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Cousins KAQ, Phillips JS, Das SR, O'Brien K, Tropea TF, Chen-Plotkin A, Shaw LM, Nasrallah IM, Mechanic-Hamilton D, McMillan CT, Irwin DJ, Lee EB, Wolk DA. Pathologic and cognitive correlates of plasma biomarkers in neurodegenerative disease. Alzheimers Dement 2024. [PMID: 38644682 DOI: 10.1002/alz.13777] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 04/23/2024]
Abstract
INTRODUCTION We investigate pathological correlates of plasma phosphorylated tau 181 (p-tau181), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL) across a clinically diverse spectrum of neurodegenerative disease, including normal cognition (NormCog) and impaired cognition (ImpCog). METHODS Participants were NormCog (n = 132) and ImpCog (n = 461), with confirmed β-amyloid (Aβ+/-) status (cerebrospinal fluid, positron emission tomography, autopsy) and single molecule array plasma measurements. Logistic regression and receiver operating characteristic (ROC) area under the curve (AUC) tested how combining plasma analytes discriminated Aβ+ from Aβ-. Survival analyses tested time to clinical dementia rating (global CDR) progression. RESULTS Multivariable models (p-tau+GFAP+NfL) had the best performance to detect Aβ+ in NormCog (ROCAUC = 0.87) and ImpCog (ROCAUC = 0.87). Survival analyses demonstrated that higher NfL best predicted faster CDR progression for both Aβ+ (hazard ratio [HR] = 2.94; p = 8.1e-06) and Aβ- individuals (HR = 3.11; p = 2.6e-09). DISCUSSION Combining plasma biomarkers can optimize detection of Alzheimer's disease (AD) pathology across cognitively normal and clinically diverse neurodegenerative disease. HIGHLIGHTS Participants were clinically heterogeneous, with autopsy- or biomarker-confirmed Aβ. Combining plasma p-tau181, GFAP, and NfL improved diagnostic accuracy for Aβ status. Diagnosis by plasma biomarkers is more accurate in amnestic AD than nonamnestic AD. Plasma analytes show independent associations with tau PET and post mortem Aβ/tau. Plasma NfL predicted longitudinal cognitive decline in both Aβ+ and Aβ- individuals.
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Affiliation(s)
- Katheryn A Q Cousins
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jeffrey S Phillips
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sandhitsu R Das
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kyra O'Brien
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Thomas F Tropea
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ilya M Nasrallah
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Dawn Mechanic-Hamilton
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Corey T McMillan
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David J Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Edward B Lee
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David A Wolk
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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2
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Reus LM, Jansen IE, Tijms BM, Visser PJ, Tesi N, van der Lee SJ, Vermunt L, Peeters CFW, De Groot LA, Hok-A-Hin YS, Chen-Plotkin A, Irwin DJ, Hu WT, Meeter LH, van Swieten JC, Holstege H, Hulsman M, Lemstra AW, Pijnenburg YAL, van der Flier WM, Teunissen CE, Del Campo Milan M. Connecting dementia risk loci to the CSF proteome identifies pathophysiological leads for dementia. Brain 2024:awae090. [PMID: 38527854 DOI: 10.1093/brain/awae090] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/29/2024] [Accepted: 02/25/2024] [Indexed: 03/27/2024] Open
Abstract
Genome-wide association studies have successfully identified many genetic risk loci for dementia, but exact biological mechanisms through which genetic risk factors contribute to dementia remains unclear. Integrating CSF proteomic data with dementia risk loci could reveal intermediate molecular pathways connecting genetic variance to the development of dementia. We tested to what extent effects of known dementia risk loci can be observed in CSF levels of 665 proteins (proximity extension-based (PEA) immunoassays) in a deeply-phenotyped mixed-memory clinic cohort (n=502, mean age (sd) = 64.1 [8.7] years, 181 female [35.4%]), including patients with Alzheimer's disease (AD, n=213), dementia with Lewy bodies (DLB, n=50) and frontotemporal dementia (FTD, n=93), and controls (n=146). Validation was assessed in independent cohorts (n=99 PEA platform, n=198, MRM-targeted mass spectroscopy and multiplex assay). We performed additional analyses stratified according to diagnostic status (AD, DLB, FTD and controls separately), to explore whether associations between CSF proteins and genetic variants were specific to disease or not. We identified four AD risk loci as protein quantitative trait loci (pQTL): CR1-CR2 (rs3818361, P=1.65e-08), ZCWPW1-PILRB (rs1476679, P=2.73e-32), CTSH-CTSH (rs3784539, P=2.88e-24) and HESX1-RETN (rs186108507, P=8.39e-08), of which the first three pQTLs showed direct replication in the independent cohorts. We identified one AD-specific association between a rare genetic variant of TREM2 and CSF IL6 levels (rs75932628, P = 3.90e-7). DLB risk locus GBA showed positive trans effects on seven inter-related CSF levels in DLB patients only. No pQTLs were identified for frontotemporal dementia, either for the total sample as for analyses performed within FTD only. pQTL variants were involved in the immune system, highlighting the importance of this system in the pathophysiology of dementia. We further identified pQTLs in stratified analyses for AD and DLB, hinting at disease-specific pQTLs in dementia. Dissecting the contribution of risk loci to neurobiological processes aids in understanding disease mechanisms underlying dementia.
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Affiliation(s)
- Lianne M Reus
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA 90095 California, USA
| | - Iris E Jansen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive research, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Betty M Tijms
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Department of Psychiatry, Maastricht University, 6229 ET Maastricht The Netherlands
| | - Niccoló Tesi
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Genomics of Neurodegenerative Diseases and Aging, Department of Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Sven J van der Lee
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Genomics of Neurodegenerative Diseases and Aging, Department of Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Lisa Vermunt
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Carel F W Peeters
- Mathematical & Statistical Methods group (Biometris), Wageningen University & Research, Wageningen, 6708 PB Wageningen, The Netherlands
| | - Lisa A De Groot
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Yanaika S Hok-A-Hin
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David J Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - William T Hu
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
- Rutgers-RWJ Medical School, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA
| | - Lieke H Meeter
- Department of Neurology and Alzheimer Center, Erasmus Medical Center Rotterdam, Rotterdam, 3015 GD, The Netherlands
| | - John C van Swieten
- Department of Neurology and Alzheimer Center, Erasmus Medical Center Rotterdam, Rotterdam, 3015 GD, The Netherlands
| | - Henne Holstege
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Genomics of Neurodegenerative Diseases and Aging, Department of Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Marc Hulsman
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
- Genomics of Neurodegenerative Diseases and Aging, Department of Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Afina W Lemstra
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, 1081 HZ Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, 1081 HZ Amsterdam, The Netherlands
| | - Marta Del Campo Milan
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, 1081 HZ Amsterdam, The Netherlands
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Madrid, 28003 Madrid, Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, 08005 Barcelona, Spain
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Shantaraman A, Dammer EB, Ugochukwu O, Duong DM, Yin L, Carter EK, Gearing M, Chen-Plotkin A, Lee EB, Trojanowski JQ, Bennett DA, Lah JJ, Levey AI, Seyfried NT, Higginbotham L. Network Proteomics of the Lewy Body Dementia Brain Reveals Presynaptic Signatures Distinct from Alzheimer's Disease. bioRxiv 2024:2024.01.23.576728. [PMID: 38328211 PMCID: PMC10849701 DOI: 10.1101/2024.01.23.576728] [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: 02/09/2024]
Abstract
Lewy body dementia (LBD), a class of disorders comprising Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB), features substantial clinical and pathological overlap with Alzheimer's disease (AD). The identification of biomarkers unique to LBD pathophysiology could meaningfully advance its diagnosis, monitoring, and treatment. Using quantitative mass spectrometry (MS), we measured over 9,000 proteins across 138 dorsolateral prefrontal cortex (DLPFC) tissues from a University of Pennsylvania autopsy collection comprising control, Parkinson's disease (PD), PDD, and DLB diagnoses. We then analyzed co-expression network protein alterations in those with LBD, validated these disease signatures in two independent LBD datasets, and compared these findings to those observed in network analyses of AD cases. The LBD network revealed numerous groups or "modules" of co-expressed proteins significantly altered in PDD and DLB, representing synaptic, metabolic, and inflammatory pathophysiology. A comparison of validated LBD signatures to those of AD identified distinct differences between the two diseases. Notably, synuclein-associated presynaptic modules were elevated in LBD but decreased in AD relative to controls. We also found that glial-associated matrisome signatures consistently elevated in AD were more variably altered in LBD, ultimately stratifying those LBD cases with low versus high burdens of concurrent beta-amyloid deposition. In conclusion, unbiased network proteomic analysis revealed diverse pathophysiological changes in the LBD frontal cortex distinct from alterations in AD. These results highlight the LBD brain network proteome as a promising source of biomarkers that could enhance clinical recognition and management.
