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Qiu T, Liu ZQ, Rheault F, Legarreta JH, Valcourt Caron A, St-Onge F, Strikwerda-Brown C, Metz A, Dadar M, Soucy JP, Pichet Binette A, Spreng RN, Descoteaux M, Villeneuve S. Structural white matter properties and cognitive resilience to tau pathology. Alzheimers Dement 2024; 20:3364-3377. [PMID: 38561254 DOI: 10.1002/alz.13776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/11/2024] [Accepted: 02/07/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION We assessed whether macro- and/or micro-structural white matter properties are associated with cognitive resilience to Alzheimer's disease pathology years prior to clinical onset. METHODS We examined whether global efficiency, an indicator of communication efficiency in brain networks, and diffusion measurements within the limbic network and default mode network moderate the association between amyloid-β/tau pathology and cognitive decline. We also investigated whether demographic and health/risk factors are associated with white matter properties. RESULTS Higher global efficiency of the limbic network, as well as free-water corrected diffusion measures within the tracts of both networks, attenuated the impact of tau pathology on memory decline. Education, age, sex, white matter hyperintensities, and vascular risk factors were associated with white matter properties of both networks. DISCUSSION White matter can influence cognitive resilience against tau pathology, and promoting education and vascular health may enhance optimal white matter properties. HIGHLIGHTS Aβ and tau were associated with longitudinal memory change over ∼7.5 years. White matter properties attenuated the impact of tau pathology on memory change. Health/risk factors were associated with white matter properties.
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Affiliation(s)
- Ting Qiu
- Douglas Mental Health University Institute, Montreal, Canada
| | - Zhen-Qi Liu
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - François Rheault
- Medical Imaging and NeuroInformatics Lab, Université de Sherbrooke, Sherbrooke, Canada
| | - Jon Haitz Legarreta
- Department of Radiology, Brigham and Women's Hospital, Mass General Brigham/Harvard Medical School, Boston, Massachusetts, USA
| | - Alex Valcourt Caron
- Sherbrooke Connectivity Imaging Laboratory, Université de Sherbrooke, Sherbrooke, Canada
| | | | - Cherie Strikwerda-Brown
- Douglas Mental Health University Institute, Montreal, Canada
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Amelie Metz
- Douglas Mental Health University Institute, Montreal, Canada
| | - Mahsa Dadar
- Douglas Mental Health University Institute, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Jean-Paul Soucy
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - R Nathan Spreng
- Douglas Mental Health University Institute, Montreal, Canada
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Laboratory, Université de Sherbrooke, Sherbrooke, Canada
| | - Sylvia Villeneuve
- Douglas Mental Health University Institute, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
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Salvadó G, Horie K, Barthélemy NR, Vogel JW, Pichet Binette A, Chen CD, Aschenbrenner AJ, Gordon BA, Benzinger TLS, Holtzman DM, Morris JC, Palmqvist S, Stomrud E, Janelidze S, Ossenkoppele R, Schindler SE, Bateman RJ, Hansson O. Disease staging of Alzheimer's disease using a CSF-based biomarker model. Nat Aging 2024:10.1038/s43587-024-00599-y. [PMID: 38514824 DOI: 10.1038/s43587-024-00599-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 02/20/2024] [Indexed: 03/23/2024]
Abstract
Biological staging of individuals with Alzheimer's disease (AD) may improve diagnostic and prognostic workup of dementia in clinical practice and the design of clinical trials. In this study, we used the Subtype and Stage Inference (SuStaIn) algorithm to establish a robust biological staging model for AD using cerebrospinal fluid (CSF) biomarkers. Our analysis involved 426 participants from BioFINDER-2 and was validated in 222 participants from the Knight Alzheimer Disease Research Center cohort. SuStaIn identified a singular biomarker sequence and revealed that five CSF biomarkers effectively constituted a reliable staging model (ordered: Aβ42/40, pT217/T217, pT205/T205, MTBR-tau243 and non-phosphorylated mid-region tau). The CSF stages (0-5) demonstrated a correlation with increased abnormalities in other AD-related biomarkers, such as Aβ-PET and tau-PET, and aligned with longitudinal biomarker changes reflective of AD progression. Higher CSF stages at baseline were associated with an elevated hazard ratio of clinical decline. This study highlights a common molecular pathway underlying AD pathophysiology across all patients, suggesting that a single CSF collection can accurately indicate the presence of AD pathologies and characterize the stage of disease progression. The proposed staging model has implications for enhancing diagnostic and prognostic assessments in both clinical practice and the design of clinical trials.
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Affiliation(s)
- Gemma Salvadó
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
| | - Kanta Horie
- Tracy Family Stable Isotope Labeling Quantitation (SILQ) Center, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Eisai, Inc., Nutley, NJ, USA
| | - Nicolas R Barthélemy
- Tracy Family Stable Isotope Labeling Quantitation (SILQ) Center, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jacob W Vogel
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Department of Clinical Science, Malmö, SciLifeLab, Lund University, Lund, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Charles D Chen
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrew J Aschenbrenner
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian A Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - David M Holtzman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Suzanne E Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Randall J Bateman
- Tracy Family Stable Isotope Labeling Quantitation (SILQ) Center, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
- Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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Coomans EM, van Westen D, Binette AP, Strandberg O, Spotorno N, Serrano GE, Beach TG, Palmqvist S, Stomrud E, Ossenkoppele R, Hansson O. Interactions between vascular burden and amyloid-β pathology on trajectories of tau accumulation. Brain 2024; 147:949-960. [PMID: 37721482 PMCID: PMC10907085 DOI: 10.1093/brain/awad317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 08/02/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023] Open
Abstract
Cerebrovascular pathology often co-exists with Alzheimer's disease pathology and can contribute to Alzheimer's disease-related clinical progression. However, the degree to which vascular burden contributes to Alzheimer's disease pathological progression is still unclear. This study aimed to investigate interactions between vascular burden and amyloid-β pathology on both baseline tau tangle load and longitudinal tau accumulation. We included 1229 participants from the Swedish BioFINDER-2 Study, including cognitively unimpaired and impaired participants with and without biomarker-confirmed amyloid-β pathology. All underwent baseline tau-PET (18F-RO948), and a subset (n = 677) underwent longitudinal tau-PET after 2.5 ± 1.0 years. Tau-PET uptake was computed for a temporal meta-region-of-interest. We focused on four main vascular imaging features and risk factors: microbleeds; white matter lesion volume; stroke-related events (infarcts, lacunes and haemorrhages); and the Framingham Heart Study Cardiovascular Disease risk score. To validate our in vivo results, we examined 1610 autopsy cases from an Arizona-based neuropathology cohort on three main vascular pathological features: cerebral amyloid angiopathy; white matter rarefaction; and infarcts. For the in vivo cohort, primary analyses included age-, sex- and APOE ɛ4-corrected linear mixed models between tau-PET (outcome) and interactions between time, amyloid-β and each vascular feature (predictors). For the neuropathology cohort, age-, sex- and APOE ɛ4-corrected linear models between tau tangle density (outcome) and an interaction between plaque density and each vascular feature (predictors) were performed. In cognitively unimpaired individuals, we observed a significant interaction between microbleeds and amyloid-β pathology on greater baseline tau load (β = 0.68, P < 0.001) and longitudinal tau accumulation (β = 0.11, P < 0.001). For white matter lesion volume, we did not observe a significant independent interaction effect with amyloid-β on tau after accounting for microbleeds. In cognitively unimpaired individuals, we further found that stroke-related events showed a significant negative interaction with amyloid-β on longitudinal tau (β = -0.08, P < 0.001). In cognitively impaired individuals, there were no significant interaction effects between cerebrovascular and amyloid-β pathology at all. In the neuropathology dataset, the in vivo observed interaction effects between cerebral amyloid angiopathy and plaque density (β = 0.38, P < 0.001) and between infarcts and plaque density (β = -0.11, P = 0.005) on tau tangle density were replicated. To conclude, we demonstrated that cerebrovascular pathology-in the presence of amyloid-β pathology-modifies tau accumulation in early stages of Alzheimer's disease. More specifically, the co-occurrence of microbleeds and amyloid-β pathology was associated with greater accumulation of tau aggregates during early disease stages. This opens the possibility that interventions targeting microbleeds may attenuate the rate of tau accumulation in Alzheimer's disease.
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Affiliation(s)
- Emma M Coomans
- Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081HV Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, 1081HV Amsterdam, The Netherlands
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081HV Amsterdam, The Netherlands
| | - Danielle van Westen
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
| | - Nicola Spotorno
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
| | - Geidy E Serrano
- Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Thomas G Beach
- Banner Sun Health Research Institute, Sun City, AZ 85351, USA
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081HV Amsterdam, The Netherlands
- Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden
- Amsterdam Neuroscience, Neurodegeneration, 1071HV Amsterdam, The Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden
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Nilsson J, Pichet Binette A, Palmqvist S, Brum WS, Janelidze S, Ashton NJ, Spotorno N, Stomrud E, Gobom J, Zetterberg H, Brinkmalm A, Blennow K, Hansson O. Cerebrospinal fluid biomarker panel for synaptic dysfunction in a broad spectrum of neurodegenerative diseases. Brain 2024:awae032. [PMID: 38325331 DOI: 10.1093/brain/awae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/31/2023] [Accepted: 01/21/2024] [Indexed: 02/09/2024] Open
Abstract
Synaptic dysfunction and degeneration is likely the key pathophysiology for the progression of cognitive decline in various dementia disorders. Synaptic status can be monitored by measurement of synaptic proteins in cerebrospinal fluid (CSF). In the current study, the aim was to investigate and compare both known and new synaptic proteins as potential biomarkers of synaptic dysfunction, especially in the context of Alzheimer's disease (AD). Seventeen synaptic proteins were quantified in CSF using two different targeted mass spectrometry assays in the prospective Swedish BioFINDER-2 study. The study included 958 individuals, characterized as having mild cognitive impairment (MCI, n = 205), AD dementia (n = 149), and a spectrum of other neurodegenerative diseases (n = 171), as well as cognitively unimpaired (CU, n = 443). Synaptic protein levels were compared between diagnostic groups and their associations with cognitive decline and key neuroimaging measures (Aβ-PET, tau-PET, and cortical thickness) were assessed. Among the 17 synaptic proteins examined, 14 were specifically elevated in the AD continuum. SNAP-25, 14-3-3 zeta/delta, beta-synuclein, and neurogranin exhibited the highest discriminatory accuracy to differentiate AD dementia from controls (AUCs = 0.81-0.93). SNAP-25 and 14-3-3 zeta/delta also had the strongest associations with tau-PET, Aβ-PET, and cortical thickness at baseline, and were associated with longitudinal changes in these imaging biomarkers (β(SE)=-0.056(0.0006) to 0.058(0.005), p < 0.0001). SNAP-25 was the strongest predictor of progression to AD dementia in non-demented individuals (Hazard ratio = 2.11). In contrast, neuronal pentraxins were decreased in all neurodegenerative diseases (except for Parkinson's disease), and NPTX2 showed the strongest associations with subsequent cognitive decline (longitudinal MMSE; β(SE) = 0.57(0.1), p ≤ 0.0001 and mPACC; β(SE) = 0.095(0.024), p ≤ 0.001) across the AD continuum. Interestingly, utilizing a ratio of the proteins that displayed higher levels in AD, such as SNAP-25 or 14-3-3 zeta/delta, over NPTX2 improved the biomarkers' association with cognitive decline and brain atrophy. We found that especially 14-3-3 zeta/delta and SNAP-25 are promising synaptic biomarkers of pathophysiological changes in AD. Neuronal pentraxins were identified as general indicators of neurodegeneration and associated with cognitive decline across various neurodegenerative dementias. The ratios of SNAP-25/NPTX2 and 14-3-3 zeta/delta/NPTX2 were found to best predict cognitive decline and brain atrophy.
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Affiliation(s)
- Johanna Nilsson
- Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, SE-43180 Mölndal, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Wagner S Brum
- Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, SE-43180 Mölndal, Sweden
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Nicholas J Ashton
- Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, SE-43180 Mölndal, Sweden
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
- Department of Old Age Psychiatry, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK
- NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Nicola Spotorno
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Johan Gobom
- Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, SE-43180 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, SE-43180 Mölndal, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, SE-43180 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, SE-43180 Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, WC1N 6BG, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, WC1N 6BG, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Ann Brinkmalm
- Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, SE-43180 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, SE-43180 Mölndal, Sweden
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, SE-43180 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, SE-43180 Mölndal, Sweden
- Paris Brain Institute, ICM, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
- Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, and Department of Neurology, Institute on Aging and Brain Disorders, University of Science and Technology of China and First Affiliated Hospital of USTC, Hefei, P.R. China
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden
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St-Onge F, Chapleau M, Breitner JCS, Villeneuve S, Pichet Binette A. Tau accumulation and its spatial progression across the Alzheimer's disease spectrum. Brain Commun 2024; 6:fcae031. [PMID: 38410618 PMCID: PMC10896475 DOI: 10.1093/braincomms/fcae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/30/2023] [Accepted: 02/05/2024] [Indexed: 02/28/2024] Open
Abstract
The accumulation of tau abnormality in sporadic Alzheimer's disease is believed typically to follow neuropathologically defined Braak staging. Recent in-vivo PET evidence challenges this belief, however, as accumulation patterns for tau appear heterogeneous among individuals with varying clinical expressions of Alzheimer's disease. We, therefore, sought a better understanding of the spatial distribution of tau in the preclinical and clinical phases of sporadic Alzheimer's disease and its association with cognitive decline. Longitudinal tau-PET data (1370 scans) from 832 participants (463 cognitively unimpaired, 277 with mild cognitive impairment and 92 with Alzheimer's disease dementia) were obtained from the Alzheimer's Disease Neuroimaging Initiative. Among these, we defined thresholds of abnormal tau deposition in 70 brain regions from the Desikan atlas, and for each group of regions characteristic of Braak staging. We summed each scan's number of regions with abnormal tau deposition to form a spatial extent index. We then examined patterns of tau pathology cross-sectionally and longitudinally and assessed their heterogeneity. Finally, we compared our spatial extent index of tau uptake with a temporal meta-region of interest-a commonly used proxy of tau burden-assessing their association with cognitive scores and clinical progression. More than 80% of amyloid-beta positive participants across diagnostic groups followed typical Braak staging, both cross-sectionally and longitudinally. Within each Braak stage, however, the pattern of abnormality demonstrated significant heterogeneity such that the overlap of abnormal regions across participants averaged less than 50%, particularly in persons with mild cognitive impairment. Accumulation of tau progressed more rapidly among cognitively unimpaired and participants with mild cognitive impairment (1.2 newly abnormal regions per year) compared to participants with Alzheimer's disease dementia (less than 1 newly abnormal region per year). Comparing the association of tau pathology and cognitive performance our spatial extent index was superior to the temporal meta-region of interest for identifying associations with memory in cognitively unimpaired individuals and explained more variance for measures of executive function in patients with mild cognitive impairments and Alzheimer's disease dementia. Thus, while participants broadly followed Braak stages, significant individual regional heterogeneity of tau binding was observed at each clinical stage. Progression of the spatial extent of tau pathology appears to be fastest in cognitively unimpaired and persons with mild cognitive impairment. Exploring the spatial distribution of tau deposits throughout the entire brain may uncover further pathological variations and their correlation with cognitive impairments.
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Affiliation(s)
- Frédéric St-Onge
- Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, QC H3A 2B4, Canada
- Research Center of the Douglas Mental Health University Institute, Montreal, QC H4H 1R3, Canada
| | - Marianne Chapleau
- Faculty of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - John C S Breitner
- Research Center of the Douglas Mental Health University Institute, Montreal, QC H4H 1R3, Canada
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC H3A 1Y2, Canada
| | - Sylvia Villeneuve
- Research Center of the Douglas Mental Health University Institute, Montreal, QC H4H 1R3, Canada
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC H3A 1Y2, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, QC H3A 2B4, Canada
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Malmö 205 02, Sweden
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Mattsson-Carlgren N, Collij LE, Stomrud E, Pichet Binette A, Ossenkoppele R, Smith R, Karlsson L, Lantero-Rodriguez J, Snellman A, Strandberg O, Palmqvist S, Ashton NJ, Blennow K, Janelidze S, Hansson O. Plasma Biomarker Strategy for Selecting Patients With Alzheimer Disease for Antiamyloid Immunotherapies. JAMA Neurol 2024; 81:69-78. [PMID: 38048096 PMCID: PMC10696515 DOI: 10.1001/jamaneurol.2023.4596] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/09/2023] [Indexed: 12/05/2023]
Abstract
Importance Antiamyloid immunotherapies against Alzheimer disease (AD) are emerging. Scalable, cost-effective tools will be needed to identify amyloid β (Aβ)-positive patients without an advanced stage of tau pathology who are most likely to benefit from these therapies. Blood-based biomarkers might reduce the need to use cerebrospinal fluid (CSF) or positron emission tomography (PET) for this. Objective To evaluate plasma biomarkers for identifying Aβ positivity and stage of tau accumulation. Design, Setting, and Participants The cohort study (BioFINDER-2) was a prospective memory-clinic and population-based study. Participants with cognitive concerns were recruited from 2017 to 2022 and divided into a training set (80% of the data) and test set (20%). Exposure Baseline values for plasma phosphorylated tau 181 (p-tau181), p-tau217, p-tau231, N-terminal tau, glial fibrillary acidic protein, and neurofilament light chain. Main Outcomes and Measures Performance to classify participants by Aβ status (defined by Aβ-PET or CSF Aβ42/40) and tau status (tau PET). Number of hypothetically saved PET scans in a plasma biomarker-guided workflow. Results Of a total 912 participants, there were 499 males (54.7%) and 413 females (45.3%), and the mean (SD) age was 71.1 (8.49) years. Among the biomarkers, plasma p-tau217 was most strongly associated with Aβ positivity (test-set area under the receiver operating characteristic curve [AUC] = 0.94; 95% CI, 0.90-0.97). A 2-cut-point procedure was evaluated, where only participants with ambiguous plasma p-tau217 values (17.1% of the participants in the test set) underwent CSF or PET to assign definitive Aβ status. This procedure had an overall sensitivity of 0.94 (95% CI, 0.90-0.98) and a specificity of 0.86 (95% CI, 0.77-0.95). Next, plasma biomarkers were used to differentiate low-intermediate vs high tau-PET load among Aβ-positive participants. Plasma p-tau217 again performed best, with the test AUC = 0.92 (95% CI, 0.86-0.97), without significant improvement when adding any of the other plasma biomarkers. At a false-negative rate less than 10%, the use of plasma p-tau217 could avoid 56.9% of tau-PET scans needed to identify high tau PET among Aβ-positive participants. The results were validated in an independent cohort (n = 118). Conclusions and Relevance This study found that algorithms using plasma p-tau217 can accurately identify most Aβ-positive individuals, including those likely to have a high tau load who would require confirmatory tau-PET imaging. Plasma p-tau217 measurements may substantially reduce the number of invasive and costly confirmatory tests required to identify individuals who would likely benefit from antiamyloid therapies.
