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Frick EA, Emilsson V, Jonmundsson T, Steindorsdottir AE, Johnson ECB, Puerta R, Dammer EB, Shantaraman A, Cano A, Boada M, Valero S, García-González P, Gudmundsson EF, Gudjonsson A, Pitts R, Qiu X, Finkel N, Loureiro JJ, Orth AP, Seyfried NT, Levey AI, Ruiz A, Aspelund T, Jennings LL, Launer LJ, Gudmundsdottir V, Gudnason V. Serum proteomics reveal APOE-ε4-dependent and APOE-ε4-independent protein signatures in Alzheimer's disease. NATURE AGING 2024; 4:1446-1464. [PMID: 39169269 PMCID: PMC11485263 DOI: 10.1038/s43587-024-00693-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 07/22/2024] [Indexed: 08/23/2024]
Abstract
A deeper understanding of the molecular processes underlying late-onset Alzheimer's disease (LOAD) could aid in biomarker and drug target discovery. Using high-throughput serum proteomics in the prospective population-based Age, Gene/Environment Susceptibility-Reykjavik Study (AGES) cohort of 5,127 older Icelandic adults (mean age, 76.6 ± 5.6 years), we identified 303 proteins associated with incident LOAD over a median follow-up of 12.8 years. Over 40% of these proteins were associated with LOAD independently of APOE-ε4 carrier status, were implicated in neuronal processes and overlapped with LOAD protein signatures in brain and cerebrospinal fluid. We identified 17 proteins whose associations with LOAD were strongly dependent on APOE-ε4 carrier status, with mostly consistent associations in cerebrospinal fluid. Remarkably, four of these proteins (TBCA, ARL2, S100A13 and IRF6) were downregulated by APOE-ε4 yet upregulated due to LOAD, a finding replicated in external cohorts and possibly reflecting a response to disease onset. These findings highlight dysregulated pathways at the preclinical stages of LOAD, including those both independent of and dependent on APOE-ε4 status.
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Affiliation(s)
| | - Valur Emilsson
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | | | - Erik C B Johnson
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Raquel Puerta
- Research Center and Memory Clinic. Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Barcelona, Spain
| | - Eric B Dammer
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Anantharaman Shantaraman
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Amanda Cano
- Research Center and Memory Clinic. Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Barcelona, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Mercè Boada
- Research Center and Memory Clinic. Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Barcelona, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Sergi Valero
- Research Center and Memory Clinic. Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Barcelona, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Pablo García-González
- Research Center and Memory Clinic. Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Barcelona, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | | | | | | | | | | | | | | | - Nicholas T Seyfried
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Allan I Levey
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Agustin Ruiz
- Research Center and Memory Clinic. Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Barcelona, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Thor Aspelund
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, MD, USA
| | - Valborg Gudmundsdottir
- Icelandic Heart Association, Kopavogur, Iceland.
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland.
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
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2
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Cano A, Capdevila M, Puerta R, Arranz J, Montrreal L, de Rojas I, García-González P, Olivé C, García-Gutiérrez F, Sotolongo-Grau O, Orellana A, Aguilera N, Ramis M, Rosende-Roca M, Lleó A, Fortea J, Tartari JP, Lafuente A, Vargas L, Pérez-Cordón A, Muñoz N, Sanabria Á, Alegret M, Morató X, Tárraga L, Fernández V, Marquié M, Valero S, Alcolea D, Boada M, Ruiz A. Clinical value of plasma pTau181 to predict Alzheimer's disease pathology in a large real-world cohort of a memory clinic. EBioMedicine 2024; 108:105345. [PMID: 39299003 PMCID: PMC11424964 DOI: 10.1016/j.ebiom.2024.105345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 09/02/2024] [Accepted: 09/02/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND The identification of patients with an elevated risk of developing Alzheimer's disease (AD) dementia and eligible for the disease-modifying treatments (DMTs) in the earliest stages is one of the greatest challenges in the clinical practice. Plasma biomarkers has the potential to predict these issues, but further research is still needed to translate them to clinical practice. Here we evaluated the clinical applicability of plasma pTau181 as a predictive marker of AD pathology in a large real-world cohort of a memory clinic. METHODS Three independent cohorts (modelling [n = 991, 59.7% female], testing [n = 642, 56.2% female] and validation [n = 441, 55.1% female]) of real-world patients with subjective cognitive decline (SCD), mild cognitive impairment (MCI), AD dementia, and other dementias were included. Paired cerebrospinal fluid (CSF) and plasma samples were used to measure AT(N) CSF biomarkers and plasma pTau181. FINDINGS CSF and plasma pTau181 showed correlation in all phenotypes except in SCD and other dementias. Age significantly influenced the biomarker's performance. The general Aβ(+) vs Aβ(-) ROC curve showed an AUC = 0.77 [0.74-0.80], whereas the specific ROC curve of MCI due to AD vs non-AD MCI showed an AUC = 0.89 [0.85-0.93]. A cut-off value of 1.30 pg/ml of plasma pTau181 exhibited a sensitivity of 93.57% [88.72-96.52], specificity of 72.38% [62.51-79.01], VPP of 77.85% [70.61-83.54], and 8.30% false negatives in the subjects with MCI of the testing cohort. The HR of cox regression showed that patients with MCI up to this cut-off value exhibited a HR = 1.84 [1.05-3.22] higher risk to convert to AD dementia than patients with MCI below the cut-off value. INTERPRETATION Plasma pTau181 has the potential to be used in the memory clinics as a screening biomarker of AD pathology in subjects with MCI, presenting a valuable prognostic utility in predicting the MCI conversion to AD dementia. In the context of a real-world population, a confirmatory test employing gold-standard procedures is still advisable. FUNDING This study has been mainly funded by Ace Alzheimer Center Barcelona, Instituto de Salud Carlos III (ISCIII), Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Spanish Ministry of Science and Innovation, Fundación ADEY, Fundación Echevarne and Grífols S.A.
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Affiliation(s)
- Amanda Cano
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain; Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain.
| | - María Capdevila
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain; Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Science, Universitat de Barcelona, Spain
| | - Raquel Puerta
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | - Javier Arranz
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Laura Montrreal
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | - Itziar de Rojas
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain; Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Pablo García-González
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain; Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Claudia Olivé
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | | | - Oscar Sotolongo-Grau
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | - Adelina Orellana
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain; Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Nuria Aguilera
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | - Maribel Ramis
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | - Maitee Rosende-Roca
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain; Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Alberto Lleó
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain; Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Juan Fortea
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain; Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain; Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain
| | - Juan Pablo Tartari
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | - Asunción Lafuente
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | - Liliana Vargas
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | - Alba Pérez-Cordón
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | - Nathalia Muñoz
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | - Ángela Sanabria
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | - Montserrat Alegret
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain; Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Xavier Morató
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | - Lluís Tárraga
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain; Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Victoria Fernández
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain
| | - Marta Marquié
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain; Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Sergi Valero
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain; Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Daniel Alcolea
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain; Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mercè Boada
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain; Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Agustín Ruiz
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, Barcelona, Spain; Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center, San Antonio, TX, USA
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Ahmad S, Yang W, Orellana A, Frölich L, de Rojas I, Cano A, Boada M, Hernández I, Hausner L, Harms AC, Bakker MHM, Cabrera-Socorro A, Amin N, Ramírez A, Ruiz A, Van Duijn CM, Hankemeier T. Association of oxidative stress and inflammatory metabolites with Alzheimer's disease cerebrospinal fluid biomarkers in mild cognitive impairment. Alzheimers Res Ther 2024; 16:171. [PMID: 39080778 PMCID: PMC11287840 DOI: 10.1186/s13195-024-01542-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/22/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND Isoprostanes and prostaglandins are biomarkers for oxidative stress and inflammation. Their role in Alzheimer's disease (AD) pathophysiology is yet unknown. In the current study, we aim to identify the association of isoprostanes and prostaglandins with the Amyloid, Tau, Neurodegeneration (ATN) biomarkers (Aβ-42, p-tau, and t-tau) of AD pathophysiology in mild cognitive impairment (MCI) subjects. METHODS Targeted metabolomics profiling was performed using liquid chromatography-mass spectrometry (LCMS) in 147 paired plasma-CSF samples from the Ace Alzheimer Center Barcelona and 58 CSF samples of MCI patients from the Mannheim/Heidelberg cohort. Linear regression was used to evaluate the association of metabolites with CSF levels of ATN biomarkers in the overall sample and stratified by Aβ-42 pathology and APOE genotype. We further evaluated the role of metabolites in MCI to AD dementia progression. RESULTS Increased CSF levels of PGF2α, 8,12-iso-iPF2α VI, and 5-iPF2α VI were significantly associated (False discovery rate (FDR) < 0.05) with higher p-tau levels. Additionally, 8,12-iso-iPF2α VI was associated with increased total tau levels in CSF. In MCI due to AD, PGF2α was associated with both p-tau and total tau, whereases 8,12-iso-iPF2α VI was specifically associated with p-tau levels. In APOE stratified analysis, association of PGF2α with p-tau and t-tau was observed in only APOE ε4 carriers while 5-iPF2α VI showed association with both p-tau and t-tau in APOE ε33 carriers. CSF levels of 8,12- iso-iPF2α VI showed association with p-tau and t-tau in APOE ε33/APOE ε4 carriers and with t-tau in APOE ε3 carriers. None of the metabolites showed evidence of association with MCI to AD progression. CONCLUSIONS Oxidative stress (8,12-iso-iPF2α VI) and inflammatory (PGF2α) biomarkers are correlated with biomarkers of AD pathology during the prodromal stage of AD and relation of PGF2α with tau pathology markers may be influenced by APOE genotype.