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Affiliation(s)
- Anantharaman Shantaraman
- Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Eric B. Dammer
- Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Obiadada Ugochukwu
- Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA
| | - Duc M. Duong
- Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Luming Yin
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - E. Kathleen Carter
- Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Marla Gearing
- Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Edward B. Lee
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - John Q. Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - James J. Lah
- Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Allan I. Levey
- Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Nicholas T. Seyfried
- Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Lenora Higginbotham
- Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
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4
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van der Ende EL, In ‘t Veld SGJG, Hanskamp I, van der Lee S, Dijkstra JIR, Hok-A-Hin YS, Blujdea ER, van Swieten JC, Irwin DJ, Chen-Plotkin A, Hu WT, Lemstra AW, Pijnenburg YAL, van der Flier WM, del Campo M, Teunissen CE, Vermunt L. CSF proteomics in autosomal dominant Alzheimer's disease highlights parallels with sporadic disease. Brain 2023; 146:4495-4507. [PMID: 37348871 PMCID: PMC10629764 DOI: 10.1093/brain/awad213] [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: 01/24/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 06/24/2023] Open
Abstract
Autosomal dominant Alzheimer's disease (ADAD) offers a unique opportunity to study pathophysiological changes in a relatively young population with few comorbidities. A comprehensive investigation of proteome changes occurring in ADAD could provide valuable insights into AD-related biological mechanisms and uncover novel biomarkers and therapeutic targets. Furthermore, ADAD might serve as a model for sporadic AD, but in-depth proteome comparisons are lacking. We aimed to identify dysregulated CSF proteins in ADAD and determine the degree of overlap with sporadic AD. We measured 1472 proteins in CSF of PSEN1 or APP mutation carriers (n = 22) and age- and sex-matched controls (n = 20) from the Amsterdam Dementia Cohort using proximity extension-based immunoassays (PEA). We compared protein abundance between groups with two-sided t-tests and identified enriched biological pathways. Using the same protein panels in paired plasma samples, we investigated correlations between CSF proteins and their plasma counterparts. Finally, we compared our results with recently published PEA data from an international cohort of sporadic AD (n = 230) and non-AD dementias (n = 301). All statistical analyses were false discovery rate-corrected. We detected 66 differentially abundant CSF proteins (65 increased, 1 decreased) in ADAD compared to controls (q < 0.05). The most strongly upregulated proteins (fold change >1.8) were related to immunity (CHIT1, ITGB2, SMOC2), cytoskeletal structure (MAPT, NEFL) and tissue remodelling (TMSB10, MMP-10). Significant CSF-plasma correlations were found for the upregulated proteins SMOC2 and LILR1B. Of the 66 differentially expressed proteins, 36 had been measured previously in the sporadic dementias cohort, 34 of which (94%) were also significantly upregulated in sporadic AD, with a strong correlation between the fold changes of these proteins in both cohorts (rs = 0.730, P < 0.001). Twenty-nine of the 36 proteins (81%) were also upregulated among non-AD patients with suspected AD co-pathology. This CSF proteomics study demonstrates substantial biochemical similarities between ADAD and sporadic AD, suggesting involvement of the same biological processes. Besides known AD-related proteins, we identified several relatively novel proteins, such as TMSB10, MMP-10 and SMOC2, which have potential as novel biomarkers. With shared pathophysiological CSF changes, ADAD study findings might be translatable to sporadic AD, which could greatly expedite therapy development.
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Affiliation(s)
- Emma L van der Ende
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Sjors G J G In ‘t Veld
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Iris Hanskamp
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Sven van der Lee
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Janna I R Dijkstra
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Yanaika S Hok-A-Hin
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Elena R Blujdea
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - John C van Swieten
- Alzheimer Center and Department of Neurology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - David J Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - William T Hu
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30307, USA
| | - Afina W Lemstra
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Marta del Campo
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28003 Madrid, Spain
- Barcelonabeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005 Barcelona, Spain
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Lisa Vermunt
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
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5
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Del Campo M, Vermunt L, Peeters CFW, Sieben A, Hok-A-Hin YS, Lleó A, Alcolea D, van Nee M, Engelborghs S, van Alphen JL, Arezoumandan S, Chen-Plotkin A, Irwin DJ, van der Flier WM, Lemstra AW, Teunissen CE. CSF proteome profiling reveals biomarkers to discriminate dementia with Lewy bodies from Alzheimer´s disease. Nat Commun 2023; 14:5635. [PMID: 37704597 PMCID: PMC10499811 DOI: 10.1038/s41467-023-41122-y] [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: 12/12/2022] [Accepted: 08/22/2023] [Indexed: 09/15/2023] Open
Abstract
Diagnosis of dementia with Lewy bodies (DLB) is challenging and specific biofluid biomarkers are highly needed. We employed proximity extension-based assays to measure 665 proteins in the cerebrospinal fluid (CSF) from patients with DLB (n = 109), Alzheimer´s disease (AD, n = 235) and cognitively unimpaired controls (n = 190). We identified over 50 CSF proteins dysregulated in DLB, enriched in myelination processes among others. The dopamine biosynthesis enzyme DDC was the strongest dysregulated protein, and could efficiently discriminate DLB from controls and AD (AUC:0.91 and 0.81 respectively). Classification modeling unveiled a 7-CSF biomarker panel that better discriminate DLB from AD (AUC:0.93). A custom multiplex panel for six of these markers (DDC, CRH, MMP-3, ABL1, MMP-10, THOP1) was developed and validated in independent cohorts, including an AD and DLB autopsy cohort. This DLB CSF proteome study identifies DLB-specific protein changes and translates these findings to a practicable biomarker panel that accurately identifies DLB patients, providing promising diagnostic and clinical trial testing opportunities.
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Affiliation(s)
- Marta Del Campo
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands.
- Barcelonaßeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain.
| | - Lisa Vermunt
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Carel F W Peeters
- Mathematical & Statistical Methods group (Biometris), Wageningen University & Research, Wageningen, The Netherlands
| | - Anne Sieben
- Lab of neuropathology, Neurobiobank, Institute Born-Bunge, Antwerp University, Edegem, Belgium
| | - Yanaika S Hok-A-Hin
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Alberto Lleó
- Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau (IIB SANT PAU) - Hospital de Sant Pau, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya, Spain
- Center of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Daniel Alcolea
- Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau (IIB SANT PAU) - Hospital de Sant Pau, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya, Spain
- Center of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Mirrelijn van Nee
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Vrije Universiteit Brussel, Center for Neurosciences (C4N), Neuroprotection and Neuromodulation Research Group (NEUR), Brussels, Belgium
- Universitair Ziekenhuis Brussel, Department of Neurology, Brussels, Belgium
| | - Juliette L van Alphen
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Sanaz Arezoumandan
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David J Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Afina W Lemstra
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
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Couto B, Sousa M, Gonzalez-Latapi P, McArthur E, Lang A, Chen-Plotkin A, Marras C. Disease Progression and Sphingolipids and Neurofilament Light Chain in Early Idiopathic Parkinson's Disease. Can J Neurol Sci 2023:1-4. [PMID: 37641969 DOI: 10.1017/cjn.2023.281] [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] [Indexed: 08/31/2023]
Abstract
Parkinson's disease(PD) lacks a biomarker for disease progression. To analyze how cerebrospinal fluid (CSF), glucosylceramide (GlcCer), sphingomyelin (SM), or serum neurofilament light chain (NfL) associate with progression of PD in a retrospective cohort, we used linear mixed-model regressions between baseline biomarkers and change in dopamine transporter brain-imaging (DaTscan©), Montreal cognitive assesment (MoCA), or global composite outcome (GCO) score. In 191 PD patients, biomarkers were not associated with DaTscan or MoCA change over 2.1 years. Higher baseline GlcCer/SM ratio and serum-NfL nonsignificantly associated with increase in GCO score. Results do not support a role for CSF-sphingolipid/serum-NfL to predict cognitive and DaTscan progression in early-PD. Potential prediction of global clinical change warrants further study.
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Affiliation(s)
- Blas Couto
- Edmond J. Safra Program in Parkinson's Disease, Rossy Program for PSP Research and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
- Institute of Cognitive and Traslational Neuroscience (INCyT), at the INECO-CONICET-Favaloro University Hospital, Buenos Aires, Argentina
| | - Mario Sousa
- Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Paulina Gonzalez-Latapi
- Ken and Ruth Davee Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | | | - Anthony Lang
- Edmond J. Safra Program in Parkinson's Disease, Rossy Program for PSP Research and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease, Rossy Program for PSP Research and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
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7
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Nilsson J, Cousins KAQ, Gobom J, Portelius E, Chen-Plotkin A, Shaw LM, Grossman M, Irwin DJ, Trojanowski JQ, Zetterberg H, Blennow K, Brinkmalm A. Cerebrospinal fluid biomarker panel of synaptic dysfunction in Alzheimer's disease and other neurodegenerative disorders. Alzheimers Dement 2023; 19:1775-1784. [PMID: 36239248 PMCID: PMC10102247 DOI: 10.1002/alz.12809] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 04/20/2022] [Revised: 08/21/2022] [Accepted: 09/02/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Synaptic degeneration is a key part of the pathophysiology of neurodegenerative diseases, and biomarkers reflecting the pathological alterations are greatly needed. METHOD Seventeen synaptic proteins were quantified in a pathology-confirmed cerebrospinal fluid cohort of patients with Alzheimer's disease (AD; n = 63), frontotemporal lobar degeneration (FTLD; n = 53), and Lewy body spectrum of disorders (LBD; n = 21), as well as healthy controls (HC; n = 48). RESULTS Comparisons revealed four distinct patterns: markers decreased across all neurodegenerative conditions compared to HC (the neuronal pentraxins), markers increased across all neurodegenerative conditions (14-3-3 zeta/delta), markers selectively increased in AD compared to other neurodegenerative conditions (neurogranin and beta-synuclein), and markers selectively decreased in LBD and FTLD compared to HC and AD (AP2B1 and syntaxin-1B). DISCUSSION Several of the synaptic proteins may serve as biomarkers for synaptic dysfunction in AD, LBD, and FTLD. Additionally, differential patterns of synaptic protein alterations seem to be present across neurodegenerative diseases. HIGHLIGHTS A panel of synaptic proteins were quantified in the cerebrospinal fluid using mass spectrometry. We compared Alzheimer's disease, frontotemporal degeneration, and Lewy body spectrum of disorders. Pathology was confirmed by autopsy or familial mutations. We discovered synaptic biomarkers for synaptic degeneration and cognitive decline. We found differential patterns of synaptic proteins across neurodegenerative diseases.
