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Zang W, Zou Q, Xiao N, Fang M, Wang S, Chen J. A methodological and reporting quality assessment of systematic reviews/meta-analyses on exercise interventions for cognitive function in older adults with mild cognitive impairment. PeerJ 2024; 12:e17773. [PMID: 39071117 PMCID: PMC11283171 DOI: 10.7717/peerj.17773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 06/28/2024] [Indexed: 07/30/2024] Open
Abstract
Objective To assess the methodological quality of meta-analytic literature on exercise interventions for cognitive function in patients with mild cognitive impairment (MCI) and the certainty of evidence for its outcome indicators, and to provide clinicians and researchers with more reliable data for making decisions. Methods Meta-analytic literature related to the effect of exercise intervention on cognitive function in patients with mild cognitive impairment was searched through PubMed, Cochrane Library, Embase, Scopus, Physiotherapy Evidence Database and Web of Science, all with a search period frame of each database until June 1, 2024. The AMSTAR2 scale was used to evaluate the methodological quality of the included studies. Results Seventeen meta-analyses were included. The AMSTAR2 scale evaluation results showed that there was one medium-quality studies (5.55%), seven low-quality studies (38.88%), and 10 very low-quality studies (55.55%). Methodological deficiencies included failure to prepare a plan and provide a registration number, literature screening, data extraction, reasons for exclusion not described in detail, poor implementation process for systematic evaluation, and failure to describe the source of funding for the included studies or relevant conflicts of interest. Conclusion The overall methodological quality of the meta-analytic literature is low, and the certainty of evidence is low. We encourage the conduction of high-quality randomized trials to generate stronger evidence. Subsequent systematic reviews can then synthesize this evidence to inform future research and clinical guidelines.
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Affiliation(s)
| | - Qinghai Zou
- Physical Education Department, Harbin Engineering University, Harbin, China
| | - Ningkun Xiao
- Department of Psychology, Ural Federal University, Yekaterinburg, Russia
| | - Mingqing Fang
- Xiangya Hospital, Central South University, Changsha, China
| | - Su Wang
- Harbin Sport University, Harbin, China
| | - Jingjing Chen
- School of Basic Medicine, Changchun University of Chinese Medicine, Jilin, China
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2
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Valles-Salgado M, Gil-Moreno MJ, Curiel Cid RE, Delgado-Álvarez A, Ortega-Madueño I, Delgado-Alonso C, Palacios-Sarmiento M, López-Carbonero JI, Cárdenas MC, Matías-Guiu J, Díez-Cirarda M, Loewenstein DA, Matias-Guiu JA. Detection of cerebrospinal fluid biomarkers changes of Alzheimer's disease using a cognitive stress test in persons with subjective cognitive decline and mild cognitive impairment. Front Psychol 2024; 15:1373541. [PMID: 38988382 PMCID: PMC11233766 DOI: 10.3389/fpsyg.2024.1373541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 06/14/2024] [Indexed: 07/12/2024] Open
Abstract
Introduction Timely and accurate diagnosis of the earliest manifestations of Alzheimer's disease (AD) is critically important. Cognitive challenge tests such as the Loewenstein Acevedo Scales for Semantic Interference and Learning (LASSI-L) have shown favorable diagnostic properties in a number of previous investigations using amyloid or FDG PET. However, no studies have examined LASSI-L performance against cerebrospinal fluid biomarkers of AD, which can be affected before the distribution of fibrillar amyloid and other changes that can be observed in brain neuroimaging. Therefore, we aimed to evaluate the relationship between LASSI-L scores and CSF biomarkers and the capacity of the cognitive challenge test to detect the presence of amyloid and tau deposition in patients with subjective cognitive decline and amnestic mild cognitive impairment (MCI). Methods One hundred and seventy-nine patients consulting for memory loss without functional impairment were enrolled. Patients were examined using comprehensive neuropsychological assessment, the LASSI-L, and cerebrospinal fluid (CSF) biomarkers (Aβ1-42/Aβ1-40 and ptau181). Means comparisons, correlations, effect sizes, and ROC curves were calculated. Results LASSI-L scores were significantly associated with CSF biomarkers Aβ1-42/Aβ1-40 in patients diagnosed with MCI and subjective cognitive decline, especially those scores evaluating the capacity to recover from proactive semantic interference effects and delayed recall. A logistic regression model for the entire sample including LASSI-L and age showed an accuracy of 0.749 and an area under the curve of 0.785 to detect abnormal amyloid deposition. Conclusion Our study supports the biological validity of the LASSI-L and its semantic interference paradigm in the context of the early stages of AD. These findings emphasize the utility and the convenience of including sensitive cognitive challenge tests in the assessment of patients with suspicion of early stages of AD.
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Affiliation(s)
- Maria Valles-Salgado
- Department of Neurology, Hospital Clínico San Carlos, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
| | - María José Gil-Moreno
- Department of Neurology, Hospital Clínico San Carlos, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
| | - Rosie E Curiel Cid
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Alfonso Delgado-Álvarez
- Department of Neurology, Hospital Clínico San Carlos, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
| | - Isabel Ortega-Madueño
- Department of Clinical Analysis, Institute of Laboratory, Hospital Clínico San Carlos, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
| | - Cristina Delgado-Alonso
- Department of Neurology, Hospital Clínico San Carlos, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
| | - Marta Palacios-Sarmiento
- Department of Neurology, Hospital Clínico San Carlos, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
| | - Juan I López-Carbonero
- Department of Neurology, Hospital Clínico San Carlos, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
| | - María Cruz Cárdenas
- Department of Clinical Analysis, Institute of Laboratory, Hospital Clínico San Carlos, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
| | - Jorge Matías-Guiu
- Department of Neurology, Hospital Clínico San Carlos, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
| | - María Díez-Cirarda
- Department of Neurology, Hospital Clínico San Carlos, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
| | - David A Loewenstein
- Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Jordi A Matias-Guiu
- Department of Neurology, Hospital Clínico San Carlos, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
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3
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Peng C, Liu X, Meng X, Chen C, Wu X, Bai L, Lu F, Liu F. IPAD-DB: a manually curated database for experimentally verified inhibitors of proteins associated with Alzheimer's disease. Database (Oxford) 2024; 2024:baae048. [PMID: 38865432 PMCID: PMC11168334 DOI: 10.1093/database/baae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 05/12/2024] [Accepted: 06/03/2024] [Indexed: 06/14/2024]
Abstract
Alzheimer's disease (AD) is a universal neurodegenerative disease with the feature of progressive dementia. Currently, there are only seven Food and Drug Administration-approved drugs for the treatment of AD, which merely offer temporary relief from symptom deterioration without reversing the underlying disease process. The identification of inhibitors capable of interacting with proteins associated with AD plays a pivotal role in the development of effective therapeutic interventions. However, a vast number of such inhibitors are dispersed throughout numerous published articles, rendering it inconvenient for researchers to explore potential drug candidates for AD. In light of this, we have manually compiled inhibitors targeting proteins associated with AD and constructed a comprehensive database known as IPAD-DB (Inhibitors of Proteins associated with Alzheimer's Disease Database). The curated inhibitors within this database encompass a diverse range of compounds, including natural compounds, synthetic compounds, drugs, natural extracts and nano-inhibitors. To date, the database has compiled >4800 entries, each representing a correspondent relationship between an inhibitor and its target protein. IPAD-DB offers a user-friendly interface that facilitates browsing, searching and downloading of its records. We firmly believe that IPAD-DB represents a valuable resource for screening potential AD drug candidates and investigating the underlying mechanisms of this debilitating disease. Access to IPAD-DB is freely available at http://www.lamee.cn/ipad-db/ and is compatible with all major web browsers. Database URL: http://www.lamee.cn/ipad-db/.