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Affiliation(s)
- Shahzad Ahmad
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
- Metabolomics and Analytics Center, Leiden Academic Centre for Drug Research, Leiden University, Einsteinweg 55, 2333 CC, Leiden, The Netherlands
- Oxford-GSK Institute of Molecular and Computational Medicine (IMCM), Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Wei Yang
- Metabolomics and Analytics Center, Leiden Academic Centre for Drug Research, Leiden University, Einsteinweg 55, 2333 CC, Leiden, The Netherlands
| | - Adelina Orellana
- Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159, Mannheim, Germany
| | - Itziar de Rojas
- Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Amanda Cano
- Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Hernández
- Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Lucrezia Hausner
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159, Mannheim, Germany
| | - Amy C Harms
- Metabolomics and Analytics Center, Leiden Academic Centre for Drug Research, Leiden University, Einsteinweg 55, 2333 CC, Leiden, The Netherlands
| | - Margot H M Bakker
- Discovery Research, AbbVie Deutschland GmbH & Co. KG, 67061, KnollstrasseLudwigshafen, Germany
| | | | - Najaf Amin
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
- Nuffield Department of Population Health, University of Oxford, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Old Road Campus, , Headington-Oxford, OX3 7FZ, UK
| | - Alfredo Ramírez
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Joseph-Stelzmann-Strasse 26, 50931, Cologne, Germany
- Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, USA
| | - Agustín Ruiz
- Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center On Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Cornelia M Van Duijn
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
- Nuffield Department of Population Health, University of Oxford, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Old Road Campus, , Headington-Oxford, OX3 7FZ, UK.
| | - Thomas Hankemeier
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
- Metabolomics and Analytics Center, Leiden Academic Centre for Drug Research, Leiden University, Einsteinweg 55, 2333 CC, Leiden, The Netherlands.
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Mastenbroek SE, Sala A, Vállez García D, Shekari M, Salvadó G, Lorenzini L, Pieperhoff L, Wink AM, Lopes Alves I, Wolz R, Ritchie C, Boada M, Visser PJ, Bucci M, Farrar G, Hansson O, Nordberg AK, Ossenkoppele R, Barkhof F, Gispert JD, Rodriguez-Vieitez E, Collij LE. Continuous β-Amyloid CSF/PET Imbalance Model to Capture Alzheimer Disease Heterogeneity. Neurology 2024; 103:e209419. [PMID: 38862136 PMCID: PMC11244744 DOI: 10.1212/wnl.0000000000209419] [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: 07/27/2023] [Accepted: 03/29/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Discordance between CSF and PET biomarkers of β-amyloid (Aβ) might reflect an imbalance between soluble and aggregated species, possibly reflecting disease heterogeneity. Previous studies generally used binary cutoffs to assess discrepancies in CSF/PET biomarkers, resulting in a loss of information on the extent of discordance. In this study, we (1) jointly modeled Aβ-CSF/PET data to derive a continuous measure of the imbalance between soluble and fibrillar pools of Aβ, (2) investigated factors contributing to this imbalance, and (3) examined associations with cognitive trajectories. METHODS Across 822 cognitively unimpaired (n = 261) and cognitively impaired (n = 561) Alzheimer's Disease Neuroimaging Initiative individuals (384 [46.7%] females, mean age 73.0 ± 7.4 years), we fitted baseline CSF-Aβ42 and global Aβ-PET to a hyperbolic regression model, deriving a participant-specific Aβ-aggregation score (standardized residuals); negative values represent more soluble relative to aggregated Aβ and positive values more aggregated relative to soluble Aβ. Using linear models, we investigated whether methodological factors, demographics, CSF biomarkers, and vascular burden contributed to Aβ-aggregation scores. With linear mixed models, we assessed whether Aβ-aggregation scores were predictive of cognitive functioning. Analyses were repeated in an early independent validation cohort of 383 Amyloid Imaging to Prevent Alzheimer's Disease Prognostic and Natural History Study individuals (224 [58.5%] females, mean age 65.2 ± 6.9 years). RESULTS The imbalance model could be fit (pseudo-R2 = 0.94) in both cohorts, across CSF kits and PET tracers. Although no associations were observed with the main methodological factors, lower Aβ-aggregation scores were associated with larger ventricular volume (β = 0.13, p < 0.001), male sex (β = -0.18, p = 0.019), and homozygous APOE-ε4 carriership (β = -0.56, p < 0.001), whereas higher scores were associated with increased uncorrected CSF p-tau (β = 0.17, p < 0.001) and t-tau (β = 0.16, p < 0.001), better baseline executive functioning (β = 0.12, p < 0.001), and slower global cognitive decline (β = 0.14, p = 0.006). In the validation cohort, we replicated the associations with APOE-ε4, CSF t-tau, and, although modestly, with cognition. DISCUSSION We propose a novel continuous model of Aβ CSF/PET biomarker imbalance, accurately describing heterogeneity in soluble vs aggregated Aβ pools in 2 independent cohorts across the full Aβ continuum. Aβ-aggregation scores were consistently associated with genetic and AD-associated CSF biomarkers, possibly reflecting disease heterogeneity beyond methodological influences.
