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Miller B, Kim SJ, Mehta HH, Cao K, Kumagai H, Thumaty N, Leelaprachakul N, Braniff RG, Jiao H, Vaughan J, Diedrich J, Saghatelian A, Arpawong TE, Crimmins EM, Ertekin-Taner N, Tubi MA, Hare ET, Braskie MN, Décarie-Spain L, Kanoski SE, Grodstein F, Bennett DA, Zhao L, Toga AW, Wan J, Yen K, Cohen P. Mitochondrial DNA variation in Alzheimer's disease reveals a unique microprotein called SHMOOSE. Mol Psychiatry 2023; 28:1813-1826. [PMID: 36127429 PMCID: PMC10027624 DOI: 10.1038/s41380-022-01769-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 08/15/2022] [Accepted: 08/26/2022] [Indexed: 01/22/2023]
Abstract
Mitochondrial DNA variants have previously associated with disease, but the underlying mechanisms have been largely elusive. Here, we report that mitochondrial SNP rs2853499 associated with Alzheimer's disease (AD), neuroimaging, and transcriptomics. We mapped rs2853499 to a novel mitochondrial small open reading frame called SHMOOSE with microprotein encoding potential. Indeed, we detected two unique SHMOOSE-derived peptide fragments in mitochondria by using mass spectrometry-the first unique mass spectrometry-based detection of a mitochondrial-encoded microprotein to date. Furthermore, cerebrospinal fluid (CSF) SHMOOSE levels in humans correlated with age, CSF tau, and brain white matter volume. We followed up on these genetic and biochemical findings by carrying out a series of functional experiments. SHMOOSE acted on the brain following intracerebroventricular administration, differentiated mitochondrial gene expression in multiple models, localized to mitochondria, bound the inner mitochondrial membrane protein mitofilin, and boosted mitochondrial oxygen consumption. Altogether, SHMOOSE has vast implications for the fields of neurobiology, Alzheimer's disease, and microproteins.
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Affiliation(s)
- Brendan Miller
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA
| | - Su-Jeong Kim
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Hemal H Mehta
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Kevin Cao
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Hiroshi Kumagai
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Neehar Thumaty
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Naphada Leelaprachakul
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Regina Gonzalez Braniff
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Henry Jiao
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Joan Vaughan
- Clayton Foundation Laboratories for Peptide Biology, The Salk Institute for Biological Studies, La Jolla, CA, USA
| | - Jolene Diedrich
- Clayton Foundation Laboratories for Peptide Biology, The Salk Institute for Biological Studies, La Jolla, CA, USA
| | - Alan Saghatelian
- Clayton Foundation Laboratories for Peptide Biology, The Salk Institute for Biological Studies, La Jolla, CA, USA
| | - Thalida E Arpawong
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Eileen M Crimmins
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | | | - Meral A Tubi
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, CA, USA
- Department of Neurology, University of Southern California, Los Angeles, CA, USA
| | - Evan T Hare
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, CA, USA
- Department of Neurology, University of Southern California, Los Angeles, CA, USA
| | - Meredith N Braskie
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, CA, USA
- Department of Neurology, University of Southern California, Los Angeles, CA, USA
| | - Léa Décarie-Spain
- Human and Evolutionary Biology Section, Department of Biological Sciences, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, USA
| | - Scott E Kanoski
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA
- Human and Evolutionary Biology Section, Department of Biological Sciences, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, USA
| | - Francine Grodstein
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Lu Zhao
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Arthur W Toga
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Junxiang Wan
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Kelvin Yen
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Pinchas Cohen
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
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Salvador CL, Oppebøen M, Vassli AØ, Pfeiffer HCV, Varhaug KN, Elgstøen KBP, Yazdani M. Increased Sphingomyelin and Free Sialic Acid in Cerebrospinal Fluid of Kearns-Sayre Syndrome: New Findings Using Untargeted Metabolomics. Pediatr Neurol 2023; 143:68-76. [PMID: 37018879 DOI: 10.1016/j.pediatrneurol.2023.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/10/2023] [Accepted: 02/25/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Kearns-Sayre syndrome (KSS) is caused by duplications and/or deletions of mitochondrial DNA (mtDNA) and is typically diagnosed based on a classic triad of symptoms with chronic progressive external ophthalmoplegia (CPEO), retinitis pigmentosa, and onset before age 20 years. The present study aimed to diagnose two patients, on suspicion of KSS. METHODS One of the patients went through a diagnostic odyssey, with normal results from several mtDNA analyses, both in blood and muscle, before the diagnosis was confirmed genetically. RESULTS Two patients presented increased tau protein and low 5-methyltetrahydrofolate (5-MTHF) levels in the cerebrospinal fluid (CSF). Untargeted metabolomics on CSF samples also showed an increase in the levels of free sialic acid and sphingomyelin C16:0 (d18:1/C16:0), compared with four control groups (patients with mitochondrial disorders, nonmitochondrial disorders, low 5-MTHF, or increased tau proteins). CONCLUSIONS It is the first time that elevated sphingomyelin C16:0 (d18:1/C16:0) and tau protein in KSS are reported. Using an untargeted metabolomics approach and standard laboratory methods, the study could shed new light on metabolism in KSS to better understand its complexity. In addition, the findings may suggest the combination of elevated free sialic acid, sphingomyelin C16:0 (d18:1/C16:0), and tau protein as well as low 5-MTHF as new biomarkers in the diagnostics of KSS.