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Affiliation(s)
- Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Lyduine E. Collij
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
- Radiology and Nuclear Medicine, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands
| | - Erik Stomrud
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Lund University, Lund, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
- Alzheimer Center Amsterdam, Neurology, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Ruben Smith
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Linda Karlsson
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Juan Lantero-Rodriguez
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - Anniina Snellman
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
- Turku PET Centre, University of Turku, Turku University Hospital, Turku, Finland
| | - Olof Strandberg
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Lund University, Lund, Sweden
| | - Nicholas J. Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, United Kingdom
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, United Kingdom
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Lund University, Lund, Sweden
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7
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St-Onge F, Javanray M, Pichet Binette A, Strikwerda-Brown C, Remz J, Spreng RN, Shafiei G, Misic B, Vachon-Presseau É, Villeneuve S. Functional connectome fingerprinting across the lifespan. Netw Neurosci 2023; 7:1206-1227. [PMID: 37781144 PMCID: PMC10473304 DOI: 10.1162/netn_a_00320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 04/24/2023] [Indexed: 10/03/2023] Open
Abstract
Systematic changes have been observed in the functional architecture of the human brain with advancing age. However, functional connectivity (FC) is also a powerful feature to detect unique "connectome fingerprints," allowing identification of individuals among their peers. Although fingerprinting has been robustly observed in samples of young adults, the reliability of this approach has not been demonstrated across the lifespan. We applied the fingerprinting framework to the Cambridge Centre for Ageing and Neuroscience cohort (n = 483 aged 18 to 89 years). We found that individuals are "fingerprintable" (i.e., identifiable) across independent functional MRI scans throughout the lifespan. We observed a U-shape distribution in the strength of "self-identifiability" (within-individual correlation across modalities), and "others-identifiability" (between-individual correlation across modalities), with a decrease from early adulthood into middle age, before improving in older age. FC edges contributing to self-identifiability were not restricted to specific brain networks and were different between individuals across the lifespan sample. Self-identifiability was additionally associated with regional brain volume. These findings indicate that individual participant-level identification is preserved across the lifespan despite the fact that its components are changing nonlinearly.
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Affiliation(s)
- Frédéric St-Onge
- Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, Canada
- Research Center of the Douglas Mental Health University Institute, Montreal, Canada
| | - Mohammadali Javanray
- Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, Canada
- Research Center of the Douglas Mental Health University Institute, Montreal, Canada
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | | | - Jordana Remz
- Research Center of the Douglas Mental Health University Institute, Montreal, Canada
| | - R. Nathan Spreng
- Research Center of the Douglas Mental Health University Institute, Montreal, Canada
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Golia Shafiei
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Bratislav Misic
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Étienne Vachon-Presseau
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
- Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, Canada
- Alan Edwards Centre for Research on Pain (AECRP), McGill University, Montreal, Canada
| | - Sylvia Villeneuve
- Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, Canada
- Research Center of the Douglas Mental Health University Institute, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
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8
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Ourry V, Binette AP, St-Onge F, Strikwerda-Brown C, Chagnot A, Poirier J, Breitner J, Arenaza-Urquijo EM, Rabin JS, Buckley R, Gonneaud J, Marchant NL, Villeneuve S. How Do Modifiable Risk Factors Affect Alzheimer's Disease Pathology or Mitigate Its Effect on Clinical Symptom Expression? Biol Psychiatry 2023:S0006-3223(23)01562-7. [PMID: 37689129 DOI: 10.1016/j.biopsych.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/11/2023] [Accepted: 09/03/2023] [Indexed: 09/11/2023]
Abstract
Epidemiological studies show that modifiable risk factors account for approximately 40% of the population variability in risk of developing dementia, including sporadic Alzheimer's disease (AD). Recent findings suggest that these factors may also modify disease trajectories of people with autosomal-dominant AD. With positron emission tomography imaging, it is now possible to study the disease many years before its clinical onset. Such studies can provide key knowledge regarding pathways for either the prevention of pathology or the postponement of its clinical expression. The former "resistance pathway" suggests that modifiable risk factors could affect amyloid and tau burden decades before the appearance of cognitive impairment. Alternatively, the resilience pathway suggests that modifiable risk factors may mitigate the symptomatic expression of AD pathology on cognition. These pathways are not mutually exclusive and may appear at different disease stages. Here, in a narrative review, we present neuroimaging evidence that supports both pathways in sporadic AD and autosomal-dominant AD. We then propose mechanisms for their protective effect. Among possible mechanisms, we examine neural and vascular mechanisms for the resistance pathway. We also describe brain maintenance and functional compensation as bases for the resilience pathway. Improved mechanistic understanding of both pathways may suggest new interventions.
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Affiliation(s)
- Valentin Ourry
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
| | - Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Clinical Memory Research Unit, Department of Clinical Sciences, Lunds Universitet, Malmö, Sweden
| | - Frédéric St-Onge
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Cherie Strikwerda-Brown
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Audrey Chagnot
- UK Dementia Research Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Judes Poirier
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - John Breitner
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Eider M Arenaza-Urquijo
- Environment and Health over the Lifecourse Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Jennifer S Rabin
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Rachel Buckley
- Melbourne School of Psychological Sciences University of Melbourne, Parkville, Victoria, Australia; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Julie Gonneaud
- Normandie University, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, Caen, France
| | - Natalie L Marchant
- Division of Psychiatry, University College London, London, United Kingdom
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
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9
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Wuestefeld A, Pichet Binette A, Berron D, Spotorno N, van Westen D, Stomrud E, Mattsson-Carlgren N, Strandberg O, Smith R, Palmqvist S, Glenn T, Moes S, Honer M, Arfanakis K, Barnes LL, Bennett DA, Schneider JA, Wisse LEM, Hansson O. Age-related and amyloid-beta-independent tau deposition and its downstream effects. Brain 2023; 146:3192-3205. [PMID: 37082959 PMCID: PMC10393402 DOI: 10.1093/brain/awad135] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/20/2023] [Accepted: 04/06/2023] [Indexed: 04/22/2023] Open
Abstract
Amyloid-β (Aβ) is hypothesized to facilitate the spread of tau pathology beyond the medial temporal lobe. However, there is evidence that, independently of Aβ, age-related tau pathology might be present outside of the medial temporal lobe. We therefore aimed to study age-related Aβ-independent tau deposition outside the medial temporal lobe in two large cohorts and to investigate potential downstream effects of this on cognition and structural measures. We included 545 cognitively unimpaired adults (40-92 years) from the BioFINDER-2 study (in vivo) and 639 (64-108 years) from the Rush Alzheimer's Disease Center cohorts (ex vivo). 18F-RO948- and 18F-flutemetamol-PET standardized uptake value ratios were calculated for regional tau and global/regional Aβ in vivo. Immunohistochemistry was used to estimate Aβ load and tangle density ex vivo. In vivo medial temporal lobe volumes (subiculum, cornu ammonis 1) and cortical thickness (entorhinal cortex, Brodmann area 35) were obtained using Automated Segmentation for Hippocampal Subfields packages. Thickness of early and late neocortical Alzheimer's disease regions was determined using FreeSurfer. Global cognition and episodic memory were estimated to quantify cognitive functioning. In vivo age-related tau deposition was observed in the medial temporal lobe and in frontal and parietal cortical regions, which was statistically significant when adjusting for Aβ. This was also observed in individuals with low Aβ load. Tau deposition was negatively associated with cortical volumes and thickness in temporal and parietal regions independently of Aβ. The associations between age and cortical volume or thickness were partially mediated via tau in regions with early Alzheimer's disease pathology, i.e. early tau and/or Aβ pathology (subiculum/Brodmann area 35/precuneus/posterior cingulate). Finally, the associations between age and cognition were partially mediated via tau in Brodmann area 35, even when including Aβ-PET as covariate. Results were validated in the ex vivo cohort showing age-related and Aβ-independent increases in tau aggregates in and outside the medial temporal lobe. Ex vivo age-cognition associations were mediated by medial and inferior temporal tau tangle density, while correcting for Aβ density. Taken together, our study provides support for primary age-related tauopathy even outside the medial temporal lobe in vivo and ex vivo, with downstream effects on structure and cognition. These results have implications for our understanding of the spreading of tau outside the medial temporal lobe, also in the context of Alzheimer's disease. Moreover, this study suggests the potential utility of tau-targeting treatments in primary age-related tauopathy, likely already in preclinical stages in individuals with low Aβ pathology.
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Affiliation(s)
- Anika Wuestefeld
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
| | - David Berron
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
| | - Nicola Spotorno
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
| | - Danielle van Westen
- Department of Diagnostic Radiology, Clinical Sciences, Lund University, SE-222 42 Lund, Sweden
- Image and Function, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Department of Neurology, Skåne University Hospital, SE-205 02 Malmö, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, 221 84 Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Department of Neurology, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Trevor Glenn
- Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Svenja Moes
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, CH-4070 Basel, Switzerland
| | - Michael Honer
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, CH-4070 Basel, Switzerland
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL 60616, USA
| | - Lisa L Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
| | - David A Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA
| | - Julie A Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA
| | - Laura E M Wisse
- Department of Diagnostic Radiology, Clinical Sciences, Lund University, SE-222 42 Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden
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10
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Horie K, Salvadó G, Barthélemy NR, Janelidze S, Li Y, He Y, Saef B, Chen CD, Jiang H, Strandberg O, Pichet Binette A, Palmqvist S, Sato C, Sachdev P, Koyama A, Gordon BA, Benzinger TLS, Holtzman DM, Morris JC, Mattsson-Carlgren N, Stomrud E, Ossenkoppele R, Schindler SE, Hansson O, Bateman RJ. CSF MTBR-tau243 is a specific biomarker of tau tangle pathology in Alzheimer's disease. Nat Med 2023; 29:1954-1963. [PMID: 37443334 PMCID: PMC10427417 DOI: 10.1038/s41591-023-02443-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 06/05/2023] [Indexed: 07/15/2023]
Abstract
Aggregated insoluble tau is one of two defining features of Alzheimer's disease. Because clinical symptoms are strongly correlated with tau aggregates, drug development and clinical diagnosis need cost-effective and accessible specific fluid biomarkers of tau aggregates; however, recent studies suggest that the fluid biomarkers currently available cannot specifically track tau aggregates. We show that the microtubule-binding region (MTBR) of tau containing the residue 243 (MTBR-tau243) is a new cerebrospinal fluid (CSF) biomarker specific for insoluble tau aggregates and compared it to multiple other phosphorylated tau measures (p-tau181, p-tau205, p-tau217 and p-tau231) in two independent cohorts (BioFINDER-2, n = 448; and Knight Alzheimer Disease Research Center, n = 219). MTBR-tau243 was most strongly associated with tau-positron emission tomography (PET) and cognition, whereas showing the lowest association with amyloid-PET. In combination with p-tau205, MTBR-tau243 explained most of the total variance in tau-PET burden (0.58 ≤ R2 ≤ 0.75) and the performance in predicting cognitive measures (0.34 ≤ R2 ≤ 0.48) approached that of tau-PET (0.44 ≤ R2 ≤ 0.52). MTBR-tau243 levels longitudinally increased with insoluble tau aggregates, unlike CSF p-tau species. CSF MTBR-tau243 is a specific biomarker of tau aggregate pathology, which may be utilized in interventional trials and in the diagnosis of patients. Based on these findings, we propose to revise the A/T/(N) criteria to include MTBR-tau243 as representing insoluble tau aggregates ('T').
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Grants
- P30 AG066444 NIA NIH HHS
- R01 AG070941 NIA NIH HHS
- P01 AG003991 NIA NIH HHS
- P01 AG026276 NIA NIH HHS
- P30 NS048056 NINDS NIH HHS
- S10 OD025214 NIH HHS
- The Tracy Family SILQ Center established by the Tracy Family, Richard Frimel and Gary Werths, GHR Foundation, David Payne, and the Willman Family brought together by The Foundation for Barnes-Jewish Hospital.
- Eisai industry grant
- The European Union’s Horizon 2020 research and innovation program under the Marie Sklodowska-Curie action grant agreement No 101061836, from Greta och Johan Kocks research grants and, travel grants from the Strategic Research Area MultiPark (Multidisciplinary Research in Parkinson’s disease) at Lund University
- U.S. Department of Health & Human Services | National Institutes of Health (NIH)
- The Swedish Research Council (2016-00906), the Knut and Alice Wallenberg foundation (2017-0383), the Marianne and Marcus Wallenberg foundation (2015.0125), the Strategic Research Area MultiPark (Multidisciplinary Research in Parkinson’s disease) at Lund University, the Swedish Alzheimer Foundation (AF-939932), the Swedish Brain Foundation (FO2021-0293), The Parkinson foundation of Sweden (1280/20), the Cure Alzheimer’s fund, the Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, the Skåne University Hospital Foundation (2020-O000028), Regionalt Forskningsstöd (2020-0314) and the Swedish federal government under the ALF agreement (2018-Projekt0279)
- The Knight ADRC developmental project
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Affiliation(s)
- Kanta Horie
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Eisai Inc., Nutley, NJ, USA
| | - Gemma Salvadó
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Nicolas R Barthélemy
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Yan Li
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Yingxin He
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Benjamin Saef
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Charles D Chen
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Hong Jiang
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Chihiro Sato
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | | | | | - Brian A Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - David M Holtzman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Suzanne E Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
- Memory Clinic, Skåne University Hospital, Malmö, Sweden.
| | - Randall J Bateman
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, USA.
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA.
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA.
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11
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Salvadó G, Horie K, Barthélemy NR, Vogel JW, Binette AP, Chen CD, Aschenbrenner AJ, Gordon BA, Benzinger TL, Holtzman DM, Morris JC, Palmqvist S, Stomrud E, Janelidze S, Ossenkoppele R, Schindler SE, Bateman RJ, Hansson O. Novel CSF tau biomarkers can be used for disease staging of sporadic Alzheimer's disease. medRxiv 2023:2023.07.14.23292650. [PMID: 37503281 PMCID: PMC10370223 DOI: 10.1101/2023.07.14.23292650] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Biological staging of individuals with Alzheimer's disease (AD) may improve diagnostic and prognostic work-up of dementia in clinical practice and the design of clinical trials. Here, we created a staging model using the Subtype and Stage Inference (SuStaIn) algorithm by evaluating cerebrospinal fluid (CSF) amyloid-β (Aβ) and tau biomarkers in 426 participants from BioFINDER-2, that represent the entire spectrum of AD. The model composition and main analyses were replicated in 222 participants from the Knight ADRC cohort. SuStaIn revealed in the two cohorts that the data was best explained by a single biomarker sequence (one subtype), and that five CSF biomarkers (ordered: Aβ42/40, tau phosphorylation occupancies at the residues 217 and 205 [pT217/T217 and pT205/T205], microtubule-binding region of tau containing the residue 243 [MTBR-tau243], and total tau) were sufficient to create an accurate disease staging model. Increasing CSF stages (0-5) were associated with increased abnormality in other AD-related biomarkers, such as Aβ- and tau-PET, and aligned with different phases of longitudinal biomarker changes consistent with current models of AD progression. Higher CSF stages at baseline were associated with higher hazard ratio of clinical decline. Our findings indicate that a common pathophysiologic molecular pathway develops across all AD patients, and that a single CSF collection is sufficient to reliably indicate the presence of both AD pathologies and the degree and stage of disease progression.
