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Gavrilova NS, Gavrilov LA. Compensation effect of mortality is a challenge to substantial lifespan extension of humans. Biogerontology 2024:10.1007/s10522-024-10111-z. [PMID: 38811415 DOI: 10.1007/s10522-024-10111-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 05/03/2024] [Indexed: 05/31/2024]
Abstract
Despite frequent claims regarding radical extensions of human lifespan in the near future, many pragmatic scientists caution against excessive and baseless optimism on this front. In this study, we examine the compensation effect of mortality (CEM) as a potential challenge to substantial lifespan extension. The CEM is an empirical mortality regularity, often depicted as relative mortality convergence at advanced ages. Analysis of mortality data from 44 human populations, available in the Human Mortality Database, demonstrated that CEM can be represented as a continuous decline in relative mortality variation (assessed through the coefficient of variation and the standard deviation of the logarithm of mortality) with age, reaching a minimum corresponding to the species-specific lifespan. Through this method, the species-specific lifespan is determined to be 96-97 years, closely aligning with estimates derived from correlations between Gompertz parameters (95-98 years). Importantly, this representation of CEM can be achieved non-parametrically, eliminating the need for estimating Gompertz parameters. CEM is a challenge to lifespan extension, because it suggests that the true aging rate in humans (based on loss of vital elements, e.g., functional cells) remains stable at approximately 1% per year in the majority of human populations and is not affected by environmental or familial longevity factors. Given this rate of functional cell loss, one might anticipate that the total pool of functional cells could be entirely depleted by the age of 115-120 years creating physiological limit to human lifespan. Mortality pattern of supercentenarians (110 + years) aligns with this prediction.
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Affiliation(s)
- Natalia S Gavrilova
- NORC at the University of Chicago, 1155 East 60th Street, Chicago, IL, 60637, USA.
- Institute for Demographic Research, Federal Center of Theoretical and Applied Sociology, Russian Academy of Sciences, Moscow, Russia.
| | - Leonid A Gavrilov
- NORC at the University of Chicago, 1155 East 60th Street, Chicago, IL, 60637, USA
- Institute for Demographic Research, Federal Center of Theoretical and Applied Sociology, Russian Academy of Sciences, Moscow, Russia
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Fleisher AS, Munsie LM, Perahia DGS, Andersen SW, Higgins IA, Hauck PM, Lo AC, Sims JR, Brys M, Mintun M. Assessment of Efficacy and Safety of Zagotenemab: Results From PERISCOPE-ALZ, a Phase 2 Study in Early Symptomatic Alzheimer Disease. Neurology 2024; 102:e208061. [PMID: 38386949 PMCID: PMC11067698 DOI: 10.1212/wnl.0000000000208061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/19/2023] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Zagotenemab (LY3303560), a monoclonal antibody that preferentially targets misfolded, extracellular, aggregated tau, was assessed in the PERISCOPE-ALZ phase 2 study to determine its ability to slow cognitive and functional decline relative to placebo in early symptomatic Alzheimer disease (AD). METHODS Participants were enrolled across 56 sites in North America and Japan. Key eligibility criteria included age of 60-85 years, Mini-Mental State Examination score of 20-28, and intermediate levels of brain tau on PET imaging. In this double-blind study, participants were equally randomized to 1,400 mg or 5,600 mg of zagotenemab, or placebo (IV infusion every 4 weeks for 100 weeks). The primary outcome was change on the Integrated AD Rating Scale (iADRS) assessed by a Bayesian Disease Progression model. Secondary measures include mixed model repeated measures analysis of additional cognitive and functional endpoints as well as biomarkers of AD pathology. RESULTS A total of 360 participants (mean age = 75.4 years; female = 52.8%) were randomized, and 218 completed the treatment period. Demographics and baseline characteristics were reasonably balanced among arms. The mean disease progression ratio (proportional decline in the treated vs placebo group) with 95% credible intervals for the iADRS was 1.10 (0.959-1.265) for the zagotenemab low-dose group and 1.05 (0.907-1.209) for the high-dose, where a ratio less than 1 favors the treatment group. Secondary clinical endpoint measures failed to show a drug-placebo difference in favor of zagotenemab. No treatment effect was demonstrated by flortaucipir PET, volumetric MRI, or neurofilament light chain (NfL) analyses. A dose-related increase in plasma phosphorylated tau181 and total tau was demonstrated. Zagotenemab treatment groups reported a higher incidence of adverse events (AEs) (85.1%) compared with the placebo group (74.6%). This difference was not attributable to any specific AE or category of AEs. DISCUSSION In participants with early symptomatic AD, zagotenemab failed to achieve significant slowing of clinical disease progression compared with placebo. Imaging biomarker and plasma NfL findings did not show evidence of pharmacodynamic activity or disease modification. TRIAL REGISTRATION INFORMATION ClinicalTrials.gov: NCT03518073. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that for patients with early symptomatic AD, zagotenemab does not slow clinical disease progression.
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Affiliation(s)
- Adam S Fleisher
- From Eli Lilly and Company, Indianapolis, IN. Dr. A.C. Lo is currently at Kisbee Therapeutics, Cambridge, MA
| | - Leanne M Munsie
- From Eli Lilly and Company, Indianapolis, IN. Dr. A.C. Lo is currently at Kisbee Therapeutics, Cambridge, MA
| | - David G S Perahia
- From Eli Lilly and Company, Indianapolis, IN. Dr. A.C. Lo is currently at Kisbee Therapeutics, Cambridge, MA
| | - Scott W Andersen
- From Eli Lilly and Company, Indianapolis, IN. Dr. A.C. Lo is currently at Kisbee Therapeutics, Cambridge, MA
| | - Ixavier A Higgins
- From Eli Lilly and Company, Indianapolis, IN. Dr. A.C. Lo is currently at Kisbee Therapeutics, Cambridge, MA
| | - Paula M Hauck
- From Eli Lilly and Company, Indianapolis, IN. Dr. A.C. Lo is currently at Kisbee Therapeutics, Cambridge, MA
| | - Albert C Lo
- From Eli Lilly and Company, Indianapolis, IN. Dr. A.C. Lo is currently at Kisbee Therapeutics, Cambridge, MA
| | - John R Sims
- From Eli Lilly and Company, Indianapolis, IN. Dr. A.C. Lo is currently at Kisbee Therapeutics, Cambridge, MA
| | - Miroslaw Brys
- From Eli Lilly and Company, Indianapolis, IN. Dr. A.C. Lo is currently at Kisbee Therapeutics, Cambridge, MA
| | - Mark Mintun
- From Eli Lilly and Company, Indianapolis, IN. Dr. A.C. Lo is currently at Kisbee Therapeutics, Cambridge, MA
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Gavrilov LA, Gavrilova NS. Exploring Patterns of Human Mortality and Aging: A Reliability Theory Viewpoint. BIOCHEMISTRY. BIOKHIMIIA 2024; 89:341-355. [PMID: 38622100 PMCID: PMC11090256 DOI: 10.1134/s0006297924020123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/27/2024] [Accepted: 01/28/2024] [Indexed: 04/17/2024]
Abstract
The most important manifestation of aging is an increased risk of death with advancing age, a mortality pattern characterized by empirical regularities known as mortality laws. We highlight three significant ones: the Gompertz law, compensation effect of mortality (CEM), and late-life mortality deceleration and describe new developments in this area. It is predicted that CEM should result in declining relative variability of mortality at older ages. The quiescent phase hypothesis of negligible actuarial aging at younger adult ages is tested and refuted by analyzing mortality of the most recent birth cohorts. To comprehend the aging mechanisms, it is crucial to explain the observed empirical mortality patterns. As an illustrative example of data-directed modeling and the insights it provides, we briefly describe two different reliability models applied to human mortality patterns. The explanation of aging using a reliability theory approach aligns with evolutionary theories of aging, including idea of chronic phenoptosis. This alignment stems from their focus on elucidating the process of organismal deterioration itself, rather than addressing the reasons why organisms are not designed for perpetual existence. This article is a part of a special issue of the journal that commemorates the legacy of the eminent Russian scientist Vladimir Petrovich Skulachev (1935-2023) and his bold ideas about evolution of biological aging and phenoptosis.
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Affiliation(s)
- Leonid A Gavrilov
- NORC at the University of Chicago, Chicago, IL 60637, USA.
- Institute for Demographic Research, Federal Center of Theoretical and Applied Sociology, Russian Academy of Sciences, Moscow, 109028, Russia
| | - Natalia S Gavrilova
- NORC at the University of Chicago, Chicago, IL 60637, USA
- Institute for Demographic Research, Federal Center of Theoretical and Applied Sociology, Russian Academy of Sciences, Moscow, 109028, Russia
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Li JX, Nguyen HL, Qian T, Woodworth DC, Sajjadi SA. Longitudinal hippocampal atrophy in hippocampal sclerosis of aging. AGING BRAIN 2023; 4:100092. [PMID: 37635712 PMCID: PMC10448324 DOI: 10.1016/j.nbas.2023.100092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 08/29/2023] Open
Abstract
Hippocampal sclerosis of aging (HS-A) is a common degenerative neuropathology in older individuals and is associated with dementia. HS-A is characterized by disproportionate hippocampal atrophy at autopsy but cannot be diagnosed during life. Therefore, little is known about the onset and progression of hippocampal atrophy in individuals with HS-A. To better understand the onset and progression of hippocampal atrophy in HS-A, we examined longitudinal hippocampal atrophy using serial MRI in participants with HS-A at autopsy (HS-A+, n = 8) compared to participants with limbic-predominant age-related TDP-43 encephalopathy neuropathological change (LATE-NC) without HS-A (n = 13), Alzheimer's disease neuropathologic change (ADNC) without HS-A or LATE-NC (n = 16), and those without these pathologies (n = 7). We found that participants with HS-A had lower hippocampal volumes compared to the other groups, and this atrophy preceded the onset of dementia. There was also some evidence that rates of hippocampal volume loss were slightly slower in those with HS-A. Together, these results suggest that the disproportionate hippocampal atrophy seen in HS-A may begin early prior to dementia.
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Affiliation(s)
- Janice X. Li
- Department of Neurology, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Hannah L. Nguyen
- Department of Neurology, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Tianchen Qian
- Department of Statistics, University of California, Irvine, Irvine, CA, USA
| | - Davis C. Woodworth
- Department of Neurology, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - S. Ahmad Sajjadi
- Department of Neurology, University of California, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
- Department of Pathology, University of California, Irvine, CA, USA
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Basheer N, Smolek T, Hassan I, Liu F, Iqbal K, Zilka N, Novak P. Does modulation of tau hyperphosphorylation represent a reasonable therapeutic strategy for Alzheimer's disease? From preclinical studies to the clinical trials. Mol Psychiatry 2023; 28:2197-2214. [PMID: 37264120 PMCID: PMC10611587 DOI: 10.1038/s41380-023-02113-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 06/03/2023]
Abstract
Protein kinases (PKs) have emerged as one of the most intensively investigated drug targets in current pharmacological research, with indications ranging from oncology to neurodegeneration. Tau protein hyperphosphorylation was the first pathological post-translational modification of tau protein described in Alzheimer's disease (AD), highlighting the role of PKs in neurodegeneration. The therapeutic potential of protein kinase inhibitors (PKIs)) and protein phosphatase 2 A (PP2A) activators in AD has recently been explored in several preclinical and clinical studies with variable outcomes. Where a number of preclinical studies demonstrate a visible reduction in the levels of phospho-tau in transgenic tauopathy models, no reduction in neurofibrillary lesions is observed. Amongst the few PKIs and PP2A activators that progressed to clinical trials, most failed on the efficacy front, with only a few still unconfirmed and potential positive trends. This suggests that robust preclinical and clinical data is needed to unequivocally evaluate their efficacy. To this end, we take a systematic look at the results of preclinical and clinical studies of PKIs and PP2A activators, and the evidence they provide regarding the utility of this approach to evaluate the potential of targeting tau hyperphosphorylation as a disease modifying therapy.
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Affiliation(s)
- Neha Basheer
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, 845 10, Slovakia
| | - Tomáš Smolek
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, 845 10, Slovakia
| | - Imtaiyaz Hassan
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025, India
| | - Fei Liu
- Department of Neurochemistry, Inge Grundke-Iqbal Research Floor, New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY, 10314, USA
| | - Khalid Iqbal
- Department of Neurochemistry, Inge Grundke-Iqbal Research Floor, New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY, 10314, USA
| | - Norbert Zilka
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, 845 10, Slovakia.
- AXON Neuroscience R&D Services SE, Bratislava, 811 02, Slovakia.
| | - Petr Novak
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, 845 10, Slovakia.
- AXON Neuroscience CRM Services SE, Bratislava, 811 02, Slovakia.