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Affiliation(s)
- Chong Peng
- Key Laboratory of Industrial Fermentation Microbiology, Ministry of Education, Tianjin 300457, P. R. China
- Tianjin Key Laboratory of Industrial Microbiology, Tianjin 300457, P. R. China
- College of Biotechnology, Tianjin University of Science and Technology, Tianjin 300457, P. R. China
| | - Xiaofeng Liu
- College of Biotechnology, Tianjin University of Science and Technology, Tianjin 300457, P. R. China
| | - Xiangbo Meng
- College of Biotechnology, Tianjin University of Science and Technology, Tianjin 300457, P. R. China
| | - Congge Chen
- College of Biotechnology, Tianjin University of Science and Technology, Tianjin 300457, P. R. China
| | - Xinming Wu
- College of Biotechnology, Tianjin University of Science and Technology, Tianjin 300457, P. R. China
| | - Lin Bai
- College of Biotechnology, Tianjin University of Science and Technology, Tianjin 300457, P. R. China
| | - Fuping Lu
- Key Laboratory of Industrial Fermentation Microbiology, Ministry of Education, Tianjin 300457, P. R. China
- Tianjin Key Laboratory of Industrial Microbiology, Tianjin 300457, P. R. China
- College of Biotechnology, Tianjin University of Science and Technology, Tianjin 300457, P. R. China
| | - Fufeng Liu
- Key Laboratory of Industrial Fermentation Microbiology, Ministry of Education, Tianjin 300457, P. R. China
- Tianjin Key Laboratory of Industrial Microbiology, Tianjin 300457, P. R. China
- College of Biotechnology, Tianjin University of Science and Technology, Tianjin 300457, P. R. China
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Huang J, Huang N, Qiu Y, Shi J. Dendrobium nobile Lindl. alkaloid decreases Tau hyperphosphorylation via regulating PI3K/Akt/GSK-3β pathway in vitro and in vivo. JOURNAL OF ETHNOPHARMACOLOGY 2024; 322:117592. [PMID: 38097026 DOI: 10.1016/j.jep.2023.117592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANT Dendrobium is a traditional and precious Chinese medicinal herb. The Compendium of Materia Medica describes its effects as "benefiting intelligence and dispelling shock, lightning the body and extending life". Dendrobium nobile Lindl. is a precious variety of Dendrobium. Our previous data showed Dendrobium nobile Lindl. alkaloid (DNLA) has significant neuroprotective effects and can improve cognitive dysfunction. However, the specific effects and mechanisms of action of its main active component, DNLA, on cognitive dysfunction caused by Tau hyperphosphorylation, are still unclear. AIM OF THE RESEARCH This study aimed to determine the effects of DNLA on phosphatidylinositol-3 kinase (PI3K)/protein kinase B (Akt)/glycogen synthase kinase 3β (GSK-3β) pathway, thus to explore the mechanisms of DNLA to inhibit Tau hyperphosphorylation. MATERIALS AND METHODS We used wortmannin (WM) and GF-109203X (GFX)-induced hyperphosphorylation of Tau in N2a cells and rats to detect the protective mechanism of DNLA in vivo and in vitro. In vitro, the effect of modeling method on Tau hyperphosphorylation was screened and verified by Western Blotting (WB), and the regulation of Tau hyperphosphorylation and PI3K/Akt/GSK-3β pathway by different concentrations of DNLA was detected by WB. In vivo, MWM was used to detect the effect of DNLA on model rats, and then Nissl staining was used to detect the loss of neurons. Finally, WB was used to detect the regulation of Tau hyperphosphorylation and PI3K/Akt/GSK-3β pathway by different concentrations of DNLA. RESULTS DNLA could rescue the abnormal PI3K/Akt/GSK-3β pathway and reverse the hyperphosphorylation of Tau induced by WM and GFX in N2a cells. Furthermore, DNLA improved the learning and memory of WM and GFX-induced model rats. Moreover, DNLA regulated PI3K/Akt/GSK-3β pathway and reduced the p-Tau and neuronal damage in the hippocampus of model rats. CONCLUSION DNLA may be a promising candidate for reducing hyperphosphorylation of Tau.
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Affiliation(s)
- Juan Huang
- Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Key Laboratory of Basic Pharmacology and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Guizhou, China; School of Public Health, Zunyi Medical University, Guizhou, China
| | - Nanqu Huang
- National Drug Clinical Trial Institution, Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi), Zunyi, Guizhou, China
| | - Yu Qiu
- Department of Pharmacology and Chemical Biology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jingshan Shi
- Key Laboratory of Basic Pharmacology and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Guizhou, China.