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Affiliation(s)
- Gemma Salvadó
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Kanta Horie
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, United States
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
- Eisai Inc., Nutley, NJ, United States
| | - Nicolas R. Barthélemy
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, United States
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
| | - Jacob W. Vogel
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Department of Clinical Science, Malmö, SciLifeLab, Lund University, Lund, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Charles D. Chen
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrew J Aschenbrenner
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian A. Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L.S. Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - David M. Holtzman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - John C. Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Suzanne E. Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Randall J. Bateman
- The Tracy Family SILQ Center, Washington University School of Medicine, St Louis, MO, United States
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
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12
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St-Onge F, Chapleau M, Breitner JCS, Villeneuve S, Binette AP. Tau accumulation and its spatial progression across the Alzheimer's disease spectrum. medRxiv 2023:2023.06.02.23290880. [PMID: 37333413 PMCID: PMC10274981 DOI: 10.1101/2023.06.02.23290880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
The spread of tau abnormality in sporadic Alzheimer's disease is believed typically to follow neuropathologically defined Braak staging. Recent in-vivo positron emission tomography (PET) evidence challenges this belief, however, as spreading patterns for tau appear heterogenous among individuals with varying clinical expression of Alzheimer's disease. We therefore sought better understanding of the spatial distribution of tau in the preclinical and clinical phases of sporadic Alzheimer's disease and its association with cognitive decline. Longitudinal tau-PET data (1,370 scans) from 832 participants (463 cognitively unimpaired, 277 with mild cognitive impairment (MCI) and 92 with Alzheimer's disease dementia) were obtained from the Alzheimer's Disease Neuroimaging Initiative. Among these, we defined thresholds of abnormal tau deposition in 70 brain regions from the Desikan atlas, and for each group of regions characteristic of Braak staging. We summed each scan's number of regions with abnormal tau deposition to form a spatial extent index. We then examined patterns of tau pathology cross-sectionally and longitudinally and assessed their heterogeneity. Finally, we compared our spatial extent index of tau uptake with a temporal meta region of interest-a commonly used proxy of tau burden-assessing their association with cognitive scores and clinical progression. More than 80% of amyloid-beta positive participants across diagnostic groups followed typical Braak staging, both cross-sectionally and longitudinally. Within each Braak stage, however, the pattern of abnormality demonstrated significant heterogeneity such that overlap of abnormal regions across participants averaged less than 50%. The annual rate of change in number of abnormal tau-PET regions was similar among individuals without cognitive impairment and those with Alzheimer's disease dementia. Spread of disease progressed more rapidly, however, among participants with MCI. The latter's change on our spatial extent measure amounted to 2.5 newly abnormal regions per year, as contrasted with 1 region/year among the other groups. Comparing the association of tau pathology and cognitive performance in MCI and Alzheimer's disease dementia, our spatial extent index was superior to the temporal meta-ROI for measures of executive function. Thus, while participants broadly followed Braak stages, significant individual regional heterogeneity of tau binding was observed at each clinical stage. Progression of spatial extent of tau pathology appears to be fastest in persons with MCI. Exploring the spatial distribution of tau deposits throughout the entire brain may uncover further pathological variations and their correlation with impairments in cognitive functions beyond memory.
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Affiliation(s)
- Frédéric St-Onge
- Integrated Program in Neuroscience, Faculty of medicine, McGill University, Montreal, Qc, H3A 2B4, Canada
- Research Center of the Douglas Mental Health University Institute, Montreal, Qc, H4H 1R3, Canada
| | - Marianne Chapleau
- Faculty of medicine, University of California San Francisco, San Francisco, CA, 94143, United-States
| | - John CS Breitner
- Research Center of the Douglas Mental Health University Institute, Montreal, Qc, H4H 1R3, Canada
- Department of psychiatry, Faculty of medicine, McGill University, Montreal, QC, H3A 1Y2, Canada
| | - Sylvia Villeneuve
- Research Center of the Douglas Mental Health University Institute, Montreal, Qc, H4H 1R3, Canada
- Department of psychiatry, Faculty of medicine, McGill University, Montreal, QC, H3A 1Y2, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, QC, H3A 2B4, Canada
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Malmö, 205 02, Sweden
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Leuzy A, Binette AP, Vogel JW, Klein G, Borroni E, Tonietto M, Strandberg O, Mattsson-Carlgren N, Palmqvist S, Pontecorvo MJ, Iaccarino L, Stomrud E, Ossenkoppele R, Smith R, Hansson O. Comparison of Group-Level and Individualized Brain Regions for Measuring Change in Longitudinal Tau Positron Emission Tomography in Alzheimer Disease. JAMA Neurol 2023; 80:614-623. [PMID: 37155176 PMCID: PMC10167602 DOI: 10.1001/jamaneurol.2023.1067] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/15/2023] [Indexed: 05/10/2023]
Abstract
Importance Longitudinal tau positron emission tomography (PET) is a relevant outcome in clinical trials evaluating disease-modifying therapies in Alzheimer disease (AD). A key unanswered question is whether the use of participant-specific (individualized) regions of interest (ROIs) is superior to conventional approaches where the same ROI (group-level) is used for each participant. Objective To compare group- and participant-level ROIs in participants at different stages of the AD clinical continuum in terms of annual percentage change in tau-PET standardized uptake value ratio (SUVR) and sample size requirements. Design, Setting, and Participants This was a longitudinal cohort study with consecutive participant enrollment between September 18, 2017, and November 15, 2021. Included in the analysis were participants with mild cognitive impairment and AD dementia from the prospective and longitudinal Swedish Biomarkers For Identifying Neurodegenerative Disorders Early and Reliably 2 (BioFINDER-2) study; in addition, a validation sample (the AVID 05e, Expedition-3, Alzheimer's Disease Neuroimaging Initiative [ADNI], and BioFINDER-1 study cohorts) was also included. Exposures Tau PET (BioFINDER-2, [18F]RO948; validation sample, [18F]flortaucipir), 7 group-level (5 data-driven stages, meta-temporal, whole brain), and 5 individualized ROIs. Main Outcomes and Measures Annual percentage change in tau-PET SUVR across ROIs. Sample size requirements in simulated clinical trials using tau PET as an outcome were also calculated. Results A total of 215 participants (mean [SD] age, 71.4 (7.5) years; 111 male [51.6%]) from the BioFINDER-2 study were included in this analysis: 97 amyloid-β (Aβ)-positive cognitively unimpaired (CU) individuals, 77 with Aβ-positive mild cognitive impairment (MCI), and 41 with AD dementia. In the validation sample were 137 Aβ-positive CU participants, 144 with Aβ-positive MCI, and 125 with AD dementia. Mean (SD) follow-up time was 1.8 (0.3) years. Using group-level ROIs, the largest annual percentage increase in tau-PET SUVR in Aβ-positive CU individuals was seen in a composite ROI combining the entorhinal cortex, hippocampus, and amygdala (4.29%; 95% CI, 3.42%-5.16%). In individuals with Aβ-positive MCI, the greatest change was seen in the temporal cortical regions (5.82%; 95% CI, 4.67%-6.97%), whereas in those with AD dementia, the greatest change was seen in the parietal regions (5.22%; 95% CI, 3.95%-6.49%). Significantly higher estimates of annual percentage change were found using several of the participant-specific ROIs. Importantly, the simplest participant-specific approach, where change in tau PET was calculated in an ROI that best matched the participant's data-driven disease stage, performed best in all 3 subgroups. For the power analysis, sample size reductions for the participant-specific ROIs ranged from 15.94% (95% CI, 8.14%-23.74%) to 72.10% (95% CI, 67.10%-77.20%) compared with the best-performing group-level ROIs. Findings were replicated using [18F]flortaucipir. Conclusions and Relevance Finding suggest that certain individualized ROIs carry an advantage over group-level ROIs for assessing longitudinal tau changes and increase the power to detect treatment effects in AD clinical trials using longitudinal tau PET as an outcome.
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Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Jacob W. Vogel
- Penn/CHOP Lifespan Brain Institute, University of Pennsylvania, Philadelphia
- Department of Psychiatry, University of Pennsylvania, Philadelphia
| | | | | | | | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
- Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Michael J. Pontecorvo
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
- Eli Lilly and Company, Indianapolis, Indiana
| | - Leonardo Iaccarino
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
- Eli Lilly and Company, Indianapolis, Indiana
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
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Binette AP, Janelidze S, Cullen N, Dage JL, Bateman RJ, Zetterberg H, Blennow K, Stomrud E, Mattsson-Carlgren N, Hansson O. Confounding factors of Alzheimer's disease plasma biomarkers and their impact on clinical performance. Alzheimers Dement 2023; 19:1403-1414. [PMID: 36152307 PMCID: PMC10499000 DOI: 10.1002/alz.12787] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/27/2022] [Accepted: 07/31/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Plasma biomarkers will likely revolutionize the diagnostic work-up of Alzheimer's disease (AD) globally. Before widespread use, we need to determine if confounding factors affect the levels of these biomarkers, and their clinical utility. METHODS Participants with plasma and CSF biomarkers, creatinine, body mass index (BMI), and medical history data were included (BioFINDER-1: n = 748, BioFINDER-2: n = 421). We measured beta-amyloid (Aβ42, Aβ40), phosphorylated tau (p-tau217, p-tau181), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP). RESULTS In both cohorts, creatinine and BMI were the main factors associated with NfL, GFAP, and to a lesser extent with p-tau. However, adjustment for BMI and creatinine had only minor effects in models predicting either the corresponding levels in CSF or subsequent development of dementia. DISCUSSION Creatinine and BMI are related to certain plasma biomarkers levels, but they do not have clinically relevant confounding effects for the vast majority of individuals. HIGHLIGHTS Creatinine and body mass index (BMI) are related to certain plasma biomarker levels. Adjusting for creatinine and BMI has minor influence on plasma-cerebrospinal fluid (CSF) associations. Adjusting for creatinine and BMI has minor influence on prediction of dementia using plasma biomarkers.
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Affiliation(s)
- Alexa Pichet Binette
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Nicholas Cullen
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Jeffrey L. Dage
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Randall J. Bateman
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, United Kingdom
- UK Dementia Research Institute at UCL, London, United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
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Smith R, Cullen NC, Pichet Binette A, Leuzy A, Blennow K, Zetterberg H, Klein G, Borroni E, Ossenkoppele R, Janelidze S, Palmqvist S, Mattsson-Carlgren N, Stomrud E, Hansson O. Tau-PET is superior to phospho-tau when predicting cognitive decline in symptomatic AD patients. Alzheimers Dement 2022. [PMID: 36516028 DOI: 10.1002/alz.12875] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/15/2022] [Accepted: 10/21/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Biomarkers for the prediction of cognitive decline in patients with amnestic mild cognitive impairment (MCI) and amnestic mild dementia are needed for both clinical practice and clinical trials. METHODS We evaluated the ability of tau-PET (positron emission tomography), cortical atrophy on magnetic resonance imaging (MRI), baseline cognition, apolipoprotein E gene (APOE) status, plasma and cerebrospinal fluid (CSF) levels of phosphorylated tau-217, neurofilament light (NfL), and amyloid beta (Aβ)42/40 ratio (individually and in combination) to predict cognitive decline over 2 years in BioFINDER-2 and Alzheimer's Disease Neuroimaging Initiative (ADNI). RESULTS Baseline tau-PET and a composite baseline cognitive score were the strongest independent predictors of cognitive decline. Cortical thickness and NfL provided some additional information. Using a predictive algorithm to enrich patient selection in a theoretical clinical trial led to a significantly lower required sample size. DISCUSSION Models including baseline tau-PET and cognition consistently provided the best prediction of change in cognitive function over 2 years in patients with amnestic MCI or mild dementia.
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Affiliation(s)
- Ruben Smith
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Nicholas C Cullen
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden
| | - Alexa Pichet Binette
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden
| | - Antoine Leuzy
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute at UCL, London, UK.,Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | | | | | - Rik Ossenkoppele
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden.,Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Shorena Janelidze
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Erik Stomrud
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Oskar Hansson
- Department of Clinical Sciences, Clinical Memory Research Unit, Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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Franzmeier N, Ewers M, Brendel M, Biel D, Ossenkoppele R, Hager P, Steward A, Dewenter A, Rubinski A, Buerger K, Janowitz D, Binette AP, Smith R, Strandberg O, Mattsson‐Carlgren N, Dichgans M, Frontzkowski L, Hansson O. Earlier Alzheimer's disease onset is associated with a shift of tau pathology towards brain hubs which facilitates tau spreading. Alzheimers Dement 2022. [DOI: 10.1002/alz.067043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Amsterdam University Medical Center Amsterdam Netherlands
| | - Paul Hager
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Anna Steward
- Institute for Stroke and Dementia Research, LMU, Munich Munich Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | | | | | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Lukas Frontzkowski
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig Maximilian University Munich Munich Germany
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
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Wuestefeld A, Wutt H, Berron D, Baumeister H, Binette AP, Stomrud E, Mattsson‐Carlgren N, Strandberg O, Smith R, Palmqvist S, van Westen D, Hansson O, Wisse LEM. Medial temporal lobe subregional atrophy patterns in early‐ and late‐onset amnestic Alzheimer’s disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.066489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | - David Berron
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Lund Sweden
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg Germany
| | - Hannah Baumeister
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg Germany
| | | | - Erik Stomrud
- Memory Clinic, Skåne University Hospital Malmö Sweden
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Niklas Mattsson‐Carlgren
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Malmö Sweden
| | | | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Neurology Clinic, Skåne University Hospital Lund Sweden
| | - Sebastian Palmqvist
- Memory Clinic, Skåne University Hospital Malmö Sweden
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Danielle van Westen
- Diagnostic Radiology, Lund University Lund Sweden
- Imaging and Function, Skåne University Hospital Lund Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Laura EM Wisse
- Department of Diagnostic Radiology, Clinical Sciences, Lund University Lund Sweden
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Binette AP, Franzmeier N, Spotorno N, Ewers M, Brendel M, Biel D, Strandberg O, Janelidze S, Palmqvist S, Mattsson‐Carlgren N, Smith R, Stomrud E, Ossenkoppele R, Hansson O. Amyloid‐associated increases in soluble tau is a key driver in accumulation of tau aggregates and cognitive decline in early Alzheimer. Alzheimers Dement 2022. [DOI: 10.1002/alz.061624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | | | - Sebastian Palmqvist
- Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Niklas Mattsson‐Carlgren
- Lund University Lund Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Malmö Sweden
- Wallenberg Center for Molecular Medicine, Lund University Lund Sweden
| | - Ruben Smith
- Lund University Lund Sweden
- Neurology Clinic, Skåne University Hospital Lund Sweden
| | - Erik Stomrud
- Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Rik Ossenkoppele
- Lund University Lund Sweden
- VU University Amsterdam Amsterdam Netherlands
| | - Oskar Hansson
- Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
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Strikwerda‐Brown C, St‐Onge F, Binette AP, Ozlen H, Buckley RF, Sperling RA, Johnson KA, Poirier J, Breitner J, Villeneuve S. Elevated tau‐PET signal predicts near‐term conversion to mild cognitive impairment in cognitively unimpaired older adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.062332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Cherie Strikwerda‐Brown
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | - Frederic St‐Onge
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | | | - Hazal Ozlen
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | - Rachel F. Buckley
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Massachusetts General Hospital, Brigham and Women’s Hospital,Harvard Medical School Boston MA USA
| | - Keith A. Johnson
- Massachusetts General Hospital, Brigham and Women’s Hospital,Harvard Medical School Boston MA USA
| | - Judes Poirier
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | - John Breitner
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | - Sylvia Villeneuve
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- Department of Psychiatry, McGill University Montreal QC Canada
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Qiu T, Liu Z, Strikwerda‐Brown C, St‐Onge F, Binette AP, Descoteaux M, Villeneuve S. Diffusion MRI subnetwork efficiency is associated with cognitive resilience to AD pathology in cognitively unimpaired older adults at risk of AD dementia. Alzheimers Dement 2022. [DOI: 10.1002/alz.064560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Ting Qiu
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | - Zhen‐Qi Liu
- McGill University Montreal QC Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute Montreal QC Canada
| | - Cherie Strikwerda‐Brown
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | - Frederic St‐Onge
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | - Alexa Pichet Binette
- Lund University Lund Sweden
- Clinical Memory Research Unit, Lund University Lund Sweden
- Clinical Memory Research Unit, Lund University Malmö QC Sweden
| | - Maxime Descoteaux
- Imeka Solutions Inc Sherbrooke QC Canada
- Université de Sherbrooke Sherbrooke QC Canada
| | - Sylvia Villeneuve
- Montreal Neurological Institute Montreal QC Canada
- Department of Psychiatry, McGill University Montreal QC Canada
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre) Montreal QC Canada
- Douglas Mental Health Research Institute Montreal QC Canada
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21
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Wuestefeld A, Wutt H, Baumeister H, Berron D, Binette AP, Stomrud E, Mattsson‐Carlgren N, Strandberg O, Smith R, Palmqvist S, van Westen D, Hansson O, Wisse LEM. Medial temporal lobe subregional atrophy patterns in early‐ and late‐onset amnestic Alzheimer’s disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.067075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | | | - Hannah Baumeister
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg Germany
| | - David Berron
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg Germany
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Lund Sweden
| | | | - Erik Stomrud
- Memory Clinic, Skåne University Hospital Malmö Sweden
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Niklas Mattsson‐Carlgren
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Wallenberg Center for Molecular Medicine, Lund University Lund Sweden
| | | | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Neurology Clinic, Skåne University Hospital Lund Sweden
| | - Sebastian Palmqvist
- Memory Clinic, Skåne University Hospital Malmö Sweden
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Danielle van Westen
- Diagnostic Radiology, Lund University Lund Sweden