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Chwa WJ, Lopez OL, Longstreth W, Dai W, Raji CA. Longitudinal Patterns of Brain Changes in a Community Sample in Relation to Aging and Cognitive Status. J Alzheimers Dis 2023; 94:1035-1045. [PMID: 37355895 PMCID: PMC10674101 DOI: 10.3233/jad-230080] [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: 06/26/2023]
Abstract
BACKGROUND Aging and Alzheimer's disease (AD) are characterized by widespread cortical and subcortical atrophy. Though atrophy patterns between aging and AD overlap considerably, regional differences between these two conditions may exist. Few studies, however, have investigated these patterns in large community samples. OBJECTIVE Elaborate longitudinal changes in brain morphometry in relation to aging and cognitive status in a well-characterized community cohort. METHODS Clinical and neuroimaging data were compiled from 72 participants from the Cardiovascular Health Study-Cognition Study, a community cohort of healthy aging and probable AD participants. Two time points were identified for each participant with a mean follow-up time of 5.36 years. MRI post-processing, morphometric measurements, and statistical analyses were performed using FreeSurfer, Version 7.1.1. RESULTS Cortical volume was significantly decreased in the bilateral superior frontal, bilateral inferior parietal, and left superior parietal regions, among others. Cortical thickness was significantly reduced in the bilateral superior frontal and left inferior parietal regions, among others. Overall gray and white matter volumes and hippocampal subfields also demonstrated significant reductions. Cortical volume atrophy trajectories between cognitively stable and cognitively declined participants were significantly different in the right postcentral region. CONCLUSION Observed volume reductions were consistent with previous studies investigating morphometric brain changes. Patterns of brain atrophy between AD and aging may be different in magnitude but exhibit widespread spatial overlap. These findings help characterize patterns of brain atrophy that may reflect the general population. Larger studies may more definitively establish population norms of aging and AD-related neuroimaging changes.
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Affiliation(s)
- Won Jong Chwa
- Saint Louis University School of Medicine, St. Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Oscar L. Lopez
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - W.T. Longstreth
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, USA
| | - Weiying Dai
- Department of Computer Science, State University of New York at Binghamton, Binghamton, NY, USA
| | - Cyrus A. Raji
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
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Clements-Cortes A, Bartel L. Long-Term Multi-Sensory Gamma Stimulation of Dementia Patients: A Case Series Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15553. [PMID: 36497624 PMCID: PMC9738557 DOI: 10.3390/ijerph192315553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/09/2022] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
Dementia prevalence is increasing globally, and symptom management and treatment strategies require further investigation. Music-based interventions have demonstrated some efficacy with respect to quality of life and symptom reduction, though limited with respect to cognition. This study reports on three case studies where the use of gamma stimulation over one year contributed to maintenance of cognition and increases in mood for participants with Alzheimer's disease or mild cognitive impairment. Auditory stimulation with isochronous sound at 40 Hz was delivered to participants via a commercially available vibroacoustic chair device five times per week for 30 min with assistance from caregivers. Further research is needed to assess the integration of this therapy in the overall care for persons with dementia.
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Tort‐Merino A, Falgàs N, Allen IE, Balasa M, Olives J, Contador J, Castellví M, Juncà‐Parella J, Guillén N, Borrego‐Écija S, Bosch B, Fernández‐Villullas G, Ramos‐Campoy O, Antonell A, Rami L, Sánchez‐Valle R, Lladó A. Early-onset Alzheimer's disease shows a distinct neuropsychological profile and more aggressive trajectories of cognitive decline than late-onset. Ann Clin Transl Neurol 2022; 9:1962-1973. [PMID: 36398437 PMCID: PMC9735361 DOI: 10.1002/acn3.51689] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Early- and late-onset Alzheimer's disease (EOAD and LOAD) share the same neuropathological traits but show distinct cognitive features. We aimed to explore baseline and longitudinal outcomes of global and domain-specific cognitive function in a well characterized cohort of patients with a biomarker-based diagnosis. METHODS In this retrospective cohort study, 195 participants were included and classified according to their age, clinical status, and CSF AD biomarker profile: 89 EOAD, 37 LOAD, 46 young healthy controls (age ≤ 65 years), and 23 old healthy controls (>65 years). All subjects underwent clinical and neuropsychological assessment, neuroimaging, APOE genotyping and lumbar puncture. RESULTS We found distinct neuropsychological profiles between EOAD and LOAD at the time of diagnosis. Both groups showed similar performances on memory and language domains, but the EOAD patients displayed worsened deficits in visual perception, praxis, and executive tasks (p < 0.05). Longitudinally, cognitive decline in EOAD was more pronounced than LOAD in the global outcomes at the expense of these non-amnestic domains. We found that years of education significantly influenced the decline in most of the neuropsychological tests. Besides, the APOE ε4 status showed a significant effect on the decline of memory-related tasks within the EOAD cohort (p < 0.05). INTERPRETATION Age of onset is a main factor shaping the cognitive trajectories in AD patients, with younger age driving to a steeper decline of the non-memory domains. Years of education are related to a transversal decline in all cognitive domains and APOE ε4 status to a specific decline in memory performance in EOAD.
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Affiliation(s)
- Adrià Tort‐Merino
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain
| | - Neus Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain,Department of Neurology & Neurological SciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA,Global Brain Health Institute, University of California San Francisco ‐ Trinity College DublinSan Francisco, California, USA ‐ Dublin, Irleand
| | - Isabel E. Allen
- Global Brain Health Institute, University of California San Francisco ‐ Trinity College DublinSan Francisco, California, USA ‐ Dublin, Irleand,Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Mircea Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain,Global Brain Health Institute, University of California San Francisco ‐ Trinity College DublinSan Francisco, California, USA ‐ Dublin, Irleand
| | - Jaume Olives
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain
| | - José Contador
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain
| | - Magdalena Castellví
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain
| | - Jordi Juncà‐Parella
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain
| | - Núria Guillén
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain
| | - Sergi Borrego‐Écija
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain
| | - Bea Bosch
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain
| | - Guadalupe Fernández‐Villullas
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain
| | - Oscar Ramos‐Campoy
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain
| | - Anna Antonell
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain
| | - Raquel Sánchez‐Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)MadridSpain
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic per a la Recerca BiomèdicaUniversity of BarcelonaBarcelonaSpain,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)MadridSpain
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Green efficient synthesis of urease and acetylcholinesterase inhibiting anisaldehyde derivatives and their in-silico studies. J Mol Struct 2022. [DOI: 10.1016/j.molstruc.2022.133624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Rane Levendovszky S. Cross-Sectional and Longitudinal Hippocampal Atrophy, Not Cortical Thinning, Occurs in Amyloid-Negative, p-Tau-Positive, Older Adults With Non-Amyloid Pathology and Mild Cognitive Impairment. FRONTIERS IN NEUROIMAGING 2022; 1:828767. [PMID: 37555137 PMCID: PMC10406207 DOI: 10.3389/fnimg.2022.828767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/11/2022] [Indexed: 08/10/2023]
Abstract
Introduction Alzheimer's disease (AD) is a degenerative disease characterized by pathological accumulation of amyloid and phosphorylated tau. Typically, the early stage of AD, also called mild cognitive impairment (MCI), shows amyloid pathology. A small but significant number of individuals with MCI do not exhibit amyloid pathology but have elevated phosphorylated tau levels (A-T+ MCI). We used CSF amyloid and phosphorylated tau to identify the individuals with A+T+ and A-T+ MCI as well as cognitively normal (A-T-) controls. To increase the sample size, we leveraged the Global Alzheimer's Association Interactive Network and identified 137 MCI+ and 61 A-T+ MCI participants. We compared baseline and longitudinal, hippocampal, and cortical atrophy between groups. Methods We applied ComBat harmonization to minimize site-related variability and used FreeSurfer for all measurements. Results Harmonization reduced unwanted variability in cortical thickness by 3.4% and in hippocampal volume measurement by 10.3%. Cross-sectionally, widespread cortical thinning with age was seen in the A+T+ and A-T+ MCI groups (p < 0.0005). A decrease in the hippocampal volume with age was faster in both groups (p < 0.05) than in the controls. Longitudinally also, hippocampal atrophy rates were significant (p < 0.05) when compared with the controls. No longitudinal cortical thinning was observed in A-T+ MCI group. Discussion A-T+ MCI participants showed similar baseline cortical thickness patterns with aging and longitudinal hippocampal atrophy rates as participants with A+T+ MCI, but did not show longitudinal cortical atrophy signature.
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Affiliation(s)
- Swati Rane Levendovszky
- Department of Radiology, School of Medicine, University of Washington, Seattle, WA, United States
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Wei X, Du X, Xie Y, Suo X, He X, Ding H, Zhang Y, Ji Y, Chai C, Liang M, Yu C, Liu Y, Qin W. Mapping cerebral atrophic trajectory from amnestic mild cognitive impairment to Alzheimer's disease. Cereb Cortex 2022; 33:1310-1327. [PMID: 35368064 PMCID: PMC9930625 DOI: 10.1093/cercor/bhac137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/13/2022] [Accepted: 03/13/2022] [Indexed: 11/14/2022] Open
Abstract
Alzheimer's disease (AD) patients suffer progressive cerebral atrophy before dementia onset. However, the region-specific atrophic processes and the influences of age and apolipoprotein E (APOE) on atrophic trajectory are still unclear. By mapping the region-specific nonlinear atrophic trajectory of whole cerebrum from amnestic mild cognitive impairment (aMCI) to AD based on longitudinal structural magnetic resonance imaging data from Alzheimer's disease Neuroimaging Initiative (ADNI) database, we unraveled a quadratic accelerated atrophic trajectory of 68 cerebral regions from aMCI to AD, especially in the superior temporal pole, caudate, and hippocampus. Besides, interaction analyses demonstrated that APOE ε4 carriers had faster atrophic rates than noncarriers in 8 regions, including the caudate, hippocampus, insula, etc.; younger patients progressed faster than older patients in 32 regions, especially for the superior temporal pole, hippocampus, and superior temporal gyrus; and 15 regions demonstrated complex interaction among age, APOE, and disease progression, including the caudate, hippocampus, etc. (P < 0.05/68, Bonferroni correction). Finally, Cox proportional hazards regression model based on the identified region-specific biomarkers could effectively predict the time to AD conversion within 10 years. In summary, cerebral atrophic trajectory mapping could help a comprehensive understanding of AD development and offer potential biomarkers for predicting AD conversion.
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Affiliation(s)
| | | | | | | | - Xiaoxi He
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Hao Ding
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China,School of Medical Imaging, Tianjin Medical University, Tianjin 300070, China
| | - Yu Zhang
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yi Ji
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Chao Chai
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Meng Liang
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China,School of Medical Imaging, Tianjin Medical University, Tianjin 300070, China
| | - Chunshui Yu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China,Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China,School of Medical Imaging, Tianjin Medical University, Tianjin 300070, China
| | - Yong Liu
- Corresponding author: Wen Qin, Department of Radiology, and Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Anshan Road No 154, Heping District, Tianjin 300052, China. ; Yong Liu, School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China.
| | - Wen Qin
- Corresponding author: Wen Qin, Department of Radiology, and Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Anshan Road No 154, Heping District, Tianjin 300052, China. ; Yong Liu, School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China.
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12
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Duara R, Barker W. Heterogeneity in Alzheimer's Disease Diagnosis and Progression Rates: Implications for Therapeutic Trials. Neurotherapeutics 2022; 19:8-25. [PMID: 35084721 PMCID: PMC9130395 DOI: 10.1007/s13311-022-01185-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 01/03/2023] Open
Abstract
The clinical presentation and the pathological processes underlying Alzheimer's disease (AD) can be very heterogeneous in severity, location, and composition including the amount and distribution of AB deposition and spread of neurofibrillary tangles in different brain regions resulting in atypical clinical patterns and the existence of distinct AD variants. Heterogeneity in AD may be related to demographic factors (such as age, sex, educational and socioeconomic level) and genetic factors, which influence underlying pathology, the cognitive and behavioral phenotype, rate of progression, the occurrence of neuropsychiatric features, and the presence of comorbidities (e.g., vascular disease, neuroinflammation). Heterogeneity is also manifest in the individual resilience to the development of neuropathology (brain reserve) and the ability to compensate for its cognitive and functional impact (cognitive and functional reserve). The variability in specific cognitive profiles and types of functional impairment may be associated with different progression rates, and standard measures assessing progression may not be equivalent for individual cognitive and functional profiles. Other factors, which may govern the presence, rate, and type of progression of AD, include the individuals' general medical health, the presence of specific systemic conditions, and lifestyle factors, including physical exercise, cognitive and social stimulation, amount of leisure activities, environmental stressors, such as toxins and pollution, and the effects of medications used to treat medical and behavioral conditions. These factors that affect progression are important to consider while designing a clinical trial to ensure, as far as possible, well-balanced treatment and control groups.
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Affiliation(s)
- Ranjan Duara
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
- Departments of Neurology, University of Florida College of Medicine, Gainesville, FL, USA
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Warren Barker
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA.
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13
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Li B, Jang I, Riphagen J, Almaktoum R, Yochim KM, Ances BM, Bookheimer SY, Salat DH. Identifying individuals with Alzheimer's disease-like brains based on structural imaging in the Human Connectome Project Aging cohort. Hum Brain Mapp 2021; 42:5535-5546. [PMID: 34582057 PMCID: PMC8559490 DOI: 10.1002/hbm.25626] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 11/28/2022] Open
Abstract
Given the difficulty in factoring out typical age effects from subtle Alzheimer's disease (AD) effects on brain structure, identification of very early, as well as younger preclinical “at‐risk” individuals has unique challenges. We examined whether age‐correction procedures could be used to better identify individuals at very early potential risk from adults who did not have any existing cognitive diagnosis. First, we obtained cross‐sectional age effects for each structural feature using data from a selected portion of the Human Connectome Project Aging (HCP‐A) cohort. After age detrending, we weighted AD structural deterioration with patterns quantified from data of the Alzheimer's Disease Neuroimaging Initiative. Support vector machine was then used to classify individuals with brains that most resembled atrophy in AD across the entire HCP‐A sample. Additionally, we iteratively adjusted the pipeline by removing individuals classified as AD‐like from the HCP‐A cohort to minimize atypical brain structural contributions to the age detrending. The classifier had a mean cross‐validation accuracy of 94.0% for AD recognition. It also could identify mild cognitive impairment with more severe AD‐specific biomarkers and worse cognition. In an independent HCP‐A cohort, 8.8% were identified as AD‐like, and they trended toward worse cognition. An “AD risk” score derived from the machine learning models also significantly correlated with cognition. This work provides a proof of concept for the potential to use structural brain imaging to identify asymptomatic individuals at young ages who show structural brain patterns similar to AD and are potentially at risk for a future clinical disorder.