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Lavekar SS, Harkin J, Hernandez M, Gomes C, Patil S, Huang KC, Puntambekar SS, Lamb BT, Meyer JS. Development of a three-dimensional organoid model to explore early retinal phenotypes associated with Alzheimer's disease. Sci Rep 2023; 13:13827. [PMID: 37620502 PMCID: PMC10449801 DOI: 10.1038/s41598-023-40382-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by the accumulation of Aβ plaques and neurofibrillary tangles, resulting in synaptic loss and neurodegeneration. The retina is an extension of the central nervous system within the eye, sharing many structural similarities with the brain, and previous studies have observed AD-related phenotypes within the retina. Three-dimensional retinal organoids differentiated from human pluripotent stem cells (hPSCs) can effectively model some of the earliest manifestations of disease states, yet early AD-associated phenotypes have not yet been examined. Thus, the current study focused upon the differentiation of hPSCs into retinal organoids for the analysis of early AD-associated alterations. Results demonstrated the robust differentiation of retinal organoids from both familial AD and unaffected control cell lines, with familial AD retinal organoids exhibiting a significant increase in the Aβ42:Aβ40 ratio as well as phosphorylated Tau protein, characteristic of AD pathology. Further, transcriptional analyses demonstrated the differential expression of many genes and cellular pathways, including those associated with synaptic dysfunction. Taken together, the current study demonstrates the ability of retinal organoids to serve as a powerful model for the identification of some of the earliest retinal alterations associated with AD.
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Affiliation(s)
- Sailee S Lavekar
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, 46202, USA
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Jade Harkin
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Melody Hernandez
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Cátia Gomes
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Shruti Patil
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Kang-Chieh Huang
- Department of Biology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, 46202, USA
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Shweta S Puntambekar
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Bruce T Lamb
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Jason S Meyer
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
- Department of Ophthalmology, Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
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6
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Jia J, Zhang Y, Shi Y, Yin X, Wang S, Li Y, Zhao T, Liu W, Zhou A, Jia L. A 19-Year-Old Adolescent with Probable Alzheimer's Disease. J Alzheimers Dis 2023; 91:915-922. [PMID: 36565128 DOI: 10.3233/jad-221065] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Alzheimer's disease (AD) primarily affects older adults. In this report, we present the case of a 19-year-old male with gradual memory decline for 2 years and World Health Organization-University of California Los Angeles Auditory Verbal Learning Test (WHO-UCLA AVLT) results also showing memory impairment. Positron emission tomography-magnetic resonance imaging with 18F fluorodeoxyglucose revealed atrophy of the bilateral hippocampus and hypometabolism in the bilateral temporal lobe. Examination of the patient's cerebrospinal fluid showed an increased concentration of p-tau181 and a decreased amyloid-β 42/40 ratio. However, through whole-genome sequencing, no known gene mutations were identified. Considering the above, the patient was diagnosed with probable AD.
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Affiliation(s)
- Jianping Jia
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.,Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, P.R. China.,Center of Alzheimer's Disease, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, P.R. China.,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, P.R. China
| | - Yue Zhang
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China
| | - Yuqing Shi
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China
| | - Xuping Yin
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China
| | - Shiyuan Wang
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China
| | - Yan Li
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China
| | - Tan Zhao
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China
| | - Wenying Liu
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China
| | - Aihong Zhou
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China
| | - Longfei Jia
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China
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7
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Ribarič S. Detecting Early Cognitive Decline in Alzheimer's Disease with Brain Synaptic Structural and Functional Evaluation. Biomedicines 2023; 11:355. [PMID: 36830892 PMCID: PMC9952956 DOI: 10.3390/biomedicines11020355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/22/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
Early cognitive decline in patients with Alzheimer's (AD) is associated with quantifiable structural and functional connectivity changes in the brain. AD dysregulation of Aβ and tau metabolism progressively disrupt normal synaptic function, leading to loss of synapses, decreased hippocampal synaptic density and early hippocampal atrophy. Advances in brain imaging techniques in living patients have enabled the transition from clinical signs and symptoms-based AD diagnosis to biomarkers-based diagnosis, with functional brain imaging techniques, quantitative EEG, and body fluids sampling. The hippocampus has a central role in semantic and episodic memory processing. This cognitive function is critically dependent on normal intrahippocampal connections and normal hippocampal functional connectivity with many cortical regions, including the perirhinal and the entorhinal cortex, parahippocampal cortex, association regions in the temporal and parietal lobes, and prefrontal cortex. Therefore, decreased hippocampal synaptic density is reflected in the altered functional connectivity of intrinsic brain networks (aka large-scale networks), including the parietal memory, default mode, and salience networks. This narrative review discusses recent critical issues related to detecting AD-associated early cognitive decline with brain synaptic structural and functional markers in high-risk or neuropsychologically diagnosed patients with subjective cognitive impairment or mild cognitive impairment.
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Affiliation(s)
- Samo Ribarič
- Faculty of Medicine, Institute of Pathophysiology, University of Ljubljana, Zaloška 4, SI-1000 Ljubljana, Slovenia
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8
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Age-linked suppression of lipoxin A4 associates with cognitive deficits in mice and humans. Transl Psychiatry 2022; 12:439. [PMID: 36216800 PMCID: PMC9551034 DOI: 10.1038/s41398-022-02208-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/29/2022] Open
Abstract
Age increases the risk for cognitive impairment and is the single major risk factor for Alzheimer's disease (AD), the most prevalent form of dementia in the elderly. The pathophysiological processes triggered by aging that render the brain vulnerable to dementia involve, at least in part, changes in inflammatory mediators. Here we show that lipoxin A4 (LXA4), a lipid mediator of inflammation resolution known to stimulate endocannabinoid signaling in the brain, is reduced in the aging central nervous system. We demonstrate that genetic suppression of 5-lipoxygenase (5-LOX), the enzyme mediating LXA4 synthesis, promotes learning impairment in mice. Conversely, administration of exogenous LXA4 attenuated cytokine production and memory loss induced by inflammation in mice. We further show that cerebrospinal fluid LXA4 is reduced in patients with dementia and positively associated with cognitive performance, brain-derived neurotrophic factor (BDNF), and AD-linked amyloid-β. Our findings suggest that reduced LXA4 levels may lead to vulnerability to age-related cognitive disorders and that promoting LXA4 signaling may comprise an effective strategy to prevent early cognitive decline in AD.