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Affiliation(s)
- Sophie E Mastenbroek
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Arianna Sala
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - David Vállez García
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Mahnaz Shekari
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Gemma Salvadó
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Luigi Lorenzini
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Leonard Pieperhoff
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Alle Meije Wink
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Isadora Lopes Alves
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Robin Wolz
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Craig Ritchie
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Mercè Boada
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Pieter Jelle Visser
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Marco Bucci
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Gill Farrar
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Oskar Hansson
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Agneta K Nordberg
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Rik Ossenkoppele
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Frederik Barkhof
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Juan Domingo Gispert
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Elena Rodriguez-Vieitez
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
| | - Lyduine E Collij
- From the Department of Radiology and Nuclear Medicine (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Vrije Universiteit Amsterdam, Amsterdam University Medical Center, location VUmc; Amsterdam Neuroscience (S.E.M., D.V.G., L.L., L.P., A.M.W., F.B., L.E.C.), Brain Imaging, the Netherlands; Clinical Memory Research Unit (S.E.M., G.S., O.H., R.O., L.E.C.), Department of Clinical Sciences Malmö, Lund University; Division of Clinical Geriatrics (A.S., M. Bucci, A.K.N., E.R.-V.), Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Coma Science Group (A.S.), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (A.S.), University Hospital of Liège, Belgium; Barcelonaβeta Brain Research Center (BBRC) (M.S., G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (M.S., J.D.G.), Barcelona; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (M.S., J.D.G.), Instituto de Salud Carlos III, Madrid; Universitat Pompeu Fabra (M.S.), Barcelona, Spain; Brain Research Center (I.L.A.), Amsterdam, the Netherlands; IXICO (R.W.), London; Centre for Clinical Brain Sciences (C.R.), University of Edinburgh, United Kingdom; Ace Alzheimer Center Barcelona (M. Boada), Universitat Internacional de Catalunya, Spain; Networking Research Center on Neurodegenerative Diseases (CIBERNED) (M. Boada), Instituto de Salud Carlos III, Madrid, Spain; Alzheimer Center Amsterdam (P.J.V., R.O.), Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc; Amsterdam Neuroscience (P.J.V.), Neurodegeneration; Alzheimer Center Limburg (P.J.V.), School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Division of Neurogeriatrics (P.J.V.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging (M. Bucci, A.K.N.), Karolinska University Hospital, Stockholm, Sweden; GE Healthcare (G.F.), Amersham, United Kingdom; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Centre for Medical Image Computing (F.B.), and Queen Square Institute of Neurology, UCL, London, United Kingdom
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Huszár Z, Engh MA, Pavlekovics M, Sato T, Steenkamp Y, Hanseeuw B, Terebessy T, Molnár Z, Hegyi P, Csukly G. Risk of conversion to mild cognitive impairment or dementia among subjects with amyloid and tau pathology: a systematic review and meta-analysis. Alzheimers Res Ther 2024; 16:81. [PMID: 38610055 PMCID: PMC11015617 DOI: 10.1186/s13195-024-01455-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Measurement of beta-amyloid (Aβ) and phosphorylated tau (p-tau) levels offers the potential for early detection of neurocognitive impairment. Still, the probability of developing a clinical syndrome in the presence of these protein changes (A+ and T+) remains unclear. By performing a systematic review and meta-analysis, we investigated the risk of mild cognitive impairment (MCI) or dementia in the non-demented population with A+ and A- alone and in combination with T+ and T- as confirmed by PET or cerebrospinal fluid examination. METHODS A systematic search of prospective and retrospective studies investigating the association of Aβ and p-tau with cognitive decline was performed in three databases (MEDLINE via PubMed, EMBASE, and CENTRAL) on January 9, 2024. The risk of bias was assessed using the Cochrane QUIPS tool. Odds ratios (OR) and Hazard Ratios (HR) were pooled using a random-effects model. The effect of neurodegeneration was not studied due to its non-specific nature. RESULTS A total of 18,162 records were found, and at the end of the selection process, data from 36 cohorts were pooled (n= 7,793). Compared to the unexposed group, the odds ratio (OR) for conversion to dementia in A+ MCI patients was 5.18 [95% CI 3.93; 6.81]. In A+ CU subjects, the OR for conversion to MCI or dementia was 5.79 [95% CI 2.88; 11.64]. Cerebrospinal fluid Aβ42 or Aβ42/40 analysis and amyloid PET imaging showed consistent results. The OR for conversion in A+T+ MCI subjects (11.60 [95% CI 7.96; 16.91]) was significantly higher than in A+T- subjects (2.73 [95% CI 1.65; 4.52]). The OR for A-T+ MCI subjects was non-significant (1.47 [95% CI 0.55; 3.92]). CU subjects with A+T+ status had a significantly higher OR for conversion (13.46 [95% CI 3.69; 49.11]) than A+T- subjects (2.04 [95% CI 0.70; 5.97]). Meta-regression showed that the ORs for Aβ exposure decreased with age in MCI. (beta = -0.04 [95% CI -0.03 to -0.083]). CONCLUSIONS Identifying Aβ-positive individuals, irrespective of the measurement technique employed (CSF or PET), enables the detection of the most at-risk population before disease onset, or at least at a mild stage. The inclusion of tau status in addition to Aβ, especially in A+T+ cases, further refines the risk assessment. Notably, the higher odds ratio associated with Aβ decreases with age. TRIAL REGISTRATION The study was registered in PROSPERO (ID: CRD42021288100).
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Affiliation(s)
- Zsolt Huszár
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
- Department of Psychiatry and Psychotherapy, Semmelweis University, Balassa utca 6, Budapest, 1083, Hungary
| | - Marie Anne Engh
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
| | - Márk Pavlekovics
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
- Department of Neurology, Jahn Ferenc Teaching Hospital, Köves utca 1, Budapest, 1204, Hungary
| | - Tomoya Sato
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
| | - Yalea Steenkamp
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
| | - Bernard Hanseeuw
- Department of Neurology and Institute of Neuroscience, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, 1200, Belgium
- Department of Radiology, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02155, USA
| | - Tamás Terebessy
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
| | - Zsolt Molnár
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
- Department of Anesthesiology and Intensive Therapy, Semmelweis University, Üllői út 78/A, Budapest, Hungary
- Department of Anesthesiology and Intensive Therapy, Poznan University of Medical Sciences, 49 Przybyszewskiego St, Poznan, Poland
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, 7624, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Tömő 25-29, Budapest, 1083, Hungary
- Translational Pancreatology Research Group, Interdisciplinary Centre of Excellence for Research Development and Innovation University of Szeged, Budapesti 9, Szeged, 6728, Hungary
| | - Gábor Csukly
- Centre for Translational Medicine, Semmelweis University, Üllői út 26, Budapest, 1085, Hungary.
- Department of Psychiatry and Psychotherapy, Semmelweis University, Balassa utca 6, Budapest, 1083, Hungary.
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6
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Huber H, Blennow K, Zetterberg H, Boada M, Jeromin A, Weninger H, Nuñez‐Llaves R, Aguilera N, Ramis M, Simrén J, Nilsson J, Lantero‐Rodriguez J, Orellana A, García‐Gutiérrez F, Morató X, Ashton NJ, Montoliu‐Gaya L. Biomarkers of Alzheimer's disease and neurodegeneration in dried blood spots-A new collection method for remote settings. Alzheimers Dement 2024; 20:2340-2352. [PMID: 38284555 PMCID: PMC11032540 DOI: 10.1002/alz.13697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/28/2023] [Accepted: 12/28/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND We aimed to evaluate the precision of Alzheimer's disease (AD) and neurodegeneration biomarker measurements from venous dried plasma spots (DPSv enous) for the diagnosis and monitoring of neurodegenerative diseases in remote settings. METHODS In a discovery (n = 154) and a validation cohort (n = 115), glial fibrillary acidic protein (GFAP); neurofilament light (NfL); amyloid beta (Aβ) 40, Aβ42; and phosphorylated tau (p-tau181 and p-tau217) were measured in paired DPSvenous and ethylenediaminetetraacetic acid plasma samples with single-molecule array. In the validation cohort, a subset of participants (n = 99) had cerebrospinal fluid (CSF) biomarkers. RESULTS All DPSvenous and plasma analytes correlated significantly, except for Aβ42. In the validation cohort, DPSvenous GFAP, NfL, p-tau181, and p-tau217 differed between CSF Aβ-positive and -negative individuals and were associated with worsening cognition. DISCUSSION Our data suggest that measuring blood biomarkers related to AD pathology and neurodegeneration from DPSvenous extends the utility of blood-based biomarkers to remote settings with simplified sampling conditions, storage, and logistics. HIGHLIGHTS A wide array of biomarkers related to Alzheimer's disease (AD) and neurodegeneration were detectable in dried plasma spots (DPSvenous). DPSvenous biomarkers correlated with standard procedures and cognitive status. DPSvenous biomarkers had a good diagnostic accuracy discriminating amyloid status. Our findings show the potential interchangeability of DPSvenous and plasma sampling. DPSvenous may facilitate remote and temperature-independent sampling for AD biomarker measurement. Innovative tools for blood biomarker sampling may help recognizing the earliest changes of AD.