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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
| | - Katheryn AQ Cousins
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - 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
| | - Erik Portelius
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, SE-43180 Mölndal, Sweden
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - David J. Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - 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, United Kingdom
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - 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
| | - 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
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8
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Cousins KAQ, Irwin DJ, Chen-Plotkin A, Shaw LM, Arezoumandan S, Lee EB, Wolk DA, Weintraub D, Spindler M, Deik A, Grossman M, Tropea TF. Plasma GFAP associates with secondary Alzheimer's pathology in Lewy body disease. Ann Clin Transl Neurol 2023; 10:802-813. [PMID: 37000892 DOI: 10.1002/acn3.51768] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 04/03/2023] Open
Abstract
OBJECTIVE Within Lewy body spectrum disorders (LBSD) with α-synuclein pathology (αSyn), concomitant Alzheimer's disease (AD) pathology is common and is predictive of clinical outcomes, including cognitive impairment and decline. Plasma phosphorylated tau 181 (p-tau181 ) is sensitive to AD neuropathologic change (ADNC) in clinical AD, and plasma glial fibrillary acidic protein (GFAP) is associated with the presence of β-amyloid plaques. While these plasma biomarkers are well tested in clinical and pathological AD, their diagnostic and prognostic performance for concomitant AD in LBSD is unknown. METHODS In autopsy-confirmed αSyn-positive LBSD, we tested how plasma p-tau181 and GFAP differed across αSyn with concomitant ADNC (αSyn+AD; n = 19) and αSyn without AD (αSyn; n = 30). Severity of burden was scored on a semiquantitative scale for several pathologies (e.g., β-amyloid and tau), and scores were averaged across sampled brainstem, limbic, and neocortical regions. RESULTS Linear models showed that plasma GFAP was significantly higher in αSyn+AD compared to αSyn (β = 0.31, 95% CI = 0.065-0.56, and P = 0.015), after covarying for age at plasma, plasma-to-death interval, and sex; plasma p-tau181 was not (P = 0.37). Next, linear models tested associations of AD pathological features with both plasma analytes, covarying for plasma-to-death, age at plasma, and sex. GFAP was significantly associated with brain β-amyloid (β = 15, 95% CI = 6.1-25, and P = 0.0018) and tau burden (β = 12, 95% CI = 2.5-22, and P = 0.015); plasma p-tau181 was not associated with either (both P > 0.34). INTERPRETATION Findings indicate that plasma GFAP may be sensitive to concomitant AD pathology in LBSD, especially accumulation of β-amyloid plaques.
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Affiliation(s)
- Katheryn A Q Cousins
- Department of Neurology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - David J Irwin
- Department of Neurology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sanaz Arezoumandan
- Department of Neurology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Edward B Lee
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David A Wolk
- Department of Neurology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Daniel Weintraub
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Meredith Spindler
- Department of Neurology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Andres Deik
- Department of Neurology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Thomas F Tropea
- Department of Neurology, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Robinson JL, Xie SX, Baer DR, Suh E, Van Deerlin VM, Loh NJ, Irwin D, McMillan CT, Wolk D, Chen-Plotkin A, Weintraub D, Schuck T, Lee VMY, Trojanowski JQ, Lee EB. Pathological combinations in neurodegenerative disease are heterogeneous and disease-associated. Brain 2023:7067885. [PMID: 36864661 PMCID: PMC10232273 DOI: 10.1093/brain/awad059] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [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: 09/08/2022] [Revised: 02/07/2023] [Accepted: 02/12/2023] [Indexed: 03/04/2023] Open
Abstract
Pathologies that are causative for neurodegenerative disease (ND) are also frequently present in unimpaired, older individuals. In this retrospective study of 1,647 autopsied individuals, we report the incidence of ten pathologies across ND and normal ageing in attempt to clarify which pathological combinations are disease-associated and which are ageing-related. Eight clinically defined groups were examined including unimpaired individuals and those with clinical Alzheimer's disease, mixed dementia, amyotrophic lateral sclerosis, frontotemporal degeneration, multiple system atrophy, probable Lewy body disease, or probable tauopathies. Up to seven pathologies were observed concurrently resulting in a heterogenous mix of 161 pathological combinations. The presence of multiple, additive pathologies associated with older age, increasing disease duration, APOE e4 allele, and presence of dementia across the clinical groups. 15-67 combinations occurred in each group with the unimpaired group defined by 35 combinations. Most combinations occurred at a < 5% prevalence included 86 that were present in only 1-2 individuals. To better understand this heterogeneity, we organized the pathologic combinations into five broad categories based on their age-related frequency: 1) Ageing only for the unimpaired group combinations, 2) ND only if only the expected pathology for that individual's clinical phenotype was present, 3) Other ND if the expected pathology was not present, 4) ND + ageing if the expected pathology was present together with aging-related pathologies at a similar prevalence as the unimpaired group, and 5) ND + associated if the expected pathology was present together with other pathologies either not observed in the unimpaired group or observed at a greater frequency. ND only cases comprised a minority of cases (19-45%) except in the amyotrophic lateral sclerosis (56%) and multiple system atrophy (65%) groups. The ND + ageing category represented 9-28% of each group, but was rare in Alzheimer's disease (1%). ND + associated combinations were common in Alzheimer's disease (58%) and Lewy body disease (37%) and were observed in all groups. The Ageing only and Other ND categories accounted for a minority of individuals in each group. This observed heterogeneity indicates that the total pathological burden in ND is frequently more than a primary expected clinicopathological correlation with a high frequency of additional disease- or age-associated pathologies.
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Affiliation(s)
- John L Robinson
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Sharon X Xie
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Daniel R Baer
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - EunRan Suh
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Vivianna M Van Deerlin
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Nicholas J Loh
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - David Irwin
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Corey T McMillan
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - David Wolk
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Alice Chen-Plotkin
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Daniel Weintraub
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Theresa Schuck
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Virginia M-Y Lee
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - John Q Trojanowski
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Edward B Lee
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Institute on Aging, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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10
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Cousins KAQ, Arezoumandan S, Shellikeri S, Ohm D, Shaw LM, Grossman M, Wolk D, McMillan CT, Chen-Plotkin A, Lee E, Trojanowski JQ, Zetterberg H, Blennow K, Irwin DJ. CSF Biomarkers of Alzheimer Disease in Patients With Concomitant α-Synuclein Pathology. Neurology 2022; 99:e2303-e2312. [PMID: 36041863 PMCID: PMC9694837 DOI: 10.1212/wnl.0000000000201202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 02/16/2022] [Accepted: 07/19/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES CSF biomarkers β-amyloid 1-42 (Aβ42), phosphorylated tau 181 (p-tau181), total tau (t-tau), and neurogranin (Ng) can diagnose Alzheimer disease (AD) in life. However, it is unknown whether CSF concentrations, and thus their accuracies, are affected by concomitant pathologies common in AD, such as α-synuclein (αSyn). Our primary goal was to test whether biomarkers in patients with AD are altered by concomitant αSyn. We compared CSF Aβ42, p-tau181, t-tau, and Ng levels across autopsy-confirmed AD and concomitant AD and αSyn (AD + αSyn). Antemortem CSF levels were related to postmortem accumulations of αSyn. Finally, we tested how concommitant AD + αSyn affected the diagnostic accuracy of 2 CSF-based strategies: the amyloid/tau/neurodegeneration (ATN) framework and the t-tau/Aβ42 ratio. METHODS Inclusion criteria were neuropathologic diagnoses of AD, mixed AD + αSyn, and αSyn. A convenience sample of nonimpaired controls was selected with available CSF and a Mini-Mental State Examination (MMSE) ≥ 27. αSyn without AD and controls were included as reference groups. Analyses of covariance (ANCOVAs) tested planned comparisons were CSF Aβ42, p-tau181, t-tau, and Ng differences across AD and AD + αSyn. Linear models tested how biomarkers were altered by αSyn accumulation in AD, accounting for pathologic β-amyloid and tau. Receiver operating characteristic and area under the curve (AUC), including 95% CI, evaluated diagnostic accuracy. RESULTS Participants were 61 patients with AD, 39 patients with mixed AD + αSyn, 20 patients with αSyn, and 61 controls. AD had similar median age (73 [interquartile range {IQR} = 12] years), MMSE (23 [IQR = 9]), and sex distribution (male = 49%) compared with AD + αSyn age (70 [IQR = 13] years; p = 0.3), MMSE (25 [IQR = 9.5]; p = 0.19), and sex distribution (male = 69%; p = 0.077). ANCOVAs showed that AD + αSyn had lower p-tau181 (F(1,94) = 17, p < 2.6e-16), t-tau (F(1,93) = 11, p = 0.0004), and Ng levels (F(1,50) = 12, p = 0.0004) than AD; there was no difference in Aβ42 (p = 0.44). Models showed increasing αSyn related to lower p-tau181 (β = -0.26, SE = 0.092, p = 0.0065), t-tau (β = -0.19, SE = 0.092, p = 0.041), and Ng levels (β = -0.2, SE = 0.066, p = 0.0046); αSyn was not a significant factor for Aβ42 (p = 1). T-tau/Aβ42 had the highest accuracy when detecting AD, including mixed AD + αSyn cases (AUC = 0.95; CI 0.92-0.98). DISCUSSION Findings demonstrate that concomitant αSyn pathology in AD is associated with lower CSF p-tau181, t-tau, and Ng levels and can affect diagnostic accuracy in patients with AD.