- Imaging and Function, Skåne University Hospital Lund Sweden
| | - Oskar Hansson
- Memory Clinic, Skåne University Hospital Malmö Sweden
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Laura EM Wisse
- Department of Diagnostic Radiology, Clinical Sciences, Lund University Lund Sweden
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Leuzy A, Binette AP, Vogel JW, Klein G, Borroni E, Tonietto M, Strandberg O, Mattsson‐Carlgren N, Palmqvist S, Pontecorvo MJ, Stomrud E, Ossenkoppele R, Hansson O. Comparison of group‐level and individualized ROIs for predicting change in longitudinal tau‐PET in preclinical and prodromal AD. Alzheimers Dement 2022. [DOI: 10.1002/alz.063057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | - Jacob W Vogel
- Penn/CHOP Lifespan Brain Institute University of Pennsylvania Philadelphia PA USA
- Department of Psychiatry University of Pennsylvania Philadelphia PA USA
| | - Gregory Klein
- Pharma Research and Early Development, F. Hoffmann‐La Roche Ltd. Basel Switzerland
| | - Edilio Borroni
- Pharma Research and Early Development, F. Hoffmann‐La Roche Ltd. Basel Switzerland
| | - Matteo Tonietto
- Roche Pharma Research and Early Development, FHoffmann‐La RocheLtd Basel Switzerland
| | | | - Niklas Mattsson‐Carlgren
- Clinical Memory Research Unit Lund University Malmö Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Malmö Sweden
- Wallenberg Center for Molecular Medicine, Lund University Lund Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | | | - Erik Stomrud
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit Lund University Malmö Sweden
- VU University Medical Center, Neuroscience Campus Amsterdam Amsterdam Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
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23
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Groot C, Smith R, Stomrud E, Binette AP, Leuzy A, Wuestefeld A, Wisse LEM, Palmqvist S, Janelidze S, Strandberg O, Ossenkoppele R, Hansson O. A biomarker profile of elevated CSF p‐tau with normal tau PET is associated with increased tau accumulation rates on PET in early Alzheimer’s disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.063622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Colin Groot
- Clinical Memory Research Unit, Lund University Lund Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Erik Stomrud
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | | | - Antoine Leuzy
- Memory Clinic, Skåne University Hospital Lund Sweden
| | | | | | | | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Malmö SI Sweden
| | | | - Rik Ossenkoppele
- Lund University Lund Sweden
- Alzheimer Center Amsterdam, Department of Neurology Neuroscience, Vrije Universiteit Amsterdam UMC, Amsterdam Amsterdam Amsterdam Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
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24
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Groot C, Smith R, Stomrud E, Binette AP, Leuzy A, Wuestefeld A, Wisse LEM, Palmqvist S, Janelidze S, Strandberg O, Ossenkoppele R, Hansson O. A biomarker profile of elevated CSF p‐tau with normal tau PET is associated with increased tau accumulation rates on PET in early Alzheimer’s disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.065666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Colin Groot
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | | | - Antoine Leuzy
- Memory Clinic, Skåne University Hospital Lund Sweden
| | | | | | | | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University Malmö SI Sweden
| | | | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Clinical Memory Research Unit, Lund University, Sweden Lund Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
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25
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Pereira JB, Janelidze S, Binette AP, Strandberg O, Palmqvist S, Mattsson‐Carlgren N, Stomrud E, Hansson O. Microglial activation might protect against accumulation of Aβ and tau aggregates over time in non‐demented Aβ‐positive individuals. Alzheimers Dement 2022. [DOI: 10.1002/alz.067765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Joana B Pereira
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute Stockholm Sweden
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | | | | | | | | | | | - Erik Stomrud
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
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26
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Binette AP, Franzmeier N, Spotorno N, Ewers M, Brendel M, Biel D, Strandberg O, Janelidze S, Palmqvist S, Mattsson‐Carlgren N, Smith R, Stomrud E, Ossenkoppele R, Hansson O. Amyloid‐associated increases in soluble tau is a key driver in accumulation of tau aggregates and cognitive decline in early Alzheimer. Alzheimers Dement 2022. [DOI: 10.1002/alz.065080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | | | - Sebastian Palmqvist
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Niklas Mattsson‐Carlgren
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Malmö Sweden
- Wallenberg Center for Molecular Medicine, Lund University Lund Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Neurology Clinic, Skåne University Hospital Lund Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Clinical Memory Research Unit, Lund University, Sweden Lund Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
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27
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Molloy EN, Binette AP, Marquardt J, Remz J, Kreißl MC, Rosa‐Neto P, Poirier J, Rajah N, Villeneuve S, Maass A. The interplay between functional MRI measures of episodic memory and CSF measures of tau in healthy adults at risk of Alzheimer’s Disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.069197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Eóin N. Molloy
- Otto von Guericke University Magdeburg Germany
- German Center for Neurodegenerative Diseases Magdeburg Germany
| | - Alexa Pichet Binette
- Douglas Mental Health Research Institute Montreal QC Canada
- Clinical Memory Research Unit, Lund University Lund Sweden
| | - Jonas Marquardt
- German Center for Neurodegenerative Diseases Magdeburg Germany
| | - Jordana Remz
- Douglas Mental Health Research Institute Montreal QC Canada
| | - Michael C. Kreißl
- Otto von Guericke University Magdeburg Germany
- German Center for Neurodegenerative Diseases Magdeburg Germany
| | - Pedro Rosa‐Neto
- Douglas Mental Health Research Institute Montreal QC Canada
- McConnell Brain Imaging Centre ‐ McGill University Montréal QC Canada
- Department of Psychiatry, McGill University Montreal QC Canada
| | - Judes Poirier
- Douglas Mental Health Research Institute Montreal QC Canada
- Department of Psychiatry, McGill University Montreal QC Canada
| | - Natasha Rajah
- Douglas Mental Health Research Institute Montreal QC Canada
- Department of Psychiatry, McGill University Montreal QC Canada
| | - Sylvia Villeneuve
- Douglas Mental Health Research Institute Montreal QC Canada
- Department of Psychiatry, McGill University Montreal QC Canada
- McConnell Brain Imaging Centre ‐ McGill University Montreal QC Canada
| | - Anne Maass
- German Center for Neurodegenerative Diseases Magdeburg Germany
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28
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Strikwerda‐Brown C, St‐Onge F, Yakoub Y, Ozlen H, Binette AP, Breitner J, Villeneuve S, Group PREVENTR. Associations between psychological factors, grey matter volume, and resistance and resilience to tau pathology in cognitively unimpaired older adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.064727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Cherie Strikwerda‐Brown
- McGill University Montreal QC Canada
- Centre for Studies on Prevention of Alzheimer’s disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
| | - Frederic St‐Onge
- McGill University Montreal QC Canada
- Centre for Studies on Prevention of Alzheimer’s disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
| | - Yara Yakoub
- McGill University Montreal QC Canada
- Centre for Studies on Prevention of Alzheimer’s disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
| | - Hazal Ozlen
- Centre for Studies on Prevention of Alzheimer’s disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
| | | | - John Breitner
- McGill University Montreal QC Canada
- Centre for Studies on Prevention of Alzheimer’s disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
| | - Sylvia Villeneuve
- Centre for Studies on Prevention of Alzheimer’s disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- Department of Psychiatry, McGill University Montreal QC Canada
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29
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Wuestefeld A, Berron D, Binette AP, van Westen D, Stomrud E, Mattsson‐Carlgren N, Strandberg O, Smith R, Palmqvist S, Glenn T, Hansson O, Wisse LEM. Age‐related tau‐PET uptake and its downstream effects extend beyond the medial temporal lobe in cognitively normal older adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.067081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - David Berron
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg Germany
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Lund Sweden
| | | | - Danielle van Westen
- Diagnostic Radiology, Lund University Lund Sweden
- Imaging and Function, Skåne University Hospital Lund Sweden
| | - Erik Stomrud
- Memory Clinic, Skåne University Hospital Malmö Sweden
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Niklas Mattsson‐Carlgren
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Wallenberg Center for Molecular Medicine, Lund University Lund Sweden
| | | | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Neurology Clinic, Skåne University Hospital Lund Sweden
| | - Sebastian Palmqvist
- Memory Clinic, Skåne University Hospital Malmö Sweden
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Laura EM Wisse
- Department of Diagnostic Radiology, Clinical Sciences, Lund University Lund Sweden
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30
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Strikwerda‐Brown C, St‐Onge F, Binette AP, Ozlen H, Buckley RF, Sperling RA, Johnson KA, Poirier J, Breitner J, Villeneuve S. Elevated tau‐PET signal predicts near‐term conversion to mild cognitive impairment in cognitively unimpaired older adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.060161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Cherie Strikwerda‐Brown
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | - Frederic St‐Onge
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | | | - Hazal Ozlen
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | - Rachel F. Buckley
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Massachusetts General Hospital, Brigham and Women’s Hospital,Harvard Medical School Boston MA USA
| | - Keith A. Johnson
- Massachusetts General Hospital, Brigham and Women’s Hospital,Harvard Medical School Boston MA USA
| | - Judes Poirier
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | - John Breitner
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | - Sylvia Villeneuve
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- Montreal Neurological Institute Montreal QC Canada
- Department of Psychiatry, McGill University Montreal QC Canada
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31
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Ashton NJ, Janelidze S, Mattsson-Carlgren N, Binette AP, Strandberg O, Brum WS, Karikari TK, González-Ortiz F, Di Molfetta G, Meda FJ, Jonaitis EM, Koscik RL, Cody K, Betthauser TJ, Li Y, Vanmechelen E, Palmqvist S, Stomrud E, Bateman RJ, Zetterberg H, Johnson SC, Blennow K, Hansson O. Differential roles of Aβ42/40, p-tau231 and p-tau217 for Alzheimer's trial selection and disease monitoring. Nat Med 2022; 28:2555-2562. [PMID: 36456833 PMCID: PMC9800279 DOI: 10.1038/s41591-022-02074-w] [Citation(s) in RCA: 89] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 10/03/2022] [Indexed: 12/03/2022]
Abstract
Blood biomarkers indicative of Alzheimer's disease (AD) pathology are altered in both preclinical and symptomatic stages of the disease. Distinctive biomarkers may be optimal for the identification of AD pathology or monitoring of disease progression. Blood biomarkers that correlate with changes in cognition and atrophy during the course of the disease could be used in clinical trials to identify successful interventions and thereby accelerate the development of efficient therapies. When disease-modifying treatments become approved for use, efficient blood-based biomarkers might also inform on treatment implementation and management in clinical practice. In the BioFINDER-1 cohort, plasma phosphorylated (p)-tau231 and amyloid-β42/40 ratio were more changed at lower thresholds of amyloid pathology. Longitudinally, however, only p-tau217 demonstrated marked amyloid-dependent changes over 4-6 years in both preclinical and symptomatic stages of the disease, with no such changes observed in p-tau231, p-tau181, amyloid-β42/40, glial acidic fibrillary protein or neurofilament light. Only longitudinal increases of p-tau217 were also associated with clinical deterioration and brain atrophy in preclinical AD. The selective longitudinal increase of p-tau217 and its associations with cognitive decline and atrophy was confirmed in an independent cohort (Wisconsin Registry for Alzheimer's Prevention). These findings support the differential association of plasma biomarkers with disease development and strongly highlight p-tau217 as a surrogate marker of disease progression in preclinical and prodromal AD, with impact for the development of new disease-modifying treatments.
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Affiliation(s)
- Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Shorena Janelidze
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Wagner S Brum
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Fernándo González-Ortiz
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Guglielmo Di Molfetta
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Francisco J Meda
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Erin M Jonaitis
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Rebecca Langhough Koscik
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Karly Cody
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Tobey J Betthauser
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Yan Li
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- SILQ Center, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Sebastian Palmqvist
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- SILQ Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Sterling C Johnson
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
- ADx NeuroSciences, Technologiepark 94, Ghent, Belgium.
| | - Oskar Hansson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden.
- Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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32
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Wuestefeld A, Berron D, Binette AP, van Westen D, Stomrud E, Mattsson‐Carlgren N, Strandberg O, Smith R, Palmqvist S, Glenn T, Hansson O, Wisse LEM. Age‐related tau‐PET uptake and its downstream effects extend beyond the medial temporal lobe in cognitively normal older adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.066545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - David Berron
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Lund Sweden
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg Germany
| | | | - Danielle van Westen
- Diagnostic Radiology, Lund University Lund Sweden
- Imaging and Function, Skåne University Hospital Lund Sweden
| | - Erik Stomrud
- Memory Clinic, Skåne University Hospital Malmö Sweden
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | | | | | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Neurology Clinic, Skåne University Hospital Lund Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Lund Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Laura EM Wisse
- Department of Diagnostic Radiology, Clinical Sciences, Lund University Lund Sweden
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33
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Pichet Binette A, Franzmeier N, Spotorno N, Ewers M, Brendel M, Biel D, Strandberg O, Janelidze S, Palmqvist S, Mattsson-Carlgren N, Smith R, Stomrud E, Ossenkoppele R, Hansson O. Amyloid-associated increases in soluble tau relate to tau aggregation rates and cognitive decline in early Alzheimer's disease. Nat Commun 2022; 13:6635. [PMID: 36333294 PMCID: PMC9636262 DOI: 10.1038/s41467-022-34129-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
For optimal design of anti-amyloid-β (Aβ) and anti-tau clinical trials, we need to better understand the pathophysiological cascade of Aβ- and tau-related processes. Therefore, we set out to investigate how Aβ and soluble phosphorylated tau (p-tau) relate to the accumulation of tau aggregates assessed with PET and subsequent cognitive decline across the Alzheimer's disease (AD) continuum. Using human cross-sectional and longitudinal neuroimaging and cognitive assessment data, we show that in early stages of AD, increased concentration of soluble CSF p-tau is strongly associated with accumulation of insoluble tau aggregates across the brain, and CSF p-tau levels mediate the effect of Aβ on tau aggregation. Further, higher soluble p-tau concentrations are mainly related to faster accumulation of tau aggregates in the regions with strong functional connectivity to individual tau epicenters. In this early stage, higher soluble p-tau concentrations is associated with cognitive decline, which is mediated by faster increase of tau aggregates. In contrast, in AD dementia, when Aβ fibrils and soluble p-tau levels have plateaued, cognitive decline is related to the accumulation rate of insoluble tau aggregates. Our data suggest that therapeutic approaches reducing soluble p-tau levels might be most favorable in early AD, before widespread insoluble tau aggregates.
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Affiliation(s)
- Alexa Pichet Binette
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden.
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Nicola Spotorno
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Olof Strandberg
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
- Department of Neurology, Skåne University Hospital, Lund, 205 02, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
- Department of Neurology, Skåne University Hospital, Lund, 205 02, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, 205 02, Sweden.
- Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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34
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Ozlen H, Pichet Binette A, Köbe T, Meyer PF, Gonneaud J, St-Onge F, Provost K, Soucy JP, Rosa-Neto P, Breitner J, Poirier J, Villeneuve S. Spatial Extent of Amyloid-β Levels and Associations With Tau-PET and Cognition. JAMA Neurol 2022; 79:1025-1035. [PMID: 35994280 PMCID: PMC9396472 DOI: 10.1001/jamaneurol.2022.2442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 06/24/2022] [Indexed: 11/14/2022]
Abstract
Importance Preventive trials of anti-amyloid agents might preferably recruit persons showing earliest biologically relevant β-amyloid (Aβ) binding on positron emission tomography (PET). Objective To investigate the timing at which Aβ-PET binding starts showing associations with other markers of Alzheimer disease. Design, Setting, and Participants This longitudinal multicentric cohort study included 3 independent cohorts: Presymptomatic Evaluation of Experimental or Novel Treatments for Alzheimer Disease (PREVENT-AD) (data collected from 2012-2020), Alzheimer Disease Neuroimaging Initiative (ADNI) (data collected from 2005-2019), and Harvard Aging Brain Study (HABS) (data collected from 2011-2019). In a 3-tiered categorization of Aβ-PET binding spatial extent, individuals were assigned as having widespread Aβ deposition if they showed positive signal throughout a designated set of brain regions prone to early Aβ accumulation. Those with binding in some but not all were categorized as having regional deposition, while those who failed to show any criterion Aβ signal were considered Aβ-negative. All participants who were cognitively unimpaired at their first Aβ PET scan. Main Outcomes and Measures Differences in cerebrospinal fluid (CSF), genetics, tau-PET burden, and cognitive decline. Results A total of 817 participants were included, including 129 from the PREVENT-AD cohort (mean [SD] age, 63.5 [4.7] years; 33 [26%] male; 126 [98%] White), 400 from ADNI (mean [SD] age, 73.6 [5.8] years; 190 [47%] male; 10 [5%] Hispanic, 338 [91%] White), and 288 from HABS (mean [SD] age, 73.7 [6.2] years; 117 [40%] male; 234 [81%] White). Compared with Aβ-negative persons, those with regional Aβ binding showed proportionately more APOE ε4 carriers (18 [64%] vs 22 [27%] in PREVENT-AD and 34 [31%] vs 38 [19%] in ADNI), reduced CSF Aβ1-42 levels (F = 24 and 71), and greater longitudinal Aβ-PET accumulation (significant β = 0.019 to 0.056). Participants with widespread amyloid binding further exhibited notable cognitive decline (significant β = -0.014 to -0.08), greater CSF phosphorylated tau181 (F = 5 and 27), and tau-PET binding (all F > 7.55). Using each cohort's specified dichotomous threshold for Aβ positivity or a visual read classification, most participants (56% to 100%, depending on classification method and cohort) with regional Aβ would have been classified Aβ-negative. Conclusions and Relevance Regional Aβ binding appears to be biologically relevant and participants at this stage remain relatively free from CSF phosphorylated tau181, tau-PET binding, and related cognitive decline, making them ideal targets for anti-amyloid agents. Most of these individuals would be classified as negative based on classical thresholds of Aβ positivity.