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Affiliation(s)
| | - Mari Oppebøen
- Department of Pediatrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Anja Østeby Vassli
- Department of Medical Biochemistry, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Helle Cecilie Viekilde Pfeiffer
- Department of Pediatrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Department of Pediatrics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Kristin Nielsen Varhaug
- The Mitochondrial Medicine and Neurogenetics (MMN) Group, Department of Clinical Medicine, University of Bergen, Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | | | - Mazyar Yazdani
- Department of Medical Biochemistry, Oslo University Hospital, Rikshospitalet, Oslo, Norway
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3
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Abed SS, Hamdan FB, Hussein MM, Al-Mayah QS. Plasma tau and neurofilament light chain as biomarkers of Alzheimer's disease and their relation to cognitive functions. J Med Life 2023; 16:284-289. [PMID: 36937471 PMCID: PMC10015560 DOI: 10.25122/jml-2022-0251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/03/2023] [Indexed: 03/21/2023] Open
Abstract
Alzheimer's disease (AD) dementia is the most frequent cause of neurodegenerative dementia. The cognitive and behavioral symptoms associated with this disorder often have overlapping characteristics, potentially resulting in delayed diagnosis or misdiagnosis. This study aimed to assess the level of peripheral blood neurofilament light chain (NfL) and total tau (t-tau) protein in AD patients and investigate their relationship with cognitive impairment. The study included 80 participants of both sexes between the ages of 60 to 85 years. The participants were divided into two groups, consisting of 40 individuals in the control group (mean age 75±6.6 years) who had no cognitive or functional impairments and 40 AD patients (mean age 74.98±5.03 years). This study utilized the DSM-5 diagnostic criteria for major or mild neurocognitive disorder attributed to Alzheimer's disease (AD). The clinical and biochemical features of all participants were documented, and the Alzheimer's disease Assessment Scale cognitive subscale (ADAS-cog) scores were evaluated. Sandwich ELISA was employed to determine serum NfL and t-tau protein levels. The median serum NfL and t-tau protein levels in AD patients were significantly higher than those of the controls (47.84 pg/ml versus 17.66 pg/ml and 12.05 pg/ml versus 11.13 pg/ml, respectively). Age was positively correlated with NfL, t-tau levels, and ADAS-cog. Although elevated NfL and t-tau protein levels may play a role in disease progression, their diagnostic value for AD was limited.
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Affiliation(s)
- Sadiruldeen Sami Abed
- Department of Pharmacy, Osol Aldeen University College, Baghdad, Iraq
- Corresponding Author: Sadiruldeen Sami Abed, Department of Pharmacy, Osol Aldeen University College, Baghdad, Iraq. E-mail:
| | - Farqad Bader Hamdan
- Department of Physiology, College of Medicine, Al-Nahrain University, Baghdad, Iraq
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Castelli A, Placidi F, Bonomi CG, Di Giuliano F, Martorana A, Pizzicannella G, Liguori C, Manfredi N, Mari L, Pagano A, Bramato V, Mercuri NB, Izzi F. Periodic sharp wave complexes identify a distinctive phenotype in Creutzfeldt-Jacob disease. Clin Neurophysiol 2022; 143:124-132. [DOI: 10.1016/j.clinph.2022.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 08/18/2022] [Accepted: 08/21/2022] [Indexed: 11/03/2022]
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Dulewicz M, Kulczyńska-Przybik A, Mroczko P, Kornhuber J, Lewczuk P, Mroczko B. Biomarkers for the Diagnosis of Alzheimer’s Disease in Clinical Practice: The Role of CSF Biomarkers during the Evolution of Diagnostic Criteria. Int J Mol Sci 2022; 23:ijms23158598. [PMID: 35955728 PMCID: PMC9369334 DOI: 10.3390/ijms23158598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/30/2022] [Accepted: 07/30/2022] [Indexed: 11/16/2022] Open
Abstract
Alzheimer’s disease (AD) is a progressive condition and the most common cause of dementia worldwide. The neuropathological changes characteristic of the disorder can be successfully detected before the development of full-blown AD. Early diagnosis of the disease constitutes a formidable challenge for clinicians. CSF biomarkers are the in vivo evidence of neuropathological changes developing in the brain of dementia patients. Therefore, measurement of their concentrations allows for improved accuracy of clinical diagnosis. Moreover, AD biomarkers may provide an indication of disease stage. Importantly, the CSF biomarkers of AD play a pivotal role in the new diagnostic criteria for the disease, and in the recent biological definition of AD by the National Institute on Aging, NIH and Alzheimer’s Association. Due to the necessity of collecting CSF by lumbar puncture, the procedure seems to be an important issue not only from a medical, but also a legal, viewpoint. Furthermore, recent technological advances may contribute to the automation of AD biomarkers measurement and may result in the establishment of unified cut-off values and reference limits. Moreover, a group of international experts in the field of AD biomarkers have developed a consensus and guidelines on the interpretation of CSF biomarkers in the context of AD diagnosis. Thus, technological advancement and expert recommendations may contribute to a more widespread use of these diagnostic tests in clinical practice to support a diagnosis of mild cognitive impairment (MCI) or dementia due to AD. This review article presents up-to-date data regarding the usefulness of CSF biomarkers in routine clinical practice and in biomarkers research.
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Affiliation(s)
- Maciej Dulewicz
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland; (A.K.-P.); (P.L.); (B.M.)