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Affiliation(s)
- Hanna Huber
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiologythe Shagreens Academy at the University of GothenburgMölndalSweden
| | - Kaj Blennow
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiologythe Shagreens Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
| | - Henrik Zetterberg
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiologythe Shagreens Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK
- UK Dementia Research InstituteUCLLondonUK
- Hong Kong Center for Neurodegenerative DiseasesHong KongChina
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Mercé Boada
- Networking Research Center on Neurodegenerative Diseases (CIBERNED)Instituto de Salud Carlos IIIMadridSpain
- Ace Alzheimer Center BarcelonaInternational University of Catalunya (UIC)BarcelonaSpain
| | | | - Haley Weninger
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiologythe Shagreens Academy at the University of GothenburgMölndalSweden
| | - Raul Nuñez‐Llaves
- Ace Alzheimer Center BarcelonaInternational University of Catalunya (UIC)BarcelonaSpain
| | - Núria Aguilera
- Ace Alzheimer Center BarcelonaInternational University of Catalunya (UIC)BarcelonaSpain
| | - Maribel Ramis
- Ace Alzheimer Center BarcelonaInternational University of Catalunya (UIC)BarcelonaSpain
| | - Joel Simrén
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiologythe Shagreens Academy at the University of GothenburgMölndalSweden
| | - Johanna Nilsson
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiologythe Shagreens Academy at the University of GothenburgMölndalSweden
| | - Juan Lantero‐Rodriguez
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiologythe Shagreens Academy at the University of GothenburgMölndalSweden
| | - Adelina Orellana
- Ace Alzheimer Center BarcelonaInternational University of Catalunya (UIC)BarcelonaSpain
| | | | - Xavier Morató
- Networking Research Center on Neurodegenerative Diseases (CIBERNED)Instituto de Salud Carlos IIIMadridSpain
- Ace Alzheimer Center BarcelonaInternational University of Catalunya (UIC)BarcelonaSpain
| | - Nicholas J. Ashton
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiologythe Shagreens Academy at the University of GothenburgMölndalSweden
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
- Centre for Age‐Related MedicineStavanger University HospitalStavangerNorway
| | - Laia Montoliu‐Gaya
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiologythe Shagreens Academy at the University of GothenburgMölndalSweden
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7
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García-Sánchez A, Sotolongo-Grau O, Tartari JP, Sanabria Á, Esteban-De Antonio E, Pérez-Cordón A, Alegret M, Pytel V, Martínez J, Aguilera N, de Rojas I, Cano A, García-González P, Puerta R, Olivé C, Capdevila M, García-Gutiérrez F, Vivas A, Gómez-Chiari M, Giménez J, Tejero MÁ, Castilla-Martí M, Castilla-Martí L, Tárraga L, Valero S, Ruiz A, Boada M, Marquié M. Macular vessel density in the superficial plexus is not a proxy of cerebrovascular damage in non-demented individuals: data from the NORFACE cohort. Alzheimers Res Ther 2024; 16:42. [PMID: 38378643 PMCID: PMC10877901 DOI: 10.1186/s13195-024-01408-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 02/04/2024] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Optical coherence tomography angiography (OCT-A) is a novel tool that allows the detection of retinal vascular changes. We investigated the association of macular vessel density (VD) in the superficial plexus assessed by OCT-A with measures of cerebrovascular pathology and atrophy quantified by brain magnetic resonance imaging (MRI) in non-demented individuals. METHODS Clinical, demographical, OCT-A, and brain MRI data from non-demented research participants were included. We analyzed the association of regional macular VD with brain vascular burden using the Fazekas scale assessed in a logistic regression analysis, and the volume of white matter hyperintensities (WMH) assessed in a multiple linear regression analysis. We also explored the associations of macular VD with hippocampal volume, ventricle volume and Alzheimer disease cortical signature (ADCS) thickness assessed in multiple linear regression analyses. All analyses were adjusted for age, sex, syndromic diagnosis and cardiovascular variables. RESULTS The study cohort comprised 188 participants: 89 with subjective cognitive decline and 99 with mild cognitive impairment. No significant association of regional macular VD with the Fazekas categories (all, p > 0.111) and WMH volume (all, p > 0.051) were detected. VD in the nasal quadrant was associated to hippocampal volume (p = 0.007), but no other associations of macular VD with brain atrophy measures were detected (all, p > 0.05). DISCUSSION Retinal vascular measures were not a proxy of cerebrovascular damage in non-demented individuals, while VD in the nasal quadrant was associated with hippocampal atrophy independently of the amyloid status.
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Affiliation(s)
- Ainhoa García-Sánchez
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Oscar Sotolongo-Grau
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Juan Pablo Tartari
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Ángela Sanabria
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
- CIBERNED, Center for Networked Biomedical Research On Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | | | - Alba Pérez-Cordón
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Montserrat Alegret
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
- CIBERNED, Center for Networked Biomedical Research On Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Vanesa Pytel
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Joan Martínez
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Núria Aguilera
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Itziar de Rojas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
- CIBERNED, Center for Networked Biomedical Research On Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Amanda Cano
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
- CIBERNED, Center for Networked Biomedical Research On Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Pablo García-González
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Raquel Puerta
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Clàudia Olivé
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Maria Capdevila
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | | | - Assumpta Vivas
- Department of Diagnostic Imaging, Clínica Corachan, Barcelona, Spain
| | | | - Juan Giménez
- Department of Diagnostic Imaging, Clínica Corachan, Barcelona, Spain
| | | | - Miguel Castilla-Martí
- Clínica Oftalmológica Dr. Castilla, Barcelona, Spain
- Vista Alpina Eye Clinic, Visp, Switzerland
| | - Luis Castilla-Martí
- PhD Programme in Surgery and Morphological Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain
- Hôpital Ophtalmique Jules-Gonin, Fondation Asiles Des Aveugles, University of Lausanne, Lausanne, Switzerland
| | - Lluís Tárraga
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
- CIBERNED, Center for Networked Biomedical Research On Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Sergi Valero
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
- CIBERNED, Center for Networked Biomedical Research On Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Agustín Ruiz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
- CIBERNED, Center for Networked Biomedical Research On Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
- CIBERNED, Center for Networked Biomedical Research On Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Marta Marquié
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.
- CIBERNED, Center for Networked Biomedical Research On Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain.
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8
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Gutierrez-Tordera L, Papandreou C, Novau-Ferré N, García-González P, Rojas M, Marquié M, Chapado LA, Papagiannopoulos C, Fernàndez-Castillo N, Valero S, Folch J, Ettcheto M, Camins A, Boada M, Ruiz A, Bulló M. Exploring small non-coding RNAs as blood-based biomarkers to predict Alzheimer's disease. Cell Biosci 2024; 14:8. [PMID: 38229129 PMCID: PMC10790437 DOI: 10.1186/s13578-023-01190-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/27/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Alzheimer's disease (AD) diagnosis relies on clinical symptoms complemented with biological biomarkers, the Amyloid Tau Neurodegeneration (ATN) framework. Small non-coding RNA (sncRNA) in the blood have emerged as potential predictors of AD. We identified sncRNA signatures specific to ATN and AD, and evaluated both their contribution to improving AD conversion prediction beyond ATN alone. METHODS This nested case-control study was conducted within the ACE cohort and included MCI patients matched by sex. Patients free of type 2 diabetes underwent cerebrospinal fluid (CSF) and plasma collection and were followed-up for a median of 2.45-years. Plasma sncRNAs were profiled using small RNA-sequencing. Conditional logistic and Cox regression analyses with elastic net penalties were performed to identify sncRNA signatures for A+(T|N)+ and AD. Weighted scores were computed using cross-validation, and the association of these scores with AD risk was assessed using multivariable Cox regression models. Gene ontology (GO) and Kyoto encyclopaedia of genes and genomes (KEGG) enrichment analysis of the identified signatures were performed. RESULTS The study sample consisted of 192 patients, including 96 A+(T|N)+ and 96 A-T-N- patients. We constructed a classification model based on a 6-miRNAs signature for ATN. The model could classify MCI patients into A-T-N- and A+(T|N)+ groups with an area under the curve of 0.7335 (95% CI, 0.7327 to 0.7342). However, the addition of the model to conventional risk factors did not improve the prediction of AD beyond the conventional model plus ATN status (C-statistic: 0.805 [95% CI, 0.758 to 0.852] compared to 0.829 [95% CI, 0.786, 0.872]). The AD-related 15-sncRNAs signature exhibited better predictive performance than the conventional model plus ATN status (C-statistic: 0.849 [95% CI, 0.808 to 0.890]). When ATN was included in this model, the prediction further improved to 0.875 (95% CI, 0.840 to 0.910). The miRNA-target interaction network and functional analysis, including GO and KEGG pathway enrichment analysis, suggested that the miRNAs in both signatures are involved in neuronal pathways associated with AD. CONCLUSIONS The AD-related sncRNA signature holds promise in predicting AD conversion, providing insights into early AD development and potential targets for prevention.
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Affiliation(s)
- Laia Gutierrez-Tordera
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), 43201, Reus, Spain
- Institute of Health Pere Virgili (IISPV), 43204, Reus, Spain
- Center of Environmental, Food and Toxicological Technology-TecnATox, Rovira i Virgili University, 43201, Reus, Spain
| | - Christopher Papandreou
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), 43201, Reus, Spain.
- Institute of Health Pere Virgili (IISPV), 43204, Reus, Spain.