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9
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Rabin JS, Nichols E, La Joie R, Casaletto KB, Palta P, Dams-O’Connor K, Kumar RG, George KM, Satizabal CL, Schneider JA, Pa J, Brickman AM. Cerebral amyloid angiopathy interacts with neuritic amyloid plaques to promote tau and cognitive decline. Brain 2022; 145:2823-2833. [PMID: 35759327 PMCID: PMC9420012 DOI: 10.1093/brain/awac178] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 12/12/2022] Open
Abstract
Accumulating data suggest that cerebrovascular disease contributes to Alzheimer's disease pathophysiology and progression toward dementia. Cerebral amyloid angiopathy is a form of cerebrovascular pathology that results from the build-up of β-amyloid in the vessel walls. Cerebral amyloid angiopathy commonly co-occurs with Alzheimer's disease pathology in the ageing brain and increases the risk of Alzheimer's disease dementia. In the present study, we examined whether cerebral amyloid angiopathy influences tau deposition and cognitive decline independently or synergistically with parenchymal β-amyloid burden. Secondly, we examined whether tau burden mediates the association between cerebral amyloid angiopathy and cognitive decline. We included data from autopsied subjects recruited from one of three longitudinal clinical-pathological cohort studies: the Rush Memory and Aging Project, the Religious Orders Study and the Minority Aging Research Study. Participants completed annual clinical and cognitive evaluations and underwent brain autopsy. Cerebral amyloid angiopathy pathology was rated as none, mild, moderate or severe. Bielschowsky silver stain was used to visualize neuritic β-amyloid plaques and neurofibrillary tangles. We used linear regression and linear mixed models to test independent versus interactive associations of cerebral amyloid angiopathy and neuritic plaque burden with tau burden and longitudinal cognitive decline, respectively. We used causal mediation models to examine whether tau mediates the association between cerebral amyloid angiopathy and cognitive decline. The study sample included 1722 autopsied subjects (age at baseline = 80.2 ± 7.1 years; age at death = 89.5 ± 6.7 years; 68% females). Cerebral amyloid angiopathy interacted with neuritic plaques to accelerate tau burden and cognitive decline. Specifically, those with more severe cerebral amyloid angiopathy pathology and higher levels of neuritic plaque burden had greater tau burden and faster cognitive decline. We also found that tau mediated the association between cerebral amyloid angiopathy and cognitive decline among participants with higher neuritic plaque burden. In summary, more severe levels of cerebral amyloid angiopathy and higher parenchymal β-amyloid burden interacted to promote cognitive decline indirectly via tau deposition. These results highlight the dynamic interplay between cerebral amyloid angiopathy and Alzheimer's disease pathology in accelerating progression toward dementia. These findings have implications for Alzheimer's disease clinical trials and therapeutic development.
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Affiliation(s)
- Jennifer S Rabin
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences
Centre, University of Toronto, Toronto, Canada M4N 3M5
- Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program,
Sunnybrook Research Institute, Toronto, Ontario,
Canada M4N 3M5
- Rehabilitation Sciences Institute, University of Toronto,
Toronto, Canada M5G 1V7
| | - Emma Nichols
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public
Health, Baltimore, MD, USA
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for
Neurosciences, University of California, San Francisco,
CA, USA 94158
| | - Kaitlin B Casaletto
- Memory and Aging Center, Department of Neurology, Weill Institute for
Neurosciences, University of California, San Francisco,
CA, USA 94158
| | - Priya Palta
- Departments of Medicine and Epidemiology, Columbia University Irving
Medical Center, New York, NY, USA
| | - Kristen Dams-O’Connor
- Department of Rehabilitation and Human Performance, Icahn School of
Medicine at Mount Sinai, New York, NY, USA 10029
- Department of Neurology, Icahn School of Medicine at Mount
Sinai, New York, NY, USA 10029
| | - Raj G Kumar
- Department of Rehabilitation and Human Performance, Icahn School of
Medicine at Mount Sinai, New York, NY, USA 10029
| | - Kristen M George
- Department of Public Health Sciences, University of California Davis School
of Medicine, Davis, CA, USA
| | - Claudia L Satizabal
- Department of Population Health Science and Biggs Institute for Alzheimer’s
and Neurodegenerative Diseases, UT Health San Antonio, San
Antonio, TX, USA
- Department of Neurology, Boston University School of
Medicine, Boston, MA, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical
Center, Chicago, IL, USA
| | - Judy Pa
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Department of
Neurology, University of Southern California, Los Angeles,
CA, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain,
Department of Neurology, College of Physicians and Surgeons, Columbia
University, New York, NY, USA 10032
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10
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Mahaman YAR, Embaye KS, Huang F, Li L, Zhu F, Wang JZ, Liu R, Feng J, Wang X. Biomarkers used in Alzheimer's disease diagnosis, treatment, and prevention. Ageing Res Rev 2022; 74:101544. [PMID: 34933129 DOI: 10.1016/j.arr.2021.101544] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 12/12/2022]
Abstract
Alzheimer's disease (AD), being the number one in terms of dementia burden, is an insidious age-related neurodegenerative disease and is presently considered a global public health threat. Its main histological hallmarks are the Aβ senile plaques and the P-tau neurofibrillary tangles, while clinically it is marked by a progressive cognitive decline that reflects the underlying synaptic loss and neurodegeneration. Many of the drug therapies targeting the two pathological hallmarks namely Aβ and P-tau have been proven futile. This is probably attributed to the initiation of therapy at a stage where cognitive alterations are already obvious. In other words, the underlying neuropathological changes are at a stage where these drugs lack any therapeutic value in reversing the damage. Therefore, there is an urgent need to start treatment in the very early stage where these changes can be reversed, and hence, early diagnosis is of primordial importance. To this aim, the use of robust and informative biomarkers that could provide accurate diagnosis preferably at an earlier phase of the disease is of the essence. To date, several biomarkers have been established that, to a different extent, allow researchers and clinicians to evaluate, diagnose, and more specially exclude other related pathologies. In this study, we extensively reviewed data on the currently explored biomarkers in terms of AD pathology-specific and non-specific biomarkers and highlighted the recent developments in the diagnostic and theragnostic domains. In the end, we have presented a separate elaboration on aspects of future perspectives and concluding remarks.
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11
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Gao X, Chen Q, Yao H, Tan J, Liu Z, Zhou Y, Zou Z. Epigenetics in Alzheimer's Disease. Front Aging Neurosci 2022; 14:911635. [PMID: 35813941 PMCID: PMC9260511 DOI: 10.3389/fnagi.2022.911635] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 05/24/2022] [Indexed: 12/19/2022] Open
Abstract
Alzheimer's disease (AD) is a neurodegenerative disease with unknown pathogenesis and complex pathological manifestations. At present, a large number of studies on targeted drugs for the typical pathological phenomenon of AD (Aβ) have ended in failure. Although there are some drugs on the market that indirectly act on AD, their efficacy is very low and the side effects are substantial, so there is an urgent need to develop a new strategy for the treatment of AD. An increasing number of studies have confirmed epigenetic changes in AD. Although it is not clear whether these epigenetic changes are the cause or result of AD, they provide a new avenue of treatment for medical researchers worldwide. This article summarizes various epigenetic changes in AD, including DNA methylation, histone modification and miRNA, and concludes that epigenetics has great potential as a new target for the treatment of AD.