- Correspondence:
| | - Agnieszka Kulczyńska-Przybik
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland; (A.K.-P.); (P.L.); (B.M.)
| | - Piotr Mroczko
- Department of Criminal Law and Criminology, Faculty of Law, University of Bialystok, 15-213 Bialystok, Poland;
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg, 91054 Erlangen, Germany;
| | - Piotr Lewczuk
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland; (A.K.-P.); (P.L.); (B.M.)
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg, 91054 Erlangen, Germany;
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland; (A.K.-P.); (P.L.); (B.M.)
- Department of Biochemical Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
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Hermann P, Haller P, Goebel S, Bunck T, Schmidt C, Wiltfang J, Zerr I. Total and Phosphorylated Cerebrospinal Fluid Tau in the Differential Diagnosis of Sporadic Creutzfeldt-Jakob Disease and Rapidly Progressive Alzheimer’s Disease. Viruses 2022; 14:v14020276. [PMID: 35215868 PMCID: PMC8874601 DOI: 10.3390/v14020276] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 01/27/2023] Open
Abstract
Background: CSF total-tau (t-tau) became a standard cerebrospinal fluid biomarker in Alzheimer’s disease (AD). In parallel, extremely elevated levels were observed in Creutzfeldt-Jakob disease (CJD). Therefore, tau is also considered as an alternative CJD biomarker, potentially complicating the interpretation of results. We investigated CSF t-tau and the t-tau/phosphorylated tau181 ratio in the differential diagnosis of sCJD and rapidly-progressive AD (rpAD). In addition, high t-tau concentrations and associated tau-ratios were explored in an unselected laboratory cohort. Methods: Retrospective analyses included n = 310 patients with CJD (n = 205), non-rpAD (n = 65), and rpAD (n = 40). The diagnostic accuracies of biomarkers were calculated and compared. Differential diagnoses were evaluated in patients from a neurochemistry laboratory with CSF t-tau >1250 pg/mL (n = 199 out of 7036). Results: CSF t-tau showed an AUC of 0.942 in the discrimination of sCJD from AD and 0.918 in the discrimination from rpAD. The tau ratio showed significantly higher AUCs (p < 0.001) of 0.992 versus non-rpAD and 0.990 versus rpAD. In the neurochemistry cohort, prion diseases accounted for only 25% of very high CSF t-tau values. High tau-ratios were observed in CJD, but also in non-neurodegenerative diseases. Conclusions: CSF t-tau is a reliable biomarker for sCJD, but false positive results may occur, especially in rpAD and acute encephalopathies. The t-tau/p-tau ratio may improve the diagnostic accuracy in centers where specific biomarkers are not available.
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Affiliation(s)
- Peter Hermann
- Department of Neurology, National Reference Center for CJD Surveillance, University Medical Center Göttingen, 37075 Göttingen, Germany; (P.H.); (S.G.); (T.B.); (C.S.); (I.Z.)
- Correspondence: ; Tel.: +49-551-39-8955
| | - Philip Haller
- Department of Neurology, National Reference Center for CJD Surveillance, University Medical Center Göttingen, 37075 Göttingen, Germany; (P.H.); (S.G.); (T.B.); (C.S.); (I.Z.)
| | - Stefan Goebel
- Department of Neurology, National Reference Center for CJD Surveillance, University Medical Center Göttingen, 37075 Göttingen, Germany; (P.H.); (S.G.); (T.B.); (C.S.); (I.Z.)
| | - Timothy Bunck
- Department of Neurology, National Reference Center for CJD Surveillance, University Medical Center Göttingen, 37075 Göttingen, Germany; (P.H.); (S.G.); (T.B.); (C.S.); (I.Z.)
| | - Christian Schmidt
- Department of Neurology, National Reference Center for CJD Surveillance, University Medical Center Göttingen, 37075 Göttingen, Germany; (P.H.); (S.G.); (T.B.); (C.S.); (I.Z.)
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany;
- German Center for Neurodegenerative Diseases (DZNE), 37075 Göttingen, Germany
- Neurosciences and Signaling Group, Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal
| | - Inga Zerr
- Department of Neurology, National Reference Center for CJD Surveillance, University Medical Center Göttingen, 37075 Göttingen, Germany; (P.H.); (S.G.); (T.B.); (C.S.); (I.Z.)
- German Center for Neurodegenerative Diseases (DZNE), 37075 Göttingen, Germany
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Levy B, Priest A, Delaney T, Hogan J, Herrawi F. Toward Pre-Diagnostic Detection of Dementia in Primary Care. J Alzheimers Dis 2022; 86:479-490. [DOI: 10.3233/jad-215242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Preventing dementia warrants the pragmatic engagement of primary care. Objective: This study predicted conversion to dementia 12 months before diagnosis with indicators that primary care can utilize within the practical constraints of routine practice. Methods: The study analyzed data from the Alzheimer’s Disease Neuroimaging Initiative (Total sample = 645, converting participants = 54). It predicted the conversion from biological (plasma neurofilament light chain), cognitive (Trails Making Test– B), and functional (Functional Activities Questionnaire) measures, in addition to demographic variables (age and education). Results: A Gradient Booster Trees classifier effectively predicted the conversion, based on a Synthetic Minority Oversampling Technique (n = 1,290, F1 Score = 92, AUC = 94, Recall = 87, Precision = 97, Accuracy = 92). Subsequent analysis indicated that the MCI False Positive group (i.e., non-converting participants with cognitive impairment flagged by the model for prospective conversion) scored significantly lower on multiple cognitive tests (Montreal Cognitive Assessment, p < 0.002; ADAS-13, p < 0.0004; Rey Auditory Verbal Learning Test, p < 0.002/0.003) than the MCI True Negative group (i.e., correctly classified non-converting participants with cognitive impairment). These groups also differed in CSF tau levels (p < 0.04), while consistent effect size differences emerged in the all-pairwise comparisons of hippocampal volume and CSF Aβ1 - 42. Conclusion: The model effectively predicted 12-month conversion to dementia and further identified non-converting participants with MCI, in the False Positive group, at relatively higher neurocognitive risk. Future studies may seek to extend these results to earlier prodromal phases. Detection of dementia before diagnosis may be feasible and practical in primary care settings, pending replication of these findings in diverse clinical samples.