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Affiliation(s)
- Hazal Ozlen
- Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Alexa Pichet Binette
- Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Theresa Köbe
- Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Pierre-François Meyer
- Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Julie Gonneaud
- Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Frédéric St-Onge
- Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Karine Provost
- Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Jean-Paul Soucy
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Pedro Rosa-Neto
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - John Breitner
- Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Judes Poirier
- Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada
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35
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Janssen O, Jansen WJ, Vos SJ, Boada M, Parnetti L, Gabryelewicz T, Fladby T, Molinuevo JL, Villeneuve S, Hort J, Epelbaum S, Lleó A, Engelborghs S, van der Flier WM, Landau S, Popp J, Wallin A, Scheltens P, Rikkert MO, Snyder PJ, Rowe C, Chételat G, Ruíz A, Marquié M, Chipi E, Wolfsgruber S, Heneka M, Boecker H, Peters O, Jarholm J, Rami L, Tort‐Merino A, Binette AP, Poirier J, Rosa‐Neto P, Cerman J, Dubois B, Teichmann M, Alcolea D, Fortea J, Sánchez‐Saudinós MB, Ebenau J, Pocnet C, Eckerström M, Thompson L, Villemagne V, Buckley R, Burnham S, Delarue M, Freund‐Levi Y, Wallin ÅK, Ramakers I, Tsolaki M, Soininen H, Hampel H, Spiru L, Tijms B, Ossenkoppele R, Verhey FRJ, Jessen F, Visser PJ. Characteristics of subjective cognitive decline associated with amyloid positivity. Alzheimers Dement 2022; 18:1832-1845. [PMID: 34877782 PMCID: PMC9786747 DOI: 10.1002/alz.12512] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/21/2021] [Accepted: 09/22/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The evidence for characteristics of persons with subjective cognitive decline (SCD) associated with amyloid positivity is limited. METHODS In 1640 persons with SCD from 20 Amyloid Biomarker Study cohort, we investigated the associations of SCD-specific characteristics (informant confirmation, domain-specific complaints, concerns, feelings of worse performance) demographics, setting, apolipoprotein E gene (APOE) ε4 carriership, and neuropsychiatric symptoms with amyloid positivity. RESULTS Between cohorts, amyloid positivity in 70-year-olds varied from 10% to 76%. Only older age, clinical setting, and APOE ε4 carriership showed univariate associations with increased amyloid positivity. After adjusting for these, lower education was also associated with increased amyloid positivity. Only within a research setting, informant-confirmed complaints, memory complaints, attention/concentration complaints, and no depressive symptoms were associated with increased amyloid positivity. Feelings of worse performance were associated with less amyloid positivity at younger ages and more at older ages. DISCUSSION Next to age, setting, and APOE ε4 carriership, SCD-specific characteristics may facilitate the identification of amyloid-positive individuals.
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Affiliation(s)
- Olin Janssen
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Willemijn J. Jansen
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Stephanie J.B. Vos
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Merce Boada
- Fundació ACEInstitut Català de Neurociències AplicadesFacultat de MedicinaUniversitat International de Catalunya‐BarcelonaBarcelonaSpain,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED)Instituto de Salud Carlos IIIMadridSpain
| | - Lucilla Parnetti
- Section of NeurologyCenter for Memory Disturbances – Lab. of Clinical NeurochemistryDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Tomasz Gabryelewicz
- Department of Neurodegenerative DisordersMossakowski Medical Research CentrePolish Academy of SciencesWarsawPoland
| | - Tormod Fladby
- Department of NeurologyAkershus University HospitalLorenskogNorway
| | - José Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders UnitNeurology Service, Hospital Clínic of BarcelonaAugust Pi i Sunyer Biomedical Research Institute (IDIBAPS)BarcelonaSpain
| | - Sylvia Villeneuve
- Centre for Studies on Prevention of Alzheimer's Disease (StOP‐AD) CentreMontrealQuebecCanada
| | - Jakub Hort
- Department of NeurologySecond Faculty of MedicineCharles University and Motol University HospitalPragueCzech Republic,International Clinical Research CenterSt. Anne's University HospitalBrnoCzech Republic
| | - Stéphane Epelbaum
- AP‐HPHôpital de la Pitié SalpêtrièreInstitute of Memory and Alzheimer's Disease (IM2A)Centre of excellence of neurodegenerative disease (CoEN)Department of NeurologyParisFrance,Inserm Sorbonne UniversitéInriaAramis project‐teamParis Brain Institute – Institut du Cerveau (ICM)ParisFrance
| | - Alberto Lleó
- Neurology DepartmentHospital de Sant PauBarcelonaSpain
| | | | - Wiesje M. van der Flier
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Susan Landau
- Helen Wills Neuroscience InstituteUniversity of CaliforniaBerkeley, CaliforniaUSA
| | - Julius Popp
- Department of Geriatric PsychiatryPsychiatric University Hospital, ZürichSwitzerland,Old Age PsychiatryUniversity Hospital of LausanneLausanneSwitzerland
| | - Anders Wallin
- CSIRO Health & BiosecurityParkvilleVictoriaAustralia,Institute of Neuroscience and PhysiologySahlgrenska Academy at University of GothenburgMölndalSweden
| | - Philip Scheltens
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Marcel Olde Rikkert
- Department of Geriatric MedicineRadboud Alzheimer CenterRadboud University Medical CenterNijmegenThe Netherlands
| | - Peter J. Snyder
- Institute of Clinical MedicineUniversity of OsloOsloNorway,KingstonThe University of Rhode IslandRhode IslandUSA
| | - Chris Rowe
- Department of Molecular Imaging & TherapyAustin HealthMelbourneAustralia
| | - Gaël Chételat
- Institut National de la Sant. et de la Recherche M.dicale (Inserm)CaenFrance
| | - Agustin Ruíz
- Fundació ACEInstitut Català de Neurociències AplicadesFacultat de MedicinaUniversitat International de Catalunya‐BarcelonaBarcelonaSpain,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED)Instituto de Salud Carlos IIIMadridSpain
| | - Marta Marquié
- Fundació ACEInstitut Català de Neurociències AplicadesFacultat de MedicinaUniversitat International de Catalunya‐BarcelonaBarcelonaSpain,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED)Instituto de Salud Carlos IIIMadridSpain
| | - Elena Chipi
- Section of NeurologyCenter for Memory Disturbances – Lab. of Clinical NeurochemistryDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Steffen Wolfsgruber
- German Center For Neurodegenerative Diseases/Clinical ResearchDeutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE)Zentrum für klinische Forschung/AGCologneGermany,Department of Neurodegenerative Diseases and PsychiatryUniversity Hospital BonnBonnGermany
| | - Michael Heneka
- Department of Neurodegenerative Diseases and PsychiatryUniversity Hospital BonnBonnGermany
| | - Henning Boecker
- Functional Neuroimaging GroupDepartment of RadiologyUniversity Hospital BonnBonnGermany
| | - Oliver Peters
- Klinik für Psychiatrie und PsychotherapieCharité Universitätsmedizin Berlin ‐ CBFBerlinDeutschland
| | - Jonas Jarholm
- Department of NeurologyAkershus University HospitalLorenskogNorway
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders UnitNeurology Service, Hospital Clínic of BarcelonaAugust Pi i Sunyer Biomedical Research Institute (IDIBAPS)BarcelonaSpain
| | - Adrià Tort‐Merino
- Alzheimer's Disease and Other Cognitive Disorders UnitNeurology Service, Hospital Clínic of BarcelonaAugust Pi i Sunyer Biomedical Research Institute (IDIBAPS)BarcelonaSpain
| | - Alexa Pichet Binette
- Centre for Studies on Prevention of Alzheimer's Disease (StOP‐AD) CentreMontrealQuebecCanada
| | - Judes Poirier
- Centre for Studies on Prevention of Alzheimer's Disease (StOP‐AD) CentreMontrealQuebecCanada
| | - Pedro Rosa‐Neto
- Centre for Studies on Prevention of Alzheimer's Disease (StOP‐AD) CentreMontrealQuebecCanada
| | - Jiri Cerman
- Department of NeurologySecond Faculty of MedicineCharles University and Motol University HospitalPragueCzech Republic,International Clinical Research CenterSt. Anne's University HospitalBrnoCzech Republic
| | - Bruno Dubois
- AP‐HPHôpital de la Pitié SalpêtrièreInstitute of Memory and Alzheimer's Disease (IM2A)Centre of excellence of neurodegenerative disease (CoEN)Department of NeurologyParisFrance
| | - Marc Teichmann
- AP‐HPHôpital de la Pitié SalpêtrièreInstitute of Memory and Alzheimer's Disease (IM2A)Centre of excellence of neurodegenerative disease (CoEN)Department of NeurologyParisFrance
| | | | - Juan Fortea
- Neurology DepartmentHospital de Sant PauBarcelonaSpain
| | | | - Jarith Ebenau
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Cornelia Pocnet
- Old Age PsychiatryUniversity Hospital of LausanneLausanneSwitzerland
| | - Marie Eckerström
- Institute of Neuroscience and PhysiologySahlgrenska Academy at University of GothenburgMölndalSweden
| | - Louisa Thompson
- Institute of Clinical MedicineUniversity of OsloOsloNorway,KingstonThe University of Rhode IslandRhode IslandUSA
| | - Victor Villemagne
- Department of Molecular Imaging & TherapyAustin HealthMelbourneAustralia,Department of PsychiatryUniversity of PittsburghPittsburghUSA
| | - Rachel Buckley
- Brigham and Women's Hospital and Department of Neurology Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Samantha Burnham
- Section of NeurologyCenter for Memory Disturbances – Lab. of Clinical NeurochemistryDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Marion Delarue
- Institut National de la Sant. et de la Recherche M.dicale (Inserm)CaenFrance
| | - Yvonne Freund‐Levi
- Department of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - Åsa K. Wallin
- Department of Clinical Sciences MalmöClinical Memory Research UnitLund UniversityLundSweden
| | - Inez Ramakers
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Magda Tsolaki
- Memory and Dementia Center3rd Department of Neurology“G Papanicolau” General HospitalAristotle University of ThessalonikiThessalonikiGreece
| | - Hilkka Soininen
- Institute of Clinical MedicineNeurologyUniversity of Eastern FinlandKuopioFinland
| | - Harald Hampel
- GRC no 21, Alzheimer Precision Medicine (AMP)AP‐HPPitié‐Salpêtrière HospitalSorbonne UniversityParisFrance
| | - Luiza Spiru
- Carol DAVILA University of Medicine and PharmacyBucharestRomania,Geriatrics‐ Gerontology and Old Age PsychiatryAlzheimer UnitAna Aslan International Foundation – Memory Center and Longevity MedicineBucharestRomania
| | | | | | | | - Betty Tijms
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Rik Ossenkoppele
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands,Clinical Memory Research UnitDepartment of Clinical SciencesMalmöLund UniversityLundSweden,Alzheimer's Disease and Other Cognitive Disorders UnitNeurology Service, Hospital Clínic of BarcelonaAugust Pi i Sunyer Biomedical Research Institute (IDIBAPS)BarcelonaSpain
| | - Frans R. J. Verhey
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Frank Jessen
- Department of PsychiatryUniversity of CologneCologneGermany,German Center For Neurodegenerative Diseases/Clinical ResearchDeutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE)Zentrum für klinische Forschung/AGCologneGermany
| | - Pieter Jelle Visser
- Alzheimer Centre LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands,Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands,Department of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
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36
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Strikwerda-Brown C, Hobbs DA, Gonneaud J, St-Onge F, Binette AP, Ozlen H, Provost K, Soucy JP, Buckley RF, Benzinger TLS, Morris JC, Villemagne VL, Doré V, Sperling RA, Johnson KA, Rowe CC, Gordon BA, Poirier J, Breitner JCS, Villeneuve S. Association of Elevated Amyloid and Tau Positron Emission Tomography Signal With Near-Term Development of Alzheimer Disease Symptoms in Older Adults Without Cognitive Impairment. JAMA Neurol 2022; 79:975-985. [PMID: 35907254 PMCID: PMC9339146 DOI: 10.1001/jamaneurol.2022.2379] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/24/2022] [Indexed: 12/12/2022]
Abstract
Importance National Institute on Aging-Alzheimer's Association (NIA-AA) workgroups have proposed biological research criteria intended to identify individuals with preclinical Alzheimer disease (AD). Objective To assess the clinical value of these biological criteria to identify older individuals without cognitive impairment who are at near-term risk of developing symptomatic AD. Design, Setting, and Participants This longitudinal cohort study used data from 4 independent population-based cohorts (PREVENT-AD, HABS, AIBL, and Knight ADRC) collected between 2003 and 2021. Participants were older adults without cognitive impairment with 1 year or more of clinical observation after amyloid β and tau positron emission tomography (PET). Median clinical follow-up after PET ranged from 1.94 to 3.66 years. Exposures Based on binary assessment of global amyloid burden (A) and a composite temporal region of tau PET uptake (T), participants were stratified into 4 groups (A+T+, A+T-, A-T+, A-T-). Presence (+) or absence (-) of neurodegeneration (N) was assessed using temporal cortical thickness. Main Outcomes and Measures Each cohort was analyzed separately. Primary outcome was clinical progression to mild cognitive impairment (MCI), identified by a Clinical Dementia Rating score of 0.5 or greater in Knight ADRC and by consensus committee review in the other cohorts. Clinical raters were blind to imaging, genetic, and fluid biomarker data. A secondary outcome was cognitive decline, based on a slope greater than 1.5 SD below the mean of an independent subsample of individuals without cognitive impairment. Outcomes were compared across the biomarker groups. Results Among 580 participants (PREVENT-AD, 128; HABS, 153; AIBL, 48; Knight ADRC, 251), mean (SD) age ranged from 67 (5) to 76 (6) years across cohorts, with between 55% (137/251) and 74% (95/128) female participants. Across cohorts, 33% to 83% of A+T+ participants progressed to MCI during follow-up (mean progression time, 2-2.72 years), compared with less than 20% of participants in other biomarker groups. Progression further increased to 43% to 100% when restricted to A+T+(N+) individuals. Cox proportional hazard ratios for progression to MCI in the A+T+ group vs other biomarker groups were all 5 or greater. Many A+T+ nonprogressors also showed longitudinal cognitive decline, while cognitive trajectories in other groups remained predominantly stable. Conclusions and Relevance The clinical prognostic value of NIA-AA research criteria was confirmed in 4 independent cohorts, with most A+T+(N+) older individuals without cognitive impairment developing AD symptoms within 2 to 3 years.