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Affiliation(s)
- Katheryn Alexandra Quilico Cousins
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK.
| | - Sanaz Arezoumandan
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK
| | - Sanjana Shellikeri
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK
| | - Daniel Ohm
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK
| | - Leslie M Shaw
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK
| | - Murray Grossman
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK
| | - David Wolk
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK
| | - Corey T McMillan
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK
| | - Alice Chen-Plotkin
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK
| | - Edward Lee
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK
| | - John Q Trojanowski
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK
| | - Henrik Zetterberg
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK
| | - Kaj Blennow
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK
| | - David John Irwin
- From the Departments of Neurology (K.A.Q.C., S.A., S.S., D.O., M.G., D.W., C.T.M., A.C.-P., D.J.I.), Pathology and Laboratory Medicine (L.M.S., E.L., J.Q.T.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Psychiatry and Neurochemistry (H.Z., K.B.), Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Neurodegenerative Disease (H.Z.), Institute of Neurology, University College London, UK
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11
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Cousins KAQ, Shaw LM, Shellikeri S, Dratch L, Rosario L, Elman LB, Quinn C, Amado DA, Wolk DA, Tropea TF, Chen-Plotkin A, Irwin DJ, Grossman M, Lee EB, Trojanowski JQ, McMillan CT. Elevated Plasma Phosphorylated Tau 181 in Amyotrophic Lateral Sclerosis. Ann Neurol 2022; 92:807-818. [PMID: 35877814 PMCID: PMC9588516 DOI: 10.1002/ana.26462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/06/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Plasma phosphorylated tau (p-tau181 ) is reliably elevated in Alzheimer's disease (AD), but less explored is its specificity relative to other neurodegenerative conditions. Here, we find novel evidence that plasma p-tau181 is elevated in amyotrophic lateral sclerosis (ALS), a neurodegenerative condition typically lacking tau pathology. We performed a detailed evaluation to identify the clinical correlates of elevated p-tau181 in ALS. METHODS Patients were clinically or pathologically diagnosed with ALS (n = 130) or AD (n = 79), or were healthy non-impaired controls (n = 26). Receiver operating characteristic (ROC) curves were analyzed and area under the curve (AUC) was used to discriminate AD from ALS. Within ALS, Mann-Whitney-Wilcoxon tests compared analytes by presence/absence of upper motor neuron and lower motor neuron (LMN) signs. Spearman correlations tested associations between plasma p-tau181 and postmortem neuron loss. RESULTS A Wilcoxon test showed plasma p-tau181 was higher in ALS than controls (W = 2,600, p = 0.000015), and ROC analyses showed plasma p-tau181 poorly discriminated AD and ALS (AUC = 0.60). In ALS, elevated plasma p-tau181 was associated with LMN signs in cervical (W = 827, p = 0.0072), thoracic (W = 469, p = 0.00025), and lumbosacral regions (W = 851, p = 0.0000029). In support of LMN findings, plasma p-tau181 was associated with neuron loss in the spinal cord (rho = 0.46, p = 0.017), but not in the motor cortex (p = 0.41). Cerebrospinal spinal fluid p-tau181 and plasma neurofilament light chain were included as reference analytes, and demonstrate specificity of findings. INTERPRETATION We found strong evidence that plasma p-tau181 is elevated in ALS and may be a novel marker specific to LMN dysfunction. ANN NEUROL 2022;92:807-818.
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Affiliation(s)
- Katheryn A Q Cousins
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sanjana Shellikeri
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Laynie Dratch
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Luis Rosario
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Lauren B Elman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Colin Quinn
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Defne A Amado
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - David A Wolk
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Thomas F Tropea
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - David J Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Edward B Lee
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA
| | - Corey T McMillan
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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12
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Del Campo M, Peeters CFW, Johnson ECB, Vermunt L, Hok-A-Hin YS, van Nee M, Chen-Plotkin A, Irwin DJ, Hu WT, Lah JJ, Seyfried NT, Dammer EB, Herradon G, Meeter LH, van Swieten J, Alcolea D, Lleó A, Levey AI, Lemstra AW, Pijnenburg YAL, Visser PJ, Tijms BM, van der Flier WM, Teunissen CE. CSF proteome profiling across the Alzheimer's disease spectrum reflects the multifactorial nature of the disease and identifies specific biomarker panels. Nat Aging 2022; 2:1040-1053. [PMID: 37118088 PMCID: PMC10292920 DOI: 10.1038/s43587-022-00300-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 09/28/2022] [Indexed: 04/30/2023]
Abstract
Development of disease-modifying therapies against Alzheimer's disease (AD) requires biomarkers reflecting the diverse pathological pathways specific for AD. We measured 665 proteins in 797 cerebrospinal fluid (CSF) samples from patients with mild cognitive impairment with abnormal amyloid (MCI(Aβ+): n = 50), AD-dementia (n = 230), non-AD dementias (n = 322) and cognitively unimpaired controls (n = 195) using proximity ligation-based immunoassays. Here we identified >100 CSF proteins dysregulated in MCI(Aβ+) or AD compared to controls or non-AD dementias. Proteins dysregulated in MCI(Aβ+) were primarily related to protein catabolism, energy metabolism and oxidative stress, whereas those specifically dysregulated in AD dementia were related to cell remodeling, vascular function and immune system. Classification modeling unveiled biomarker panels discriminating clinical groups with high accuracies (area under the curve (AUC): 0.85-0.99), which were translated into custom multiplex assays and validated in external and independent cohorts (AUC: 0.8-0.99). Overall, this study provides novel pathophysiological leads delineating the multifactorial nature of AD and potential biomarker tools for diagnostic settings or clinical trials.
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Affiliation(s)
- Marta Del Campo
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands.
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain.
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.
| | - Carel F W Peeters
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
- Mathematical & Statistical Methods group (Biometris), Wageningen University & Research, Wageningen, The Netherlands
| | - Erik C B Johnson
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, GA, USA
| | - Lisa Vermunt
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Yanaika S Hok-A-Hin
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Mirrelijn van Nee
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - David J Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - William T Hu
- Rutgers-RWJ Medical School, Institute for Health, Health Care Policy, and Aging Research, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - James J Lah
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, GA, USA
| | - Nicholas T Seyfried
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Eric B Dammer
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Gonzalo Herradon
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
| | - Lieke H Meeter
- Department of Neurology and Alzheimer Center, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - John van Swieten
- Department of Neurology and Alzheimer Center, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Daniel Alcolea
- Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau - Hospital de Sant Pau, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Alberto Lleó
- Department of Neurology, Institut d'Investigacions Biomèdiques Sant Pau - Hospital de Sant Pau, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Allan I Levey
- Goizueta Alzheimer's Disease Research Center, Emory University, Atlanta, GA, USA
| | - Afina W Lemstra
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Pieter J Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Betty M Tijms
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
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13
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Cousins KAQ, Shaw LM, Chen-Plotkin A, Wolk DA, Van Deerlin VM, Lee EB, McMillan CT, Grossman M, Irwin DJ. Distinguishing Frontotemporal Lobar Degeneration Tau From TDP-43 Using Plasma Biomarkers. JAMA Neurol 2022; 79:1155-1164. [PMID: 36215050 PMCID: PMC9552044 DOI: 10.1001/jamaneurol.2022.3265] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 04/18/2022] [Accepted: 08/05/2022] [Indexed: 01/14/2023]
Abstract
Importance Biomarkers are lacking that can discriminate frontotemporal lobar degeneration (FTLD) associated with tau (FTLD-tau) or TDP-43 (FTLD-TDP). Objective To test whether plasma biomarkers glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), or their ratio (GFAP/NfL) differ between FTLD-tau and FTLD-TDP. Design, Setting, and Participants This retrospective cross-sectional study included data from 2009 to 2020 from the University of Pennsylvania Integrated Neurodegenerative Disease Database, with a median (IQR) follow-up duration of 2 (0.3-4.2) years. The training sample was composed of patients with autopsy-confirmed and familial FTLD; nonimpaired controls were included as a reference group. The independent validation sample included patients with FTD with a clinical diagnosis of progressive supranuclear palsy syndrome (PSPS) associated with tau (PSPS-tau) or amytrophic lateral sclerosis (ALS) associated with TDP-43 (ALS-TDP). In patients with FTLD with autopsy-confirmed or variant-confirmed pathology, receiver operating characteristic (ROC) curves tested the GFAP/NfL ratio and established a pathology-confirmed cut point. The cut point was validated in an independent sample of patients with clinical frontotemporal dementia (FTD). Data were analyzed from February to July 2022. Exposures Clinical, postmortem histopathological assessments, and plasma collection. Main Outcomes and Measures ROC and area under the ROC curve (AUC) with 90% CIs evaluated discrimination of pure FTLD-tau from pure FTLD-TDP using plasma GFAP/NfL ratio; the Youden index established optimal cut points. Sensitivity and specificity of cut points were assessed in an independent validation sample. Results Of 349 participants with available plasma data, 234 met inclusion criteria (31 controls, 141 in the training sample, and 62 in the validation sample). In the training sample, patients with FTLD-tau were older than patients with FTLD-TDP (FTLD-tau: n = 46; mean [SD] age, 65.8 [8.29] years; FTLD-TDP: n = 95; mean [SD] age, 62.3 [7.82] years; t84.6 = 2.45; mean difference, 3.57; 95% CI, 0.67-6.48; P = .02) but with similar sex distribution (FTLD-tau: 27 of 46 [59%] were male; FTLD-TDP: 51 of 95 [54%] were male; χ21 = 0.14; P = .70). In the validation sample, patients with PSPS-tau were older than those with ALS-TDP (PSPS-tau: n = 31; mean [SD] age, 69.3 [7.35] years; ALS-TDP: n = 31; mean [SD] age, 54.6 [10.17] years; t54.6 = 6.53; mean difference, 14.71; 95% CI, 10.19-19.23; P < .001) and had fewer patients who were male (PSPS-tau: 9 of 31 [29%] were male; ALS-TDP: 22 of 31 [71%] were male; χ21 = 9.3; P = .002). ROC revealed excellent discrimination of FTLD-tau from FTLD-TDP by plasma GFAP/NfL ratio (AUC = 0.89; 90% CI, 0.82-0.95; sensitivity = 0.73; 90% CI, 0.65-0.89; specificity = 0.89; 90% CI, 0.78-0.98), which was higher than either GFAP level alone (AUC = 0.65; 90% CI, 0.54-0.76) or NfL levels alone (AUC = 0.75; 90% CI, 0.64-0.85). In the validation sample, there was sensitivity of 0.84 (90% CI, 0.66-0.94) and specificity of 0.81 (90% CI, 0.62-0.91) when applying the autopsy-derived plasma GFAP/NfL threshold. Conclusions and Relevance The plasma ratio of GFAP/NfL may discriminate FTLD-tau from FTLD-TDP.