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Affiliation(s)
- Boaz Levy
- Department of Counseling and School Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Amanda Priest
- Department of Counseling and School Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Tyler Delaney
- Department of Counseling and School Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Jacqueline Hogan
- Department of Counseling and School Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Farahdeba Herrawi
- Department of Counseling and School Psychology, University of Massachusetts Boston, Boston, MA, USA
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Willemse EAJ, Sieben A, Somers C, Vermeiren Y, De Roeck N, Timmers M, Van Broeckhoven C, De Vil B, Cras P, De Deyn PP, Martin JJ, Teunissen CE, Engelborghs S, Bjerke M. Neurogranin as biomarker in CSF is non-specific to Alzheimer's disease dementia. Neurobiol Aging 2021; 108:99-109. [PMID: 34551375 DOI: 10.1016/j.neurobiolaging.2021.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 07/10/2021] [Accepted: 08/01/2021] [Indexed: 11/19/2022]
Abstract
We aimed to evaluate the specificity of neurogranin (Ng) for Alzheimer's disease (AD) in a dementia cohort. Cerebrospinal fluid (CSF) Ng was measured (ELISA) in two independent cohorts: (1) clinical (n = 116; age 72±11 years): AD, non-AD (+high T-tau), and controls; and (2) autopsy-confirmed (n = 97; age 71±11 years): AD and non-AD, and 50 controls (age 60±6 years). In 16 autopsy-confirmed AD and 8 control subjects, Ng was measured in tissue (BA6+BA22). Ng was compared across diagnostic groups or neuropathological staging using multilinear regression models. Median[IQR] Ng concentrations were elevated in AD (414[315-499]pg/mL) and non-AD (464[319-699]pg/mL) compared to controls (260[193-306]pg/mL), but highest in AD-high-T-tau (874[716, 1148] pg/mL) and Creutzfeldt-Jakob disease (CJD; 828[703-1373]pg/mL) in cohort 1 (p < 0.01), but not in cohort 2: AD: 358[249-470]pg/mL; non-AD:245[137-416]pg/mL; controls: 259[193-370]pg/mL. Ng and tau biomarkers strongly correlated (r = 0.4-0.9, p < 0.05), except in CJD. CSF Ng concentrations were not associated with neuropathological AD hallmarks, nor with tissue Ng concentrations. CSF Ng is a general biomarker for synaptic degeneration, strongly correlating with CSF tau, but without added value for AD differential diagnosis.
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Affiliation(s)
- Eline A J Willemse
- Reference Center for Biological Markers of Dementia (BIODEM) and Laboratory of Neurochemistry and Behavior, Laboratory of Neurobiology, Laboratory of Neurogenetics, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Neurochemistry laboratory. Dept. of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Alzheimer Center, Dept. of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Anne Sieben
- Reference Center for Biological Markers of Dementia (BIODEM) and Laboratory of Neurochemistry and Behavior, Laboratory of Neurobiology, Laboratory of Neurogenetics, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Charisse Somers
- Reference Center for Biological Markers of Dementia (BIODEM) and Laboratory of Neurochemistry and Behavior, Laboratory of Neurobiology, Laboratory of Neurogenetics, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Yannick Vermeiren
- Reference Center for Biological Markers of Dementia (BIODEM) and Laboratory of Neurochemistry and Behavior, Laboratory of Neurobiology, Laboratory of Neurogenetics, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Naomi De Roeck
- Reference Center for Biological Markers of Dementia (BIODEM) and Laboratory of Neurochemistry and Behavior, Laboratory of Neurobiology, Laboratory of Neurogenetics, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Maarten Timmers
- Reference Center for Biological Markers of Dementia (BIODEM) and Laboratory of Neurochemistry and Behavior, Laboratory of Neurobiology, Laboratory of Neurogenetics, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Janssen Research and Development, a Division of Janssen Pharmaceutica NV, Beerse, Belgium
| | - Christine Van Broeckhoven
- Reference Center for Biological Markers of Dementia (BIODEM) and Laboratory of Neurochemistry and Behavior, Laboratory of Neurobiology, Laboratory of Neurogenetics, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Neurodegenerative Brain Diseases Group, VIB Center for Molecular Neurology, University of Antwerp, Antwerp, Belgium
| | - Bart De Vil
- Reference Center for Biological Markers of Dementia (BIODEM) and Laboratory of Neurochemistry and Behavior, Laboratory of Neurobiology, Laboratory of Neurogenetics, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Patrick Cras
- Reference Center for Biological Markers of Dementia (BIODEM) and Laboratory of Neurochemistry and Behavior, Laboratory of Neurobiology, Laboratory of Neurogenetics, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Department of Neurology, University Hospital Antwerp, Antwerp, Belgium
| | - Peter P De Deyn
- Reference Center for Biological Markers of Dementia (BIODEM) and Laboratory of Neurochemistry and Behavior, Laboratory of Neurobiology, Laboratory of Neurogenetics, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium
| | - Jean-Jacques Martin
- Reference Center for Biological Markers of Dementia (BIODEM) and Laboratory of Neurochemistry and Behavior, Laboratory of Neurobiology, Laboratory of Neurogenetics, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Charlotte E Teunissen
- Neurochemistry laboratory. Dept. of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM) and Laboratory of Neurochemistry and Behavior, Laboratory of Neurobiology, Laboratory of Neurogenetics, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Department of Neurology and Center for Neurosciences (C4N), Universitair Ziekenhuis Brussel (UZ Brussel) and Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Maria Bjerke
- Reference Center for Biological Markers of Dementia (BIODEM) and Laboratory of Neurochemistry and Behavior, Laboratory of Neurobiology, Laboratory of Neurogenetics, and Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Neurochemistry laboratory, Department of Clinical Biology and Center for Neurosciences (C4N), Universitair Ziekenhuis Brussel (UZ Brussel) and Vrije Universiteit Brussel (VUB), Brussels, Belgium.