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Affiliation(s)
- Cherie Strikwerda-Brown
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Diana A. Hobbs
- Washington University School of Medicine, St Louis, Missouri
| | - Julie Gonneaud
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Inserm, Inserm UMR-S U1237, Université de Caen-Normandie, GIP Cyceron, Caen, France
| | - Frédéric St-Onge
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Hazal Ozlen
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Karine Provost
- Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - Jean-Paul Soucy
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Rachel F. Buckley
- Department of Neurology, Massachusetts General Hospital, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | | | - John C. Morris
- Washington University School of Medicine, St Louis, Missouri
| | | | - Vincent Doré
- Department of Molecular Imaging & Therapy, Austin Health, Melbourne, Victoria, Australia
| | - Reisa A. Sperling
- Department of Neurology, Massachusetts General Hospital, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Keith A. Johnson
- Department of Neurology, Massachusetts General Hospital, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Christopher C. Rowe
- Department of Molecular Imaging & Therapy, Austin Health, Melbourne, Victoria, Australia
| | - Brian A. Gordon
- Washington University School of Medicine, St Louis, Missouri
| | - Judes Poirier
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - John C. S. Breitner
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada
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37
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Groot C, Smith R, Stomrud E, Binette AP, Leuzy A, Wuestefeld A, Wisse LEM, Palmqvist S, Mattsson-Carlgren N, Janelidze S, Strandberg O, Ossenkoppele R, Hansson O. Phospho-tau with subthreshold tau-PET predicts increased tau accumulation rates in amyloid-positive individuals. Brain 2022; 146:1580-1591. [PMID: 36084009 PMCID: PMC10115173 DOI: 10.1093/brain/awac329] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Different tau biomarkers become abnormal at different stages of Alzheimer’s disease, with CSF phospho-tau typically becoming elevated at subthreshold levels of tau-PET binding. To capitalize on the temporal order of tau biomarker-abnormality and capture the earliest changes of tau accumulation, we implemented an observational study design to examine longitudinal changes in Tau-PET, cortical thickness and cognitive decline in amyloid-β-positive (A+) individuals with elevated CSF P-tau levels (P+) but subthreshold Tau-PET retention (T-). To this end, individuals without dementia (i.e., cognitively unimpaired or mild cognitive impairment, N = 231) were selected from the BioFINDER-2 study. Amyloid-β-positive (A+) individuals were categorized into biomarker groups based on cut-offs for abnormal CSF P-tau217 and [18F]RO948 (Tau) PET, yielding groups of tau-concordant-negative (A + P-T-; n = 30), tau-discordant (i.e., A + P+T-; n = 48) and tau-concordant-positive (A + P+T+; n = 18) individuals. In addition, 135 amyloid-β-negative, tau-negative, cognitively unimpaired individuals served as controls. Differences in annual change in regional Tau-PET, cortical thickness and cognition between the groups were assessed using general linear models, adjusted for age, sex, clinical diagnosis and (for cognitive measures only) education. Mean follow-up time was ∼2 years. Longitudinal increase in Tau-PET was faster in the A + P+T- group than in the control and A + P-T- groups across medial temporal and neocortical regions, with the highest accumulation rates in the medial temporal lobe. The A + P+T- group showed a slower rate of increases in tau-PET compared to the A + P+T+ group, primarily in neocortical regions. We did not detect differences in yearly change in cortical thickness or in cognitive decline between the A + P+T- and A + P-T- groups. The A + P+T+ group, however, showed faster cognitive decline compared to all other groups. Altogether, these findings suggest that the A + P+T- biomarker profile in persons without dementia is associated with an isolated effect on increased Tau-PET accumulation rates but not on cortical thinning and cognitive decline. While this suggests that the tau-discordant biomarker profile is not strongly associated with short-term clinical decline, this group does represent an interesting population for monitoring effects of interventions with disease modifying agents on tau accumulation in early Alzheimer’s disease, and for examining the emergence of tau aggregates in Alzheimer’s disease. Further, we suggest to update the AT(N) criteria for Alzheimer’s disease biomarker classification to APT(N).
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Affiliation(s)
- Colin Groot
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Alzheimer center, Amsterdam UMC location Vumc , Amsterdam , The Netherlands
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Department of Neurology, Skåne University Hospital, Lund University , Lund , Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Memory Clinic, Skåne University Hospital , Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
| | - Anika Wuestefeld
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
| | - Laura E M Wisse
- Department of Diagnostic Radiology, Lund University , Lund , Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Memory Clinic, Skåne University Hospital , Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Department of Neurology, Skåne University Hospital, Lund University , Lund , Sweden
- Wallenberg Center for Molecular Medicine, Lund University , Lund , Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Alzheimer center, Amsterdam UMC location Vumc , Amsterdam , The Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences in Malmö, Lund University , Sweden
- Memory Clinic, Skåne University Hospital , Sweden
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Frontzkowski L, Ewers M, Brendel M, Biel D, Ossenkoppele R, Hager P, Steward A, Dewenter A, Römer S, Rubinski A, Buerger K, Janowitz D, Binette AP, Smith R, Strandberg O, Carlgren NM, Dichgans M, Hansson O, Franzmeier N. Earlier Alzheimer’s disease onset is associated with tau pathology in brain hub regions and facilitated tau spreading. Nat Commun 2022; 13:4899. [PMID: 35987901 PMCID: PMC9392750 DOI: 10.1038/s41467-022-32592-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 08/08/2022] [Indexed: 12/20/2022] Open
Abstract
AbstractIn Alzheimer’s disease (AD), younger symptom onset is associated with accelerated disease progression and tau spreading, yet the mechanisms underlying faster disease manifestation are unknown. To address this, we combined resting-state fMRI and longitudinal tau-PET in two independent samples of controls and biomarker-confirmed AD patients (ADNI/BioFINDER, n = 240/57). Consistent across both samples, we found that younger symptomatic AD patients showed stronger tau-PET in globally connected fronto-parietal hubs, i.e., regions that are critical for maintaining cognition in AD. Stronger tau-PET in hubs predicted faster subsequent tau accumulation, suggesting that tau in globally connected regions facilitates connectivity-mediated tau spreading. Further, stronger tau-PET in hubs mediated the association between younger age and faster tau accumulation in symptomatic AD patients, which predicted faster cognitive decline. These independently validated findings suggest that younger AD symptom onset is associated with stronger tau pathology in brain hubs, and accelerated tau spreading throughout connected brain regions and cognitive decline.
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Pichet Binette A, Palmqvist S, Bali D, Farrar G, Buckley CJ, Wolk DA, Zetterberg H, Blennow K, Janelidze S, Hansson O. Combining plasma phospho-tau and accessible measures to evaluate progression to Alzheimer's dementia in mild cognitive impairment patients. Alzheimers Res Ther 2022; 14:46. [PMID: 35351181 PMCID: PMC8966264 DOI: 10.1186/s13195-022-00990-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/16/2022] [Indexed: 02/06/2023]
Abstract
Background Up to now, there are no clinically available minimally invasive biomarkers to accurately identify mild cognitive impairment (MCI) patients who are at greater risk to progress to Alzheimer’s disease (AD) dementia. The recent advent of blood-based markers opens the door for more accessible biomarkers. We aimed to identify which combinations of AD related plasma biomarkers and other easily accessible assessments best predict progression to AD dementia in patients with mild cognitive impairment (MCI). Methods We included patients with amnestic MCI (n = 110) followed prospectively over 3 years to assess clinical status. Baseline plasma biomarkers (amyloid-β 42/40, phosphorylated tau217 [p-tau217], neurofilament light and glial fibrillary acidic protein), hippocampal volume, APOE genotype, and cognitive tests were available. Logistic regressions with conversion to amyloid-positive AD dementia within 3 years as outcome was used to evaluate the performance of different biomarkers measured at baseline, used alone or in combination. The first analyses included only the plasma biomarkers to determine the ones most related to AD dementia conversion. Second, hippocampal volume, APOE genotype and a brief cognitive composite score (mPACC) were combined with the best plasma biomarker. Results Of all plasma biomarker combinations, p-tau217 alone had the best performance for discriminating progression to AD dementia vs all other combinations (AUC 0.84, 95% CI 0.75–0.93). Next, combining p-tau217 with hippocampal volume, cognition, and APOE genotype provided the best discrimination between MCI progressors vs. non-progressors (AUC 0.89, 0.82–0.95). Across the few best models combining different markers, p-tau217 and cognition were consistently the main contributors. The most parsimonious model including p-tau217 and cognition had a similar model fit, but a slightly lower AUC (0.87, 0.79–0.95, p = 0.07). Conclusion We identified that combining plasma p-tau217 and a brief cognitive composite score was strongly related to greater risk of progression to AD dementia in MCI patients, suggesting that these measures could be key components of future prognostic algorithms for early AD. Trial registration NCT01028053, registered December 9, 2009.
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Affiliation(s)
- Alexa Pichet Binette
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, SE-20502, Malmö, Sweden
| | - Divya Bali
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | | | | | - David A Wolk
- Department of Neurology, Penn Memory Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK.,UK Dementia Research Institute at UCL, London, UK.,Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden. .,Memory Clinic, Skåne University Hospital, SE-20502, Malmö, Sweden.
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40
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Jansen WJ, Janssen O, Tijms BM, Vos SJB, Ossenkoppele R, Visser PJ, Aarsland D, Alcolea D, Altomare D, von Arnim C, Baiardi S, Baldeiras I, Barthel H, Bateman RJ, Van Berckel B, Binette AP, Blennow K, Boada M, Boecker H, Bottlaender M, den Braber A, Brooks DJ, Van Buchem MA, Camus V, Carill JM, Cerman J, Chen K, Chételat G, Chipi E, Cohen AD, Daniels A, Delarue M, Didic M, Drzezga A, Dubois B, Eckerström M, Ekblad LL, Engelborghs S, Epelbaum S, Fagan AM, Fan Y, Fladby T, Fleisher AS, Van der Flier WM, Förster S, Fortea J, Frederiksen KS, Freund-Levi Y, Frings L, Frisoni GB, Fröhlich L, Gabryelewicz T, Gertz HJ, Gill KD, Gkatzima O, Gómez-Tortosa E, Grimmer T, Guedj E, Habeck CG, Hampel H, Handels R, Hansson O, Hausner L, Hellwig S, Heneka MT, Herukka SK, Hildebrandt H, Hodges J, Hort J, Huang CC, Iriondo AJ, Itoh Y, Ivanoiu A, Jagust WJ, Jessen F, Johannsen P, Johnson KA, Kandimalla R, Kapaki EN, Kern S, Kilander L, Klimkowicz-Mrowiec A, Klunk WE, Koglin N, Kornhuber J, Kramberger MG, Kuo HC, Van Laere K, Landau SM, Landeau B, Lee DY, de Leon M, Leyton CE, Lin KJ, Lleó A, Löwenmark M, Madsen K, Maier W, Marcusson J, Marquié M, Martinez-Lage P, Maserejian N, Mattsson N, de Mendonça A, Meyer PT, Miller BL, Minatani S, Mintun MA, Mok VCT, Molinuevo JL, Morbelli SD, Morris JC, Mroczko B, Na DL, Newberg A, Nobili F, Nordberg A, Olde Rikkert MGM, de Oliveira CR, Olivieri P, Orellana A, Paraskevas G, Parchi P, Pardini M, Parnetti L, Peters O, Poirier J, Popp J, Prabhakar S, Rabinovici GD, Ramakers IH, Rami L, Reiman EM, Rinne JO, Rodrigue KM, Rodríguez-Rodriguez E, Roe CM, Rosa-Neto P, Rosen HJ, Rot U, Rowe CC, Rüther E, Ruiz A, Sabri O, Sakhardande J, Sánchez-Juan P, Sando SB, Santana I, Sarazin M, Scheltens P, Schröder J, Selnes P, Seo SW, Silva D, Skoog I, Snyder PJ, Soininen H, Sollberger M, Sperling RA, Spiru L, Stern Y, Stomrud E, Takeda A, Teichmann M, Teunissen CE, Thompson LI, Tomassen J, Tsolaki M, Vandenberghe R, Verbeek MM, Verhey FRJ, Villemagne V, Villeneuve S, Vogelgsang J, Waldemar G, Wallin A, Wallin ÅK, Wiltfang J, Wolk DA, Yen TC, Zboch M, Zetterberg H. Prevalence Estimates of Amyloid Abnormality Across the Alzheimer Disease Clinical Spectrum. JAMA Neurol 2022; 79:228-243. [PMID: 35099509 DOI: 10.1001/jamaneurol.2021.5216] [Citation(s) in RCA: 89] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE One characteristic histopathological event in Alzheimer disease (AD) is cerebral amyloid aggregation, which can be detected by biomarkers in cerebrospinal fluid (CSF) and on positron emission tomography (PET) scans. Prevalence estimates of amyloid pathology are important for health care planning and clinical trial design. OBJECTIVE To estimate the prevalence of amyloid abnormality in persons with normal cognition, subjective cognitive decline, mild cognitive impairment, or clinical AD dementia and to examine the potential implications of cutoff methods, biomarker modality (CSF or PET), age, sex, APOE genotype, educational level, geographical region, and dementia severity for these estimates. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional, individual-participant pooled study included participants from 85 Amyloid Biomarker Study cohorts. Data collection was performed from January 1, 2013, to December 31, 2020. Participants had normal cognition, subjective cognitive decline, mild cognitive impairment, or clinical AD dementia. Normal cognition and subjective cognitive decline were defined by normal scores on cognitive tests, with the presence of cognitive complaints defining subjective cognitive decline. Mild cognitive impairment and clinical AD dementia were diagnosed according to published criteria. EXPOSURES Alzheimer disease biomarkers detected on PET or in CSF. MAIN OUTCOMES AND MEASURES Amyloid measurements were dichotomized as normal or abnormal using cohort-provided cutoffs for CSF or PET or by visual reading for PET. Adjusted data-driven cutoffs for abnormal amyloid were calculated using gaussian mixture modeling. Prevalence of amyloid abnormality was estimated according to age, sex, cognitive status, biomarker modality, APOE carrier status, educational level, geographical location, and dementia severity using generalized estimating equations. RESULTS Among the 19 097 participants (mean [SD] age, 69.1 [9.8] years; 10 148 women [53.1%]) included, 10 139 (53.1%) underwent an amyloid PET scan and 8958 (46.9%) had an amyloid CSF measurement. Using cohort-provided cutoffs, amyloid abnormality prevalences were similar to 2015 estimates for individuals without dementia and were similar across PET- and CSF-based estimates (24%; 95% CI, 21%-28%) in participants with normal cognition, 27% (95% CI, 21%-33%) in participants with subjective cognitive decline, and 51% (95% CI, 46%-56%) in participants with mild cognitive impairment, whereas for clinical AD dementia the estimates were higher for PET than CSF (87% vs 79%; mean difference, 8%; 95% CI, 0%-16%; P = .04). Gaussian mixture modeling-based cutoffs for amyloid measures on PET scans were similar to cohort-provided cutoffs and were not adjusted. Adjusted CSF cutoffs resulted in a 10% higher amyloid abnormality prevalence than PET-based estimates in persons with normal cognition (mean difference, 9%; 95% CI, 3%-15%; P = .004), subjective cognitive decline (9%; 95% CI, 3%-15%; P = .005), and mild cognitive impairment (10%; 95% CI, 3%-17%; P = .004), whereas the estimates were comparable in persons with clinical AD dementia (mean difference, 4%; 95% CI, -2% to 9%; P = .18). CONCLUSIONS AND RELEVANCE This study found that CSF-based estimates using adjusted data-driven cutoffs were up to 10% higher than PET-based estimates in people without dementia, whereas the results were similar among people with dementia. This finding suggests that preclinical and prodromal AD may be more prevalent than previously estimated, which has important implications for clinical trial recruitment strategies and health care planning policies.