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Affiliation(s)
- Binyin Li
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ikbeom Jang
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Joost Riphagen
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA.,Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Randa Almaktoum
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Kathryn Morrison Yochim
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Beau M Ances
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Susan Y Bookheimer
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California, USA
| | - David H Salat
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Neuroimaging Research for Veterans Center, VA Boston Healthcare System, Boston, Massachusetts, USA
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14
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The prevalence of inorganic mercury in human cells increases during aging but decreases in the very old. Sci Rep 2021; 11:16714. [PMID: 34408264 PMCID: PMC8373952 DOI: 10.1038/s41598-021-96359-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 07/30/2021] [Indexed: 11/09/2022] Open
Abstract
Successful aging is likely to involve both genetic and environmental factors, but environmental toxicants that accelerate aging are not known. Human exposure to mercury is common, and mercury has genotoxic, autoimmune, and free radical effects which could contribute to age-related disorders. The presence of inorganic mercury was therefore assessed in the organs of 170 people aged 1-104 years to determine the prevalence of mercury in human tissues at different ages. Mercury was found commonly in cells of the brain, kidney, thyroid, anterior pituitary, adrenal medulla and pancreas. The prevalence of mercury in these organs increased during aging but decreased in people aged over 80 years. People with mercury in one organ usually also had mercury in several others. In conclusion, the prevalence of inorganic mercury in human organs increases with age. The relative lack of tissue mercury in the very old could account for the flattened mortality rate and reduced incidence of cancer in this advanced age group. Since mercury may accelerate aging, efforts to reduce atmospheric mercury pollution could improve the chances of future successful aging.
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15
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Ayodele T, Rogaeva E, Kurup JT, Beecham G, Reitz C. Early-Onset Alzheimer's Disease: What Is Missing in Research? Curr Neurol Neurosci Rep 2021; 21:4. [PMID: 33464407 PMCID: PMC7815616 DOI: 10.1007/s11910-020-01090-y] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Early-onset Alzheimer's disease (EOAD), defined as Alzheimer's disease (AD) occurring before age 65, is significantly less well studied than the late-onset form (LOAD) despite EOAD often presenting with a more aggressive disease progression. The aim of this review is to summarize the current understanding of the etiology of EOAD, their translation into clinical practice, and to suggest steps to be taken to move our understanding forward. RECENT FINDINGS EOAD cases make up 5-10% of AD cases but only 10-15% of these cases show known mutations in the APP, PSEN1, and PSEN2, which are linked to EOAD. New data suggests that these unexplained cases following a non-Mendelian pattern of inheritance is potentially caused by a mix of common and newly discovered rare variants. However, only a fraction of this genetic variation has been identified to date leaving the molecular mechanisms underlying this type of AD and their association with clinical, biomarker, and neuropathological changes unclear. While great advancements have been made in characterizing EOAD, much work is needed to disentangle the molecular mechanisms underlying this type of AD and to identify putative targets for more precise disease screening, diagnosis, prevention, and treatment.
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Affiliation(s)
- Temitope Ayodele
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- Department of Neurology, Columbia University, New York, NY, USA
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, 60 Leonard Avenue, Toronto, ON, M5T 0S8, Canada
| | - Jiji T Kurup
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Gary Beecham
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA
| | - Christiane Reitz
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.
- The Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA.
- Department of Neurology, Columbia University, New York, NY, USA.
- Department of Epidemiology, Sergievsky Center, Taub Institute for Research on the Aging Brain, Columbia University, 630 W 168th Street, New York, NY, 10032, USA.
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16
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Arruda F, Rosselli M, Greig MT, Loewenstein DA, Lang M, Torres VL, Vélez-Uribe I, Conniff J, Barker WW, Curiel RE, Adjouadi M, Duara R. The Association Between Functional Assessment and Structural Brain Biomarkers in an Ethnically Diverse Sample With Normal Cognition, Mild Cognitive Impairment, or Dementia. Arch Clin Neuropsychol 2021; 36:51-61. [PMID: 32890393 DOI: 10.1093/arclin/acaa065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/13/2020] [Accepted: 07/27/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To investigate the association between the functional activities questionnaire (FAQ) and brain biomarkers (bilateral hippocampal volume [HV], bilateral entorhinal volume [ERV], and entorhinal cortical thickness [ERT]) in cognitively normal (CN) individuals, mild cognitive impairment (MCI), or dementia. METHOD In total, 226 participants (137 females; mean age = 71.76, SD = 7.93; Hispanic Americans = 137; European Americans = 89) were assessed with a comprehensive clinical examination, a neuropsychological battery, a structural magnetic resonance imaging, and were classified as CN or diagnosed with MCI or dementia. Linear regression analyses examined the association between functional activities as measured by the FAQ on brain biomarkers, including HV, ERV, and ERT, controlling for age, education, global cognition, gender, and ethnicity. RESULTS The FAQ significantly predicted HV, ERV, and ERT for the entire sample. However, this association was not significant for ERV and ERT when excluding the dementia group. The FAQ score remained a significant predictor of HV for the non-dementia group. Age, education, gender, ethnicity, Montreal Cognitive Assessment score, and FAQ were also significant predictors of HV for the overall sample, suggesting that younger Hispanic females with fewer years of education, higher global mental status, and better functioning, were more likely to have larger HV. CONCLUSION FAQ scores were related to HV in older adults across clinical groups (CN, MCI, and dementia), but its association with the entorhinal cortex was driven by individuals with dementia. Demographic variables, including ethnicity, additionally influenced these associations.
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Affiliation(s)
- Fernanda Arruda
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Mónica Rosselli
- Department of Psychology, Florida Atlantic University, Davie, FL, USA.,1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA
| | - Maria T Greig
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - David A Loewenstein
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Department of Psychiatry and Behavioral Sciences, Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Merike Lang
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Valeria L Torres
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Idaly Vélez-Uribe
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Joshua Conniff
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Warren W Barker
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Rosie E Curiel
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Department of Psychiatry and Behavioral Sciences, Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Malek Adjouadi
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Engineering Center, Florida International University, Miami, FL, USA
| | - Ranjan Duara
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
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17
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Meysami S, Raji CA, Merrill DA, Porter VR, Mendez MF. Quantitative MRI Differences Between Early versus Late Onset Alzheimer's Disease. Am J Alzheimers Dis Other Demen 2021; 36:15333175211055325. [PMID: 34814740 PMCID: PMC10623969 DOI: 10.1177/15333175211055325] [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: 11/16/2022]
Abstract
Investigators report greater parietal tau deposition and alternate frontoparietal network involvement in early onset Alzheimer's Disease (EOAD) with onset <65 years as compared with typical late onset AD (LOAD). To determine whether clinical brain MRI volumes reflect these differences in EOAD compared with LOAD. This study investigated the clinical MRI scans of 45 persons with Clinically Probable AD with onset <65 years, and compared them to 32 with Clinically Probable AD with onset ≥65 years. Brain volumes on their T1 MRI scans were quantified with a volumetric program. Receiver operating curve analyses were performed. Persons with EOAD had significantly smaller parietal lobes (volumetric percentiles) than LOAD. Late onset Alzheimer's Disease had a smaller left putamen and hippocampus. Area Under the Curve was 96.5% with brain region delineation of EOAD compared to LOAD. This study indicates parietal atrophy less than 30% of normal on clinical MRI scans is suggestive of EOAD compared to LOAD.
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Affiliation(s)
- Somayeh Meysami
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Cyrus A. Raji
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St Louis, St Louis, MO, USA
| | - David A. Merrill
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Providence and St Johns Health Center, Pacific Neuroscience Institute, Santa Monica, CA, USA
| | - Verna R. Porter
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Providence and St Johns Health Center, Pacific Neuroscience Institute, Santa Monica, CA, USA
| | - Mario F. Mendez
- Department of Neurology, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- V.A. Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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18
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Kang YJ, Diep YN, Tran M, Cho H. Therapeutic Targeting Strategies for Early- to Late-Staged Alzheimer's Disease. Int J Mol Sci 2020; 21:E9591. [PMID: 33339351 PMCID: PMC7766709 DOI: 10.3390/ijms21249591] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/30/2020] [Accepted: 12/08/2020] [Indexed: 02/08/2023] Open
Abstract
Alzheimer's disease (AD) is the most common cause of dementia, typically showing progressive neurodegeneration in aging brains. The key signatures of the AD progression are the deposition of amyloid-beta (Aβ) peptides, the formation of tau tangles, and the induction of detrimental neuroinflammation leading to neuronal loss. However, conventional pharmacotherapeutic options are merely relying on the alleviation of symptoms that are limited to mild to moderate AD patients. Moreover, some of these medicines discontinued to use due to either the insignificant effectiveness in improving the cognitive impairment or the adverse side effects worsening essential bodily functions. One of the reasons for the failure is the lack of knowledge on the underlying mechanisms that can accurately explain the major causes of the AD progression correlating to the severity of AD. Therefore, there is an urgent need for the better understanding of AD pathogenesis and the development of the disease-modifying treatments, particularly for severe and late-onset AD, which have not been covered thoroughly. Here, we review the underlying mechanisms of AD progression, which have been employed for the currently established therapeutic strategies. We believe this will further spur the discovery of a novel disease-modifying treatment for mild to severe, as well as early- to late-onset, AD.
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Affiliation(s)
- You Jung Kang
- Department of Mechanical Engineering and Engineering Science, Center for Biomedical Engineering and Science, University of North Carolina, Charlotte, NC 28223, USA;
- Department of Biological Sciences, Center for Biomedical Engineering and Science, University of North Carolina, Charlotte, NC 28223, USA
| | - Yen N. Diep
- Institute of Quantum Biophysics, Department of Biophysics, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do 16419, Korea; (Y.N.D.); (M.T.)
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do 16419, Korea
| | - Minh Tran
- Institute of Quantum Biophysics, Department of Biophysics, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do 16419, Korea; (Y.N.D.); (M.T.)
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do 16419, Korea
| | - Hansang Cho
- Institute of Quantum Biophysics, Department of Biophysics, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do 16419, Korea; (Y.N.D.); (M.T.)
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do 16419, Korea
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19
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Elbadawy AM, Mansour AE, Abdelrassoul IA, Abdelmoneim RO. Relationship between thyroid dysfunction and dementia. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2020. [DOI: 10.1186/s43162-020-00003-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Thyroid hormones are essential for normal development and function of the central nervous system. Thyroid dysfunction is associated with many neuropsychiatric disorders mainly cognitive impairment.
Results
We found a close correlation between thyroid status and cognitive dysfunction. Serum FT3 levels decreased, whereas the serum thyroid-stimulating hormone (TSH) level increased, with the decline in cognitive functions. Furthermore, the TSH level showed a negative correlation with the Mini-Mental State Examination (MMSE) scores. We suggested that thyroid function was associated with cognitive impairments induced by subcortical ischemic vascular dementia (SIVD).
Conclusion
We found that thyroid dysfunction especially subclinical hypothyroidism is associated with cognitive impairment. Dementia increases more with more increase in TSH, and the MMSE score decreases with the increase of age.
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20
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Reitz C, Rogaeva E, Beecham GW. Late-onset vs nonmendelian early-onset Alzheimer disease: A distinction without a difference? NEUROLOGY-GENETICS 2020; 6:e512. [PMID: 33225065 PMCID: PMC7673282 DOI: 10.1212/nxg.0000000000000512] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 08/07/2020] [Indexed: 12/21/2022]
Abstract
There is mounting evidence that only a small fraction of early-onset Alzheimer disease cases (onset <65 years) are explained by known mutations. Even multiplex families with early onset often also have late-onset cases, suggesting that the commonly applied categorization of Alzheimer disease into early- and late-onset forms may not reflect distinct underlying etiology. Nevertheless, this categorization continues to govern today's research and the design of clinical trials. The aim of this review is to evaluate this categorization by providing a comprehensive, critical review of reported clinical, neuropathologic, and genomic characteristics of both onset-based subtypes and explore potential overlap between both categories. The article will lay out the need to comprehensively assess the phenotypic, neuropathologic, and molecular variability in Alzheimer disease and identify factors explaining the observed significant variation in onset age in persons with and without known mutations. The article will critically review ongoing large-scale genomic efforts in Alzheimer disease research (e.g., Alzheimer Disease Sequencing Project, Dominantly Inherited Alzheimer Network, Alzheimer Disease Neuroimaging Initiative) and their shortcomings to disentangle the delineation of unexplained nonmendelian early-onset from late-onset and mendelian forms of Alzheimer disease. In addition, it will outline specific approaches including epigenetic research through which a comprehensive characterization of this delineation can be achieved.