- Center of Environmental, Food and Toxicological Technology-TecnATox, Rovira i Virgili University, 43201, Reus, Spain.
| | - Nil Novau-Ferré
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), 43201, Reus, Spain
- Institute of Health Pere Virgili (IISPV), 43204, Reus, Spain
- Center of Environmental, Food and Toxicological Technology-TecnATox, Rovira i Virgili University, 43201, Reus, Spain
| | - Pablo García-González
- ACE Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
| | - Melina Rojas
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), 43201, Reus, Spain
- Institute of Health Pere Virgili (IISPV), 43204, Reus, Spain
- Center of Environmental, Food and Toxicological Technology-TecnATox, Rovira i Virgili University, 43201, Reus, Spain
| | - Marta Marquié
- ACE Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
| | - Luis A Chapado
- Laboratory of Epigenetics of Lipid Metabolism, Instituto Madrileño de Estudios Avanzados (IMDEA)-Alimentación, CEI UAM+CSIC, 28049, Madrid, Spain
| | - Christos Papagiannopoulos
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45500, Ioannina, Greece
| | - Noèlia Fernàndez-Castillo
- Department de Genetics, Microbiology and Statistics, Faculty of Biology, Universitat de Barcelona, 08007, Barcelona, Spain
| | - Sergi Valero
- ACE Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
| | - Jaume Folch
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), 43201, Reus, Spain
- Institute of Health Pere Virgili (IISPV), 43204, Reus, Spain
- Center of Environmental, Food and Toxicological Technology-TecnATox, Rovira i Virgili University, 43201, Reus, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
| | - Miren Ettcheto
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Science, Universitat de Barcelona, 08028, Barcelona, Spain
- Institute of Neuroscience, Universitat de Barcelona, 08035, Barcelona, Spain
| | - Antoni Camins
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Science, Universitat de Barcelona, 08028, Barcelona, Spain
- Institute of Neuroscience, Universitat de Barcelona, 08035, Barcelona, Spain
| | - Mercè Boada
- ACE Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
| | - Agustín Ruiz
- ACE Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Carlos III Health Institute, 28031, Madrid, Spain
| | - Mònica Bulló
- Nutrition and Metabolic Health Research Group, Department of Biochemistry and Biotechnology, Rovira i Virgili University (URV), 43201, Reus, Spain.
- Institute of Health Pere Virgili (IISPV), 43204, Reus, Spain.
- Center of Environmental, Food and Toxicological Technology-TecnATox, Rovira i Virgili University, 43201, Reus, Spain.
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029, Madrid, Spain.
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Timsina J, Ali M, Do A, Wang L, Western D, Sung YJ, Cruchaga C. Harmonization of CSF and imaging biomarkers in Alzheimer's disease: Need and practical applications for genetics studies and preclinical classification. Neurobiol Dis 2024; 190:106373. [PMID: 38072165 DOI: 10.1016/j.nbd.2023.106373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/06/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023] Open
Abstract
In Alzheimer's disease (AD) research, cerebrospinal fluid (CSF) Amyloid beta (Aβ), Tau and pTau are the most accepted and well validated biomarkers. Several methods and platforms exist to measure those biomarkers, leading to challenges in combining data across studies. Thus, there is a need to identify methods that harmonize and standardize these values. We used a Z-score based approach to harmonize CSF and amyloid imaging data from multiple cohorts and compared GWAS results using this approach with currently accepted methods. We also used a generalized mixture model to calculate the threshold for biomarker-positivity. Based on our findings, our normalization approach performed as well as meta-analysis and did not lead to any spurious results. In terms of dichotomization, cutoffs calculated with this approach were very similar to those reported previously. These findings show that the Z-score based harmonization approach can be applied to heterogeneous platforms and provides biomarker cut-offs consistent with the classical approaches without requiring any additional data.
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Affiliation(s)
- Jigyasha Timsina
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA; NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Muhammad Ali
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA; NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Anh Do
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63110, USA; Division of Biology and Biomedical Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Lihua Wang
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA; NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Daniel Western
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA; NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Yun Ju Sung
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA; NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63110, USA; Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA; NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63110, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO 63110, USA.
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10
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Kurihara M, Kondo S, Ohse K, Nojima H, Kikkawa-Saito E, Iwata A. Relationship Between Cerebrospinal Fluid Alzheimer's Disease Biomarker Values Measured via Lumipulse Assays and Conventional ELISA: Single-Center Experience and Systematic Review. J Alzheimers Dis 2024; 99:1077-1092. [PMID: 38759016 PMCID: PMC11191528 DOI: 10.3233/jad-240185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2024] [Indexed: 05/19/2024]
Abstract
Background Although Lumipulse assays and conventional ELISA are strongly correlated, the precise relationship between their measured values remains undetermined. Objective To determine the relationship between Lumipulse and ELISA measurement values. Methods Patients who underwent cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarker measurements and consented to biobanking between December 2021 and June 2023 were included. The relationship between values measured via Lumipulse assays and conventional ELISA were evaluated by Passing-Bablok analyses for amyloid-β 1-42 (Aβ42), total tau (t-tau), and phospho-tau 181 (p-tau 181). Studies using both assays were systematically searched for in PubMed and summarized after quality assessment. Results Regression line slopes and intercepts were 1.41 (1.23 to 1.60) and -77.8 (-198.4 to 44.5) for Aβ42, 0.94 (0.88 to 1.01) and 98.2 (76.9 to 114.4) for t-tau, and 1.60 (1.43 to 1.75) and -21.1 (-26.9 to -15.6) for p-tau181. Spearman's correlation coefficients were 0.90, 0.95, and 0.95 for Aβ42, t-tau, and p-tau181, respectively. We identified 13 other studies that included 2,117 patients in total. Aβ42 slope varied among studies, suggesting inter-lab difference of ELISA. The slope and intercept of t-tau were approximately 1 and 0, respectively, suggesting small proportional and systematic differences. Conversely, the p-tau181 slope was significantly higher than 1, distributed between 1.5-2 in most studies, with intercepts significantly lower than 0, suggesting proportional and systematic differences. Conclusions We characterized different relationship between measurement values for each biomarker, which may be useful for understanding the differences in CSF biomarker measurement values on different platforms and for future global harmonization.
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Affiliation(s)
- Masanori Kurihara
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Soichiro Kondo
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kensuke Ohse
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | | | | | - Atsushi Iwata
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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11
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Frick EA, Emilsson V, Jonmundsson T, Steindorsdottir AE, Johnson ECB, Puerta R, Dammer EB, Shantaraman A, Cano A, Boada M, Valero S, García-González P, Gudmundsson EF, Gudjonsson A, Loureiro JJ, Orth AP, Seyfried NT, Levey AI, Ruiz A, Aspelund T, Jennings LL, Launer LJ, Gudmundsdottir V, Gudnason V. Serum proteomics reveals APOE dependent and independent protein signatures in Alzheimer's disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.08.23298251. [PMID: 37986771 PMCID: PMC10659486 DOI: 10.1101/2023.11.08.23298251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
The current demand for early intervention, prevention, and treatment of late onset Alzheimer's disease (LOAD) warrants deeper understanding of the underlying molecular processes which could contribute to biomarker and drug target discovery. Utilizing high-throughput proteomic measurements in serum from a prospective population-based cohort of older adults (n=5,294), we identified 303 unique proteins associated with incident LOAD (median follow-up 12.8 years). Over 40% of these proteins were associated with LOAD independently of APOE-ε4 carrier status. These proteins were implicated in neuronal processes and overlapped with protein signatures of LOAD in brain and cerebrospinal fluid. We found 17 proteins which LOAD-association was strongly dependent on APOE-ε4 carrier status. Most of them showed consistent associations with LOAD in cerebrospinal fluid and a third had brain-specific gene expression. Remarkably, four proteins in this group (TBCA, ARL2, S100A13 and IRF6) were downregulated by APOE-ε4 yet upregulated as a consequence of LOAD as determined in a bi-directional Mendelian randomization analysis, reflecting a potential response to the disease onset. Accordingly, the direct association of these proteins to LOAD was reversed upon APOE-ε4 genotype adjustment, a finding which we replicate in an external cohort (n=719). Our findings provide an insight into the dysregulated pathways that may lead to the development and early detection of LOAD, including those both independent and dependent on APOE-ε4. Importantly, many of the LOAD-associated proteins we find in the circulation have been found to be expressed - and have a direct link with AD - in brain tissue. Thus, the proteins identified here, and their upstream modulating pathways, provide a new source of circulating biomarker and therapeutic target candidates for LOAD.