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Affiliation(s)
- Katheryn A. Q. Cousins
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - David A. Wolk
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | | | - Edward B. Lee
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia
| | - Corey T. McMillan
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - David J. Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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14
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Zuroff L, Rezk A, Shinoda K, Espinoza DA, Elyahu Y, Zhang B, Chen AA, Shinohara RT, Jacobs D, Alcalay RN, Tropea TF, Chen-Plotkin A, Monsonego A, Li R, Bar-Or A. Immune aging in multiple sclerosis is characterized by abnormal CD4 T cell activation and increased frequencies of cytotoxic CD4 T cells with advancing age. EBioMedicine 2022; 82:104179. [PMID: 35868128 PMCID: PMC9305354 DOI: 10.1016/j.ebiom.2022.104179] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 11/17/2021] [Revised: 06/12/2022] [Accepted: 07/05/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Immunosenescence (ISC) describes age-related changes in immune-system composition and function. Multiple sclerosis (MS) is a lifelong inflammatory condition involving effector and regulatory T-cell imbalance, yet little is known about T-cell ISC in MS. We examined age-associated changes in circulating T cells in MS compared to normal controls (NC). METHODS Forty untreated MS (Mean Age 43·3, Range 18-72) and 49 NC (Mean Age 48·6, Range 20-84) without inflammatory conditions were included in cross-sectional design. T-cell subsets were phenotypically and functionally characterized using validated multiparametric flow cytometry. Their aging trajectories, and differences between MS and NC, were determined using linear mixed-effects models. FINDINGS MS patients demonstrated early and persistent redistribution of naïve and memory CD4 T-cell compartments. While most CD4 and CD8 T-cell aging trajectories were similar between groups, MS patients exhibited abnormal age-associated increases of activated (HLA-DR+CD38+; (P = 0·013) and cytotoxic CD4 T cells, particularly in patients >60 (EOMES: P < 0·001). Aging MS patients also failed to upregulate CTLA-4 expression on both CD4 (P = 0·014) and CD8 (P = 0·009) T cells, coupled with abnormal age-associated increases in frequencies of B cells expressing costimulatory molecules. INTERPRETATION While many aspects of T-cell aging in MS are conserved, the older MS patients harbour abnormally increased frequencies of CD4 T cells with activated and cytotoxic effector profiles. Age-related decreased expression of T-cell co-inhibitory receptor CTLA-4, and increased B-cell costimulatory molecule expression, may provide a mechanism that drives aberrant activation of effector CD4 T cells that have been implicated in progressive disease. FUNDING Stated in Acknowledgements section of manuscript.
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Affiliation(s)
- Leah Zuroff
- The Center for Neuroinflammation and Experimental Therapeutics and the Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Ayman Rezk
- The Center for Neuroinflammation and Experimental Therapeutics and the Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Koji Shinoda
- The Center for Neuroinflammation and Experimental Therapeutics and the Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Diego A Espinoza
- The Center for Neuroinflammation and Experimental Therapeutics and the Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Yehezqel Elyahu
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences; Zlotowski Neuroscience Center and Regenerative Medicine and Stem Cell Research Center; and National Institute for Biotechnology, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Bo Zhang
- Department of Cardiology, The fourth affiliated hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, China
| | - Andrew A Chen
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Russell T Shinohara
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Dina Jacobs
- The Center for Neuroinflammation and Experimental Therapeutics and the Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Roy N Alcalay
- Department of Neurology, Columbia University, New York, NY 10032, USA; The Center for Movement Disorders, Neurological Institute, Tel Aviv Medical Center, Tel Aviv 6423914, Israel
| | - Thomas F Tropea
- Department of Neurology, Perelman school of medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman school of medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Alon Monsonego
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences; Zlotowski Neuroscience Center and Regenerative Medicine and Stem Cell Research Center; and National Institute for Biotechnology, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Rui Li
- The Center for Neuroinflammation and Experimental Therapeutics and the Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Amit Bar-Or
- The Center for Neuroinflammation and Experimental Therapeutics and the Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, 19104, USA.
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15
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Blömeke L, Pils M, Kraemer-Schulien V, Dybala A, Schaffrath A, Kulawik A, Rehn F, Cousin A, Nischwitz V, Willbold J, Zack R, Tropea TF, Bujnicki T, Tamgüney G, Weintraub D, Irwin D, Grossman M, Wolk DA, Trojanowski JQ, Bannach O, Chen-Plotkin A, Willbold D. Quantitative detection of α-Synuclein and Tau oligomers and other aggregates by digital single particle counting. NPJ Parkinsons Dis 2022; 8:68. [PMID: 35655068 PMCID: PMC9163356 DOI: 10.1038/s41531-022-00330-x] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 05/10/2022] [Indexed: 12/13/2022] Open
Abstract
The pathological hallmark of neurodegenerative diseases is the formation of toxic oligomers by proteins such as alpha-synuclein (aSyn) or microtubule-associated protein tau (Tau). Consequently, such oligomers are promising biomarker candidates for diagnostics as well as drug development. However, measuring oligomers and other aggregates in human biofluids is still challenging as extreme sensitivity and specificity are required. We previously developed surface-based fluorescence intensity distribution analysis (sFIDA) featuring single-particle sensitivity and absolute specificity for aggregates. In this work, we measured aSyn and Tau aggregate concentrations of 237 cerebrospinal fluid (CSF) samples from five cohorts: Parkinson’s disease (PD), dementia with Lewy bodies (DLB), Alzheimer’s disease (AD), progressive supranuclear palsy (PSP), and a neurologically-normal control group. aSyn aggregate concentration discriminates PD and DLB patients from normal controls (sensitivity 73%, specificity 65%, area under the receiver operating curve (AUC) 0.68). Tau aggregates were significantly elevated in PSP patients compared to all other groups (sensitivity 87%, specificity 70%, AUC 0.76). Further, we found a tight correlation between aSyn and Tau aggregate titers among all patient cohorts (Pearson coefficient of correlation r = 0.81). Our results demonstrate that aSyn and Tau aggregate concentrations measured by sFIDA differentiate neurodegenerative disease diagnostic groups. Moreover, sFIDA-based Tau aggregate measurements might be particularly useful in distinguishing PSP from other parkinsonisms. Finally, our findings suggest that sFIDA can improve pre-clinical and clinical studies by identifying those individuals that will most likely respond to compounds designed to eliminate specific oligomers or to prevent their formation.
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Affiliation(s)
- Lara Blömeke
- Institute of Biological Information Processing (Structural Biochemistry: IBI-7), Forschungszentrum Jülich, 52428, Jülich, Germany.,attyloid GmbH, 40225, Düsseldorf, Germany
| | - Marlene Pils
- attyloid GmbH, 40225, Düsseldorf, Germany.,Institut für Physikalische Biologie, Heinrich-Heine-Universität Düsseldorf, 40225, Düsseldorf, Germany
| | - Victoria Kraemer-Schulien
- Institute of Biological Information Processing (Structural Biochemistry: IBI-7), Forschungszentrum Jülich, 52428, Jülich, Germany
| | - Alexandra Dybala
- attyloid GmbH, 40225, Düsseldorf, Germany.,Institut für Physikalische Biologie, Heinrich-Heine-Universität Düsseldorf, 40225, Düsseldorf, Germany
| | - Anja Schaffrath
- Institute of Biological Information Processing (Structural Biochemistry: IBI-7), Forschungszentrum Jülich, 52428, Jülich, Germany
| | - Andreas Kulawik
- Institute of Biological Information Processing (Structural Biochemistry: IBI-7), Forschungszentrum Jülich, 52428, Jülich, Germany.,attyloid GmbH, 40225, Düsseldorf, Germany.,Institut für Physikalische Biologie, Heinrich-Heine-Universität Düsseldorf, 40225, Düsseldorf, Germany
| | - Fabian Rehn
- Institute of Biological Information Processing (Structural Biochemistry: IBI-7), Forschungszentrum Jülich, 52428, Jülich, Germany
| | - Anneliese Cousin
- Institute of Biological Information Processing (Structural Biochemistry: IBI-7), Forschungszentrum Jülich, 52428, Jülich, Germany
| | - Volker Nischwitz
- Central Institute for Engineering, Electronics and Analytics, Analytics (ZEA-3), Forschungszentrum Jülich, 52428, Jülich, Germany
| | - Johannes Willbold
- Institute of Biological Information Processing (Structural Biochemistry: IBI-7), Forschungszentrum Jülich, 52428, Jülich, Germany
| | - Rebecca Zack
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas F Tropea
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Tuyen Bujnicki
- Institute of Biological Information Processing (Structural Biochemistry: IBI-7), Forschungszentrum Jülich, 52428, Jülich, Germany
| | - Gültekin Tamgüney
- Institute of Biological Information Processing (Structural Biochemistry: IBI-7), Forschungszentrum Jülich, 52428, Jülich, Germany.,Institut für Physikalische Biologie, Heinrich-Heine-Universität Düsseldorf, 40225, Düsseldorf, Germany
| | - Daniel Weintraub
- Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease and Mental Illness Research, Education, and Clinical Centers, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - David Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David A Wolk
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John Q Trojanowski
- Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Oliver Bannach
- Institute of Biological Information Processing (Structural Biochemistry: IBI-7), Forschungszentrum Jülich, 52428, Jülich, Germany.,attyloid GmbH, 40225, Düsseldorf, Germany.,Institut für Physikalische Biologie, Heinrich-Heine-Universität Düsseldorf, 40225, Düsseldorf, Germany
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dieter Willbold
- Institute of Biological Information Processing (Structural Biochemistry: IBI-7), Forschungszentrum Jülich, 52428, Jülich, Germany. .,Institut für Physikalische Biologie, Heinrich-Heine-Universität Düsseldorf, 40225, Düsseldorf, Germany.