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Affiliation(s)
- Willemijn J Jansen
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.,Banner Alzheimer's Institute, Phoenix, Arizona
| | - Olin Janssen
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Betty M Tijms
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands
| | - Stephanie J B Vos
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands.,Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Pieter Jelle Visser
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Dag Aarsland
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division for Neurogeriatrics, Karolinska Institutet, Huddinge, Sweden.,Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Daniel Alcolea
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Daniele Altomare
- Laboratory Alzheimer's Neuroimaging and Epidemiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fatebenefratelli, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Christine von Arnim
- Division of Geriatrics, University of Goettingen Medical School, Goettingen, Germany.,Clinic for Neurogeriatrics and Neurological Rehabilitation, University and Rehabilitation Hospital Ulm, Ulm, Germany
| | - Simone Baiardi
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Spain
| | - Ines Baldeiras
- Center for Neuroscience and Cell Biology (CIBB), University of Coimbra, Coimbra, Portugal.,Neurology Department and Laboratory of Neurochemistry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Coimbra, Portugal
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Randall J Bateman
- Department of Neurology and the Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Bart Van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Department of Neuroscience and Physiology, Sahlgren's University Hospital, Mölndal, Sweden
| | - Merce Boada
- Research Center and Memory Clinic of Fundació Alzheimer Centre Educacional, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Henning Boecker
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Bonn, Germany
| | - Michel Bottlaender
- Université Paris-Saclay, Service Hospitalier Frédéric Joliot (CEA), French National Centre for Scientific Research (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), BioMaps, Service Hospitalier Frederic Joliot, Orsay, France
| | - Anouk den Braber
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David J Brooks
- Translational and Clinical Research Institute, University of Newcastle upon Tyne, United Kingdom.,Department of Nuclear Medicine, Positron Emission Tomography Centre, Aarhus University, Aarhus, Denmark.,Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Mark A Van Buchem
- Department of Neurology, University Hospital Leiden, Leiden, the Netherlands
| | - Vincent Camus
- Unite Mixte de Recherche, INSERM U930, French National Centre for Scientific Research (CNRS) ERL, Tours, France
| | - Jose Manuel Carill
- Nuclear Medicine Department, University Hospital Marqués de Valdecilla, Molecular Imaging, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), University of Cantabria, Santander, Spain
| | - Jiri Cerman
- Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, Arizona
| | - Gaël Chételat
- Normandie University, University of Caen Normandie (UNICAEN), INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
| | - Elena Chipi
- Centro Disturbi della Memoria, Laboratorio di Neurochimica Clinica, Clinica Neurologica, Università di Perugia, Perugia, Italy
| | - Ann D Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Alisha Daniels
- Department of Neurology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Marion Delarue
- Normandie University, University of Caen Normandie (UNICAEN), INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
| | - Mira Didic
- Assistance Publique Hôpitaux de Marseille (AP-HM), Timone, Service de Neurologie et Neuropsychologie, Hôpital Timone Adultes, Marseille, France.,Aix Marseille Univ, INSERM, Institut de Neurosciences des Systèmes (INS), Marseille, France
| | - Alexander Drzezga
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Bonn, Germany.,Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
| | - Bruno Dubois
- Department of Neurology, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence Démences Rares, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Marie Eckerström
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | | | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium.,Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Stéphane Epelbaum
- Department of Neurology, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence Démences Rares, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Anne M Fagan
- Department of Neurology and the Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Yong Fan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Lorenskog, Norway
| | | | - Wiesje M Van der Flier
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Stefan Förster
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Department of Nuclear Medicine, Klinikum Bayreuth, Bayreuth, Germany
| | - Juan Fortea
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Kristian Steen Frederiksen
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Yvonne Freund-Levi
- School of Medical Sciences, Örebro University, Örebro, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden.,Department of Old Age Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Lars Frings
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Giovanni B Frisoni
- Memory Clinic, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Lutz Fröhlich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Tomasz Gabryelewicz
- Department of Neurodegenerative Disorders, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - Hermann-Josef Gertz
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Kiran Dip Gill
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Olymbia Gkatzima
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | | | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Eric Guedj
- Aix Marseille University, AP-HM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, Centre Européen de Recherche en Imagerie Médicale (CERIMED), Nuclear Medicine Department, Marseille, France
| | - Christian G Habeck
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York
| | - Harald Hampel
- Sorbonne University, Clinical Research Group no. 21, Alzheimer Precision Medicine, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Ron Handels
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Lucrezia Hausner
- Universität Heidelberg, Abteilung Gerontopsychiatrie, Zentralinstitut für Seelische Gesundheit Mannheim, Mannheim, Germany
| | - Sabine Hellwig
- Department of Psychiatry and Psychotherapy Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael T Heneka
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital of Bonn, Bonn, Germany.,Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester
| | - Sanna-Kaisa Herukka
- Institute of Clinical Medicine-Neurology, University of Eastern Finland, Kuopio, Finland.,Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Helmut Hildebrandt
- Klinikum Bremen-Ost, University of Oldenburg, Institute of Psychology, Oldenburg, Germany
| | - John Hodges
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jakub Hort
- Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | | | - Ane Juaristi Iriondo
- Center for Research and Advanced Therapies, Centro de Investigación y Ciencias Avanzadas-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Yoshiaki Itoh
- Department of Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Adrian Ivanoiu
- Department of Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley.,Division of Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, California
| | - Frank Jessen
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany.,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,DZNE, Bonn, Germany
| | - Peter Johannsen
- Memory Disorder Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Keith A Johnson
- Department of Radiology, Massachusetts General Hospital, Boston
| | - Ramesh Kandimalla
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,Department of Radiation Oncology, Emory University, Atlanta, Georgia.,Applied Biology, Council of Scientific and Industrial Research (CSIR)-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad, Telangana State, India.,Department of Biochemistry, Kakatiya Medical College/Mahatma Gandhi Memorial Hospital, Warangal, Telangana State, India
| | - Elisabeth N Kapaki
- National and Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, Athens, Greece
| | - Silke Kern
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Lena Kilander
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Aleksandra Klimkowicz-Mrowiec
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - William E Klunk
- Department of Psychiatry, Massachusetts General Hospital, Boston.,Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Milica G Kramberger
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Hung-Chou Kuo
- Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Koen Van Laere
- Division of Nuclear Medicine and Molecular Imaging, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Susan M Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley
| | - Brigitte Landeau
- Normandie University, University of Caen Normandie (UNICAEN), INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Mony de Leon
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Cristian E Leyton
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Kun-Ju Lin
- Healthy Aging Research Center and Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nuclear Medicine and Molecular Imaging Center, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan
| | - Alberto Lleó
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Malin Löwenmark
- Memory Clinic, Department of Geriatrics, Uppsala University Hospital, Uppsala, Sweden
| | - Karine Madsen
- Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Jan Marcusson
- Acute Internal Medicine and Geriatrics, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marta Marquié
- Research Center and Memory Clinic of Fundació Alzheimer Centre Educacional, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Pablo Martinez-Lage
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | | | - Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | | | - Philipp T Meyer
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Shinobu Minatani
- Department of Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mark A Mintun
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
| | - Vincent C T Mok
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China.,BrainNow Research Institute, Guangdong Province, Shenzhen, China
| | - Jose Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Clinic University Hospital, Barcelona, Spain
| | - Silvia Daniela Morbelli
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
| | - John C Morris
- Department of Neurology and the Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Białystok, Białystok, Poland.,Department of Biochemical Diagnostics, University Hospital of Białystok, Białystok, Poland
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Andrew Newberg
- Myrna Brind Center of Integrative Medicine, Thomas Jefferson University and Hospital, Philadelphia, Pennsylvania
| | - Flavio Nobili
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), University of Genoa, Genoa, Italy.,Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
| | - Agneta Nordberg
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division for Neurogeriatrics, Karolinska Institutet, Huddinge, Sweden.,Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | | | | | - Pauline Olivieri
- Department of Neurology of Memory and Language, Groupe Hospitalier Universitaire Paris Psychiatry and Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France.,Université de Paris, Paris, Université Paris-Saclay, BioMaps, CEA, CNRS, INSERM, Orsay, France
| | - Adela Orellana
- Research Center and Memory Clinic of Fundació Alzheimer Centre Educacional, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - George Paraskevas
- National and Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, Athens, Greece
| | - Piero Parchi
- Istituto delle Scienze Neurologiche di Bologna, IRCCS, Bologna, Italy.,DIMES, University of Bologna, Bologna, Italy
| | | | - Lucilla Parnetti
- Centro Disturbi della Memoria, Laboratorio di Neurochimica Clinica, Clinica Neurologica, Università di Perugia, Perugia, Italy
| | - Oliver Peters
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin-CBF, Berlin, Deutschland
| | - Judes Poirier
- Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada
| | - Julius Popp
- Department of Geriatric Psychiatry, University Hospital of Psychiatry Zürich and University of Zürich, Zürich, Switzerland.,Old Age Psychiatry, Department of Psychiatry, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Sudesh Prabhakar
- Department of Neurology, Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Inez H Ramakers
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, IDIBAPS, Barcelona, Spain
| | | | | | - Karen M Rodrigue
- Center for Vital Longevity, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas
| | | | - Catherine M Roe
- Department of Neurology and the Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Pedro Rosa-Neto
- Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Uros Rot
- Department of Neurology, Medical Center, Zaloska 7, Ljubljana, Slovenia
| | - Christopher C Rowe
- Department of Molecular Imaging, Austin Health, Melbourne, Victoria, Australia.,Florey Department of Neuroscience, University of Melbourne, Melbourne, Victoria, Australia
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany
| | - Agustín Ruiz
- Research Center and Memory Clinic of Fundació Alzheimer Centre Educacional, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Jayant Sakhardande
- Cognitive Neuroscience Division, Department of Neurology and the Taub Institute, Columbia University, New York, New York
| | - Pascual Sánchez-Juan
- Service of Neurology, University Hospital Marqués de Valdecilla-IDIVAL, CIBERNED, Santander, Spain
| | - Sigrid Botne Sando
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology, University Hospital of Trondheim, Trondheim, Norway
| | - Isabel Santana
- Center for Neuroscience and Cell Biology (CIBB), University of Coimbra, Coimbra, Portugal.,Neurology Department and Laboratory of Neurochemistry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Coimbra, Portugal
| | - Marie Sarazin
- Department of Neurology of Memory and Language, Groupe Hospitalier Universitaire Paris Psychiatry and Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France.,Université de Paris, Paris, Université Paris-Saclay, BioMaps, CEA, CNRS, INSERM, Orsay, France
| | - Philip Scheltens
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Johannes Schröder
- Section for Geriatric Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Per Selnes
- Department of Neurology, Akershus University Hospital, Lorenskog, Norway
| | - Sang Won Seo
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
| | - Dina Silva
- Faculty of Medicine, University of Lisboa, Lisboa, Portugal
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Peter J Snyder
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, The University of Rhode Island, Kingston
| | - Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Marc Sollberger
- Memory Clinic, University Department of Geriatric Medicine, Felix Platter-Hospital, Basel, Switzerland.,Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Reisa A Sperling
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Harvard Aging Brain Study, Department of Neurology, Harvard Medical School, Boston, Massachusetts
| | - Luisa Spiru
- Geriatrics, Gerontology and Old Age Psychiatry Clinical Department, Carol Davila University of Medicine and Pharmacy-Elias, Emergency Clinical Hospital, Bucharest, Romania.,Memory Clinic and Longevity Medicine, Ana Aslan International Foundation, Bucharest, Romania
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of Neurology and the Taub Institute, Columbia University, New York, New York
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Akitoshi Takeda
- Department of Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Marc Teichmann
- Department of Neurology, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence Démences Rares, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Centre de Référence Démences Rares, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France
| | - Charlotte E Teunissen
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Louisa I Thompson
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Jori Tomassen
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Magda Tsolaki
- Aristotle University of Thessaloniki, Memory and Dementia Center, 3rd Department of Neurology, George Papanicolau General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, University of Leuven, Leuven, Belgium.,Neurology Department, University Hospitals Leuven, Leuven, Belgium
| | - Marcel M Verbeek
- Departments of Neurology and Laboratory Medicine, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Nijmegen, the Netherlands
| | - Frans R J Verhey
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Victor Villemagne
- Department of Molecular Imaging, Austin Health, Melbourne, Victoria, Australia.,Molecular Biomarkers in Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Montreal, Quebec, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Jonathan Vogelgsang
- Translational Neuroscience Laboratory, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Gunhild Waldemar
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anders Wallin
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Åsa K Wallin
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.,Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - Tzu-Chen Yen
- Department of Nuclear Medicine and Molecular Imaging Center, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan.,Healthy Aging Research Center and Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Marzena Zboch
- Research-Scientific-Didactic Centre of Dementia-Related Diseases in Scinawa, Medical University of Wroclaw, Wroclaw, Poland
| | - Henrik Zetterberg
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, University College London (UCL) Queen Square Institute of Neurology, Queen Square, London, United Kingdom.,UK Dementia Research Institute, London, United Kingdom.,Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
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Meyer PF, Ashton NJ, Karikari TK, Strikwerda-Brown C, Köbe T, Gonneaud J, Pichet Binette A, Ozlen H, Yakoub Y, Simrén J, Pannee J, Lantero-Rodriguez J, Labonté A, Baker SL, Schöll M, Vanmechelen E, Breitner JCS, Zetterberg H, Blennow K, Poirier J, Villeneuve S. Plasma p-tau231, p-tau181, PET biomarkers and cognitive change in older adults. Ann Neurol 2022; 91:548-560. [PMID: 35084051 DOI: 10.1002/ana.26308] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate novel plasma p-tau231, p-tau181 as well as Aβ40 and Aβ42 assays as indicators of tau and Aβ pathologies measured with positron emission tomography (PET), and their association with cognitive change, in cognitively unimpaired older adults. METHODS In a cohort of 244 older adults at risk of AD owing to a family history of AD dementia, we measured single molecule array (Simoa)-based plasma tau biomarkers (p-tau231, p-tau181), Aβ40 and Aβ42 with immunoprecipitation mass spectrometry, and Simoa NfL. A subset of 129 participants underwent amyloid-β (18 F-NAV4694) and tau (18 F-flortaucipir) PET assessments. We investigated plasma biomarker associations with Aβ and tau PET at the global and voxel level and tested plasma biomarker combinations for improved detection of Aβ-PET positivity. We also investigated associations with 8-year cognitive change. RESULTS Plasma p-tau biomarkers correlated with flortaucipir binding in medial temporal, parietal and inferior temporal regions. P-tau231 showed further associations in lateral parietal and occipital cortices. Plasma Aβ42/40 explained more variance in global Aβ-PET binding than Aβ42 alone. P-tau231 also showed strong and widespread associations with cortical Aβ-PET binding. Combining Aβ42/40 with p-tau231 or p-tau181 allowed for good distinction between Aβ-negative and -positive participants (AUC range 0.81-0.86). Individuals with low plasma Aβ42/40 and high p-tau experienced faster cognitive decline. INTERPRETATION Plasma p-tau231 showed more robust associations with PET biomarkers than p-tau181 in pre-symptomatic individuals. The combination of p-tau and Aβ42/40 biomarkers detected early AD pathology and cognitive decline. Such markers could be used as pre-screening tools to reduce the cost of prevention trials. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Pierre-François Meyer
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Sweden.,King's College London, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, London, UK.,NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Cherie Strikwerda-Brown
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Theresa Köbe
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Julie Gonneaud
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Alexa Pichet Binette
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Hazal Ozlen
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Yara Yakoub
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Joel Simrén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Josef Pannee
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Juan Lantero-Rodriguez
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anne Labonté
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Suzanne L Baker
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, United States
| | - Michael Schöll
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Sweden.,Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | | | - John C S Breitner
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Judes Poirier
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
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Strikwerda-Brown C, Ozlen H, Pichet Binette A, Chapleau M, Marchant NL, Breitner JC, Villeneuve S. Trait Mindfulness Is Associated With Less Amyloid, Tau, and Cognitive Decline in Individuals at Risk for Alzheimer's Disease. Biol Psychiatry Glob Open Sci 2022; 3:130-138. [PMID: 36712573 PMCID: PMC9874144 DOI: 10.1016/j.bpsgos.2022.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/06/2022] [Accepted: 01/06/2022] [Indexed: 02/01/2023] Open
Abstract
Background Mindfulness, defined as nonjudgmental awareness of the present moment, has been associated with an array of mental and physical health benefits. Mindfulness may also represent a protective factor for Alzheimer's disease (AD). Here, we tested the potential protective effect of trait mindfulness on cognitive decline and AD pathology in older adults at risk for AD dementia. Methods Measures of trait mindfulness, longitudinal cognitive assessments, and amyloid-β (Aβ) and tau positron emission tomography scans were collected in 261 nondemented older adults with a family history of AD dementia from the PREVENT-AD (Pre-symptomatic Evaluation of Experimental or Novel Treatments for AD) observational cohort study. Multivariate partial least squares analyses were used to examine relationships between combinations of different facets of trait mindfulness and 1) cognitive decline, 2) Aβ, and 3) tau. Results Higher levels of mindful nonjudgment, describing, and nonreactivity were associated with less cognitive decline in attention, global cognition, and immediate and delayed memory. Higher levels of mindful nonjudgment and nonreactivity were related to less Aβ positron emission tomography signal in bilateral medial and lateral temporoparietal and frontal regions. Higher levels of mindful acting with awareness, describing, nonjudgment, and nonreactivity were associated with less tau positron emission tomography signal in bilateral medial and lateral temporal regions. Conclusions Trait mindfulness was associated with less cognitive decline and less Aβ and tau in the brain in older adults at risk for AD dementia. Longitudinal studies examining the temporal relationship between trait mindfulness and AD markers, along with mindfulness intervention studies, will be important for further clarifying the potential protective benefits of mindfulness on AD risk.
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Affiliation(s)
- Cherie Strikwerda-Brown
- Centre for Studies on the Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada,Department of Psychiatry, McGill University, Montreal, Quebec, Canada,Cherie Strikwerda-Brown, Ph.D.
| | - Hazal Ozlen
- Centre for Studies on the Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Alexa Pichet Binette
- Centre for Studies on the Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada,Department of Psychiatry, McGill University, Montreal, Quebec, Canada,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Marianne Chapleau
- Centre for Studies on the Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Natalie L. Marchant
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - John C.S. Breitner
- Centre for Studies on the Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Centre for Studies on the Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada,Department of Psychiatry, McGill University, Montreal, Quebec, Canada,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada,McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada,Address correspondence to Sylvia Villeneuve, Ph.D.