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Affiliation(s)
- Xiaodie Gao
- Guangxi Key Lab of Brain and Cognitive Neuroscience, Guilin Medical University, Guilin, China
- Department of Scientific Research, Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, China
| | - Qiang Chen
- Department of Scientific Research, Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, China
| | - Hua Yao
- Guangxi Key Lab of Brain and Cognitive Neuroscience, Guilin Medical University, Guilin, China
| | - Jie Tan
- Guangxi Key Lab of Brain and Cognitive Neuroscience, Guilin Medical University, Guilin, China
| | - Zheng Liu
- Guangxi Key Lab of Brain and Cognitive Neuroscience, Guilin Medical University, Guilin, China
- *Correspondence: Zheng Liu,
| | - Yan Zhou
- Guangxi Key Lab of Brain and Cognitive Neuroscience, Guilin Medical University, Guilin, China
- Yan Zhou,
| | - Zhenyou Zou
- Guangxi Key Lab of Brain and Cognitive Neuroscience, Guilin Medical University, Guilin, China
- Department of Scientific Research, Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, China
- Zhenyou Zou,
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12
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Guo T, Landau SM, Jagust WJ. Age, vascular disease, and Alzheimer's disease pathologies in amyloid negative elderly adults. ALZHEIMERS RESEARCH & THERAPY 2021; 13:174. [PMID: 34654465 PMCID: PMC8520216 DOI: 10.1186/s13195-021-00913-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/03/2021] [Indexed: 02/04/2023]
Abstract
Background We recently reported that CSF phosphorylated tau (p-Tau181) relative to Aβ40 (CSF p-Tau/Aβ40 ratio) was less noisy and increased associations with Alzheimer’s disease (AD) biomarkers compared to CSF p-Tau181 alone. While elevations of CSF p-Tau/Aβ40 can occur in amyloid-β (Aβ) negative (Aβ-) individuals, the factors associated with these elevations and their role in neurodegeneration and cognitive decline are unknown. We aim to explore factors associated with elevated tau in CSF, and how these elevated tau are related to neurodegeneration and cognitive decline in the absence of Aβ positivity. Methods We examined relationships between CSF p-Tau/Aβ40, and CSF Aβ42/Aβ40, Aβ PET, and white matter hyperintensities (WMH) as well as vascular risk factors in 149 cognitively unimpaired and 52 impaired individuals who were presumably not on the Alzheimer’s disease (AD) pathway due to negative Aβ status on both CSF and PET. Subgroups had 18F-fluorodeoxyglucose (FDG) PET and adjusted hippocampal volume (aHCV), and longitudinal measures of CSF, aHCV, FDG PET, and cognition data, so we examined CSF p-Tau/Aβ40 associations with these measures as well. Results Elevated CSF p-Tau/Aβ40 was associated with older age, male sex, greater WMH, and hypertension as well as a pattern of hippocampal atrophy and temporoparietal hypometabolism characteristic of AD. Lower CSF Aβ42/Aβ40, higher WMH, and hypertension but not age, sex, Aβ PET, APOE-ε4 status, body mass index, smoking, and hyperlipidemia at baseline predicted CSF p-Tau/Aβ40 increases over approximately 5 years of follow-up. The relationship between CSF p-Tau/Aβ40 and subsequent cognitive decline was partially or fully explained by neurodegenerative measurements. Conclusions These data provide surprising clues as to the etiology and significance of tau pathology in the absence of Aβ. It seems likely that, in addition to age, both cerebrovascular disease and subthreshold levels of Aβ are related to this tau accumulation. Crucially, this phenotype of CSF tau elevation in amyloid-negative individuals share features with AD such as a pattern of metabolic decline and regional brain atrophy. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-021-00913-5.
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Affiliation(s)
- Tengfei Guo
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, No.5 Kelian Road, Shenzhen, 518132, China.
| | - Susan M Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, 94720, USA.,Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, 94720, USA.,Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
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13
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Shen X, Kuo K, Yang Y, Li H, Chen S, Cui M, Tan L, Dong Q, Yu J. Subtle cognitive impairment as a marker of Alzheimer's pathologies and clinical progression in cognitively normal individuals. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12198. [PMID: 34095433 PMCID: PMC8158163 DOI: 10.1002/dad2.12198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 04/15/2021] [Accepted: 04/21/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Subtle cognitive impairment (SCI) may appear before pathological changes surpass thresholds for abnormality. We aimed to investigate whether SCI could predict Alzheimer's pathologies and advancement. METHODS A total of 816 cognitively normal individuals were enrolled to assess the longitudinal neuropathological and clinical correlates of baseline SCI, via linear mixed-effects and Cox proportional-hazard models. Cross-lagged panel models were used in specific time waves. RESULTS SCI individuals had a faster increase in brain amyloid burden and a higher risk of conversion. They also showed greater rates of cerebrospinal fluid (CSF) phosphorylated tau (p-tau)181 increase and glucose metabolism decrease. In addition, baseline SCI predicted worse clinical progression, whereas multi-domain SCI advanced faster compared to the single domain group. DISCUSSION Baseline SCI could be an imperative prediction indicator of clinical and pathological progression. It enables cognitive measures to be informative at a very early stage and provided objective criteria for high-risk population screening.