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Affiliation(s)
- Christiane Reitz
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R.), Gertrude H. Sergievsky Center (C.R.), Department of Neurology (C.R.), and Department of Epidemiology (C.R.), College of Physicians and Surgeons, Columbia University, New York, NY; Tanz Centre for Research in Neurodegenerative Disease (E.R.), University of Toronto, ON, Canada; and The John P. Hussman Institute for Human Genomics (G.W.B.), University of Miami, FL
| | - Ekaterina Rogaeva
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R.), Gertrude H. Sergievsky Center (C.R.), Department of Neurology (C.R.), and Department of Epidemiology (C.R.), College of Physicians and Surgeons, Columbia University, New York, NY; Tanz Centre for Research in Neurodegenerative Disease (E.R.), University of Toronto, ON, Canada; and The John P. Hussman Institute for Human Genomics (G.W.B.), University of Miami, FL
| | - Gary W Beecham
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain (C.R.), Gertrude H. Sergievsky Center (C.R.), Department of Neurology (C.R.), and Department of Epidemiology (C.R.), College of Physicians and Surgeons, Columbia University, New York, NY; Tanz Centre for Research in Neurodegenerative Disease (E.R.), University of Toronto, ON, Canada; and The John P. Hussman Institute for Human Genomics (G.W.B.), University of Miami, FL
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21
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Peng Zhou, Fang Hua. Exploration of Acetylcholinesterase Inhibitors from Flavonoids and Flavonoid Glycosides. NEUROCHEM J+ 2020. [DOI: 10.1134/s1819712420030137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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22
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Fiford CM, Nicholas JM, Biessels GJ, Lane CA, Cardoso MJ, Barnes J. High blood pressure predicts hippocampal atrophy rate in cognitively impaired elders. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12035. [PMID: 32587882 PMCID: PMC7308793 DOI: 10.1002/dad2.12035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Understanding relationships among blood pressure (BP), cognition, and brain volume could inform Alzheimer's disease (AD) management. METHODS We investigated Alzheimer's Disease Neuroimaging Initiative (ADNI) participants: 200 controls, 346 mild cognitive impairment (MCI), and 154 AD. National Alzheimer's Co-ordinating Center (NACC) participants were separately analyzed: 1098 controls, 2297 MCI, and 4845 AD. Relationships between cognition and BP were assessed in both cohorts and BP and atrophy rates in ADNI. Multivariate mixed linear-regression models were fitted with joint outcomes of BP (systolic, diastolic, and pulse pressure), cognition (Mini-Mental State Examination, Logical Memory, and Digit Symbol) and atrophy rate (whole-brain, hippocampus). RESULTS ADNI MCI and AD patients with greater baseline systolic BP had higher hippocampal atrophy rates ([r, P value]; 0.2, 0.005 and 0.2, 0.04, respectively). NACC AD patients with lower systolic BP had lower cognitive scores (0.1, 0.0003). DISCUSSION Higher late-life BP may be associated with faster decline in cognitively impaired elders.
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Affiliation(s)
- Cassidy M. Fiford
- Department of Neurodegenerative Disease, Dementia Research CentreUCL Institute of NeurologyLondonUK
| | | | - Geert Jan Biessels
- Department of Neurology and NeurosurgeryBrain Center Rudolf MagnusUniversity Medical CenterUtrechtthe Netherlands
| | - Christopher A. Lane
- Department of Neurodegenerative Disease, Dementia Research CentreUCL Institute of NeurologyLondonUK
| | - M. Jorge Cardoso
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Josephine Barnes
- Department of Neurodegenerative Disease, Dementia Research CentreUCL Institute of NeurologyLondonUK
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23
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Holland D, Frei O, Desikan R, Fan CC, Shadrin AA, Smeland OB, Sundar VS, Thompson P, Andreassen OA, Dale AM. Beyond SNP heritability: Polygenicity and discoverability of phenotypes estimated with a univariate Gaussian mixture model. PLoS Genet 2020; 16:e1008612. [PMID: 32427991 PMCID: PMC7272101 DOI: 10.1371/journal.pgen.1008612] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 06/04/2020] [Accepted: 01/15/2020] [Indexed: 12/27/2022] Open
Abstract
Estimating the polygenicity (proportion of causally associated single nucleotide polymorphisms (SNPs)) and discoverability (effect size variance) of causal SNPs for human traits is currently of considerable interest. SNP-heritability is proportional to the product of these quantities. We present a basic model, using detailed linkage disequilibrium structure from a reference panel of 11 million SNPs, to estimate these quantities from genome-wide association studies (GWAS) summary statistics. We apply the model to diverse phenotypes and validate the implementation with simulations. We find model polygenicities (as a fraction of the reference panel) ranging from ≃ 2 × 10-5 to ≃ 4 × 10-3, with discoverabilities similarly ranging over two orders of magnitude. A power analysis allows us to estimate the proportions of phenotypic variance explained additively by causal SNPs reaching genome-wide significance at current sample sizes, and map out sample sizes required to explain larger portions of additive SNP heritability. The model also allows for estimating residual inflation (or deflation from over-correcting of z-scores), and assessing compatibility of replication and discovery GWAS summary statistics.
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Affiliation(s)
- Dominic Holland
- Center for Multimodal Imaging and Genetics, University of California at San Diego, La Jolla, California, United States of America
- Department of Neurosciences, University of California, San Diego, La Jolla, California, United States of America
| | - Oleksandr Frei
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Rahul Desikan
- Department of Radiology, University of California, San Francisco, San Francisco, California, United States of America
| | - Chun-Chieh Fan
- Center for Multimodal Imaging and Genetics, University of California at San Diego, La Jolla, California, United States of America
- Department of Radiology, University of California, San Diego, La Jolla, California, United States of America
- Department of Cognitive Sciences, University of California at San Diego, La Jolla, California, United States of America
| | - Alexey A. Shadrin
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Olav B. Smeland
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - V. S. Sundar
- Center for Multimodal Imaging and Genetics, University of California at San Diego, La Jolla, California, United States of America
- Department of Radiology, University of California, San Diego, La Jolla, California, United States of America
| | - Paul Thompson
- Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Ole A. Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anders M. Dale
- Center for Multimodal Imaging and Genetics, University of California at San Diego, La Jolla, California, United States of America
- Department of Neurosciences, University of California, San Diego, La Jolla, California, United States of America
- Department of Radiology, University of California, San Diego, La Jolla, California, United States of America
- Department of Psychiatry, University of California, San Diego, La Jolla, California, United States of America
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24
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La Joie R, Visani AV, Baker SL, Brown JA, Bourakova V, Cha J, Chaudhary K, Edwards L, Iaccarino L, Janabi M, Lesman-Segev OH, Miller ZA, Perry DC, O'Neil JP, Pham J, Rojas JC, Rosen HJ, Seeley WW, Tsai RM, Miller BL, Jagust WJ, Rabinovici GD. Prospective longitudinal atrophy in Alzheimer's disease correlates with the intensity and topography of baseline tau-PET. Sci Transl Med 2020; 12:eaau5732. [PMID: 31894103 PMCID: PMC7035952 DOI: 10.1126/scitranslmed.aau5732] [Citation(s) in RCA: 300] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/13/2019] [Accepted: 11/13/2019] [Indexed: 12/16/2022]
Abstract
β-Amyloid plaques and tau-containing neurofibrillary tangles are the two neuropathological hallmarks of Alzheimer's disease (AD) and are thought to play crucial roles in a neurodegenerative cascade leading to dementia. Both lesions can now be visualized in vivo using positron emission tomography (PET) radiotracers, opening new opportunities to study disease mechanisms and improve patients' diagnostic and prognostic evaluation. In a group of 32 patients at early symptomatic AD stages, we tested whether β-amyloid and tau-PET could predict subsequent brain atrophy measured using longitudinal magnetic resonance imaging acquired at the time of PET and 15 months later. Quantitative analyses showed that the global intensity of tau-PET, but not β-amyloid-PET, signal predicted the rate of subsequent atrophy, independent of baseline cortical thickness. Additional investigations demonstrated that the specific distribution of tau-PET signal was a strong indicator of the topography of future atrophy at the single patient level and that the relationship between baseline tau-PET and subsequent atrophy was particularly strong in younger patients. These data support disease models in which tau pathology is a major driver of local neurodegeneration and highlight the relevance of tau-PET as a precision medicine tool to help predict individual patient's progression and design future clinical trials.
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Affiliation(s)
- Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
| | - Adrienne V Visani
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Suzanne L Baker
- Molecular Biophysics and Integrated Bioimaging Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Jesse A Brown
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Viktoriya Bourakova
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jungho Cha
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Kiran Chaudhary
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lauren Edwards
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Leonardo Iaccarino
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Mustafa Janabi
- Molecular Biophysics and Integrated Bioimaging Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Orit H Lesman-Segev
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Zachary A Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - David C Perry
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - James P O'Neil
- Molecular Biophysics and Integrated Bioimaging Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Julie Pham
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Julio C Rojas
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Richard M Tsai
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - William J Jagust
- Molecular Biophysics and Integrated Bioimaging Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Molecular Biophysics and Integrated Bioimaging Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
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Buciuc M, Wennberg AM, Weigand SD, Murray ME, Senjem ML, Spychalla AJ, Boeve BF, Knopman DS, Jack CR, Kantarci K, Parisi JE, Dickson DW, Petersen RC, Whitwell JL, Josephs KA. Effect Modifiers of TDP-43-Associated Hippocampal Atrophy Rates in Patients with Alzheimer's Disease Neuropathological Changes. J Alzheimers Dis 2020; 73:1511-1523. [PMID: 31929165 PMCID: PMC7081101 DOI: 10.3233/jad-191040] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Transactive response DNA-binding protein of 43 kDa (TDP-43) is associated with hippocampal atrophy in Alzheimer's disease (AD), but whether the association is modified by other factors is unknown. OBJECTIVE To evaluate whether the associations between TDP-43 and hippocampal volume and atrophy rate are affected by age, gender, apolipoprotein E (APOE) ɛ4, Lewy bodies (LBs), amyloid-β (Aβ), or Braak neurofibrillary tangle (NFT) stage. METHODS In this longitudinal neuroimaging-clinicopathological study of 468 cases with AD neuropathological changes (Aβ-positive) that had completed antemortem head MRI, we investigated how age, gender, APOEɛ4, presence of LBs, Aβ, TDP-43, and Braak NFT stages are associated with hippocampal volumes and rates of atrophy over time. We included field strength in the models since our cohort included 1.5T and 3T scans. We then determined whether the associations between hippocampal atrophy and TDP-43 are modified by these factors using mixed effects models. RESULTS Older age, female gender, APOEɛ4, higher field strength, higher TDP-43, and Braak NFT stages were associated with smaller hippocampi. Rate of atrophy was greater with higher TDP-43 and Braak NFT stage, but lower in older patients. The association of TDP-43 with greater rate of atrophy was enhanced in APOEɛ4 carriers (p = 0.04). CONCLUSION Neurodegenerative effects of TDP-43 seem to be independent of most factors except perhaps APOE in cases with AD neuropathological changes. TDP-43 and tau appear to behave independently of one another.
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Affiliation(s)
- Marina Buciuc
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | | | | | | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Joseph E. Parisi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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Survival and life-expectancy in a young-onset dementia cohort with six years of follow-up: the NeedYD-study. Int Psychogeriatr 2019; 31:1781-1789. [PMID: 30915930 DOI: 10.1017/s1041610219000152] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of this study was to investigate survival time and life-expectancy in people with young-onset dementia (YOD) and to examine the relationship with age, sex, dementia subtype and comorbidity. DESIGN, SETTING AND PARTICIPANTS Survival was examined in 198 participants in the Needs in Young-onset Dementia study, including participants with Alzheimer's dementia (AD), vascular dementia (VaD) and frontotemporal dementia (FTD). MEASURES The primary outcomes were survival time after symptom onset and after date of diagnosis. Cox proportional hazards models were used to explore the relationship between survival and age, sex, dementia subtype and comorbidity. Additionally, the impact on remaining life expectancy was explored. RESULTS During the six-year follow-up, 77 of the participants died (38.9%), 78 participants survived (39.4%) and 43 were lost to follow-up (21.7%). The mean survival time after symptom onset and diagnosis was 209 months (95% CI 185-233) and 120 months (95% CI 110-130) respectively. Participants with AD had a statistically significant shorter survival compared with VaD participants, both regarding survival after symptom onset (p = 0.047) as well as regarding survival after diagnosis (p = 0.049). Younger age at symptom onset or at diagnosis was associated with longer survival times. The remaining life expectancy, after diagnosis, was reduced with 51% for males and 59% for females compared to the life expectancy of the general population in the same age groups. CONCLUSION/IMPLICATIONS It is important to consider the dementia subtype when persons with YOD and their families are informed about the prognosis of survival. Our study suggests longer survival times compared to other studies on YOD, and survival is prolonged compared to studies on LOD. Younger age at symptom onset or at diagnosis was positively related to survival but diagnosis at younger ages, nevertheless, still diminishes life expectancy dramatically.