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Interest of biological biomarkers in the diagnostic approach of neurocognitive disorders in the elderly. Rev Neurol (Paris) 2020; 176:677-683. [PMID: 32169325 DOI: 10.1016/j.neurol.2019.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/13/2019] [Indexed: 02/07/2023]
Abstract
Alzheimer's disease (AD) is the most common cause of major neurocognitive disorders in older adults, affecting millions of individuals worldwide and leading to irreversible cognitive decline. The main neuropathological features of AD are brain amyloid deposition and neurofibrillary tangles. The biomarkers of AD are highly accurate in detecting these pathophysiological and neuropathological changes, up to several decades before the onset of cognitive impairment. They specifically reflect the presence of abnormal proteins in the brain, and can be measured reliably in the cerebrospinal fluid of affected individuals and in plasma for research purposes. Their implementation in clinical practice, together with neuropsychological assessment and neuroimaging, strongly increases diagnostic precision. Thus, amyloid and tau biomarkers can help rule out differential diagnoses such as vascular cognitive impairment or frontotemporal lobar degeneration. They also enable earlier diagnosis and are used in research to characterize the preclinical stage of AD. The new definition of AD has highlighted the usefulness of these biomarkers, shifting the focus from symptoms to biological and brain changes in living patients. Recent longitudinal studies demonstrated the ability of these biomarkers to predict future cognitive decline, regardless of the stage of the disease. Ongoing drug trials against AD systematically require diagnostic confirmation with biomarkers. Apart from clinical research, they have been increasingly used for several years in clinical practice, in secondary and tertiary-referral memory clinics. Nevertheless, their use has been raising ethical issues, in particular in the oldest old or in patients with multimorbidity. Their interpretation in patients older than 90 years is limited by the lack of evidence. The implications of a misdiagnosis of AD should be taken into account. Besides, there may be discrepancies between the biological diagnosis and the clinical course of the disease. In the absence of clear guidelines for their utilization, we hereby discuss their potential interests and limitations in older individuals.
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Abstract
Importance Worldwide, 47 million people live with dementia and, by 2050, the number is expected to increase to 131 million. Observations Dementia is an acquired loss of cognition in multiple cognitive domains sufficiently severe to affect social or occupational function. In the United States, Alzheimer disease, one cause of dementia, affects 5.8 million people. Dementia is commonly associated with more than 1 neuropathology, usually Alzheimer disease with cerebrovascular pathology. Diagnosing dementia requires a history evaluating for cognitive decline and impairment in daily activities, with corroboration from a close friend or family member, in addition to a thorough mental status examination by a clinician to delineate impairments in memory, language, attention, visuospatial cognition such as spatial orientation, executive function, and mood. Brief cognitive impairment screening questionnaires can assist in initiating and organizing the cognitive assessment. However, if the assessment is inconclusive (eg, symptoms present, but normal examination findings), neuropsychological testing can help determine whether dementia is present. Physical examination may help identify the etiology of dementia. For example, focal neurologic abnormalities suggest stroke. Brain neuroimaging may demonstrate structural changes including, but not limited to, focal atrophy, infarcts, and tumor, that may not be identified on physical examination. Additional evaluation with cerebrospinal fluid assays or genetic testing may be considered in atypical dementia cases, such as age of onset younger than 65 years, rapid symptom onset, and/or impairment in multiple cognitive domains but not episodic memory. For treatment, patients may benefit from nonpharmacologic approaches, including cognitively engaging activities such as reading, physical exercise such as walking, and socialization such as family gatherings. Pharmacologic approaches can provide modest symptomatic relief. For Alzheimer disease, this includes an acetylcholinesterase inhibitor such as donepezil for mild to severe dementia, and memantine (used alone or as an add-on therapy) for moderate to severe dementia. Rivastigmine can be used to treat symptomatic Parkinson disease dementia. Conclusions and Relevance Alzheimer disease currently affects 5.8 million persons in the United States and is a common cause of dementia, which is usually accompanied by other neuropathology, often cerebrovascular disease such as brain infarcts. Causes of dementia can be diagnosed by medical history, cognitive and physical examination, laboratory testing, and brain imaging. Management should include both nonpharmacologic and pharmacologic approaches, although efficacy of available treatments remains limited.