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Affiliation(s)
| | - Valur Emilsson
- Icelandic Heart Association, Kopavogur, 200, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | | | | | - Erik C B Johnson
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, 30329, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, 30329, GA, USA
| | - Raquel Puerta
- Research Center and Memory Clinic. Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, 08028, Spain, Barcelona
| | - Eric B Dammer
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, 30329, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, 30329, GA, USA
| | - Anantharaman Shantaraman
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, 30329, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, 30329, GA, USA
| | - Amanda Cano
- Research Center and Memory Clinic. Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, 08028, Spain, Barcelona
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, 28029, Spain
| | - Mercè Boada
- Research Center and Memory Clinic. Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, 08028, Spain, Barcelona
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, 28029, Spain
| | - Sergi Valero
- Research Center and Memory Clinic. Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, 08028, Spain, Barcelona
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, 28029, Spain
| | - Pablo García-González
- Research Center and Memory Clinic. Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, 08028, Spain, Barcelona
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, 28029, Spain
| | | | | | | | | | - Nicholas T Seyfried
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, 30329, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, 30329, GA, USA
| | - Allan I Levey
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, 30329, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, 30329, GA, USA
| | - Agustin Ruiz
- Research Center and Memory Clinic. Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, 08028, Spain, Barcelona
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, 28029, Spain
| | - Thor Aspelund
- Icelandic Heart Association, Kopavogur, 200, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | | | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, 20892, MD, USA
| | - Valborg Gudmundsdottir
- Icelandic Heart Association, Kopavogur, 200, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, 200, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, 101, Iceland
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12
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García-Gutiérrez F, Marquié M, Muñoz N, Alegret M, Cano A, de Rojas I, García-González P, Olivé C, Puerta R, Orellana A, Montrreal L, Pytel V, Ricciardi M, Zaldua C, Gabirondo P, Hinzen W, Lleonart N, García-Sánchez A, Tárraga L, Ruiz A, Boada M, Valero S. Harnessing acoustic speech parameters to decipher amyloid status in individuals with mild cognitive impairment. Front Neurosci 2023; 17:1221401. [PMID: 37746151 PMCID: PMC10512723 DOI: 10.3389/fnins.2023.1221401] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/08/2023] [Indexed: 09/26/2023] Open
Abstract
Alzheimer's disease (AD) is a neurodegenerative condition characterized by a gradual decline in cognitive functions. Currently, there are no effective treatments for AD, underscoring the importance of identifying individuals in the preclinical stages of mild cognitive impairment (MCI) to enable early interventions. Among the neuropathological events associated with the onset of the disease is the accumulation of amyloid protein in the brain, which correlates with decreased levels of Aβ42 peptide in the cerebrospinal fluid (CSF). Consequently, the development of non-invasive, low-cost, and easy-to-administer proxies for detecting Aβ42 positivity in CSF becomes particularly valuable. A promising approach to achieve this is spontaneous speech analysis, which combined with machine learning (ML) techniques, has proven highly useful in AD. In this study, we examined the relationship between amyloid status in CSF and acoustic features derived from the description of the Cookie Theft picture in MCI patients from a memory clinic. The cohort consisted of fifty-two patients with MCI (mean age 73 years, 65% female, and 57% positive amyloid status). Eighty-eight acoustic parameters were extracted from voice recordings using the extended Geneva Minimalistic Acoustic Parameter Set (eGeMAPS), and several ML models were used to classify the amyloid status. Furthermore, interpretability techniques were employed to examine the influence of input variables on the determination of amyloid-positive status. The best model, based on acoustic variables, achieved an accuracy of 75% with an area under the curve (AUC) of 0.79 in the prediction of amyloid status evaluated by bootstrapping and Leave-One-Out Cross Validation (LOOCV), outperforming conventional neuropsychological tests (AUC = 0.66). Our results showed that the automated analysis of voice recordings derived from spontaneous speech tests offers valuable insights into AD biomarkers during the preclinical stages. These findings introduce novel possibilities for the use of digital biomarkers to identify subjects at high risk of developing AD.
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Affiliation(s)
| | - Marta Marquié
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Nathalia Muñoz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Montserrat Alegret
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Amanda Cano
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Itziar de Rojas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Pablo García-González
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Clàudia Olivé
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Raquel Puerta
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Adelina Orellana
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Montrreal
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Vanesa Pytel
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Mario Ricciardi
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | | | - Wolfram Hinzen
- Department of Translation and Language Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Institut Català de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Núria Lleonart
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ainhoa García-Sánchez
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Lluís Tárraga
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Agustín Ruiz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergi Valero
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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13
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Cruchaga C, Western D, Timsina J, Wang L, Wang C, Yang C, Ali M, Beric A, Gorijala P, Kohlfeld P, Budde J, Levey A, Morris J, Perrin R, Ruiz A, Marquié M, Boada M, de Rojas I, Rutledge J, Oh H, Wilson E, Guen YL, Alvarez I, Aguilar M, Greicius M, Pastor P, Pulford D, Ibanez L, Wyss-Coray T, Sung YJ, Phillips B. Proteogenomic analysis of human cerebrospinal fluid identifies neurologically relevant regulation and informs causal proteins for Alzheimer's disease. RESEARCH SQUARE 2023:rs.3.rs-2814616. [PMID: 37333337 PMCID: PMC10275048 DOI: 10.21203/rs.3.rs-2814616/v1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
The integration of quantitative trait loci (QTL) with disease genome-wide association studies (GWAS) has proven successful at prioritizing candidate genes at disease-associated loci. QTL mapping has mainly been focused on multi-tissue expression QTL or plasma protein QTL (pQTL). Here we generated the largest-to-date cerebrospinal fluid (CSF) pQTL atlas by analyzing 7,028 proteins in 3,107 samples. We identified 3,373 independent study-wide associations for 1,961 proteins, including 2,448 novel pQTLs of which 1,585 are unique to CSF, demonstrating unique genetic regulation of the CSF proteome. In addition to the established chr6p22.2-21.32 HLA region, we identified pleiotropic regions on chr3q28 near OSTN and chr19q13.32 near APOE that were enriched for neuron-specificity and neurological development. We also integrated this pQTL atlas with the latest Alzheimer's disease (AD) GWAS through PWAS, colocalization and Mendelian Randomization and identified 42 putative causal proteins for AD, 15 of which have drugs available. Finally, we developed a proteomics-based risk score for AD that outperforms genetics-based polygenic risk scores. These findings will be instrumental to further understand the biology and identify causal and druggable proteins for brain and neurological traits.
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Affiliation(s)
| | - Dan Western
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Jigyasha Timsina
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Lihua Wang
- Washington University School of Medicine
| | | | | | | | | | | | - Patsy Kohlfeld
- Washington University School of Medicine, St Louis, MO, USA
| | | | | | | | | | | | | | - Mercè Boada
- Memory Clinic of Fundaciò ACE, Catalan Institute of Applied Neurosciences
| | | | | | | | | | | | - Ignacio Alvarez
- Fundació Docència i Recerca Mútua Terrassa, Terrassa, Barcelona, Spain
| | | | | | - Pau Pastor
- University Hospital Germans Trias i Pujol
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14
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Timsina J, Ali M, Do A, Wang L, Sung YJ, Cruchaga C. Harmonization of CSF and imaging biomarkers for Alzheimer's disease biomarkers: need and practical applications for genetics studies and preclinical classification. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.24.542118. [PMID: 37292823 PMCID: PMC10245826 DOI: 10.1101/2023.05.24.542118] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION In Alzheimer's disease (AD) research, cerebrospinal fluid (CSF) Amyloid beta (Aβ), Tau and pTau are the most accepted and well validated biomarkers. Several methods and platforms exist to measure those biomarkers which leads to challenges in combining data across studies. Thus, there is a need to identify methods that harmonize and standardize these values. METHODS We used a Z-score based approach to harmonize CSF and amyloid imaging data from multiple cohorts and compared GWAS result using this method with currently accepted methods. We also used a generalized mixture modelling to calculate the threshold for biomarker-positivity. RESULTS Z-scores method performed as well as meta-analysis and did not lead to any spurious results. Cutoffs calculated with this approach were found to be very similar to those reported previously. DISCUSSION This approach can be applied to heterogeneous platforms and provides biomarker cut-offs consistent with the classical approaches without requiring any additional data.