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27
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Hildre AS, Solvang SEH, Aarsland D, Midtun Ø, McCann A, Ervik AO, Nygård O, Ueland PM, Nordrehaug JE, Giil LM. Components of the choline oxidation pathway modify the association between the apolipoprotein ε4 gene variant and cognitive decline in patients with dementia. Brain Res 2019; 1726:146519. [PMID: 31654640 DOI: 10.1016/j.brainres.2019.146519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/12/2019] [Accepted: 10/19/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Metabolites involved in one-carbon metabolism (OCM) may predict cognitive prognosis in dementia. The link between OCM, apolipoprotein E (APOE), and DNA methylation creates a biologically plausible mechanism of interaction. AIM To assess OCM metabolites as predictors of 5-year cognitive prognosis in patients with mild dementia, and in subgroups defined by the APOEε4 allele variant. METHODS We followed one-hundred and fifty-two patients with mild dementia (86 with Alzheimer's disease, 66 with Lewy body dementia, including 90 with at least one APOEε4 allele) for 5 years with annual Mini-Mental State Examinations (MMSE). Total homocysteine, methionine, choline, betaine, dimethylglycine, sarcosine, folate, cobalamin and pyridoxal 5'-phoshate were measured in serum at baseline. We used linear mixed models to assess metabolite-MMSE associations, including 3-way interactions between metabolites, time, and APOEε4. False-discovery rate adjusted p-values (Q-values) are reported. RESULTS Metabolite concentrations were not different in patients with dementia according to the presence of APOEε4. Overall, serum concentration of total homocysteine was inversely associated with MMSE performance, while betaine was positively associated with MMSE (Q < 0.05), but neither was associated with MMSE decline. Serum concentrations of betaine, dimethylglycine and sarcosine, however, were associated with slower MMSE decline in patients with APOEε4, but with faster MMSE decline in patients without the allele (all 3-way interactions: Q < 0.05). CONCLUSION Components of the choline oxidation pathway are associated with a better cognitive prognosis in APOEε4 carriers and a worse cognitive prognosis in non-carriers. Further research investigating targeted metabolic interventions according to APOE allele status is warranted.
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Affiliation(s)
| | - Stein-Erik Hafstad Solvang
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Dag Aarsland
- Department of Old Age Psychiatry, King's College University, London, UK
| | | | | | - Arne Olav Ervik
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Ottar Nygård
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | | | - Jan Erik Nordrehaug
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Lasse Melvaer Giil
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway.
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Pavlik VN, Chan W, Darby E. Cohort Effects in Progression Rate on Cognitive and Functional Measures in an Alzheimer's Disease Clinical Cohort. J Alzheimers Dis 2019; 71:659-669. [PMID: 31424408 DOI: 10.3233/jad-190661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Accurate prediction of Alzheimer's disease (AD) cognitive and functional outcomes in clinical research requires consistent underlying rates of change over time. OBJECTIVE To examine cohort effects in AD progression rate over five years of follow-up using a clinical database of probable AD patients. METHODS Baseline characteristics of three cohorts enrolled from 1995-1999, 2000-2004, and 2005-2009 were compared using ANOVA and chi-square tests. Differences in 5-year decline on the Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) and Clinical Dementia Rating Scale Sum of Boxes (CDR-SB), the Lawton and Brody Physical Self-maintenance Scale (PSMS), and Activities of Daily Living Scale (ADL) were assessed using longitudinal mixed effects regression, adjusting for age, sex, education, and other relevant clinical characteristics. RESULTS Cohorts 1 (n = 287), 2 (n = 257), and 3 (n = 374) did not differ on age, race, APOE genotype, or cognitive and functional measures. Educational attainment increased over time (13.4, 14.1, and 14.5 years, respectively, p < 0.001). Anti-dementia drug use at baseline was less common in Cohort 1 (32.2% versus 65.0%, and 66.8%, p < 0.001). The rate of decline in MMSE and CDR-SB did not differ across cohorts. ADAS-Cog scores for Cohort 2 declined more slowly than Cohort 3 (Btime ×cohort2 = -0.91 ± 0.35, p = 0.009), whereas Cohort 1 did not differ from cohort 3 (reference). Cohorts 1 and 2 differed from Cohort 3 in progression rate on the PSMS, but not the IADL. CONCLUSIONS There were no consistent temporal trends in progression rates over time. Longitudinal data over 15-20 years may be confidently pooled for outcomes analysis, but unexplained variability in rate of decline on some measures may occur.
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Affiliation(s)
- Valory N Pavlik
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Wenyaw Chan
- Department of Biostatistics and Data Science, University of Texas Health Sciences Center at Houston, School of Public Health, Houston, TX, USA
| | - Eveleen Darby
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
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Scheltens NME, Tijms BM, Heymans MW, Rabinovici GD, Cohn-Sheehy BI, Miller BL, Kramer JH, Wolfsgruber S, Wagner M, Kornhuber J, Peters O, Scheltens P, van der Flier WM. Prominent Non-Memory Deficits in Alzheimer's Disease Are Associated with Faster Disease Progression. J Alzheimers Dis 2019; 65:1029-1039. [PMID: 30103316 DOI: 10.3233/jad-171088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is a heterogeneous disorder. OBJECTIVE To investigate whether cognitive AD subtypes are associated with different rates of disease progression. METHODS We included 1,066 probable AD patients from the Amsterdam Dementia Cohort (n = 290), Alzheimer's Disease Neuroimaging Initiative (n = 268), Dementia Competence Network (n = 226), and University of California, San Francisco (n = 282) with available follow-up data. Patients were previously clustered into two subtypes based on their neuropsychological test results: one with most prominent memory impairment (n = 663) and one with most prominent non-memory impairment (n = 403). We examined associations between cognitive subtype and disease progression, as measured with repeated Mini-Mental State Examination (MMSE) and Clinical Dementia Rating scale sum of boxes (CDR sob), using linear mixed models. Furthermore, we investigated mortality risk associated with subtypes using Cox proportional hazard analyses. RESULTS Patients were 71±9 years old; 541 (51%) were female. At baseline, pooled non-memory patients had worse MMSE scores (23.1±0.1) and slightly worse CDR sob (4.4±0.1) than memory patients (MMSE 24.0±0.1; p < 0.001; CDR sob 4.1±0.1; p < 0.001). During follow-up, pooled non-memory patients showed steeper annual decline in MMSE (-2.8±0.1) and steeper annual increase in CDR sob (1.8±0.1) than memory patients (MMSE - 1.9±0.1; pinteraction<0.001; CDR sob 1.3±0.1; pinteraction<0.001). Furthermore, the non-memory subtype was associated with an increased risk of mortality compared with the memory subtype at trend level (HR = 1.36, CI = 1.00-1.85, p = 0.05). CONCLUSIONS AD patients with most prominently non-memory impairment show faster disease progression and higher risk of mortality than patients with most prominently memory impairment.
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Affiliation(s)
- Nienke M E Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Betty M Tijms
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, The Netherlands
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Brendan I Cohn-Sheehy
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Steffen Wolfsgruber
- Department of Psychiatry, University of Bonn, Bonn, Germany, and German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Michael Wagner
- Department of Psychiatry, University of Bonn, Bonn, Germany, and German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Johannes Kornhuber
- Department of Psychiatry, Friedrich-Alexander-University Erlangen, Erlangen, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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Abstract
Naturally occurring food-derived active ingredients have received huge attention for their chemopreventive and chemotherapy capabilities in several diseases. Rosmarinic acid (RA) is a caffeic acid ester and a naturally-occurring phenolic compound in a number of plants belonging to the Lamiaceae family, such as Rosmarinus officinalis (rosemary) from which it was formerly isolated. RA intervenes in carcinogenesis through different ways, including in tumor cell proliferation, apoptosis, metastasis, and inflammation. On the other hand, it also exerts powerful antimicrobial, anti-inflammatory, antioxidant and even antidepressant, anti-aging effects. The present review aims to provide an overview on anticancer activities of RA and to deliberate its therapeutic potential against a wide variety of diseases. Given the current evidence, RA may be considered as part of the daily diet in the treatment of several diseases, with pre-determined doses avoiding cytotoxicity.
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Stanley K, Whitfield T, Kuchenbaecker K, Sanders O, Stevens T, Walker Z. Rate of Cognitive Decline in Alzheimer’s Disease Stratified by Age. J Alzheimers Dis 2019; 69:1153-1160. [DOI: 10.3233/jad-181047] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Karen Stanley
- Essex Partnership University Foundation Trust, St Margaret’s Hospital, The Plain, Epping, Essex, UK
- UCL Division of Psychiatry, London, UK
| | - Tim Whitfield
- Essex Partnership University Foundation Trust, St Margaret’s Hospital, The Plain, Epping, Essex, UK
- UCL Division of Psychiatry, London, UK
| | - Karoline Kuchenbaecker
- UCL Division of Psychiatry, London, UK
- UCL Genetics Institute, University College London, London, UK
| | - Oliver Sanders
- Essex Partnership University Foundation Trust, St Margaret’s Hospital, The Plain, Epping, Essex, UK
| | - Tim Stevens
- Essex Partnership University Foundation Trust, St Margaret’s Hospital, The Plain, Epping, Essex, UK
| | - Zuzana Walker
- Essex Partnership University Foundation Trust, St Margaret’s Hospital, The Plain, Epping, Essex, UK
- UCL Division of Psychiatry, London, UK
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32
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Joung KI, Kim S, Cho YH, Cho SI. Association of Anticholinergic Use with Incidence of Alzheimer's Disease: Population-based Cohort Study. Sci Rep 2019; 9:6802. [PMID: 31043628 PMCID: PMC6494800 DOI: 10.1038/s41598-019-43066-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 04/10/2019] [Indexed: 11/09/2022] Open
Abstract
Drugs with strong anticholinergic properties are used under a variety of conditions; however, they can cause various adverse effects including a negative impact on cognitive functions, with older adults being more susceptible to these effects. We explored whether the use of anticholinergic agents (ACs) affects the risk of Alzheimer’s disease (AD) in terms of incidence by using National Health Insurance Service elderly cohort database (2002–2013). As a result, AD risk was higher in subjects with an increased amount of prescriptions for strong ACs over a long period of time (9–12 years) than that in the least-exposed reference group (0–9 dose/year) [hazard ratio (HR) (95% confidence interval (95% CI)) 0.99 (0.95–1.03), 1.19 (1.12–1.26), 1.39 (1.30–1.50); in the 10–49 doses/year, 50–119 doses/year, and ≥120 doses/year groups]. Hazard ratios were particularly high in the young-old subgroup (60–64 years old in 2002) [HR (95% CI) 1.11 (1.04–1.22), 1.43 (1.25–1.65), 1.83 (1.56–2.14); in the 10–49 doses/year, 50–119 doses/year, and ≥120 doses/year groups]. Use of strong ACs dose-dependently increased the risk of AD in terms of incidence when exposure was followed up for 9 years or more, and the association was greater in the young-old subgroup.
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Affiliation(s)
- Kyung-In Joung
- Division of Epidemiology, Department of Public Health Science, Graduate School of Public Health, Seoul National University, 08826, Seoul, Republic of Korea
| | - Sukil Kim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 06591, Seoul, Republic of Korea
| | - Yoon Hee Cho
- Department of Biomedical & Pharmaceutical Sciences, The University of Montana, 59812, Missoula, USA
| | - Sung-Il Cho
- Department of Public Health Science, Graduate School of Public Health and Institute of Health and Environment, Seoul National University, 08826, Seoul, Republic of Korea.
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Dicks E, Vermunt L, van der Flier WM, Visser PJ, Barkhof F, Scheltens P, Tijms BM. Modeling grey matter atrophy as a function of time, aging or cognitive decline show different anatomical patterns in Alzheimer's disease. NEUROIMAGE-CLINICAL 2019; 22:101786. [PMID: 30921610 PMCID: PMC6439228 DOI: 10.1016/j.nicl.2019.101786] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/12/2019] [Accepted: 03/16/2019] [Indexed: 01/27/2023]
Abstract
Background Grey matter (GM) atrophy in Alzheimer's disease (AD) is most commonly modeled as a function of time. However, this approach does not take into account inter-individual differences in initial disease severity or changes due to aging. Here, we modeled GM atrophy within individuals across the AD clinical spectrum as a function of time, aging and MMSE, as a proxy for disease severity, and investigated how these models influence estimates of GM atrophy. Methods We selected 523 individuals from ADNI (100 preclinical AD, 288 prodromal AD, 135 AD dementia) with abnormal baseline amyloid PET/CSF and ≥1 year of MRI follow-up. We calculated total and 90 regional GM volumes for 2281 MRI scans (median [IQR]; 4 [3–5] scans per individual over 2 [1.6–4] years) and used linear mixed models to investigate atrophy as a function of time, aging and decline on MMSE. Analyses included clinical stage as interaction with the predictor and were corrected for baseline age, sex, education, field strength and total intracranial volume. We repeated analyses for a sample of participants with normal amyloid (n = 387) to assess whether associations were specific for amyloid pathology. Results Using time or aging as predictors, amyloid abnormal participants annually declined −1.29 ± 0.08 points and − 0.28 ± 0.03 points respectively on the MMSE and −12.23 ± 0.47 cm3 and −8.87 ± 0.34 respectively in total GM volume (p < .001). For the time and age models atrophy was widespread and preclinical and prodromal AD showed similar atrophy patterns. Comparing prodromal AD to AD dementia, AD dementia showed faster atrophy mostly in temporal lobes as modeled with time, while prodromal AD showed faster atrophy in mostly frontoparietal areas as modeled with age (pFDR < 0.05). Modeling change in GM volume as a function of decline on MMSE, slopes were less steep compared to those based on time and aging (−4.1 ± 0.25 cm3 per MMSE point decline; p < .001) and showed steeper atrophy for prodromal AD compared to preclinical AD in the right inferior temporal gyrus (p < .05) and compared to AD dementia mostly in temporal areas (pFDR < 0.05). Associations with time, aging and MMSE remained when accounting for these effects in the other models, suggesting that all measures explain part of the variance in GM atrophy. Repeating analyses in amyloid normal individuals, effects for time and aging showed similar widespread anatomical patterns, while associations with MMSE were largely reduced. Conclusion Effects of time, aging and MMSE all explained variance in GM atrophy slopes within individuals. Associations with MMSE were weaker than those for time or age, but specific for amyloid pathology. This suggests that at least some of the atrophy observed in time or age models may not be specific to AD. Modeling atrophy as a function of time or aging show similar anatomical patterns. GM atrophy as a function of time or aging seems nonspecific for amyloid pathology. GM atrophy as a function of MMSE shows involvement of different anatomical patterns. Atrophy modeled based on time or age was steeper than modeled based on MMSE. Atrophy patterns based on MMSE were specific for amyloid pathology.