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Affiliation(s)
- Zoe Arvanitakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
- Dept of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - Raj C. Shah
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
- Dept of Family Medicine, Rush University Medical Center, Chicago, IL
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
- Dept of Neurological Sciences, Rush University Medical Center, Chicago, IL
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Lacour M, Quenez O, Rovelet-Lecrux A, Salomon B, Rousseau S, Richard AC, Quillard-Muraine M, Pasquier F, Rollin-Sillaire A, Martinaud O, Zarea A, de la Sayette V, Boutoleau-Bretonniere C, Etcharry-Bouyx F, Chauviré V, Sarazin M, le Ber I, Epelbaum S, Jonveaux T, Rouaud O, Ceccaldi M, Godefroy O, Formaglio M, Croisile B, Auriacombe S, Magnin E, Sauvée M, Marelli C, Gabelle A, Pariente J, Paquet C, Boland A, Deleuze JF, Campion D, Hannequin D, Nicolas G, Wallon D. Causative Mutations and Genetic Risk Factors in Sporadic Early Onset Alzheimer’s Disease Before 51 Years. J Alzheimers Dis 2019; 71:227-243. [DOI: 10.3233/jad-190193] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Morgane Lacour
- Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Department of Neurology and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | - Olivier Quenez
- Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Department of Genetics and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | - Anne Rovelet-Lecrux
- Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Department of Genetics and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | - Bruno Salomon
- Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Department of Neurology and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | - Stephane Rousseau
- Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Department of Genetics and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | - Anne-Claire Richard
- Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Department of Genetics and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | | | - Florence Pasquier
- Department of Neurology and CNR-MAJ, Lille University Hospital, Lille, France
- Univ Lille, Inserm UMR-S 1171, Distalz, Lille, France
| | - Adeline Rollin-Sillaire
- Department of Neurology and CNR-MAJ, Lille University Hospital, Lille, France
- Univ Lille, Inserm UMR-S 1171, Distalz, Lille, France
| | | | - Aline Zarea
- Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Department of Neurology and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | | | | | | | - Valérie Chauviré
- Department of Neurology, Angers University Hospital, Angers, France
| | - Marie Sarazin
- Department of Neurology, Saint Anne University Hospital, Paris, France
| | - Isabelle le Ber
- National Reference Center for Rare or Early Dementias and Center of Excellence of Neurodegenerative Disease (CoEN), Institute of Memory and Alzheimer’s Disease (IM2A), APHP, Hôpital Pitié-Salpêtrière, Paris, and Sorbonne Universités, UPMC Univ Paris 06, Inserm U1127, CNRS UMR 7225, Brain and Spine Institute (ICM), Hôpital Pitié-Salpêtrière, Paris, France
| | - Stéphane Epelbaum
- National Reference Center for Rare or Early Dementias and Center of Excellence of Neurodegenerative Disease (CoEN), Institute of Memory and Alzheimer’s Disease (IM2A), APHP, Hôpital Pitié-Salpêtrière, Paris, and Sorbonne Universités, UPMC Univ Paris 06, Inserm U1127, CNRS UMR 7225, Brain and Spine Institute (ICM), Hôpital Pitié-Salpêtrière, Paris, France
| | - Thérèse Jonveaux
- Department of Geriatrics and CMRR, Nancy University Hospital, Nancy, France
| | - Olivier Rouaud
- Department of Neurology, Dijon University Hospital, Dijon, France
| | - Mathieu Ceccaldi
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Service de Neurologie et de Neuropsychologie, CHU de la Timone, APHM, Marseille, France
| | - Olivier Godefroy
- Departments of Neurology, Amiens University Hospital, and Laboratory of Functional Neurosciences1, 6 (EA 4559), Jules Verne University of Picardie, Amiens, France
| | - Maite Formaglio
- Service de Neuropsychologie and CMRR, Lyon University Hospital, Lyon, France
| | - Bernard Croisile
- Service de Neuropsychologie and CMRR, Lyon University Hospital, Lyon, France
| | - Sophie Auriacombe
- Department of Neurology, Bordeaux University Hospital, Bordeaux, France
| | - Eloi Magnin
- Department of Neurology, Besançon University Hospital, Besançon, France
| | - Mathilde Sauvée
- Department of Neurology, Grenoble University Hospital, Grenoble, France
| | - Cecilia Marelli
- Department of Neurology, Montpellier, University Hospital, Montpellier, France
| | - Audrey Gabelle
- Department of Neurology, Montpellier, University Hospital, Montpellier, France
| | - Jeremie Pariente
- CMRR Department of Neurology, Toulouse University Hospital, Toulouse, France
| | - Claire Paquet
- Cognitive Neurology Center/CMRR Paris Nord Ile de France, Lariboisière Fernand-Widal Hospital Université de Paris, INSERMU1144, Paris
| | - Anne Boland
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Evry, France
| | - Dominique Campion
- Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Department of Genetics and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
- Department of Research, Centre Hospitalier du Rouvray, Sotteville-lès-Rouen, France