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Affiliation(s)
- Jigyasha Timsina
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Muhammad Ali
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Anh Do
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63110, USA
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Lihua Wang
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Yun Ju Sung
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63110, USA
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, MO 63110, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO 63110, USA
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15
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Sacchi L, Contarino VE, Siggillino S, Carandini T, Fumagalli GG, Pietroboni AM, Arcaro M, Fenoglio C, Orunesu E, Castellani M, Casale S, Conte G, Liu C, Triulzi F, Galimberti D, Scarpini E, Arighi A. Banks of the Superior Temporal Sulcus in Alzheimer's Disease: A Pilot Quantitative Susceptibility Mapping Study. J Alzheimers Dis 2023:JAD230095. [PMID: 37182885 DOI: 10.3233/jad-230095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Brain iron homeostasis is disrupted in neurodegeneration and areas of iron overload partially overlap with regions of amyloid and tau burden in Alzheimer's disease (AD). Previous studies demonstrated alterations in brain iron accumulation in AD using quantitative susceptibility mapping (QSM). OBJECTIVE Here, we investigate brain alterations of QSM values in AD and non-AD patients as compared to healthy controls (HC) in the superior temporal sulcus and its banks (BANKSSTS), one of the top AD-affected regions. METHODS Thirty-four patients who underwent brain MRI including a multi-echo gradient-echo sequence were subdivided into AD (n = 19) and non-AD (n = 15) groups according to their clinical profile, CSF (Aβ 42/40) and/or amyloid-PET status. Ten HC were also included. QSM values were extracted from left and right BANKSSTS and compared among groups. Correlation and binomial regression analyses between QSM values and CSF-AD biomarkers were conducted. RESULTS QSM in left BANKSSTS was significantly different among groups (p = 0.003, H = 11.40), being higher in AD. QSM values in left BANKSSTS were correlated with Aβ 42 (rho -0.55, p = 0.005), Aβ 42/40 (rho -0.66, p < 0.001), pTau (rho 0.63, p < 0.001), tTau (rho 0.56, p = 0.005), tTau/Aβ 42 (rho 0.68, p < 0.001) and pTau/Aβ 42 (rho 0.71, p < 0.001). No correlations between QSM values and amyloid-PET SUVR in the left BANKSSTS were found. QSM values in left BANKSSTS showed good accuracy in discriminating AD (AUC = 0.80, CI95 % [0.66-0.93]). Higher QSM values were independent predictors of Aβ 42 (B = 0.63, p = 0.032), Aβ 42/40 (B = 0.81, p = 0.028), pTau (B = 0.96, p = 0.046), tTau (B = 0.55, p = 0.027), and tTau/Aβ 42 (B = 1.13, p = 0.042) positivity. CONCLUSION Our preliminary data support the potential role of increased QSM values in the left BANKSSTS as an auxiliary imaging biomarker in AD diagnosis.
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Affiliation(s)
- Luca Sacchi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Valeria Elisa Contarino
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Siggillino
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Tiziana Carandini
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Anna Margherita Pietroboni
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marina Arcaro
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Fenoglio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Eva Orunesu
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimo Castellani
- Nuclear Medicine Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Casale
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giorgio Conte
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chunlei Liu
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
| | - Fabio Triulzi
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Elio Scarpini
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Andrea Arighi
- Neurodegenerative Diseases Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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16
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Cano A, Esteban-de-Antonio E, Bernuz M, Puerta R, García-González P, de Rojas I, Olivé C, Pérez-Cordón A, Montrreal L, Núñez-Llaves R, Sotolongo-Grau Ó, Alarcón-Martín E, Valero S, Alegret M, Martín E, Martino-Adami PV, Ettcheto M, Camins A, Vivas A, Gomez-Chiari M, Tejero MÁ, Orellana A, Tárraga L, Marquié M, Ramírez A, Martí M, Pividori MI, Boada M, Ruíz A. Plasma extracellular vesicles reveal early molecular differences in amyloid positive patients with early-onset mild cognitive impairment. J Nanobiotechnology 2023; 21:54. [PMID: 36788617 PMCID: PMC9930227 DOI: 10.1186/s12951-023-01793-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/24/2023] [Indexed: 02/16/2023] Open
Abstract
In the clinical course of Alzheimer's disease (AD) development, the dementia phase is commonly preceded by a prodromal AD phase, which is mainly characterized by reaching the highest levels of Aβ and p-tau-mediated neuronal injury and a mild cognitive impairment (MCI) clinical status. Because of that, most AD cases are diagnosed when neuronal damage is already established and irreversible. Therefore, a differential diagnosis of MCI causes in these prodromal stages is one of the greatest challenges for clinicians. Blood biomarkers are emerging as desirable tools for pre-screening purposes, but the current results are still being analyzed and much more data is needed to be implemented in clinical practice. Because of that, plasma extracellular vesicles (pEVs) are gaining popularity as a new source of biomarkers for the early stages of AD development. To identify an exosome proteomics signature linked to prodromal AD, we performed a cross-sectional study in a cohort of early-onset MCI (EOMCI) patients in which 184 biomarkers were measured in pEVs, cerebrospinal fluid (CSF), and plasma samples using multiplex PEA technology of Olink© proteomics. The obtained results showed that proteins measured in pEVs from EOMCI patients with established amyloidosis correlated with CSF p-tau181 levels, brain ventricle volume changes, brain hyperintensities, and MMSE scores. In addition, the correlations of pEVs proteins with different parameters distinguished between EOMCI Aβ( +) and Aβ(-) patients, whereas the CSF or plasma proteome did not. In conclusion, our findings suggest that pEVs may be able to provide information regarding the initial amyloidotic changes of AD. Circulating exosomes may acquire a pathological protein signature of AD before raw plasma, becoming potential biomarkers for identifying subjects at the earliest stages of AD development.
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Affiliation(s)
- Amanda Cano
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain.
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain.
| | - Ester Esteban-de-Antonio
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
| | - Mireia Bernuz
- Grup de Sensors I Biosensors, Departament de Química, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
| | - Raquel Puerta
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
| | - Pablo García-González
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Itziar de Rojas
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Claudia Olivé
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
| | - Alba Pérez-Cordón
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
| | - Laura Montrreal
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
| | - Raúl Núñez-Llaves
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
| | - Óscar Sotolongo-Grau
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
| | - Emilio Alarcón-Martín
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
| | - Sergi Valero
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Montserrat Alegret
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Elvira Martín
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
| | - Pamela V Martino-Adami
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
| | - Miren Ettcheto
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Antonio Camins
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Assumpta Vivas
- Departament de Diagnòstic Per La Imatge, Clínica Corachan, Barcelona, Spain
| | - Marta Gomez-Chiari
- Departament de Diagnòstic Per La Imatge, Clínica Corachan, Barcelona, Spain
| | | | - Adelina Orellana
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Lluís Tárraga
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Marta Marquié
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Alfredo Ramírez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937, Cologne, Germany
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Medical Faculty, 53127, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), 53127, Bonn, Germany
- Department of Psychiatry and Glenn, Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, 78229, USA
- Cluster of Excellence Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50931, Cologne, Germany
| | - Mercè Martí
- Grup de Sensors I Biosensors, Departament de Química, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
| | - María Isabel Pividori
- Grup de Sensors I Biosensors, Departament de Química, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
- Biosensing and Bioanalysis Group, Institut de Biotecnologia I de Biomedicina (IBB-UAB), Mòdul B Parc de Recerca UAB, Campus Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Agustín Ruíz
- Ace Alzheimer Center Barcelona - International University of Catalunya (UIC), C/Marquès de Sentmenat, 57, 08029, Barcelona, Spain.
- Biomedical Research Networking Centre in Neurodegenerative Diseases (CIBERNED), Madrid, Spain.