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Affiliation(s)
- Ellen Dicks
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, the Netherlands.
| | - Lisa Vermunt
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, the Netherlands.
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, the Netherlands.
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, the Netherlands; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, the Netherlands.
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, The Netherlands; Institutes of Neurology & Healthcare Engineering, UCL London, London, United Kingdom.
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, the Netherlands.
| | - Betty M Tijms
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, the Netherlands.
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Angelova DM, Brown DR. Altered Processing of β-Amyloid in SH-SY5Y Cells Induced by Model Senescent Microglia. ACS Chem Neurosci 2018; 9:3137-3152. [PMID: 30052418 DOI: 10.1021/acschemneuro.8b00334] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The single greatest risk factor for neurodegenerative diseases is aging. Aging of cells such as microglia in the nervous system has an impact not only on the ability of those cells to function but also on cells they interact with. We have developed a model microglia system that recapitulates the dystrophic/senescent phenotype, and we have combined this with the study of β-amyloid processing. The model is based on the observation that aged microglia have increased iron content. By overloading a human microglial cell line with iron, we were able to change the secretory profile of the microglia. When combining these senescent microglia with SH-SY5Y cells, we noted an increase in extracellular β-amyloid. The increased levels of β-amyloid were due to a decrease in the release of insulin-degrading enzyme by the model senescent microglia. Further analysis revealed that the senescent microglia showed both decreased autophagy and increased ER stress. These studies demonstrate the potential impact of an aging microglial population in terms of β-amyloid produced by neurons, which could play a causal role in diseases like Alzheimer's disease. Our results also further develop the potential utility of an in vitro model of senescent microglia for the study of brain aging and neurodegenerative disease.
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Affiliation(s)
- Dafina M. Angelova
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7AY, U.K
| | - David R. Brown
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7AY, U.K
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Pamphlett R, Bishop DP, Kum Jew S, Doble PA. Age-related accumulation of toxic metals in the human locus ceruleus. PLoS One 2018; 13:e0203627. [PMID: 30231068 PMCID: PMC6145836 DOI: 10.1371/journal.pone.0203627] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/23/2018] [Indexed: 12/28/2022] Open
Abstract
Damage to the locus ceruleus has been implicated in the pathogenesis of a number of neurological conditions. Locus ceruleus neurons accumulate toxic metals such as mercury selectively, however, the presence of toxic metals in locus ceruleus neurons of people of different ages, and with a variety of disorders, is not known. To demonstrate at what age toxic metals are first detectable in the locus ceruleus, and to evaluate whether their presence is more common in certain clinicopathological conditions, we looked for these metals in 228 locus ceruleus samples. Samples were taken at coronial autopsies from individuals with a wide range of ages, pre-existing conditions and causes of death. Paraffin sections of pons containing the locus ceruleus were stained with silver nitrate autometallography, which indicates inorganic mercury, silver and bismuth within cells (termed autometallography-detected toxic metals, or AMG™). No locus ceruleus AMG neurons were seen in 38 individuals aged under 20 years. 47% of the 190 adults (ie, aged 20 years and over) had AMG locus ceruleus neurons. The proportion of adults with locus ceruleus AMG neurons increased during aging, except for a decreased proportion in the 90-plus years age group. No differences were found in the proportions of locus ceruleus AMG neurons between groups with different neurological, psychiatric, or other clinicopathological conditions, or among various causes of death. Elemental analysis with laser ablation-inductively coupled plasma-mass spectrometry was used to cross-validate the metals detected by AMG, by looking for silver, gold, bismuth, cadmium, chromium, iron, mercury, nickel, and lead in the locus ceruleus of ten individuals. This confirmed the presence of mercury in locus ceruleus samples containing AMG neurons, and showed cadmium, silver, lead, iron, and nickel in the locus ceruleus of some individuals. In conclusion, toxic metals stained by AMG (most likely inorganic mercury) appear in locus ceruleus neurons in early adult life. About half of adults in this study had locus ceruleus neurons containing inorganic mercury, and elemental analysis found a range of other toxic metals in the locus ceruleus. Locus ceruleus inorganic mercury increased during aging, except for a decrease in advanced age, but was not found more often in any single clinicopathological condition or cause of death.
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Affiliation(s)
- Roger Pamphlett
- Discipline of Pathology, Sydney Medical School, Brain and Mind Centre, The University of Sydney, New South Wales, Australia
- Department of Neuropathology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - David P. Bishop
- Elemental Bio-imaging Facility, University of Technology, Sydney, New South Wales, Australia
| | - Stephen Kum Jew
- Discipline of Pathology, Sydney Medical School, Brain and Mind Centre, The University of Sydney, New South Wales, Australia
| | - Philip A. Doble
- Elemental Bio-imaging Facility, University of Technology, Sydney, New South Wales, Australia
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Hart B, Cribben I, Fiecas M. A longitudinal model for functional connectivity networks using resting-state fMRI. Neuroimage 2018; 178:687-701. [PMID: 29879474 DOI: 10.1016/j.neuroimage.2018.05.071] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 05/09/2018] [Accepted: 05/30/2018] [Indexed: 11/25/2022] Open
Abstract
Many neuroimaging studies collect functional magnetic resonance imaging (fMRI) data in a longitudinal manner. However, the current fMRI literature lacks a general framework for analyzing functional connectivity (FC) networks in fMRI data obtained from a longitudinal study. In this work, we build a novel longitudinal FC model using a variance components approach. First, for all subjects' visits, we account for the autocorrelation inherent in the fMRI time series data using a non-parametric technique. Second, we use a generalized least squares approach to estimate 1) the within-subject variance component shared across the population, 2) the baseline FC strength, and 3) the FC's longitudinal trend. Our novel method for longitudinal FC networks seeks to account for the within-subject dependence across multiple visits, the variability due to the subjects being sampled from a population, and the autocorrelation present in fMRI time series data, while restricting the number of parameters in order to make the method computationally feasible and stable. We develop a permutation testing procedure to draw valid inference on group differences in the baseline FC network and change in FC over longitudinal time between a set of patients and a comparable set of controls. To examine performance, we run a series of simulations and apply the model to longitudinal fMRI data collected from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Overall, we found no difference in the global FC network between Alzheimer's disease patients and healthy controls, but did find differing local aging patterns in the FC between the left hippocampus and the posterior cingulate cortex.
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Affiliation(s)
- Brian Hart
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, 55455, USA.
| | - Ivor Cribben
- Department of Finance and Statistical Analysis, Alberta School of Business, University of Alberta, Edmonton, AB, T6G 2R6, Canada.
| | - Mark Fiecas
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, 55455, USA.
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Jaafaru MS, Nordin N, Shaari K, Rosli R, Abdull Razis AF. Isothiocyanate from Moringa oleifera seeds mitigates hydrogen peroxide-induced cytotoxicity and preserved morphological features of human neuronal cells. PLoS One 2018; 13:e0196403. [PMID: 29723199 PMCID: PMC5933767 DOI: 10.1371/journal.pone.0196403] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/12/2018] [Indexed: 01/12/2023] Open
Abstract
Reactive oxygen species are well known for induction of oxidative stress conditions through oxidation of vital biomarkers leading to cellular death via apoptosis and other process, thereby causing devastative effects on the host organs. This effect is believed to be linked with pathological alterations seen in several neurodegenerative disease conditions. Many phytochemical compounds proved to have robust antioxidant activities that deterred cells against cytotoxic stress environment, thus protect apoptotic cell death. In view of that we studied the potential of glucomoringin-isothiocyanate (GMG-ITC) or moringin to mitigate the process that lead to neurodegeneration in various ways. Neuroprotective effect of GMG-ITC was performed on retinoic acid (RA) induced differentiated neuroblastoma cells (SHSY5Y) via cell viability assay, flow cytometry analysis and fluorescence microscopy by means of acridine orange and propidium iodide double staining, to evaluate the anti-apoptotic activity and morphology conservation ability of the compound. Additionally, neurite surface integrity and ultrastructural analysis were carried out by means of scanning and transmission electron microscopy to assess the orientation of surface and internal features of the treated neuronal cells. GMG-ITC pre-treated neuron cells showed significant resistance to H2O2-induced apoptotic cell death, revealing high level of protection by the compound. Increase of intracellular oxidative stress induced by H2O2 was mitigated by GMG-ITC. Thus, pre-treatment with the compound conferred significant protection to cytoskeleton and cytoplasmic inclusion coupled with conservation of surface morphological features and general integrity of neuronal cells. Therefore, the collective findings in the presence study indicated the potentials of GMG-ITC to protect the integrity of neuron cells against induced oxidative-stress related cytotoxic processes, the hallmark of neurodegenerative diseases.
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Affiliation(s)
- Mohammed Sani Jaafaru
- UPM-MAKNA Cancer Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia
- Department of Biochemistry, Kaduna State University, Main Campus, Kaduna, Nigeria
| | - Norshariza Nordin
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia
| | - Khozirah Shaari
- Laboratory of Natural Product, Institute of Bioscience, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia
- Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia
| | - Rozita Rosli
- UPM-MAKNA Cancer Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia
| | - Ahmad Faizal Abdull Razis
- Laboratory of Molecular Biomedicine, Institute of Bioscience, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia
- Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia
- Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia
- * E-mail:
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Lawrence E, Vegvari C, Ower A, Hadjichrysanthou C, De Wolf F, Anderson RM. A Systematic Review of Longitudinal Studies Which Measure Alzheimer's Disease Biomarkers. J Alzheimers Dis 2018; 59:1359-1379. [PMID: 28759968 PMCID: PMC5611893 DOI: 10.3233/jad-170261] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Alzheimer’s disease (AD) is a progressive and fatal neurodegenerative disease, with no effective treatment or cure. A gold standard therapy would be treatment to slow or halt disease progression; however, knowledge of causation in the early stages of AD is very limited. In order to determine effective endpoints for possible therapies, a number of quantitative surrogate markers of disease progression have been suggested, including biochemical and imaging biomarkers. The dynamics of these various surrogate markers over time, particularly in relation to disease development, are, however, not well characterized. We reviewed the literature for studies that measured cerebrospinal fluid or plasma amyloid-β and tau, or took magnetic resonance image or fluorodeoxyglucose/Pittsburgh compound B-positron electron tomography scans, in longitudinal cohort studies. We summarized the properties of the major cohort studies in various countries, commonly used diagnosis methods and study designs. We have concluded that additional studies with repeat measures over time in a representative population cohort are needed to address the gap in knowledge of AD progression. Based on our analysis, we suggest directions in which research could move in order to advance our understanding of this complex disease, including repeat biomarker measurements, standardization and increased sample sizes.
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Affiliation(s)
- Emma Lawrence
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Carolin Vegvari
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Alison Ower
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | | | - Frank De Wolf
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.,Janssen Prevention Center, Leiden, The Netherlands
| | - Roy M Anderson
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
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Gerritsen AA, Bakker C, Verhey FR, Bor H, Pijnenburg YA, de Vugt ME, Koopmans RT. The Progression of Dementia and Cognitive Decline in a Dutch 2-Year Cohort Study of People with Young-Onset Dementia. J Alzheimers Dis 2018; 63:343-351. [DOI: 10.3233/jad-170859] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Adrie A.J. Gerritsen
- De Wever, Centre for Elderly Care, Tilburg, The Netherlands
- Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Christian Bakker
- Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, Nijmegen, The Netherlands
- Florence, Mariahoeve, Centre for Specialized Care in Young-onset Dementia, Den Haag, The Netherlands
- Radboud Alzheimer Centre, Radboud University, Medical Centre, Nijmegen, The Netherlands
| | - Frans R.J. Verhey
- School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Hans Bor
- Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Yolande A.L. Pijnenburg
- Department of Neurology and Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands
| | - Marjolein E. de Vugt
- School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Raymond T.C.M. Koopmans
- Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, Nijmegen, The Netherlands
- Radboud Alzheimer Centre, Radboud University, Medical Centre, Nijmegen, The Netherlands
- Joachim en Anna, Centre for Specialized Geriatric Care, Nijmegen, The Netherlands
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Fiford CM, Ridgway GR, Cash DM, Modat M, Nicholas J, Manning EN, Malone IB, Biessels GJ, Ourselin S, Carmichael OT, Cardoso MJ, Barnes J. Patterns of progressive atrophy vary with age in Alzheimer's disease patients. Neurobiol Aging 2018; 63:22-32. [PMID: 29220823 PMCID: PMC5805840 DOI: 10.1016/j.neurobiolaging.2017.11.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 10/14/2017] [Accepted: 11/06/2017] [Indexed: 01/18/2023]
Abstract
Age is not only the greatest risk factor for Alzheimer's disease (AD) but also a key modifier of disease presentation and progression. Here, we investigate how longitudinal atrophy patterns vary with age in mild cognitive impairment (MCI) and AD. Data comprised serial longitudinal 1.5-T magnetic resonance imaging scans from 153 AD, 339 MCI, and 191 control subjects. Voxel-wise maps of longitudinal volume change were obtained and aligned across subjects. Local volume change was then modeled in terms of diagnostic group and an interaction between group and age, adjusted for total intracranial volume, white-matter hyperintensity volume, and apolipoprotein E genotype. Results were significant at p < 0.05 with family-wise error correction for multiple comparisons. An age-by-group interaction revealed that younger AD patients had significantly faster atrophy rates in the bilateral precuneus, parietal, and superior temporal lobes. These results suggest younger AD patients have predominantly posterior progressive atrophy, unexplained by white-matter hyperintensity, apolipoprotein E, or total intracranial volume. Clinical trials may benefit from adapting outcome measures for patient groups with lower average ages, to capture progressive atrophy in posterior cortices.