| | - Didier Hannequin
- Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Department of Neurology and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | - Gael Nicolas
- Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Department of Genetics and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
| | - David Wallon
- Normandie Univ, UNIROUEN, Inserm U1245 and Rouen University Hospital, Department of Neurology and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen, France
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Lehmann S, Paquet C, Malaplate-Armand C, Magnin E, Schraen S, Quillard-Muraine M, Bousiges O, Delaby C, Dumurgier J, Hugon J, Sablonnière B, Blanc F, Wallon D, Gabelle A, Laplanche JL, Bouaziz-Amar E, Peoc'h K. Diagnosis associated with Tau higher than 1200 pg/mL: Insights from the clinical and laboratory practice. Clin Chim Acta 2019; 495:451-456. [PMID: 31051163 DOI: 10.1016/j.cca.2019.04.081] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 04/25/2019] [Accepted: 04/29/2019] [Indexed: 01/25/2023]
Abstract
CONTEXT Cerebrospinal fluid (CSF) biomarkers are valuable tools for the diagnosis of neurological diseases. We aimed to investigate within a retrospective multicentric study the final diagnosis associated with very high CSF Tau levels and to identify patterns of biomarkers that would differentiate them in clinical practice, to help clinical biologists into physicians' counseling. PATIENTS AND METHODS Within the national multicentric network ePLM, we included 1743 patients from January 1, 2008, to December 31, 2013, with CSF biomarkers assayed by the same Innotest assays (protein Tau, phospho-Tau [pTau], and Aβ 1-42). We identified 205 patients with protein Tau concentration higher than 1200 pg/mL and final diagnosis. RESULTS Among those patients, 105 (51.2%) were suffering from Alzheimer's disease, 37 (18%) from sporadic Creuztfeldt-Jakob disease, and 63 (30.7%) from other neurological diseases including paraneoplastic/ central nervous system tumor, frontotemporal dementia, other diagnoses, amyloid angiopathy, Lewy body dementia, and infections of the central nervous system. Phospho-Tau, Aβ1-42 and Aβ1-42/pTau values differed significantly between the three groups of patients (p < .001). An Aβ1-42/pTau ratio between 4.7 and 9.7 was suggestive of other neurological diseases (threshold in AD: 8.3). CSF 14-3-3 was useful to discriminate Alzheimer's disease from Creuztfeldt-Jakob disease in case of Aβ1-42 concentrations <550 pg/mL or pTau>60 pg/mL. CONCLUSION This work emphasizes the interest of a well-thought-out interpretation of CSF biomarkers in neurological diseases, particularly in the case of high Tau protein concentrations in the CSF.
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Affiliation(s)
- S Lehmann
- CHU de Montpellier and Université de Montpellier, IRMB, CRB, Laboratoire de Biochimie et Protéomique Clinique, 80 Avenue Augustin Fliche, 34295 Montpellier, France
| | - C Paquet
- Centre de Neurologie Cognitive, Groupe Hospitalier Saint-Louis Lariboisière Fernand-Widal APHP, INSERM U942, Université Paris Diderot, France
| | - C Malaplate-Armand
- Laboratoire de Biochimie et Biologie Moléculaire, UF Oncologie - Endocrinologie - Neurobiologie, Hôpital Central, Centre Hospitalier Universitaire, Nancy, France
| | - E Magnin
- Centre Mémoire Ressources Recherche Besançon Franche-Comté, Departement of Neurology, CHU Besançon, Besançon, France
| | - S Schraen
- Univ.Lille, Inserm, CHU-Lille, UMR-S1172 and Neurobiology Unit, Centre de Biologie-Pathologie, Lille, France
| | | | - O Bousiges
- Laboratoire de Biochimie et de Biologie Moléculaire, Hôpital de Hautepierre, Hôpitaux Universitaire de Strasbourg, Strasbourg, France; Laboratoire de Neurosciences cognitives et Adaptatives (LNCA), UMR7364 Unistra/CNRS, Strasbourg, France
| | - C Delaby
- CHU de Montpellier and Université de Montpellier, IRMB, CRB, Laboratoire de Biochimie et Protéomique Clinique, 80 Avenue Augustin Fliche, 34295 Montpellier, France
| | - J Dumurgier
- Centre de Neurologie Cognitive, Groupe Hospitalier Saint-Louis Lariboisière Fernand-Widal APHP, INSERM U942, Université Paris Diderot, France
| | - J Hugon
- Centre de Neurologie Cognitive, Groupe Hospitalier Saint-Louis Lariboisière Fernand-Widal APHP, INSERM U942, Université Paris Diderot, France
| | - B Sablonnière
- Centre Mémoire Ressources Recherche Besançon Franche-Comté, Departement of Neurology, CHU Besançon, Besançon, France
| | - F Blanc
- 2ICube laboratory and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS-Neurocrypto, University of Strasbourg and CNRS, Strasbourg, France
| | - D Wallon
- Inserm U1079, University of Rouen, Department of Neurology, France
| | - A Gabelle
- Centre Mémoire Ressources Recherche, CHU de Montpellier, Hôpital Gui de Chauliac, Montpellier, Université Montpellier, Montpellier, France
| | - J L Laplanche
- Service de Biochimie et Biologie moléculaire, GH Saint-Louis-Lariboisière-Fernand Widal, APHP, Paris, France
| | - E Bouaziz-Amar
- Service de Biochimie et Biologie moléculaire, GH Saint-Louis-Lariboisière-Fernand Widal, APHP, Paris, France
| | - K Peoc'h
- Service de Biochimie et Biologie moléculaire, GH Saint-Louis-Lariboisière-Fernand Widal, APHP, Paris, France; APHP, HUPNVS, Hôpital Beaujon, Biochimie clinique, Clichy, France; Université Paris Diderot, France.