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43
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Leuzy A, Smith R, Cullen NC, Strandberg O, Vogel JW, Binette AP, Borroni E, Janelidze S, Ohlsson T, Jögi J, Ossenkoppele R, Palmqvist S, Mattsson-Carlgren N, Klein G, Stomrud E, Hansson O. Biomarker-Based Prediction of Longitudinal Tau Positron Emission Tomography in Alzheimer Disease. JAMA Neurol 2021; 79:149-158. [PMID: 34928318 PMCID: PMC8689441 DOI: 10.1001/jamaneurol.2021.4654] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Question Which biomarkers best predict longitudinal tau accumulation at different clinical stages of Alzheimer disease? Findings In this cohort study of 343 participants including amyloid-β–positive individuals who were cognitively unimpaired or had mild cognitive impairment, the largest annual increase in [18F]RO948 tau positron emission tomography (PET) was seen across the entorhinal cortex, hippocampus, and amygdala and in temporal cortical regions, respectively. In a power analysis, plasma phosphorylated tau217 with tau PET at baseline in stage I and II, respectively, resulted in sample size reductions. Meaning In trials using tau PET as a main outcome, plasma phosphorylated tau217 with tau PET may prove optimal for enrichment in both preclinical and prodromal Alzheimer disease. Importance There is currently no consensus as to which biomarkers best predict longitudinal tau accumulation at different clinical stages of Alzheimer disease (AD). Objective To describe longitudinal [18F]RO948 tau positron emission tomography (PET) findings across the clinical continuum of AD and determine which biomarker combinations showed the strongest associations with longitudinal tau PET and best optimized clinical trial enrichment. Design, Setting, and Participants This longitudinal cohort study consecutively enrolled amyloid-β (Aβ)–negative cognitively unimpaired (CU) participants, Aβ-positive CU individuals, Aβ-positive individuals with mild cognitive impairment (MCI), and individuals with AD dementia between September 2017 and November 2020 from the Swedish BioFINDER-2 (discovery cohort) and BioFINDER-1 (validation cohort) studies. Exposures Baseline plasma and cerebrospinal fluid Aβ42/Aβ40, tau phosphorylated at threonine-217 (p-tau217), p-tau181 and neurofilament light, magnetic resonance imaging, amyloid PET ([18F]flutemetamol), and tau PET ([18F]RO948 in the BioFINDER-2 study; [18F]flortaucipir in the BioFINDER-1 study). Main Outcomes and Measures Baseline tau PET standardized uptake value ratio (SUVR) and annual percent change in tau PET SUVR across regions of interest derived using a data-driven approach combining clustering and event-based modeling. Regression models were used to examine associations between individual biomarkers and longitudinal tau PET and to identify which combinations best predicted longitudinal tau PET. These combinations were then entered in a power analysis to examine how their use as an enrichment strategy would affect sample size in a simulated clinical trial. Results Of 343 participants, the mean (SD) age was 72.56 (7.24) years, and 157 (51.1%) were female. The clustering/event-based modeling–based approach identified 5 regions of interest (stages). In Aβ-positive CU individuals, the largest annual increase in tau PET SUVR was seen in stage I (entorhinal cortex, hippocampus, and amygdala; 4.04% [95% CI, 2.67%-5.32%]). In Aβ-positive individuals with MCI and with AD dementia, the greatest increases were seen in stages II (temporal cortical regions; 4.45% [95% CI, 3.41%-5.49%]) and IV (certain frontal regions; 5.22% [95% CI, 3.95%-6.49%]), respectively. In Aβ-negative CU individuals and those with MCI, modest change was seen in stage I (1.38% [95% CI, 0.78%-1.99%] and 1.80% [95% CI, 0.76%-2.84%], respectively). When looking at individual predictors and longitudinal tau PET in the stages that showed most change, plasma p-tau217 (R2 = 0.27, P < .005), tau PET (stage I baseline SUVR; R2 = 0.13, P < .05) and amyloid PET (R2 = 0.10, P < .05) were significantly associated with longitudinal tau PET in stage I in Aβ-positive CU individuals. In Aβ-positive individuals with MCI, plasma p-tau217 (R2 = 0.24, P < .005) and tau PET (stage II baseline SUVR; R2 = 0.44, P < .001) were significantly associated with longitudinal tau PET in stage II. Findings were replicated in BioFINDER-1 using longitudinal [18F]flortaucipir. For the power analysis component, plasma p-tau217 with tau PET resulted in sample size reductions of 43% (95% CI, 34%-46%; P < .005) in Aβ-positive CU individuals and of 68% (95% CI, 61%-73%; P < .001) in Aβ-positive individuals with MCI. Conclusions and Relevance In trials using tau PET as the outcome, plasma p-tau217 with tau PET may prove optimal for enrichment in preclinical and prodromal AD. However, plasma p-tau217 was most important in preclinical AD, while tau PET was more important in prodromal AD.
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Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Nicholas C Cullen
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Jacob W Vogel
- Penn/CHOP Lifespan Brain Institute, University of Pennsylvania, Philadelphia.,Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Tomas Ohlsson
- Department of Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Jonas Jögi
- Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | | | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Lund, Sweden
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Binette AP, Janelidze S, Cullen N, Mattsson‐Carlgren N, Hansson O. Creatinine and body mass index influence on plasma amyloid ratio, p‐tau217 and neurofilament light. Alzheimers Dement 2021. [DOI: 10.1002/alz.057769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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45
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Strikwerda‐Brown C, Ozlen H, Binette AP, Chapleau M, Villeneuve S. Mindfulness is associated with amyloid, tau and cognition in preclinical AD. Alzheimers Dement 2021. [DOI: 10.1002/alz.051111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Cherie Strikwerda‐Brown
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
- McGill University Montreal QC Canada
| | - Hazal Ozlen
- Douglas Mental Health University Institute Montreal QC Canada
| | - Alexa Pichet Binette
- McGill University Montreal QC Canada
- Douglas Mental Health University Institute Montreal QC Canada
| | | | - Sylvia Villeneuve
- McGill University Montreal QC Canada
- Douglas Mental Health University Institute Montreal QC Canada
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Gonneaud J, Baria AT, Pichet Binette A, Gordon BA, Chhatwal JP, Cruchaga C, Jucker M, Levin J, Salloway S, Farlow M, Gauthier S, Benzinger TLS, Morris JC, Bateman RJ, Breitner JCS, Poirier J, Vachon-Presseau E, Villeneuve S. Accelerated functional brain aging in pre-clinical familial Alzheimer's disease. Nat Commun 2021; 12:5346. [PMID: 34504080 PMCID: PMC8429427 DOI: 10.1038/s41467-021-25492-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/06/2021] [Indexed: 01/02/2023] Open
Abstract
Resting state functional connectivity (rs-fMRI) is impaired early in persons who subsequently develop Alzheimer's disease (AD) dementia. This impairment may be leveraged to aid investigation of the pre-clinical phase of AD. We developed a model that predicts brain age from resting state (rs)-fMRI data, and assessed whether genetic determinants of AD, as well as beta-amyloid (Aβ) pathology, can accelerate brain aging. Using data from 1340 cognitively unimpaired participants between 18-94 years of age from multiple sites, we showed that topological properties of graphs constructed from rs-fMRI can predict chronological age across the lifespan. Application of our predictive model to the context of pre-clinical AD revealed that the pre-symptomatic phase of autosomal dominant AD includes acceleration of functional brain aging. This association was stronger in individuals having significant Aβ pathology.
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Affiliation(s)
- Julie Gonneaud
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
| | - Alex T Baria
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Alexa Pichet Binette
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Brian A Gordon
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Jasmeer P Chhatwal
- Brigham and Women's Hospital-Massachusetts General Hospital, Boston, MA, USA
| | - Carlos Cruchaga
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Mathias Jucker
- Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Johannes Levin
- Ludwig-Maximilians-Universität München, German Center for Neurodegenerative Diseases and Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | | | - Martin Farlow
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Serge Gauthier
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Tammie L S Benzinger
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Randall J Bateman
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - John C S Breitner
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Judes Poirier
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Etienne Vachon-Presseau
- Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
| | - Sylvia Villeneuve
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
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47
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Tremblay-Mercier J, Madjar C, Das S, Pichet Binette A, Dyke SOM, Étienne P, Lafaille-Magnan ME, Remz J, Bellec P, Louis Collins D, Natasha Rajah M, Bohbot V, Leoutsakos JM, Iturria-Medina Y, Kat J, Hoge RD, Gauthier S, Tardif CL, Mallar Chakravarty M, Poline JB, Rosa-Neto P, Evans AC, Villeneuve S, Poirier J, Breitner JCS. Open science datasets from PREVENT-AD, a longitudinal cohort of pre-symptomatic Alzheimer's disease. Neuroimage Clin 2021; 31:102733. [PMID: 34192666 PMCID: PMC8254111 DOI: 10.1016/j.nicl.2021.102733] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 02/07/2023]
Abstract
To move Alzheimer Disease (AD) research forward it is essential to collect data from large cohorts, but also make such data available to the global research community. We describe the creation of an open science dataset from the PREVENT-AD (PResymptomatic EValuation of Experimental or Novel Treatments for AD) cohort, composed of cognitively unimpaired older individuals with a parental or multiple-sibling history of AD. From 2011 to 2017, 386 participants were enrolled (mean age 63 years old ± 5) for sustained investigation among whom 349 have retrospectively agreed to share their data openly. Repositories are findable through the unified interface of the Canadian Open Neuroscience Platform and contain up to five years of longitudinal imaging data, cerebral fluid biochemistry, neurosensory capacities, cognitive, genetic, and medical information. Imaging data can be accessed openly at https://openpreventad.loris.ca while most of the other information, sensitive by nature, is accessible by qualified researchers at https://registeredpreventad.loris.ca. In addition to being a living resource for continued data acquisition, PREVENT-AD offers opportunities to facilitate understanding of AD pathogenesis.
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Affiliation(s)
| | - Cécile Madjar
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Samir Das
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Alexa Pichet Binette
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
| | - Stephanie O M Dyke
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Pierre Étienne
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
| | - Marie-Elyse Lafaille-Magnan
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; Centre for Child Development and Mental Health, Jewish General Hospital. Montréal, QC, Canada.
| | - Jordana Remz
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada.
| | - Pierre Bellec
- CRIUGM - Université de Montréal, Montréal, QC, Canada; Université de Montréal, Montréal, QC, Canada.
| | - D Louis Collins
- McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - M Natasha Rajah
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
| | - Veronique Bohbot
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
| | | | - Yasser Iturria-Medina
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Justin Kat
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Richard D Hoge
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; Université de Montréal, Montréal, QC, Canada.
| | - Serge Gauthier
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McGill University Research Centre for Studies in Aging, McGill University, Montréal, QC, Canada.
| | - Christine L Tardif
- McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - M Mallar Chakravarty
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
| | - Jean-Baptiste Poline
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Pedro Rosa-Neto
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University Research Centre for Studies in Aging, McGill University, Montréal, QC, Canada.
| | - Alan C Evans
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Sylvia Villeneuve
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Judes Poirier
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
| | - John C S Breitner
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
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Pichet Binette A, Theaud G, Rheault F, Roy M, Collins DL, Levin J, Mori H, Lee JH, Farlow MR, Schofield P, Chhatwal JP, Masters CL, Benzinger T, Morris J, Bateman R, Breitner JC, Poirier J, Gonneaud J, Descoteaux M, Villeneuve S. Bundle-specific associations between white matter microstructure and Aβ and tau pathology in preclinical Alzheimer's disease. eLife 2021; 10:62929. [PMID: 33983116 PMCID: PMC8169107 DOI: 10.7554/elife.62929] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 05/12/2021] [Indexed: 12/12/2022] Open
Abstract
Beta-amyloid (Aβ) and tau proteins, the pathological hallmarks of Alzheimer's disease (AD), are believed to spread through connected regions of the brain. Combining diffusion imaging and positron emission tomography, we investigated associations between white matter microstructure specifically in bundles connecting regions where Aβ or tau accumulates and pathology. We focused on free-water-corrected diffusion measures in the anterior cingulum, posterior cingulum, and uncinate fasciculus in cognitively normal older adults at risk of sporadic AD and presymptomatic mutation carriers of autosomal dominant AD. In Aβ-positive or tau-positive groups, lower tissue fractional anisotropy and higher mean diffusivity related to greater Aβ and tau burden in both cohorts. Associations were found in the posterior cingulum and uncinate fasciculus in preclinical sporadic AD, and in the anterior and posterior cingulum in presymptomatic mutation carriers. These results suggest that microstructural alterations accompany pathological accumulation as early as the preclinical stage of both sporadic and autosomal dominant AD.
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Affiliation(s)
- Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada.,Douglas Mental Health University Institute, Montreal, Canada
| | - Guillaume Theaud
- Sherbrooke Connectivity Imaging Laboratory (SCIL), Université de Sherbrooke, Sherbrooke, Canada
| | - François Rheault
- Electrical Engineering, Vanderbilt University, Nashville, United States
| | - Maggie Roy
- Sherbrooke Connectivity Imaging Laboratory (SCIL), Université de Sherbrooke, Sherbrooke, Canada
| | - D Louis Collins
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Hiroshi Mori
- Department of Clinical Neuroscience, Osaka City University Medical School, Osaka, Japan
| | - Jae Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | - Peter Schofield
- Neuroscience Research Australia, Sydney, Australia.,School of Medical Sciences, UNSW Sydney, Sydney, Australia
| | - Jasmeer P Chhatwal
- Harvard Medical School, Massachusetts General Hospital, Boston, United States
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia
| | - Tammie Benzinger
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, United States.,Department of Neurology, Washington University School of Medicine, St. Louis, United States
| | - John Morris
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, United States.,Department of Neurology, Washington University School of Medicine, St. Louis, United States
| | - Randall Bateman
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, United States.,Department of Neurology, Washington University School of Medicine, St. Louis, United States
| | - John Cs Breitner
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada.,Douglas Mental Health University Institute, Montreal, Canada
| | - Judes Poirier
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada.,Douglas Mental Health University Institute, Montreal, Canada
| | - Julie Gonneaud
- Douglas Mental Health University Institute, Montreal, Canada.,Normandie Univ, UNICAEN, INSERM, U1237, Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Laboratory (SCIL), Université de Sherbrooke, Sherbrooke, Canada
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada.,Douglas Mental Health University Institute, Montreal, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada
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49
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Pichet Binette A, Vachon-Presseau É, Morris J, Bateman R, Benzinger T, Collins DL, Poirier J, Breitner JCS, Villeneuve S. Amyloid and Tau Pathology Associations With Personality Traits, Neuropsychiatric Symptoms, and Cognitive Lifestyle in the Preclinical Phases of Sporadic and Autosomal Dominant Alzheimer's Disease. Biol Psychiatry 2021; 89:776-785. [PMID: 32228870 PMCID: PMC7415608 DOI: 10.1016/j.biopsych.2020.01.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Major prevention trials for Alzheimer's disease (AD) are now focusing on multidomain lifestyle interventions. However, the exact combination of behavioral factors related to AD pathology remains unclear. In 2 cohorts of cognitively unimpaired individuals at risk of AD, we examined which combinations of personality traits, neuropsychiatric symptoms, and cognitive lifestyle (years of education or lifetime cognitive activity) related to the pathological hallmarks of AD, amyloid-β, and tau deposits. METHODS A total of 115 older adults with a parental or multiple-sibling family history of sporadic AD (PREVENT-AD [PRe-symptomatic EValuation of Experimental or Novel Treatments for AD] cohort) underwent amyloid and tau positron emission tomography and answered several questionnaires related to behavioral attributes. Separately, we studied 117 mutation carriers from the DIAN (Dominant Inherited Alzheimer Network) study group cohort with amyloid positron emission tomography and behavioral data. Using partial least squares analysis, we identified latent variables relating amyloid or tau pathology with combinations of personality traits, neuropsychiatric symptoms, and cognitive lifestyle. RESULTS In PREVENT-AD, lower neuroticism, neuropsychiatric burden, and higher education were associated with less amyloid deposition (p = .014). Lower neuroticism and neuropsychiatric features, along with higher measures of openness and extraversion, were related to less tau deposition (p = .006). In DIAN, lower neuropsychiatric burden and higher education were also associated with less amyloid (p = .005). The combination of these factors accounted for up to 14% of AD pathology. CONCLUSIONS In the preclinical phase of both sporadic and autosomal dominant AD, multiple behavioral features were associated with AD pathology. These results may suggest potential pathways by which multidomain interventions might help delay AD onset or progression.
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Affiliation(s)
- Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Étienne Vachon-Presseau
- Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Faculty of Dentistry, McGill University, Montreal, Quebec, Canada; Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada
| | - John Morris
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri; Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Randall Bateman
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri; Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Tammie Benzinger
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri; Department of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - D Louis Collins
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Judes Poirier
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - John C S Breitner
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
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50
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Köbe T, Binette AP, Vogel JW, Meyer PF, Breitner JCS, Poirier J, Villeneuve S. Vascular risk factors are associated with a decline in resting-state functional connectivity in cognitively unimpaired individuals at risk for Alzheimer's disease: Vascular risk factors and functional connectivity changes. Neuroimage 2021; 231:117832. [PMID: 33549747 DOI: 10.1016/j.neuroimage.2021.117832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 12/12/2022] Open
Abstract
Resting-state functional connectivity is suggested to be cross-sectionally associated with both vascular burden and Alzheimer's disease (AD) pathology. However, evidence is lacking regarding longitudinal changes in functional connectivity. This study includes 247 cognitively unimpaired individuals with a family history of sporadic AD (185 women/ 62 men; mean [SD] age of 63 [5.3] years). Plasma total-, HDL-, and LDL-cholesterol and systolic and diastolic blood pressure were measured at baseline. Global (whole-brain) brain functional connectivity and connectivity from canonical functional networks were computed from resting-state functional MRI obtained at baseline and ~3.5 years of annual follow-ups, using a predefined functional parcellation. A subsample underwent Aβ- and tau-PET (n=91). Linear mixed-effects models demonstrated that global functional connectivity increased over time across the entire sample. In contrast, higher total-cholesterol and LDL-cholesterol levels were associated with greater reduction of functional connectivity in the default-mode network over time. In addition, higher diastolic blood pressure was associated with global functional connectivity reduction. The associations were similar when the analyses were repeated using two other functional brain parcellations. Aβ and tau deposition in the brain were not associated with changes in functional connectivity over time in the subsample. These findings provide evidence that vascular burden is associated with a decrease in functional connectivity over time in older adults with elevated risk for AD. Future studies are needed to determine if the impact of vascular risk factors on functional brain changes precede the impact of AD pathology on functional brain changes.
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Affiliation(s)
- Theresa Köbe
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada; German Center for Neurodegenerative Diseases (DZNE), 01307, Dresden, Germany.
| | - Alexa Pichet Binette
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada
| | - Jacob W Vogel
- Montreal Neurological Institute, McGill University, H3A 2B4, Montreal, QC, Canada
| | - Pierre-François Meyer
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada
| | - John C S Breitner
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada
| | - Judes Poirier
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University, H3A 2B4, Montreal, Quebec, Canada.
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