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Cervantes González A, Irwin DJ, Alcolea D, McMillan CT, Chen-Plotkin A, Wolk D, Sirisi S, Dols-Icardo O, Querol-Vilaseca M, Illán-Gala I, Santos-Santos MA, Fortea J, Lee EB, Trojanowski JQ, Grossman M, Lleó A, Belbin O. Multimarker synaptic protein cerebrospinal fluid panels reflect TDP-43 pathology and cognitive performance in a pathological cohort of frontotemporal lobar degeneration. Mol Neurodegener 2022; 17:29. [PMID: 35395770 PMCID: PMC8991834 DOI: 10.1186/s13024-022-00534-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 09/13/2021] [Accepted: 03/30/2022] [Indexed: 12/13/2022] Open
Abstract
Background Synapse degeneration is an early event in pathological frontotemporal lobar degeneration (FTLD). Consequently, a surrogate marker of synapse loss could be used to monitor early pathologic changes in patients with underlying FTLD. The aim of this study was to evaluate the relationship of antemortem cerebrospinal fluid (CSF) levels of 8 synaptic proteins with postmortem global tau and TDP-43 burden and cognitive performance and to assess their diagnostic capacity in a neuropathological FTLD cohort. Methods We included patients with a neuropathological confirmation of FTLD-Tau (n = 24, mean age-at-CSF 67 years ± 11), FTLD-TDP (n = 25, 66 years ± 9) or AD (n = 25, 73 years ± 6) as well as cognitively normal controls (n = 35, 69 years ± 7) from the Penn FTD Center and ADRC. We used a semi-quantitative measure of tau and TDP-43 inclusions to quantify pathological burden across 16 brain regions. Statistical methods included Spearman rank correlations, one-way analysis of covariance, ordinal regression, step-wise multiple linear regression and receiver-operating characteristic curves. Result CSF calsyntenin-1 and neurexin-2a were correlated in all patient groups (rs = .55 to .88). In FTLD-TDP, we observed low antemortem CSF levels of calsyntenin-1 and neurexin-2a compared to AD (.72-fold, p = .001, .77-fold, p = .04, respectively) and controls (.80-fold, p = .02, .78-fold, p = .02, respectively), which were inversely associated with post-mortem global TDP-43 burden (regression r2 = .56, p = .007 and r2 = .57, p = .006, respectively). A multimarker panel including calsyntenin-1 was associated with TDP-43 burden (r2 = .69, p = .003) and MMSE score (r2 = .19, p = .03) in FTLD. A second multimarker synaptic panel, also including calsyntenin-1, was associated with MMSE score in FTLD-tau (r2 = .49, p = .04) and improved diagnostic performance to discriminate FTLD-Tau and FTLD-TDP neuropathologic subtypes (AUC = .83). Conclusion These synaptic panels have potential in the differential diagnosis of FTLD neuropathologic subtypes and as surrogate markers of cognitive performance in future clinical trials targeting TDP-43 or tau. Supplementary Information The online version contains supplementary material available at 10.1186/s13024-022-00534-y.
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Affiliation(s)
- Alba Cervantes González
- Hospital de La Santa Creu I Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain.,Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Memory Unit and Biomedical Research Institute, IIB Sant Pau, c/Sant Quintí 77, 08041, Barcelona, Spain
| | - David J Irwin
- Penn FTD Center, Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel Alcolea
- Hospital de La Santa Creu I Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain.,Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Memory Unit and Biomedical Research Institute, IIB Sant Pau, c/Sant Quintí 77, 08041, Barcelona, Spain
| | - Corey T McMillan
- Penn FTD Center, Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Alice Chen-Plotkin
- Penn Alzheimer's Disease Research Center, Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - David Wolk
- Penn Alzheimer's Disease Research Center, Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Sònia Sirisi
- Hospital de La Santa Creu I Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain.,Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Memory Unit and Biomedical Research Institute, IIB Sant Pau, c/Sant Quintí 77, 08041, Barcelona, Spain
| | - Oriol Dols-Icardo
- Hospital de La Santa Creu I Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain.,Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Memory Unit and Biomedical Research Institute, IIB Sant Pau, c/Sant Quintí 77, 08041, Barcelona, Spain
| | - Marta Querol-Vilaseca
- Hospital de La Santa Creu I Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain.,Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Memory Unit and Biomedical Research Institute, IIB Sant Pau, c/Sant Quintí 77, 08041, Barcelona, Spain
| | - Ignacio Illán-Gala
- Hospital de La Santa Creu I Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain.,Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Memory Unit and Biomedical Research Institute, IIB Sant Pau, c/Sant Quintí 77, 08041, Barcelona, Spain
| | - Miguel Angel Santos-Santos
- Hospital de La Santa Creu I Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain.,Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Memory Unit and Biomedical Research Institute, IIB Sant Pau, c/Sant Quintí 77, 08041, Barcelona, Spain
| | - Juan Fortea
- Hospital de La Santa Creu I Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain.,Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Memory Unit and Biomedical Research Institute, IIB Sant Pau, c/Sant Quintí 77, 08041, Barcelona, Spain
| | - Edward B Lee
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - John Q Trojanowski
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Murray Grossman
- Penn FTD Center, Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Alberto Lleó
- Hospital de La Santa Creu I Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain.,Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Memory Unit and Biomedical Research Institute, IIB Sant Pau, c/Sant Quintí 77, 08041, Barcelona, Spain
| | - Olivia Belbin
- Hospital de La Santa Creu I Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain. .,Centre of Biomedical Investigation Network for Neurodegenerative Diseases (CIBERNED), Madrid, Spain. .,Memory Unit and Biomedical Research Institute, IIB Sant Pau, c/Sant Quintí 77, 08041, Barcelona, Spain.
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Li R, Tropea TF, Baratta LR, Zuroff L, Diaz-Ortiz ME, Zhang B, Shinoda K, Rezk A, Alcalay RN, Chen-Plotkin A, Bar-Or A. Abnormal B-Cell and Tfh-Cell Profiles in Patients With Parkinson Disease: A Cross-sectional Study. Neurol Neuroimmunol Neuroinflamm 2022; 9:9/2/e1125. [PMID: 34955458 PMCID: PMC8711073 DOI: 10.1212/nxi.0000000000001125] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 11/09/2021] [Indexed: 12/22/2022]
Abstract
Background and Objectives There has been growing interest in potential roles of the immune system in the pathogenesis of Parkinson disease (PD). The aim of the current study was to comprehensively characterize phenotypic and functional profiles of circulating immune cells in patients with PD vs controls. Methods Peripheral blood was collected from patients with PD and age- and sex-matched neurologically normal controls (NCs) in 2 independent cohorts (discovery and validation). Comprehensive multicolor flow cytometry was performed on whole blood leukocytes and peripheral blood mononuclear cells to characterize different immune subsets and their ex vivo responses. Results The discovery cohort included 17 NCs and 12 participants with PD, and the validation cohort included 18 NCs and 18 participants with PD. Among major immune cell types, B cells appeared to be preferentially affected in PD. Proliferating B cell counts were decreased in patients with PD compared with controls. Proportions of B-cell subsets with regulatory capacity such as transitional B cells were preferentially reduced in the patients with PD, whereas proportions of proinflammatory cytokine-producing B cells increased, resulting in a proinflammatory shift of their B-cell functional cytokine responses. Unsupervised principal component analysis revealed increased expression of TNFα and GM-CSF by both B cells and T cells of patients with PD. In addition, levels of follicular T cells, an important B-cell helper T-cell population, decreased in the patients with PD, correlating with their B-cell abnormality. Discussion Our findings define a novel signature of peripheral immune cells and implicate aberrant Tfh:B-cell interactions in patients with PD.