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Review: Fluid biomarkers in the human prion diseases. Mol Cell Neurosci 2018; 97:81-92. [PMID: 30529227 DOI: 10.1016/j.mcn.2018.12.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 11/29/2018] [Accepted: 12/03/2018] [Indexed: 01/27/2023] Open
Abstract
The human prion diseases are a diverse set of often rapidly progressive neurodegenerative conditions associated with abnormal forms of the prion protein. We review work to establish diagnostic biomarkers and assays that might fill other important roles, particularly those that could assist the planning and interpretation of clinical trials. The field now benefits from highly sensitive and specific diagnostic biomarkers using cerebrospinal fluid: detecting by-products of rapid neurodegeneration or specific functional properties of abnormal prion protein, with the second generation real time quaking induced conversion (RT-QuIC) assay being particularly promising. Blood has been a more challenging analyte, but has now also yielded valuable biomarkers. Blood-based assays have been developed with the potential to screen for variant Creutzfeldt-Jakob disease, although it remains uncertain whether these will ever be used in practice. The very rapid neurodegeneration of prion disease results in strong signals from surrogate protein markers in the blood that reflect neuronal, axonal, synaptic or glial pathology in the brain: notably the tau and neurofilament light chain proteins. We discuss early evidence that such tests, applied alongside robust diagnostic biomarkers, may have potential to add value as clinical trial outcome measures, predictors of future disease course (including for asymptomatic individuals at high risk of prion disease), and as rapidly accessible and sensitive markers to aid early diagnosis.
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Abstract
Dementia is a syndrome seen most commonly in older people and characterized by a decline in cognitive performance which impacts on the person's ability to function. There are approximately 47 million people worldwide with dementia and there are 10 million new cases every year. It is a major cause of disability and dependence and impacts on the physical, psychologic, and social well-being of families and carers. Alzheimer's disease is the most common form of dementia. Gait and balance impairments are common in people with dementia and contribute to the significantly elevated risk of falls. Older people with dementia are at increased risk of injury, institutionalization, hospitalization, morbidity, and death after a fall. There is preliminary evidence, predominantly from relatively small studies, that falls and disability can be prevented in this population. However, more good-quality research is needed, both to provide some certainty around the existing evidence base as well as to explore alternate approaches to prevention, including combined cognitive-motor training and cognitive pharmacotherapy.
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Affiliation(s)
- Morag E Taylor
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia; Prince of Wales Clinical School, Medicine, University of New South Wales, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - Jacqueline C T Close
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia; Prince of Wales Clinical School, Medicine, University of New South Wales, Sydney, NSW, Australia
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Biomarkers in cerebrospinal fluid for synucleinopathies, tauopathies, and other neurodegenerative disorders. HANDBOOK OF CLINICAL NEUROLOGY 2018; 146:99-113. [DOI: 10.1016/b978-0-12-804279-3.00007-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Humpel C, Benke T. Cerebrospinal Fluid Levels of 14-3-3 Gamma: What Does It Tell Us About Sporadic Creutzfeldt-Jakob Disease? Pharmacology 2017; 100:243-245. [PMID: 28743115 DOI: 10.1159/000479115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 07/02/2017] [Indexed: 11/19/2022]
Abstract
Clinical diagnosis of Creutzfeldt-Jakob disease (CJD) can be supported by the analysis of Tau and 14-3-3 in the cerebrospinal fluid (CSF). In this short report, we report about a retrospective analysis performed on 2,296 routinely collected CSF samples, and 44 samples with a ratio of phosphoTau181/Tau <0.075 were selected. Analysis was performed with a novel 14-3-3 gamma CircuLex Elisa. We show that control levels were around 6,000 AU/mL and samples from Alzheimer patients were not different from those collected from healthy controls. Four cases of verified CJD had 14-3-3 CSF levels of >100,000 AU/mL, while 10 out of 12 suspected CJD samples with 14-3-3 CSF levels between 50,000-100,000 AU/mL were CJD positive. All samples with 14-3-3 levels between 15,000 and 50,000 AU/mL were not CJD cases but disorders with complex neuropathology. In conclusion, our data suggests that in CSF samples with a phospho-Tau-181/Tau ratio <0.075 CSF levels of 14-3-3 should be analyzed. Our data suggests a very high risk for CJD with 14-3-3 levels above 100,000 AU/mL and a probable diagnosis of CJD based on laboratory parameters above 50,000 AU/mL.
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Affiliation(s)
- Christian Humpel
- Laboratory of Psychiatry and Experimental Alzheimer's Research, Medical University of Innsbruck, Innsbruck, Austria
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Magnin E, Dumurgier J, Bouaziz-Amar E, Bombois S, Wallon D, Gabelle A, Lehmann S, Blanc F, Bousiges O, Hannequin D, Jung B, Miguet-Alfonsi C, Quillard M, Pasquier F, Peoc’h K, Laplanche JL, Hugon J, Paquet C. Les biomarqueurs du liquide cérébro-spinal dans la maladie d’Alzheimer : un outil de recherche utile dans la pratique clinique courante des consultations mémoire pour les cas complexes. Rev Med Interne 2017; 38:250-255. [DOI: 10.1016/j.revmed.2016.10.383] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/19/2016] [Accepted: 10/18/2016] [Indexed: 01/08/2023]
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