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Affiliation(s)
- Xue‐Ning Shen
- Department of Neurology and Institute of NeurologyHuashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Kevin Kuo
- Department of Neurology and Institute of NeurologyHuashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Yu‐Xiang Yang
- Department of Neurology and Institute of NeurologyHuashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Hong‐Qi Li
- Department of Neurology and Institute of NeurologyHuashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Shi‐Dong Chen
- Department of Neurology and Institute of NeurologyHuashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Mei Cui
- Department of Neurology and Institute of NeurologyHuashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Lan Tan
- Department of NeurologyQingdao Municipal HospitalQingdao UniversityQingdaoChina
| | - Qiang Dong
- Department of Neurology and Institute of NeurologyHuashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Jin‐Tai Yu
- Department of Neurology and Institute of NeurologyHuashan Hospital, Shanghai Medical CollegeFudan UniversityShanghaiChina
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14
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Yao W, Chen H, Luo C, Sheng X, Zhao H, Xu Y, Bai F. Hyperconnectivity of Self-Referential Network as a Predictive Biomarker of the Progression of Alzheimer's Disease. J Alzheimers Dis 2021; 80:577-590. [PMID: 33579849 DOI: 10.3233/jad-201376] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Self-referential processing is associated with the progression of Alzheimer's disease (AD), and cerebrospinal fluid (CSF) proteins have become accepted biomarkers of AD. OBJECTIVE Our objective in this study was to focus on the relationships between the self-referential network (SRN) and CSF pathology in AD-spectrum patients. METHODS A total of 80 participants, including 20 cognitively normal, 20 early mild cognitive impairment (EMCI), 20 late MCI (LMCI), and 20 AD, were recruited for this study. Independent component analysis was used to explore the topological SRN patterns, and the abnormalities of this network were identified at different stages of AD. Finally, CSF pathological characteristics (i.e., CSF Aβ, t-tau, and p-tau) that affected the abnormalities of the SRN were further determined during the progression of AD. RESULTS Compared to cognitively normal subjects, AD-spectrum patients (i.e., EMCI, LMCI, and AD) showed a reversing trend toward an association between CSF pathological markers and the abnormal SRN occurring during the progression of AD. However, a certain disease state (i.e., the present LMCI) with a low concentration of CSF tau could evoke more hyperconnectivity of the SRN than other patients with progressively increasing concentrations of CSF tau (i.e., EMCI and AD), and this fluctuation of CSF tau was more sensitive to the hyperconnectivity of the SRN than the dynamic changes of CSF Aβ. CONCLUSION The integrity of the SRN was closely associated with CSF pathological characteristics, and these findings support the view that the hyperconnectivity of the SRN will play an important role in monitoring the progression of the pre-dementia state to AD.
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Affiliation(s)
- Weina Yao
- Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Haifeng Chen
- Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Caimei Luo
- Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Xiaoning Sheng
- Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China
| | - Hui Zhao
- Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Yun Xu
- Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Feng Bai
- Department of Neurology, Nanjing Drum Tower Hospital of The Affiliated Hospital of Nanjing University Medical School, and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
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15
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He B, Wang L, Xu B, Zhang Y. Association between CSF Aβ42 and amyloid negativity in patients with different stage mild cognitive impairment. Neurosci Lett 2021; 754:135765. [PMID: 33667602 DOI: 10.1016/j.neulet.2021.135765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 11/30/2022]
Abstract
Whether the cerebrospinal fluid (CSF) biomarkers of amyloid-positive and amyloid-negative patients with mild cognitive impairment (MCI) or Alzheimer's disease (AD) are significantly different is still unknown. The purpose of this study is to compare the differences in CSF total tau, P-tau and Aβ42 in patients with amyloid-positive positron emission tomography (PET) and amyloid-negative PET, and to explore related risk factors in cognitive normal (CN), early MCI (EMCI), late MCI (LMCI) and AD. 558 participants (140 CN; 233 EMCI; 125 LMCI; 60 AD) were recruited in this study from the AD Neuroimaging Initiative (ADNI) database. The associations between CSF biomarkers were assessed by partial correlation analysis. The relations between significant variables were determined by multinomial logistic regression. Compared with amyloid-positive PET patients, patients with amyloid-negative PET had higher CSF Aβ42 and lower P-tau in the whole samples. The concentration of Aβ42 in the positive amyloid PET was significantly different in different groups, but not the negative amyloid PET (CN vs. LMCI; CN vs. AD; EMCI vs. AD, all P < 0.05). When amyloid PET was positive, a weak correlation was found between the levels of Aβ42 and P-tau only in CN group. However, a moderate degree of correlation between Aβ42 and P-tau was found in EMCI and LMCI when amyloid PET was negative. After covariates adjustment, CSF Aβ42 was significantly associated with EMCI [adjusted odds ratio (OR) = 0.99, 95 % confidence interval (CI) = 0.99-1.00, P = 0.02) and LMCI (adjusted OR = 0.99, 95 % CI = 0.99-1.00, P = 0.007)] in patients with negative amyloid PET, not in patients with positive amyloid PET. Our findings highlight that Aβ42 had strong correlations with other biomarkers and might help reduce risk of EMCI or LMCI in patients with amyloid negativity.
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Affiliation(s)
- Bingjie He
- Department of Rehabilitation, Panyu Health Management Center (Panyu Rehabilitation Hospital), Guangzhou, China
| | - Lijun Wang
- Department of Neurology, Institute of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bingdong Xu
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yusheng Zhang
- Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
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16
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Prasanna P, Upadhyay A. Flavonoid-Based Nanomedicines in Alzheimer's Disease Therapeutics: Promises Made, a Long Way To Go. ACS Pharmacol Transl Sci 2021; 4:74-95. [PMID: 33615162 PMCID: PMC7887745 DOI: 10.1021/acsptsci.0c00224] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Indexed: 12/11/2022]
Abstract
Alzheimer's disease (AD) is characterized by the continuous decline of the cognitive abilities manifested due to the accumulation of large aggregates of amyloid-beta 42 (Aβ42), the formation of neurofibrillary tangles of hyper-phosphorylated forms of microtubule-associated tau protein, which may lead to many alterations at the cellular and systemic level. The current therapeutic strategies primarily focus on alleviating pathological symptoms rather than providing a possible cure. AD is one of the highly studied but least understood neurological problems and remains an unresolved condition of human brain degeneration. Over the years, multiple naturally derived small molecules, including plant products, microbial isolates, and some metabolic byproducts, have been projected as supplements reducing the risk or possible treatment of the disease. However, unfortunately, none has met the expected success. One major challenge for most medications is their ability to cross the blood-brain barrier (BBB). In past decades, nanotechnology-based interventions have offered an alternative platform to address the problem of the successful delivery of the drugs to the specific targets. Interestingly, the exciting interface of natural products and nanomedicine is delivering promising results in AD treatment. The potential applications of flavonoids, the plant-derived compounds best known for their antioxidant activities, and their amalgamation with nanomedicinal approaches may lead to highly effective therapeutic strategies for treating well-known neurodegenerative diseases. In the present review, we explore the possibilities and recent developments on an exciting combination of flavonoids and nanoparticles in AD.