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Affiliation(s)
- Rui Li
- From the The Center for Neuroinflammation and Neurotherapeutics and the Department of Neurology (R.L., L.Z., K.S., A.R., A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Neurology (T.F.T., L.R.B., M.E.D.-O., A.C-P.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Bioengineering (M.E.D.-O.), School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia; Department of Cardiology (B.Z.), the Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China; Department of Neurology (R.N.A.), Columbia University, New York, NY
| | - Thomas Francis Tropea
- From the The Center for Neuroinflammation and Neurotherapeutics and the Department of Neurology (R.L., L.Z., K.S., A.R., A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Neurology (T.F.T., L.R.B., M.E.D.-O., A.C-P.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Bioengineering (M.E.D.-O.), School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia; Department of Cardiology (B.Z.), the Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China; Department of Neurology (R.N.A.), Columbia University, New York, NY
| | - Laura Rosa Baratta
- From the The Center for Neuroinflammation and Neurotherapeutics and the Department of Neurology (R.L., L.Z., K.S., A.R., A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Neurology (T.F.T., L.R.B., M.E.D.-O., A.C-P.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Bioengineering (M.E.D.-O.), School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia; Department of Cardiology (B.Z.), the Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China; Department of Neurology (R.N.A.), Columbia University, New York, NY
| | - Leah Zuroff
- From the The Center for Neuroinflammation and Neurotherapeutics and the Department of Neurology (R.L., L.Z., K.S., A.R., A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Neurology (T.F.T., L.R.B., M.E.D.-O., A.C-P.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Bioengineering (M.E.D.-O.), School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia; Department of Cardiology (B.Z.), the Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China; Department of Neurology (R.N.A.), Columbia University, New York, NY
| | - Maria E Diaz-Ortiz
- From the The Center for Neuroinflammation and Neurotherapeutics and the Department of Neurology (R.L., L.Z., K.S., A.R., A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Neurology (T.F.T., L.R.B., M.E.D.-O., A.C-P.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Bioengineering (M.E.D.-O.), School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia; Department of Cardiology (B.Z.), the Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China; Department of Neurology (R.N.A.), Columbia University, New York, NY
| | - Bo Zhang
- From the The Center for Neuroinflammation and Neurotherapeutics and the Department of Neurology (R.L., L.Z., K.S., A.R., A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Neurology (T.F.T., L.R.B., M.E.D.-O., A.C-P.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Bioengineering (M.E.D.-O.), School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia; Department of Cardiology (B.Z.), the Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China; Department of Neurology (R.N.A.), Columbia University, New York, NY
| | - Koji Shinoda
- From the The Center for Neuroinflammation and Neurotherapeutics and the Department of Neurology (R.L., L.Z., K.S., A.R., A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Neurology (T.F.T., L.R.B., M.E.D.-O., A.C-P.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Bioengineering (M.E.D.-O.), School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia; Department of Cardiology (B.Z.), the Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China; Department of Neurology (R.N.A.), Columbia University, New York, NY
| | - Ayman Rezk
- From the The Center for Neuroinflammation and Neurotherapeutics and the Department of Neurology (R.L., L.Z., K.S., A.R., A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Neurology (T.F.T., L.R.B., M.E.D.-O., A.C-P.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Bioengineering (M.E.D.-O.), School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia; Department of Cardiology (B.Z.), the Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China; Department of Neurology (R.N.A.), Columbia University, New York, NY
| | - Roy N Alcalay
- From the The Center for Neuroinflammation and Neurotherapeutics and the Department of Neurology (R.L., L.Z., K.S., A.R., A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Neurology (T.F.T., L.R.B., M.E.D.-O., A.C-P.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Bioengineering (M.E.D.-O.), School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia; Department of Cardiology (B.Z.), the Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China; Department of Neurology (R.N.A.), Columbia University, New York, NY
| | - Alice Chen-Plotkin
- From the The Center for Neuroinflammation and Neurotherapeutics and the Department of Neurology (R.L., L.Z., K.S., A.R., A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Neurology (T.F.T., L.R.B., M.E.D.-O., A.C-P.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Bioengineering (M.E.D.-O.), School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia; Department of Cardiology (B.Z.), the Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China; Department of Neurology (R.N.A.), Columbia University, New York, NY
| | - Amit Bar-Or
- From the The Center for Neuroinflammation and Neurotherapeutics and the Department of Neurology (R.L., L.Z., K.S., A.R., A.B.-O.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Neurology (T.F.T., L.R.B., M.E.D.-O., A.C-P.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Bioengineering (M.E.D.-O.), School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia; Department of Cardiology (B.Z.), the Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China; Department of Neurology (R.N.A.), Columbia University, New York, NY.
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18
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Gallagher J, Rick J, Xie SX, Martinez-Martin P, Mamikonyan E, Chen-Plotkin A, Dahodwala N, Morley J, Duda JE, Trojanowski JQ, Siderowf A, Weintraub D. Psychometric Properties of the Clinical Dementia Rating Scale Sum of Boxes in Parkinson's Disease. J Parkinsons Dis 2021; 11:737-745. [PMID: 33386814 PMCID: PMC8058172 DOI: 10.3233/jpd-202390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND A composite measure that assesses both cognitive and functional abilities in Parkinson's disease (PD) would be useful for diagnosing mild cognitive impairment (MCI) and PD dementia (PDD) and as an outcome measure in randomized controlled trials. The Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) was designed to assess both cognition and basic-instrumental activities of daily living in Alzheimer's disease but has not yet been validated in PD. OBJECTIVE To validate the CDR-SOB as a composite cognitive-functional measure for PD patients, as well as to assess its sensitivity to change. METHODS The CDR-SOB and a comprehensive cognitive and functional battery was administered to 101 PD patients at baseline (39 normal cognition [NC], 41 MCI and 21 PDD by expert consensus panel), and re-administered to 64 patients after 1-2 years follow-up (32 NC and 32 cognitive impairment [CI] at baseline). RESULTS Cross-sectionally, CDR-SOB and domain scores were correlated with corresponding neuropsychological or functional measures and were significantly different between cognitive subgroups both at baseline and at follow-up. In addition, CDR-SOB ROC curves distinguished between normal cognition and dementia with high sensitivity, but did not distinguish well between NC and MCI. Longitudinal changes in the CDR-SOB and domain scores were not significant and were inconsistent in predicting change in commonly-used cognitive and functional tests. CONCLUSION The CDR-SOB detects dementia-level cognitive impairment in PD but may not be appropriate for predicting longitudinal combined cognitive-functional changes in patients without significant cognitive impairment at baseline.
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Affiliation(s)
- Julia Gallagher
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Jacqueline Rick
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Sharon X Xie
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Eugenia Mamikonyan
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Nabila Dahodwala
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - James Morley
- Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veteran's Affairs Medical Center, Philadelphia, PA, USA
| | - John E Duda
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veteran's Affairs Medical Center, Philadelphia, PA, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew Siderowf
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel Weintraub
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veteran's Affairs Medical Center, Philadelphia, PA, USA
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19
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Howard E, Irwin DJ, Rascovsky K, Nevler N, Shellikeri S, Tropea TF, Spindler M, Deik A, Chen-Plotkin A, Siderowf A, Dahodwala N, Weintraub D, Shaw LM, Trojanowski JQ, Vaishnavi SN, Wolk DA, Mechanic-Hamilton D, Morley JF, Duda JE, Grossman M, Cousins KAQ. Cognitive Profile and Markers of Alzheimer Disease-Type Pathology in Patients With Lewy Body Dementias. Neurology 2021; 96:e1855-e1864. [PMID: 33593865 PMCID: PMC8105963 DOI: 10.1212/wnl.0000000000011699] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 07/09/2020] [Accepted: 01/06/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To determine whether patients with Lewy body dementia (LBD) with likely Alzheimer disease (AD)-type copathology are more impaired on confrontation naming than those without likely AD-type copathology. METHODS We selected 57 patients with LBD (dementia with Lewy bodies [DLB], n = 38; Parkinson disease dementia [PDD], n = 19) with available AD CSF biomarkers and neuropsychological data. CSF β-amyloid1-42 (Aβ42), phosphorylated-tau (p-tau), and total-tau (t-tau) concentrations were measured. We used an autopsy-validated CSF cut point (t-tau:Aβ42 ratio > 0.3, n = 43), or autopsy data when available (n = 14), to categorize patients as having LBD with (LBD + AD, n = 26) and without (LBD - AD, n = 31) likely AD-type copathology. Analysis of covariance tested between-group comparisons across biologically defined groups (LBD + AD, LBD - AD) and clinical phenotypes (DLB, PDD) on confrontation naming (30-item Boston Naming Test [BNT]), executive abilities (letter fluency [LF], reverse digit span [RDS]), and global cognition (Mini-Mental State Examination [MMSE]), with adjustment for age at dementia onset, time from dementia onset to test date, and time from CSF to test date. Spearman correlation related cognitive performance to CSF analytes. RESULTS Patients with LBD + AD performed worse on BNT than patients with LBD - AD (F = 4.80, p = 0.03); both groups performed similarly on LF, RDS, and MMSE (all p > 0.1). Clinically defined PDD and DLB groups did not differ in performance on any of these measures (all p > 0.05). A correlation across all patients showed that BNT score was negatively associated with CSF t-tau (ρ = -0.28, p < 0.05) and p-tau (ρ = -0.26, p = 0.05) but not Aβ42 (p > 0.1). CONCLUSION Markers of AD-type copathology are implicated in impaired language performance in LBD. Biologically based classification of LBD may be advantageous over clinically defined syndromes to elucidate clinical heterogeneity.
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Affiliation(s)
- Erica Howard
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - David J Irwin
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Katya Rascovsky
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Naomi Nevler
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Sanjana Shellikeri
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Thomas F Tropea
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Meredith Spindler
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Andres Deik
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Alice Chen-Plotkin
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Andrew Siderowf
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Nabila Dahodwala
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Daniel Weintraub
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Leslie M Shaw
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - John Q Trojanowski
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Sanjeev N Vaishnavi
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - David A Wolk
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Dawn Mechanic-Hamilton
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - James F Morley
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - John E Duda
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Murray Grossman
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA
| | - Katheryn A Q Cousins
- From the Department of Neurology (E.H., D.J.I., K.R., N.N., S.S., T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W., S.N.V., D.A.W., D.M.-H., J.F.M., J.E.D., M.G., K.A.Q.C.), Frontotemporal Degeneration Center (E.H., D.J.I., K.R., N.N., S.S., M.G., K.A.Q.C.), Parkinson's Disease and Movement Disorders Center (T.F.T., M.S., A.D., A.C.-P., A.S., N.D., D.W.), Digital Neuropathology Laboratory (D.J.I.), Alzheimer's Disease Center (J.Q.T., S.N.V., D.A.W., D.M.-H.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), and Department of Pathology and Laboratory Medicine (L.M.S., J.Q.T., D.A.W.), Perelman School of Medicine at the University of Pennsylvania; and Michael J. Crescenz VA Medical Center (D.W., J.F.M., J.E.D.), Parkinson's Disease Research, Education, and Clinical Center, Philadelphia, PA.