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Affiliation(s)
- Cassidy M Fiford
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.
| | - Gerard R Ridgway
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Wellcome Trust Centre for Neuroimaging, 12 Queen Square, London, UK
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK; Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Marc Modat
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK; Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | | | - Emily N Manning
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Ian B Malone
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sebastien Ourselin
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK; Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | | | - M Jorge Cardoso
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK; Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Josephine Barnes
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
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Wesley D. Regular Expressions: Mixed Effects Models. J Insur Med 2017; 47:23-30. [PMID: 28836910 DOI: 10.17849/insm-47-01-23-30.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Canneti B, Mosqueira AJ, Carreras T, Gago-Veiga AB, Onsurbe C, Ruiz M, Vivancos J. Differences in performance in CAMCOG-R domains between old and oldest old patients with Alzheimer's disease. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2017; 25:588-597. [PMID: 28705033 DOI: 10.1080/13825585.2017.1353679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The purpose of this study is to evaluate the neuropsychological performance in a ≥90-year-old population with Alzheimer disease (AD) in comparison with younger elderly patients. We retrospectively studied all patients with AD attended in a specialized clinic between 1999 and 2011. Age, sex, educational level, and sensory loss data were collected. Neuropsychological evaluation included Mini-Mental State Examination and Global Deterioration Scale. We used the eight Cambridge Cognitive Assessment (CAMCOG-R) domains to evaluate and compare the neuropsychological performance in the younger than 90 years old (<90) and older than 90 years old (≥90) groups. We selected 2931 patients, 2897 <90 (98.83%) and 34 ≥90 years old (1.17%). The ≥90 group had significant lower punctuations in memory, praxis, and abstract thinking CAMOCG-R domains with 1.49, 0.75, and 0.58 less points, respectively, (p < 0.05). Neuropsychological characteristics of cognitive decline seem to be different in ≥90 compared to <90 years old patients. According to age, the biggest differences in the CAMCOG-R performance are in the memory, praxis, and abstract thinking domains.
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Affiliation(s)
- B Canneti
- a Neurology Department , Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa , Madrid , Spain
| | - A J Mosqueira
- a Neurology Department , Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa , Madrid , Spain
| | - T Carreras
- a Neurology Department , Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa , Madrid , Spain
| | - A B Gago-Veiga
- a Neurology Department , Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa , Madrid , Spain
| | - C Onsurbe
- a Neurology Department , Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa , Madrid , Spain
| | - M Ruiz
- a Neurology Department , Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa , Madrid , Spain
| | - J Vivancos
- a Neurology Department , Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa , Madrid , Spain
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Ritchie C, Smailagic N, Noel‐Storr AH, Ukoumunne O, Ladds EC, Martin S. CSF tau and the CSF tau/ABeta ratio for the diagnosis of Alzheimer's disease dementia and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev 2017; 3:CD010803. [PMID: 28328043 PMCID: PMC6464349 DOI: 10.1002/14651858.cd010803.pub2] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Research suggests that measurable change in cerebrospinal fluid (CSF) biomarkers occurs years in advance of the onset of clinical symptoms (Beckett 2010). In this review, we aimed to assess the ability of CSF tau biomarkers (t-tau and p-tau) and the CSF tau (t-tau or p-tau)/ABeta ratio to enable the detection of Alzheimer's disease pathology in patients with mild cognitive impairment (MCI). These biomarkers have been proposed as important in new criteria for Alzheimer's disease dementia that incorporate biomarker abnormalities. OBJECTIVES To determine the diagnostic accuracy of 1) CSF t-tau, 2) CSF p-tau, 3) the CSF t-tau/ABeta ratio and 4) the CSF p-tau/ABeta ratio index tests for detecting people with MCI at baseline who would clinically convert to Alzheimer's disease dementia or other forms of dementia at follow-up. SEARCH METHODS The most recent search for this review was performed in January 2013. We searched MEDLINE (OvidSP), Embase (OvidSP), BIOSIS Previews (Thomson Reuters Web of Science), Web of Science Core Collection, including Conference Proceedings Citation Index (Thomson Reuters Web of Science), PsycINFO (OvidSP), and LILACS (BIREME). We searched specialized sources of diagnostic test accuracy studies and reviews. We checked reference lists of relevant studies and reviews for additional studies. We contacted researchers for possible relevant but unpublished data. We did not apply any language or data restriction to the electronic searches. We did not use any methodological filters as a method to restrict the search overall. SELECTION CRITERIA We selected those studies that had prospectively well-defined cohorts with any accepted definition of MCI and with CSF t-tau or p-tau and CSF tau (t-tau or p-tau)/ABeta ratio values, documented at or around the time the MCI diagnosis was made. We also included studies which looked at data from those cohorts retrospectively, and which contained sufficient data to construct two by two tables expressing those biomarker results by disease status. Moreover, studies were only selected if they applied a reference standard for Alzheimer's disease dementia diagnosis, for example, the NINCDS-ADRDA or Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. DATA COLLECTION AND ANALYSIS We screened all titles generated by the electronic database searches. Two review authors independently assessed the abstracts of all potentially relevant studies, and the full papers for eligibility. Two independent assessors performed data extraction and quality assessment. Where data allowed, we derived estimates of sensitivity at fixed values of specificity from the model we fitted to produce the summary receiver operating characteristic (ROC) curve. MAIN RESULTS In total, 1282 participants with MCI at baseline were identified in the 15 included studies of which 1172 had analysable data; 430 participants converted to Alzheimer's disease dementia and 130 participants to other forms of dementia. Follow-up ranged from less than one year to over four years for some participants, but in the majority of studies was in the range one to three years. Conversion to Alzheimer's disease dementia The accuracy of the CSF t-tau was evaluated in seven studies (291 cases and 418 non-cases).The sensitivity values ranged from 51% to 90% while the specificity values ranged from 48% to 88%. At the median specificity of 72%, the estimated sensitivity was 75% (95% CI 67 to 85), the positive likelihood ratio was 2.72 (95% CI 2.43 to 3.04), and the negative likelihood ratio was 0.32 (95% CI 0.22 to 0.47).Six studies (164 cases and 328 non-cases) evaluated the accuracy of the CSF p-tau. The sensitivities were between 40% and 100% while the specificities were between 22% and 86%. At the median specificity of 47.5%, the estimated sensitivity was 81% (95% CI: 64 to 91), the positive likelihood ratio was 1.55 (CI 1.31 to 1.84), and the negative likelihood ratio was 0.39 (CI: 0.19 to 0.82).Five studies (140 cases and 293 non-cases) evaluated the accuracy of the CSF p-tau/ABeta ratio. The sensitivities were between 80% and 96% while the specificities were between 33% and 95%. We did not conduct a meta-analysis because the studies were few and small. Only one study reported the accuracy of CSF t-tau/ABeta ratio.Our findings are based on studies with poor reporting. A significant number of studies had unclear risk of bias for the reference standard, participant selection and flow and timing domains. According to the assessment of index test domain, eight of 15 studies were of poor methodological quality.The accuracy of these CSF biomarkers for 'other dementias' had not been investigated in the included primary studies. Investigation of heterogeneity The main sources of heterogeneity were thought likely to be reference standards used for the target disorders, sources of recruitment, participant sampling, index test methodology and aspects of study quality (particularly, inadequate blinding).We were not able to formally assess the effect of each potential source of heterogeneity as planned, due to the small number of studies available to be included. AUTHORS' CONCLUSIONS The insufficiency and heterogeneity of research to date primarily leads to a state of uncertainty regarding the value of CSF testing of t-tau, p-tau or p-tau/ABeta ratio for the diagnosis of Alzheimer's disease in current clinical practice. Particular attention should be paid to the risk of misdiagnosis and overdiagnosis of dementia (and therefore over-treatment) in clinical practice. These tests, like other biomarker tests which have been subject to Cochrane DTA reviews, appear to have better sensitivity than specificity and therefore might have greater utility in ruling out Alzheimer's disease as the aetiology to the individual's evident cognitive impairment, as opposed to ruling it in. The heterogeneity observed in the few studies awaiting classification suggests our initial summary will remain valid. However, these tests may have limited clinical value until uncertainties have been addressed. Future studies with more uniformed approaches to thresholds, analysis and study conduct may provide a more homogenous estimate than the one that has been available from the included studies we have identified.
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Affiliation(s)
- Craig Ritchie
- University of EdinburghCentre for Clinical Brain SciencesEdinburghUK
| | - Nadja Smailagic
- University of CambridgeInstitute of Public HealthForvie SiteRobinson WayCambridgeUKCB2 0SR
| | - Anna H Noel‐Storr
- University of OxfordRadcliffe Department of MedicineRoom 4401c (4th Floor)John Radcliffe Hospital, HeadingtonOxfordUKOX3 9DU
| | - Obioha Ukoumunne
- University of Exeter Medical School, University of ExeterNIHR CLAHRC South West Peninsula (PenCLAHRC)Veysey BuildingSalmon Pool LaneExeterDevonUKEX2 4SG
| | - Emma C Ladds
- North Bristol NHS TrustSouthmead hospitalBristolUK
| | - Steven Martin
- University of CambridgeInstitute of Public HealthForvie SiteRobinson WayCambridgeUKCB2 0SR
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Cespedes MI, Fripp J, McGree JM, Drovandi CC, Mengersen K, Doecke JD. Comparisons of neurodegeneration over time between healthy ageing and Alzheimer's disease cohorts via Bayesian inference. BMJ Open 2017; 7:e012174. [PMID: 28174220 PMCID: PMC5306526 DOI: 10.1136/bmjopen-2016-012174] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES In recent years, large-scale longitudinal neuroimaging studies have improved our understanding of healthy ageing and pathologies including Alzheimer's disease (AD). A particular focus of these studies is group differences and identification of participants at risk of deteriorating to a worse diagnosis. For this, statistical analysis using linear mixed-effects (LME) models are used to account for correlated observations from individuals measured over time. A Bayesian framework for LME models in AD is introduced in this paper to provide additional insight often not found in current LME volumetric analyses. SETTING AND PARTICIPANTS Longitudinal neuroimaging case study of ageing was analysed in this research on 260 participants diagnosed as either healthy controls (HC), mild cognitive impaired (MCI) or AD. Bayesian LME models for the ventricle and hippocampus regions were used to: (1) estimate how the volumes of these regions change over time by diagnosis, (2) identify high-risk non-AD individuals with AD like degeneration and (3) determine probabilistic trajectories of diagnosis groups over age. RESULTS We observed (1) large differences in the average rate of change of volume for the ventricle and hippocampus regions between diagnosis groups, (2) high-risk individuals who had progressed from HC to MCI and displayed similar rates of deterioration as AD counterparts, and (3) critical time points which indicate where deterioration of regions begins to diverge between the diagnosis groups. CONCLUSIONS To the best of our knowledge, this is the first application of Bayesian LME models to neuroimaging data which provides inference on a population and individual level in the AD field. The application of a Bayesian LME framework allows for additional information to be extracted from longitudinal studies. This provides health professionals with valuable information of neurodegeneration stages, and a potential to provide a better understanding of disease pathology.
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Affiliation(s)
- Marcela I Cespedes
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jurgen Fripp
- CSIRO Digital Productivity and Services, Australia E-Health Research Centre, Herston, Queensland, Australia
| | - James M McGree
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Christopher C Drovandi
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kerrie Mengersen
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - James D Doecke
- CSIRO Digital Productivity and Services, Australia E-Health Research Centre, Herston, Queensland, Australia
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Song Y, Wu G, Bahrami K, Sun Q, Shen D. Progressive multi-atlas label fusion by dictionary evolution. Med Image Anal 2017; 36:162-171. [PMID: 27914302 PMCID: PMC5239730 DOI: 10.1016/j.media.2016.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 10/08/2016] [Accepted: 11/18/2016] [Indexed: 10/20/2022]
Abstract
Accurate segmentation of anatomical structures in medical images is important in recent imaging based studies. In the past years, multi-atlas patch-based label fusion methods have achieved a great success in medical image segmentation. In these methods, the appearance of each input image patch is first represented by an atlas patch dictionary (in the image domain), and then the latent label of the input image patch is predicted by applying the estimated representation coefficients to the corresponding anatomical labels of the atlas patches in the atlas label dictionary (in the label domain). However, due to the generally large gap between the patch appearance in the image domain and the patch structure in the label domain, the estimated (patch) representation coefficients from the image domain may not be optimal for the final label fusion, thus reducing the labeling accuracy. To address this issue, we propose a novel label fusion framework to seek for the suitable label fusion weights by progressively constructing a dynamic dictionary in a layer-by-layer manner, where the intermediate dictionaries act as a sequence of guidance to steer the transition of (patch) representation coefficients from the image domain to the label domain. Our proposed multi-layer label fusion framework is flexible enough to be applied to the existing labeling methods for improving their label fusion performance, i.e., by extending their single-layer static dictionary to the multi-layer dynamic dictionary. The experimental results show that our proposed progressive label fusion method achieves more accurate hippocampal segmentation results for the ADNI dataset, compared to the counterpart methods using only the single-layer static dictionary.