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Affiliation(s)
- Pragya Prasanna
- Department
of Biotechnology, National Institute of
Pharmaceutical Education and Research, Hajipur, Bihar, India 844102
| | - Arun Upadhyay
- Department
of Biochemistry, School of Life Sciences, Central University of Rajasthan, Bandar Sindari, Kishangarh Ajmer, Rajasthan, India 305817
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17
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Iaccarino L, La Joie R, Edwards L, Strom A, Schonhaut DR, Ossenkoppele R, Pham J, Mellinger T, Janabi M, Baker SL, Soleimani-Meigooni D, Rosen HJ, Miller BL, Jagust WJ, Rabinovici GD. Spatial Relationships between Molecular Pathology and Neurodegeneration in the Alzheimer's Disease Continuum. Cereb Cortex 2021; 31:1-14. [PMID: 32808011 PMCID: PMC7727356 DOI: 10.1093/cercor/bhaa184] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/01/2020] [Accepted: 06/08/2020] [Indexed: 12/12/2022] Open
Abstract
A deeper understanding of the spatial relationships of β-amyloid (Aβ), tau, and neurodegeneration in Alzheimer's disease (AD) could provide insight into pathogenesis and clinical trial design. We included 81 amyloid-positive patients (age 64.4 ± 9.5) diagnosed with AD dementia or mild cognitive impairment due to AD and available 11C-PiB (PIB), 18F-Flortaucipir (FTP),18F-FDG-PET, and 3T-MRI, and 31 amyloid-positive, cognitively normal participants (age 77.3 ± 6.5, no FDG-PET). W-score voxel-wise deviation maps were created and binarized for each imaging-modality (W > 1.64, P < 0.05) adjusting for age, sex, and total intracranial volume (sMRI-only) using amyloid-negative cognitively normal adults. For symptomatic patients, FDG-PET and atrophy W-maps were combined into neurodegeneration maps (ND). Aβ-pathology showed the greatest proportion of cortical gray matter suprathreshold voxels (spatial extent) for both symptomatic and asymptomatic participants (median 94-55%, respectively), followed by tau (79-11%) and neurodegeneration (41-3%). Amyloid > tau > neurodegeneration was the most frequent hierarchy for both groups (79-77%, respectively), followed by tau > amyloid > neurodegeneration (13-10%) and amyloid > neurodegeneration > tau (6-13%). For symptomatic participants, most abnormal voxels were PIB+/FTP+/ND- (median 35%), and the great majority of ND+ voxels (91%) colocalized with molecular pathology. Amyloid spatially exceeded tau and neurodegeneration, with individual heterogeneities. Molecular pathology and neurodegeneration showed a progressive overlap along AD course, indicating shared vulnerabilities or synergistic toxic mechanisms.
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Affiliation(s)
- Leonardo Iaccarino
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Lauren Edwards
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Amelia Strom
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Daniel R Schonhaut
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA
| | - Rik Ossenkoppele
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam 1081 HV, The Netherlands
| | - Julie Pham
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Taylor Mellinger
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Mustafa Janabi
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Suzanne L Baker
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - David Soleimani-Meigooni
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
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18
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Associations between brain amyloid accumulation and the use of angiotensin-converting enzyme inhibitors versus angiotensin receptor blockers. Neurobiol Aging 2020; 100:22-31. [PMID: 33461049 DOI: 10.1016/j.neurobiolaging.2020.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/23/2020] [Accepted: 12/08/2020] [Indexed: 01/06/2023]
Abstract
Some studies suggest that angiotensin II type 1 receptor blockers (ARBs) may protect against memory decline more than angiotensin-converting enzyme inhibitors (ACE-Is), but few have examined possible mechanisms. We assessed longitudinal differences between ARB versus ACE-I users in global and sub-regional amyloid-β accumulation by 18F-florbetapir. In cognitively normal older adults (n= 142), propensity-weighted linear mixed-effects models showed that ARB versus ACE-I use was associated with slower amyloid-β accumulation in the cortex, and specifically in the caudal anterior cingulate and precuneus, and in the precentral and postcentral gyri. In amyloid-positive participants with Alzheimer's disease dementia or mild cognitive impairment (n = 169), ARB versus ACE-I use was not associated with different rates of amyloid-β accumulation. Apolipoprotein E ε4 carrier status explained some heterogeneity in the different rates of amyloid-β accumulation between users of ARBs versus ACE-Is in the study. Replicative studies and clinical trials are warranted to confirm potential benefits of ARBs on rates of amyloid-β accumulation in the contexts of Alzheimer's disease prevention and treatment.
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19
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Tan MS, Yang YX, Wang HF, Xu W, Tan CC, Zuo CT, Dong Q, Tan L, Yu JT. PET Amyloid and Tau Status Are Differently Affected by Patient Features. J Alzheimers Dis 2020; 78:1129-1136. [PMID: 33104024 DOI: 10.3233/jad-200124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Amyloid-β (Aβ) plaques and tau neurofibrillary tangles are two neuropathological hallmarks of Alzheimer's disease (AD), which both can be visualized in vivo using PET radiotracers, opening new opportunities to study disease mechanisms. OBJECTIVE Our study investigated 11 non-PET factors in 5 categories (including demographic, clinical, genetic, MRI, and cerebrospinal fluid (CSF) features) possibly affecting PET amyloid and tau status to explore the relationships between amyloid and tau pathology, and whether these features had a different association with amyloid and tau status. METHODS We included 372 nondemented elderly from the Alzheimer's Disease Neuroimaging Initiative cohort. All underwent PET amyloid and tau analysis simultaneously, and were grouped into amyloid/tau quadrants based on previously established abnormality cut points. We examined the associations of above selected features with PET amyloid and tau status using a multivariable logistic regression model, then explored whether there was an obvious correlation between the significant features and PET amyloid or tau levels. RESULTS Our results demonstrated that PET amyloid and tau status were differently affected by patient features, and CSF biomarker features provided most significant values associating PET findings. CSF Aβ42/40 was the most important factor affecting amyloid PET status, and negatively correlated with amyloid PET levels. CSF pTau could significantly influence both amyloid and tau PET status. Besides CSF pTau and Aβ42, APOEɛ4 allele status and Mini-Mental State Examination scores also could influence tau PET status, and significantly correlated with tau PET levels. CONCLUSION Our results support that tau pathology possibly affected by Aβ-independent factors, implicating the importance of tau pathology in AD pathogenesis.
