneration without amyloid deposition. These subjects may not be on an AD pathway. Neurodegeneration appears to be a key factor in predicting progression relative to amyloid deposition alone. INTERPRETATION The NIA-AA criteria apply to most MCI subjects in both the community and clinical trials settings; however, a sizeable proportion of subjects had conflicting biomarkers, which may be very important and need to be explored.
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Affiliation(s)
- Ronald C. Petersen
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN
- Mayo Clinic Alzheimer’s Disease Research Center, Mayo Clinic and Foundation, Rochester, MN
- Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN
| | - Paul Aisen
- University of California San Diego Department of Neurosciences
| | - Bradley F. Boeve
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN
- Mayo Clinic Alzheimer’s Disease Research Center, Mayo Clinic and Foundation, Rochester, MN
| | - Yonas E. Geda
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN
| | - Robert J. Ivnik
- Department of Psychiatry and Psychology, Mayo Clinic and Foundation, Rochester, MN
| | - David S. Knopman
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN
- Mayo Clinic Alzheimer’s Disease Research Center, Mayo Clinic and Foundation, Rochester, MN
| | - Michelle Mielke
- Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN
| | - Vernon S. Pankratz
- Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN
| | - Rosebud Roberts
- Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN
| | - Walter A. Rocca
- Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN
| | - Stephen Weigand
- Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN
| | - Michael Weiner
- Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN
| | - Heather Wiste
- Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, MN
| | - Clifford R. Jack
- Department of Radiology, Mayo Clinic and Foundation, Rochester, MN
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de Souza LC, Sarazin M, Uspenskaya O, Habert MO, Lamari F, Lehéricy S, Dubois B. [Markers of prodromal Alzheimer's disease]. Rev Neurol (Paris) 2012; 168:815-24. [PMID: 22944619 DOI: 10.1016/j.neurol.2012.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The diagnosis of Alzheimer's disease has long been considered a diagnosis of probability, as the definitive diagnosis can only be established by histopathological examination. However, the development of in-vivo biomarkers, considered a reflection of physiopathological processes, has changed our view of the disease. New criteria have recently been proposed that integrate such biomarkers as found in the cerebrospinal fluid (CSF) using new diagnostic tools such as magnetic resonance imaging (MRI), brain scintigraphy, FDG-positron emission tomography (PET) and PET amyloid ligand uptake studies. The value of these new criteria for the diagnosis of prodromal Alzheimer's disease and the prospect of disease-modifying drugs are also discussed.
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Affiliation(s)
- L C de Souza
- Hôpital de la Pitié-Salpêtrière, institut de la mémoire et de la maladie d'Alzheimer, AP-HP, 47-83 boulevard de l'Hôpital, Paris, France
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Key role of nuclear medicine in bringing imaging biomarkers into clinical practice. Eur J Nucl Med Mol Imaging 2011; 36:1937-9. [PMID: 19890630 DOI: 10.1007/s00259-009-1318-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ferreira LK, Busatto GF. Neuroimaging in Alzheimer's disease: current role in clinical practice and potential future applications. Clinics (Sao Paulo) 2011; 66 Suppl 1:19-24. [PMID: 21779719 PMCID: PMC3118433 DOI: 10.1590/s1807-59322011001300003] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Accepted: 06/16/2011] [Indexed: 12/20/2022] Open
Abstract
'Alzheimer's disease is the most common cause of dementia and its prevalence is expected to increase in the coming years. Therefore, accurate diagnosis is crucial for patients, clinicians and researchers. Neuroimaging techniques have provided invaluable information about Alzheimer's disease and, owing to recent advances, these methods will have an increasingly important role in research and clinical practice. The purpose of this article is to review recent neuroimaging studies of Alzheimer's disease that provide relevant information to clinical practice, including a new modality: in vivo amyloid imaging. Magnetic resonance imaging, single photon emission computed tomography and 18F-fluorodeoxyglucose-positron emission tomography are currently available for clinical use. Patients with suspected Alzheimer's disease are commonly investigated with magnetic resonance imaging because it provides detailed images of brain structure and allows the identification of supportive features for the diagnosis. Neurofunctional techniques such as single photon emission computed tomography and 18F-fluorodeoxyglucose-positron emission tomography can also be used to complement the diagnostic investigation in cases of uncertainty. Amyloid imaging is a non-invasive technique that uses positron emission tomography technology to investigate the accumulation of the β-amyloid peptide in the brain, which is a hallmark of Alzheimer's disease. This is a promising test but currently its use is restricted to very few specialized research centers in the world. Technological innovations will probably increase its availability and reliability, which are the necessary steps to achieve robust clinical applicability. Thus, in the future it is likely that amyloid imaging techniques will be used in the clinical evaluation of patients with Alzheimer's disease.
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Affiliation(s)
- Luiz Kobuti Ferreira
- Laboratory of Psychiatric Neuroimaging, Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
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