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Affiliation(s)
- Yantao Song
- School of Computer Science & Technology, Nanjing University of Science and Technology, Nanjing, Jiangsu 210094, China; Department of Radiology and BRIC, University of North Carolina at Chapel Hill, NC 27599, USA.
| | - Guorong Wu
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, NC 27599, USA
| | - Khosro Bahrami
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, NC 27599, USA
| | - Quansen Sun
- School of Computer Science & Technology, Nanjing University of Science and Technology, Nanjing, Jiangsu 210094, China
| | - Dinggang Shen
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, NC 27599, USA; Department of Brain and Cognitive Engineering, Korea University, Seoul, 02841, Republic of Korea.
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Cognitive interventions in Alzheimer's and Parkinson's diseases: emerging mechanisms and role of imaging. Curr Opin Neurol 2016; 29:405-11. [PMID: 27213773 PMCID: PMC4939805 DOI: 10.1097/wco.0000000000000346] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Purpose of review There has been recent debate about the lack of compelling scientific evidence on the efficacy of cognitive interventions. The goal of this study is to review the current state of cognitive interventions in Alzheimer's disease and Parkinson's disease, present emerging mechanisms, and discuss the role of imaging in designing effective intervention strategies. Recent findings Cognitive interventions appear to be promising in Alzheimer's disease and Parkinson's disease. Although feasibility has been shown in mild cognitive impairment, early Alzheimer's disease, and mild to moderate Parkinson's disease, studies to investigate long-term efficacy and mechanisms underlying these interventions are still needed. Summary There is a need to conduct scientifically rigorous studies to validate the efficacy of cognitive intervention trials. Future studies will greatly benefit from including longitudinal imaging in their study design. Imaging can be used to demonstrate the efficacy and mechanisms by measuring brain changes over the intervention period. Imaging can also be used to determine biological and disease-related factors that may influence the treatment response, that is, the effect modifiers. Consideration of effect modifiers will allow us to measure the treatment response in biomarkers and cognition with greater sensitivity and also aid in designing trials that will lead to better patient outcomes.
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De Vita E, Ridgway GR, White MJ, Porter MC, Caine D, Rudge P, Collinge J, Yousry TA, Jager HR, Mead S, Thornton JS, Hyare H. Neuroanatomical correlates of prion disease progression - a 3T longitudinal voxel-based morphometry study. Neuroimage Clin 2016; 13:89-96. [PMID: 27942451 PMCID: PMC5133666 DOI: 10.1016/j.nicl.2016.10.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/19/2016] [Accepted: 10/28/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE MRI has become an essential tool for prion disease diagnosis. However there exist only a few serial MRI studies of prion patients, and these mostly used whole brain summary measures or region of interest based approaches. We present here the first longitudinal voxel-based morphometry (VBM) study in prion disease. The aim of this study was to systematically characterise progressive atrophy in patients with prion disease and identify whether atrophy in specific brain structures correlates with clinical assessment. METHODS Twenty-four prion disease patients with early stage disease (3 sporadic, 2 iatrogenic, 1 variant and 18 inherited CJD) and 25 controls were examined at 3T with a T1-weighted 3D MPRAGE sequence at multiple time-points (2-6 examinations per subject, interval range 0.1-3.2 years). Longitudinal VBM provided intra-subject and inter-subject image alignment, allowing voxel-wise comparison of progressive structural change. Clinical disease progression was assessed using the MRC Prion Disease Rating Scale. Firstly, in patients, we determined the brain regions where grey and white matter volume change between baseline and final examination correlated with the corresponding change in MRC Scale score. Secondly, in the 21/24 patients with interscan interval longer than 3 months, we identified regions where annualised rates of regional volume change in patients were different from rates in age-matched controls. Given the heterogeneity of the cohort, the regions identified reflect the common features of the different prion sub-types studied. RESULTS In the patients there were multiple regions where volume loss significantly correlated with decreased MRC scale, partially overlapping with anatomical regions where yearly rates of volume loss were significantly greater than controls. The key anatomical areas involved included: the basal ganglia and thalamus, pons and medulla, the hippocampal formation and the superior parietal lobules. There were no areas demonstrating volume loss significantly higher in controls than patients or negative correlation between volume and MRC Scale score. CONCLUSIONS Using 3T MRI and longitudinal VBM we have identified key anatomical regions of progressive volume loss which correlate with an established clinical disease severity index and are relevant to clinical deterioration. Localisation of the regions of progressive brain atrophy correlating most strongly with clinical decline may help to provide more targeted imaging endpoints for future clinical trials.
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Affiliation(s)
- Enrico De Vita
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH Hospitals NHS Foundation Trust, Box 65, Queen Square, London WC1N 3BG, United Kingdom
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom
| | - Gerard R Ridgway
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, 12 Queen Square, London WC1N 3BG, United Kingdom
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom
| | - Mark J White
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH Hospitals NHS Foundation Trust, Box 65, Queen Square, London WC1N 3BG, United Kingdom
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom
| | - Marie-Claire Porter
- National Prion Clinic, National Hospital for Neurology and Neurosurgery, UCLH Hospitals NHS Foundation Trust, Box 98, Queen Square, London WC1N 3BG, United Kingdom
- MRC Prion Unit, Department of Neurodegenerative Diseases, UCL Institute of Neurology, Queen Square House, Queen Square, London WC1N 3BG, United Kingdom
| | - Diana Caine
- National Prion Clinic, National Hospital for Neurology and Neurosurgery, UCLH Hospitals NHS Foundation Trust, Box 98, Queen Square, London WC1N 3BG, United Kingdom
- MRC Prion Unit, Department of Neurodegenerative Diseases, UCL Institute of Neurology, Queen Square House, Queen Square, London WC1N 3BG, United Kingdom
| | - Peter Rudge
- National Prion Clinic, National Hospital for Neurology and Neurosurgery, UCLH Hospitals NHS Foundation Trust, Box 98, Queen Square, London WC1N 3BG, United Kingdom
- MRC Prion Unit, Department of Neurodegenerative Diseases, UCL Institute of Neurology, Queen Square House, Queen Square, London WC1N 3BG, United Kingdom
| | - John Collinge
- National Prion Clinic, National Hospital for Neurology and Neurosurgery, UCLH Hospitals NHS Foundation Trust, Box 98, Queen Square, London WC1N 3BG, United Kingdom
- MRC Prion Unit, Department of Neurodegenerative Diseases, UCL Institute of Neurology, Queen Square House, Queen Square, London WC1N 3BG, United Kingdom
| | - Tarek A Yousry
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH Hospitals NHS Foundation Trust, Box 65, Queen Square, London WC1N 3BG, United Kingdom
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom
| | - Hans Rolf Jager
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH Hospitals NHS Foundation Trust, Box 65, Queen Square, London WC1N 3BG, United Kingdom
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom
| | - Simon Mead
- National Prion Clinic, National Hospital for Neurology and Neurosurgery, UCLH Hospitals NHS Foundation Trust, Box 98, Queen Square, London WC1N 3BG, United Kingdom
- MRC Prion Unit, Department of Neurodegenerative Diseases, UCL Institute of Neurology, Queen Square House, Queen Square, London WC1N 3BG, United Kingdom
| | - John S Thornton
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCLH Hospitals NHS Foundation Trust, Box 65, Queen Square, London WC1N 3BG, United Kingdom
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom
| | - Harpreet Hyare
- National Prion Clinic, National Hospital for Neurology and Neurosurgery, UCLH Hospitals NHS Foundation Trust, Box 98, Queen Square, London WC1N 3BG, United Kingdom
- MRC Prion Unit, Department of Neurodegenerative Diseases, UCL Institute of Neurology, Queen Square House, Queen Square, London WC1N 3BG, United Kingdom
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Abstract
Two new sets of criteria for Alzheimer’s disease (AD) are now in play, including one set released in 2014, and a proposal for a “new lexicon” for how to describe the disease spectrum. A 2012 Canadian consensus conference said that to then, none of the new criteria or terminology would change primary care practice; that is still likely to be so. For dementia consultants, however, the new criteria pose challenges and offer opportunities. In general, the new criteria see an expanded role for bio-markers. Even so, the evidence base for this remains incomplete. Our understanding of the neuropathological criteria for dementia changed as the evidence base included more community cases. This is likely to inform the experience with biomarkers. At present, each of the criteria specifies an exclusive research role. Still, wider uptake is likely, especially in the United States. Geriatricians should be aware of the fundamental change in the terminology now being employed: AD diagnosis no longer obliges a diagnosis of dementia. Until more data emerge—something to which geriatricians can contribute—there is reason to be cautious in the adoption of the new criteria, as they are likely to be least applicable to older adults.
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Affiliation(s)
- Pierre Molin
- Department of Medicine, Divisions of Geriatric Medicine and of Neurology, Dalhousie University, Halifax, NS;; Département de médecine, Division de gériatrie, Université Laval, Québec, QC, Canada
| | - Kenneth Rockwood
- Department of Medicine, Divisions of Geriatric Medicine and of Neurology, Dalhousie University, Halifax, NS
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Abstract
Deux nouvelles séries de critères pour le diagnostic de la maladie d’Alzheimer sont maintenant en vigueur, incluant une série publiée en 2014. Un « nouveau lexique » conceptualisant la maladie a également été proposé. En 2012, la Conférence consensuelle canadienne affirmait que, pour l’instant, ni les nouveaux critères ni la nouvelle terminologie ne modifiaient la pratique en première ligne. Néanmoins, pour les consultants spécialisés en démence, l’avènement de ces critères ouvre la porte à de nombreux défis et occasions. En général, les nouveaux critères accordent une place grandissante aux biomarqueurs. Toutefois, les évidences qui sous-tendent leur utilisation demeurent incomplètes. L’étude de sujets provenant de la communauté ayant raffiné notre compréhension des critères neuropathologiques des démences, il est probable que notre expérience avec les biomarqueurs en bénéficierait également. Pour l’instant, ces critères sont réservés à la recherche. Cependant, leur adoption à plus large échelle est pressentie, particulièrement aux États-Unis. Les gériatres canadiens doivent être conscients de la terminologie maintenant utilisée et du changement fondamental qui en découle : un diagnostic de maladie d’Alzheimer ne requiert plus un diagnostic de démence. Dans l’attente de nouvelles données – auxquelles les gériatres peuvent contribuer – il y a lieu de faire preuve de prudence dans l’adoption des nouveaux critères, car ils sont susceptibles de moins bien s’appliquer aux personnes âgées.
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Affiliation(s)
- Pierre Molin
- Department of Medicine, Divisions of Geriatric Medicine and of Neurology, Dalhousie University, Halifax, NS;; Département de médecine, Division de gériatrie, Université Laval, Québec, QC
| | - Kenneth Rockwood
- Department of Medicine, Divisions of Geriatric Medicine and of Neurology, Dalhousie University, Halifax, NS
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Knight MJ, McCann B, Kauppinen RA, Coulthard EJ. Magnetic Resonance Imaging to Detect Early Molecular and Cellular Changes in Alzheimer's Disease. Front Aging Neurosci 2016; 8:139. [PMID: 27378911 PMCID: PMC4909770 DOI: 10.3389/fnagi.2016.00139] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 05/27/2016] [Indexed: 11/13/2022] Open
Abstract
Recent pharmaceutical trials have demonstrated that slowing or reversing pathology in Alzheimer's disease is likely to be possible only in the earliest stages of disease, perhaps even before significant symptoms develop. Pathology in Alzheimer's disease accumulates for well over a decade before symptoms are detected giving a large potential window of opportunity for intervention. It is therefore important that imaging techniques detect subtle changes in brain tissue before significant macroscopic brain atrophy. Current diagnostic techniques often do not permit early diagnosis or are too expensive for routine clinical use. Magnetic Resonance Imaging (MRI) is the most versatile, affordable, and powerful imaging modality currently available, being able to deliver detailed analyses of anatomy, tissue volumes, and tissue state. In this mini-review, we consider how MRI might detect patients at risk of future dementia in the early stages of pathological change when symptoms are mild. We consider the contributions made by the various modalities of MRI (structural, diffusion, perfusion, relaxometry) in identifying not just atrophy (a late-stage AD symptom) but more subtle changes reflective of early dementia pathology. The sensitivity of MRI not just to gross anatomy but to the underlying "health" at the cellular (and even molecular) scales, makes it very well suited to this task.
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Affiliation(s)
- Michael J Knight
- School of Experimental Psychology, University of Bristol Bristol, UK
| | - Bryony McCann
- School of Experimental Psychology, University of Bristol Bristol, UK
| | - Risto A Kauppinen
- School of Experimental Psychology, University of BristolBristol, UK; Clinical Research and Imaging Centre, University of BristolBristol, UK
| | - Elizabeth J Coulthard
- Research into Memory the Brain and Dementia Group, Institute of Clinical Neuroscience, University of BristolBristol, UK; North Bristol NHS TrustBristol, UK
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