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Marquié M, García-Gutiérrez F, Orellana A, Montrreal L, de Rojas I, García-González P, Puerta R, Olivé C, Cano A, Hernández I, Rosende-Roca M, Vargas L, Tartari JP, Esteban-De Antonio E, Bojaryn U, Ricciardi M, Ariton DM, Pytel V, Alegret M, Ortega G, Espinosa A, Pérez-Cordón A, Sanabria Á, Muñoz N, Lleonart N, Aguilera N, García-Sánchez A, Alarcón-Martín E, Tárraga L, Ruiz A, Boada M, Valero S. The Synergic Effect of AT(N) Profiles and Depression on the Risk of Conversion to Dementia in Patients with Mild Cognitive Impairment. Int J Mol Sci 2023; 24:1371. [PMID: 36674881 PMCID: PMC9865785 DOI: 10.3390/ijms24021371] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
Few studies have addressed the impact of the association between Alzheimer's disease (AD) biomarkers and NPSs in the conversion to dementia in patients with mild cognitive impairment (MCI), and no studies have been conducted on the interaction effect of these two risk factors. AT(N) profiles were created using AD-core biomarkers quantified in cerebrospinal fluid (CSF) (normal, brain amyloidosis, suspected non-Alzheimer pathology (SNAP) and prodromal AD). NPSs were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). A total of 500 individuals with MCI were followed-up yearly in a memory unit. Cox regression analysis was used to determine risk of conversion, considering additive and multiplicative interactions between AT(N) profile and NPSs on the conversion to dementia. A total of 224 participants (44.8%) converted to dementia during the 2-year follow-up study. Pathologic AT(N) groups (brain amyloidosis, prodromal AD and SNAP) and the presence of depression and apathy were associated with a higher risk of conversion to dementia. The additive combination of the AT(N) profile with depression exacerbates the risk of conversion to dementia. A synergic effect of prodromal AD profile with depressive symptoms is evidenced, identifying the most exposed individuals to conversion among MCI patients.
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Affiliation(s)
- Marta Marquié
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Fernando García-Gutiérrez
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Adelina Orellana
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Laura Montrreal
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Itziar de Rojas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Pablo García-González
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Raquel Puerta
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Clàudia Olivé
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Amanda Cano
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Isabel Hernández
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Maitée Rosende-Roca
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Liliana Vargas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Juan Pablo Tartari
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Ester Esteban-De Antonio
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Urszula Bojaryn
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Mario Ricciardi
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Diana M. Ariton
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Vanesa Pytel
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Montserrat Alegret
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Gemma Ortega
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Ana Espinosa
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Alba Pérez-Cordón
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Ángela Sanabria
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Nathalia Muñoz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Núria Lleonart
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Núria Aguilera
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Ainhoa García-Sánchez
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Emilio Alarcón-Martín
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
| | - Lluís Tárraga
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Agustín Ruiz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Sergi Valero
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), 08028 Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Marquié M, García-Sánchez A, Alarcón-Martín E, Martínez J, Castilla-Martí M, Castilla-Martí L, Orellana A, Montrreal L, de Rojas I, García-González P, Puerta R, Olivé C, Cano A, Hernández I, Rosende-Roca M, Vargas L, Tartari JP, Esteban-De Antonio E, Bojaryn U, Ricciardi M, Ariton DM, Pytel V, Alegret M, Ortega G, Espinosa A, Pérez-Cordón A, Sanabria Á, Muñoz N, Lleonart N, Aguilera N, Tárraga L, Valero S, Ruiz A, Boada M. Macular vessel density in the superficial plexus is not associated to cerebrospinal fluid core biomarkers for Alzheimer's disease in individuals with mild cognitive impairment: The NORFACE cohort. Front Neurosci 2023; 17:1076177. [PMID: 36908784 PMCID: PMC9995931 DOI: 10.3389/fnins.2023.1076177] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023] Open
Abstract
Background Optical coherence tomography angiography (OCT-A) is a novel method in the dementia field that allows the detection of retinal vascular changes. The comparison of OCT-A measures with established Alzheimer's disease (AD)-related biomarkers is essential to validate the former as a marker of cerebrovascular impairment in the AD continuum. We aimed to investigate the association of macular vessel density (VD) in the superficial plexus quantified by OCT-A with the AT(N) classification based on cerebrospinal fluid (CSF) Aβ1-42, p181-tau and t-tau measurements in individuals with mild cognitive impairment (MCI). Materials and methods Clinical, demographic, ophthalmological, OCT-A and CSF core biomarkers for AD data from the Neuro-ophthalmology Research at Fundació ACE (NORFACE) project were analyzed. Differences in macular VD in four quadrants (superior, nasal, inferior, and temporal) among three AT(N) groups [Normal, Alzheimer and Suspected non-Alzheimer pathology (SNAP)] were assessed in a multivariate regression model, adjusted for age, APOE ε4 status, hypertension, diabetes mellitus, dyslipidemia, heart disease, chronic obstructive pulmonary disease and smoking habit, using the Normal AT(N) group as the reference category. Results The study cohort comprised 144 MCI participants: 66 Normal AT(N), 45 Alzheimer AT(N) and 33 SNAP AT(N). Regression analysis showed no significant association of the AT(N) groups with any of the regional macular VD measures (all, p > 0.16). The interaction between sex and AT(N) groups had no effect on differentiating VD. Lastly, CSF Aβ1-42, p181-tau and t-tau measures were not correlated to VD (all r < 0.13; p > 0.13). Discussion Our study showed that macular VD measures were not associated with the AT(N) classification based on CSF biomarkers in patients with MCI, and did not differ between AD and other underlying causes of cognitive decline in our cohort.
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Affiliation(s)
- Marta Marquié
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Ainhoa García-Sánchez
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Emilio Alarcón-Martín
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Joan Martínez
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Miguel Castilla-Martí
- Clínica Oftalmológica Dr. Castilla, Barcelona, Spain.,Vista Alpina Eye Clinic, Visp, Switzerland
| | - Luis Castilla-Martí
- Ph.D. Programme in Surgery and Morphological Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain.,Hôpital Ophtalmique Jules-Gonin, Fondation Asile des Aveugles, University of Lausanne, Lausanne, Switzerland
| | - Adelina Orellana
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Montrreal
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Itziar de Rojas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Pablo García-González
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Raquel Puerta
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Clàudia Olivé
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Amanda Cano
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Hernández
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Maitée Rosende-Roca
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Liliana Vargas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Juan Pablo Tartari
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | | | - Urszula Bojaryn
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Mario Ricciardi
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Diana M Ariton
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Vanesa Pytel
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Montserrat Alegret
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Ortega
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Espinosa
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Alba Pérez-Cordón
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Ángela Sanabria
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Nathalia Muñoz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Núria Lleonart
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Núria Aguilera
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Lluís Tárraga
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergi Valero
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Agustín Ruiz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.,Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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Morató X, Pytel V, Jofresa S, Ruiz A, Boada M. Symptomatic and Disease-Modifying Therapy Pipeline for Alzheimer's Disease: Towards a Personalized Polypharmacology Patient-Centered Approach. Int J Mol Sci 2022; 23:9305. [PMID: 36012569 PMCID: PMC9409252 DOI: 10.3390/ijms23169305] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 02/07/2023] Open
Abstract
Since 1906, when Dr. Alois Alzheimer first described in a patient "a peculiar severe disease process of the cerebral cortex", people suffering from this pathology have been waiting for a breakthrough therapy. Alzheimer's disease (AD) is an irreversible, progressive neurodegenerative brain disorder and the most common form of dementia in the elderly with a long presymptomatic phase. Worldwide, approximately 50 million people are living with dementia, with AD comprising 60-70% of cases. Pathologically, AD is characterized by the deposition of amyloid β-peptide (Aβ) in the neuropil (neuritic plaques) and blood vessels (amyloid angiopathy), and by the accumulation of hyperphosphorylated tau in neurons (neurofibrillary tangles) in the brain, with associated loss of synapses and neurons, together with glial activation, and neuroinflammation, resulting in cognitive deficits and eventually dementia. The current competitive landscape in AD consists of symptomatic treatments, of which there are currently six approved medications: three AChEIs (donepezil, rivastigmine, and galantamine), one NMDA-R antagonist (memantine), one combination therapy (memantine/donepezil), and GV-971 (sodium oligomannate, a mixture of oligosaccharides derived from algae) only approved in China. Improvements to the approved therapies, such as easier routes of administration and reduced dosing frequencies, along with the developments of new strategies and combined treatments are expected to occur within the next decade and will positively impact the way the disease is managed. Recently, Aducanumab, the first disease-modifying therapy (DMT) has been approved for AD, and several DMTs are in advanced stages of clinical development or regulatory review. Small molecules, mAbs, or multimodal strategies showing promise in animal studies have not confirmed that promise in the clinic (where small to moderate changes in clinical efficacy have been observed), and therefore, there is a significant unmet need for a better understanding of the AD pathogenesis and the exploration of alternative etiologies and therapeutic effective disease-modifying therapies strategies for AD. Therefore, a critical review of the disease-modifying therapy pipeline for Alzheimer's disease is needed.
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Affiliation(s)
- Xavier Morató
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
| | - Vanesa Pytel
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
| | - Sara Jofresa
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
| | - Agustín Ruiz
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Mercè Boada
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
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