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Affiliation(s)
- Meng-Shan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yu-Xiang Yang
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hui-Fu Wang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Xu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Chen-Chen Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Chuan-Tao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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20
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Rabin JS, Neal TE, Nierle HE, Sikkes SAM, Buckley RF, Amariglio RE, Papp KV, Rentz DM, Schultz AP, Johnson KA, Sperling RA, Hedden T. Multiple markers contribute to risk of progression from normal to mild cognitive impairment. NEUROIMAGE-CLINICAL 2020; 28:102400. [PMID: 32919366 PMCID: PMC7491146 DOI: 10.1016/j.nicl.2020.102400] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/17/2020] [Accepted: 08/25/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To identify a parsimonious set of markers that optimally predicts subsequent clinical progression from normal to mild cognitive impairment (MCI). METHODS 250 clinically normal adults (mean age = 73.6 years, SD = 6.0) from the Harvard Aging Brain Study were assessed at baseline on a wide set of markers, including magnetic resonance imaging markers of gray matter thickness and volume, white matter lesions, fractional anisotropy, resting state functional connectivity, positron emission tomography markers of glucose metabolism and β-amyloid (Aβ) burden, and a measure of vascular risk. Participants were also tested annually on a battery of clinical and cognitive tests (median follow-up = 5.0 years, SD = 1.66). We applied least absolute shrinkage and selection operator (LASSO) Cox models to determine the minimum set of non-redundant markers that predicts subsequent clinical progression from normal to MCI, adjusting for age, sex, and education. RESULTS 23 participants (9.2%) progressed to MCI over the study period (mean years of follow-up to diagnosis = 3.96, SD = 1.89). Progression was predicted by several brain markers, including reduced entorhinal thickness (hazard ratio, HR = 1.73), greater Aβ burden (HR = 1.58), lower default network connectivity (HR = 1.42), and smaller hippocampal volume (HR = 1.30). When cognitive test scores were added to the model, the aforementioned neuroimaging markers remained significant and lower striatum volume as well as lower scores on baseline memory and processing speed tests additionally contributed to progression. CONCLUSION Among a large set of brain, vascular and cognitive markers, a subset of markers independently predicted progression from normal to MCI. These markers may enhance risk stratification by identifying clinically normal individuals who are most likely to develop clinical symptoms and would likely benefit most from therapeutic intervention.
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Affiliation(s)
- Jennifer S Rabin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Harquail Centre for Neuromodulation and Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; Department of Medicine (Neurology), University of Toronto, Toronto, ON M5S 3H2, Canada
| | - Taylor E Neal
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Hannah E Nierle
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Sietske A M Sikkes
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Center, Vrije Universiteit, The Netherlands; Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA
| | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Florey Institutes of Neuroscience and Mental Health, Melbourne and Melbourne School of Psychological Science, University of Melbourne, Melbourne, Australia; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Rebecca E Amariglio
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Kathryn V Papp
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Dorene M Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Aaron P Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
| | - Keith A Johnson
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA; Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, MA 02144, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02144, USA; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
| | - Trey Hedden
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA.
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Guo T, Shaw LM, Trojanowski JQ, Jagust WJ, Landau SM. Association of CSF Aβ, amyloid PET, and cognition in cognitively unimpaired elderly adults. Neurology 2020; 95:e2075-e2085. [PMID: 32759202 DOI: 10.1212/wnl.0000000000010596] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 04/28/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To compare CSF β-amyloid (Aβ) and florbetapir PET measurements in cognitively unimpaired (CU) elderly adults in order to detect the earliest abnormalities and compare their predictive effect for cognitive decline. METHODS A total of 259 CU individuals were categorized as abnormal (+) or normal (-) on CSF Aβ1-42/Aβ1-40 analyzed with mass spectrometry and Aβ PET measured with 18F-florbetapir. Simultaneous longitudinal measurements of CSF and PET were compared for 39 individuals who were unambiguously Aβ-negative at baseline (CSF-/PET-). We also examined the relationship between baseline CSF/PET group membership and longitudinal changes in CSF Aβ, Aβ PET, and cognition. RESULTS The proportions of individuals in each discordant group were similar (8.1% CSF+/PET- and 7.7% CSF-/PET+). Among baseline Aβ-negative (CSF-/PET-) individuals with longitudinal CSF and PET measurements, a larger proportion subsequently worsened on CSF Aβ (odds ratio 4 [95% confidence interval (CI) 1.1, 22.1], p = 0.035) than Aβ PET over 3.5 ± 1.0 years. Compared to CSF-/PET- individuals, CSF+/PET- individuals had faster (estimate 0.009 [95% CI 0.005, 0.013], p < 0.001) rates of Aβ PET accumulation over 4.4 ± 1.7 years, while CSF-/PET+ individuals had faster (estimate -0.492 [95% CI -0.861, -0.123], p = 0.01) rates of cognitive decline over 4.5 ± 1.9 years. CONCLUSIONS The proportions of discordant PET and CSF Aβ-positive individuals were similar cross-sectionally. However, unambiguously Aβ-negative (CSF-/PET-) individuals are more likely to show subsequent worsening on CSF than PET, supporting the idea that CSF detects the earliest Aβ changes. In discordant cases, only PET abnormality predicted cognitive decline, suggesting that abnormal Aβ PET changes are a later phenomenon in cognitively normal individuals.
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Affiliation(s)
- Tengfei Guo
- From the Helen Wills Neuroscience Institute (T.G., W.J.J., S.M.L.), University of California; Molecular Biophysics and Integrated Bioimaging (T.G., W.J.J., S.M.L.), Lawrence Berkeley National Laboratory, Berkeley, CA; and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia.
| | - Leslie M Shaw
- From the Helen Wills Neuroscience Institute (T.G., W.J.J., S.M.L.), University of California; Molecular Biophysics and Integrated Bioimaging (T.G., W.J.J., S.M.L.), Lawrence Berkeley National Laboratory, Berkeley, CA; and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - John Q Trojanowski
- From the Helen Wills Neuroscience Institute (T.G., W.J.J., S.M.L.), University of California; Molecular Biophysics and Integrated Bioimaging (T.G., W.J.J., S.M.L.), Lawrence Berkeley National Laboratory, Berkeley, CA; and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - William J Jagust
- From the Helen Wills Neuroscience Institute (T.G., W.J.J., S.M.L.), University of California; Molecular Biophysics and Integrated Bioimaging (T.G., W.J.J., S.M.L.), Lawrence Berkeley National Laboratory, Berkeley, CA; and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Susan M Landau
- From the Helen Wills Neuroscience Institute (T.G., W.J.J., S.M.L.), University of California; Molecular Biophysics and Integrated Bioimaging (T.G., W.J.J., S.M.L.), Lawrence Berkeley National Laboratory, Berkeley, CA; and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia
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