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Tropea TF, Amari N, Han N, Rick J, Suh E, Akhtar RS, Dahodwala N, Deik A, Gonzalez-Alegre P, Hurtig H, Siderowf A, Spindler M, Stern M, Thenganatt MA, Weintraub D, Willis AW, Van Deerlin V, Chen-Plotkin A. Whole Clinic Research Enrollment in Parkinson's Disease: The Molecular Integration in Neurological Diagnosis (MIND) Study. J Parkinsons Dis 2021; 11:757-765. [PMID: 33492247 PMCID: PMC8058284 DOI: 10.3233/jpd-202406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Observational studies in Parkinson's disease (PD) have focused on relatively small numbers of research participants who are studied extensively. The Molecular Integration in Neurological Diagnosis Initiative at the University of Pennsylvania aims to characterize molecular and clinical features of PD in every patient in a large academic center. OBJECTIVE To determine the feasibility and interest in a global-capture biomarker research protocol. Additionally, to describe the clinical characteristics and GBA and LRRK2 variant carrier status among participants. METHODS All patients at UPenn with a clinical diagnosis of PD were eligible. Informed consent included options for access to the medical record, future recontact, and use of biosamples for additional studies. A blood sample and a completed questionnaire were obtained from participants. Targeted genotyping for four GBA and eight LRRK2 variants was performed, with plasma and DNA banked for future research. RESULTS Between September 2018 and December 2019, 704 PD patients were approached for enrollment; 652 (92.6%) enrolled, 28 (3.97%) declined, and 24 (3.41%) did not meet eligibility criteria. Median age was 69 (IQR 63_75) years, disease duration was 5.41 (IQR 2.49_9.95) years, and 11.10%of the cohort was non-white. Disease risk-associated variants in GBA were identified in 39 participants (5.98%) and in LRRK2 in 16 participants (2.45%). CONCLUSIONS We report the clinical and genetic characteristics of PD patients in an all-comers, global capture protocol from an academic center. Patient interest in participation and yield for identification of GBA and LRRK2 mutation carriers is high, demonstrating feasibility of PD clinic-wide molecular characterization.
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Affiliation(s)
- Thomas F. Tropea
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Noor Amari
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Noah Han
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jacqueline Rick
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - EunRan Suh
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rizwan S. Akhtar
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nabila Dahodwala
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andres Deik
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Pedro Gonzalez-Alegre
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Howard Hurtig
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew Siderowf
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Meredith Spindler
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Matthew Stern
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mary Ann Thenganatt
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel Weintraub
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Parkinson’s Disease Research, Education and Clinical Centers (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Allison W. Willis
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Vivianna Van Deerlin
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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21
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Zhang JV, Irwin DJ, Blennow K, Zetterberg H, Lee EB, Shaw LM, Rascovsky K, Massimo L, McMillan CT, Chen-Plotkin A, Elman L, Lee VMY, McCluskey L, Toledo JB, Weintraub D, Wolk D, Trojanowski JQ, Grossman M. Neurofilament Light Chain Related to Longitudinal Decline in Frontotemporal Lobar Degeneration. Neurol Clin Pract 2020; 11:105-116. [PMID: 33842063 DOI: 10.1212/cpj.0000000000000959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/06/2020] [Indexed: 11/15/2022]
Abstract
Objective Accurate diagnosis and prognosis of frontotemporal lobar degeneration (FTLD) during life is an urgent concern in the context of emerging disease-modifying treatment trials. Few CSF markers have been validated longitudinally in patients with known pathology, and we hypothesized that CSF neurofilament light chain (NfL) would be associated with longitudinal cognitive decline in patients with known FTLD-TAR DNA binding protein ~43kD (TDP) pathology. Methods This case-control study evaluated CSF NfL, total tau, phosphorylated tau, and β-amyloid1-42 in patients with known FTLD-tau or FTLD-TDP pathology (n = 50) and healthy controls (n = 65) and an extended cohort of clinically diagnosed patients with likely FTLD-tau or FTLD-TDP (n = 148). Regression analyses related CSF analytes to longitudinal cognitive decline (follow-up ∼1 year), controlling for demographic variables and core AD CSF analytes. Results In FTLD-TDP with known pathology, CSF NfL is significantly elevated compared with controls and significantly associated with longitudinal decline on specific executive and language measures, after controlling for age, disease duration, and core AD CSF analytes. Similar findings are found in the extended cohort, also including clinically identified likely FTLD-TDP. Although CSF NfL is elevated in FTLD-tau compared with controls, the association between NfL and longitudinal cognitive decline is limited to executive measures. Conclusion CSF NfL is associated with longitudinal clinical decline in relevant cognitive domains in patients with FTLD-TDP after controlling for demographic factors and core AD CSF analytes and may also be related to longitudinal decline in executive functioning in FTLD-tau.
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Affiliation(s)
- Jiasi Vicky Zhang
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - David J Irwin
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Kaj Blennow
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Henrik Zetterberg
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Edward B Lee
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Leslie M Shaw
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Lauren Massimo
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Corey T McMillan
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Alice Chen-Plotkin
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Lauren Elman
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Virginia M-Y Lee
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Leo McCluskey
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Jon B Toledo
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Daniel Weintraub
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - David Wolk
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - John Q Trojanowski
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center (JVZ, DJI, KR, L. Massimo, CTM, MG) and Department of Neurology (DJI, KR, L. Massimo, CTM, AC-P, LE, L. McCluskey, D. Wolk, MG), Department of Pathology and Laboratory Medicine and Center for Neurodegenerative Disease Research (EBL, LMS, VM-YL, JBT, JQT), Department of Psychiatry (D. Weintraub), University of Pennsylvania, Philadelphia; Institute of Neuroscience and Physiology (KB, HZ), Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory (KB, HZ), Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL (HZ); and Department of Neurodegenerative Disease (HZ), UCL Institute of Neurology, UK
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22
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Breazzano MP, Shen J, Abdelhakim AH, Glass LRD, Horowitz JD, Xie SX, de Moraes CG, Chen-Plotkin A, Chen RW. New York City COVID-19 resident physician exposure during exponential phase of pandemic. J Clin Invest 2020; 130:4726-4733. [PMID: 32463802 PMCID: PMC7456242 DOI: 10.1172/jci139587] [Citation(s) in RCA: 58] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/21/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUNDFrom March 2, 2020, to April 12, 2020, New York City (NYC) experienced exponential growth of the COVID-19 pandemic due to novel coronavirus (SARS-CoV-2). Little is known regarding how physicians have been affected. We aimed to characterize the COVID-19 impact on NYC resident physicians.METHODSIRB-exempt and expedited cross-sectional analysis through survey to NYC residency program directors April 3-12, 2020, encompassing events from March 2, 2020, to April 12, 2020.RESULTSFrom an estimated 340 residency programs around NYC, recruitment yielded 91 responses, representing 24 specialties and 2306 residents. In 45.1% of programs, at least 1 resident with confirmed COVID-19 was reported. One hundred one resident physicians were confirmed COVID-19-positive, with an additional 163 residents presumed positive for COVID-19 based on symptoms but awaiting or unable to obtain testing. Two COVID-19-positive residents were hospitalized, with 1 in intensive care. Among specialties with more than 100 residents represented, negative binomial regression indicated that infection risk differed by specialty (P = 0.039). In 80% of programs, quarantining a resident was reported. Ninety of 91 programs reported reuse or extended mask use, and 43 programs reported that personal protective equipment (PPE) was suboptimal. Sixty-five programs (74.7%) redeployed residents elsewhere to support COVID-19 efforts.CONCLUSIONMany resident physicians around NYC have been affected by COVID-19 through direct infection, quarantine, or redeployment. Lack of access to testing and concern regarding suboptimal PPE are common among residency programs. Infection risk may differ by specialty.FUNDINGNational Eye Institute Core Grant P30EY019007; Research to Prevent Blindness Unrestricted Grant; Parker Family Chair; University of Pennsylvania.
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Affiliation(s)
- Mark P. Breazzano
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA
- Department of Ophthalmology, New York University School of Medicine, New York University Langone Health, New York, New York, USA
- Manhattan Eye, Ear and Throat Hospital, Lenox Hill Hospital, Northwell Health, New York, New York, USA
| | | | - Aliaa H. Abdelhakim
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA
- Department of Ophthalmology, New York University School of Medicine, New York University Langone Health, New York, New York, USA
- Manhattan Eye, Ear and Throat Hospital, Lenox Hill Hospital, Northwell Health, New York, New York, USA
| | - Lora R. Dagi Glass
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA
| | - Jason D. Horowitz
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA
| | - Sharon X. Xie
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - C. Gustavo de Moraes
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA
| | | | - Royce W.S. Chen
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, USA
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23
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Purri R, Brennan L, Rick J, Xie SX, Deck BL, Chahine LM, Dahodwala N, Chen-Plotkin A, Duda JE, Morley JF, Akhtar RS, Trojanowski JQ, Siderowf A, Weintraub D. Subjective Cognitive Complaint in Parkinson's Disease Patients With Normal Cognition: Canary in the Coal Mine? Mov Disord 2020; 35:1618-1625. [PMID: 32520435 DOI: 10.1002/mds.28115] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [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: 01/24/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The objective of this study was to determine the frequency and impact of subjective cognitive complaint (SCC) in Parkinson's disease (PD) patients with normal cognition. METHODS Patients with PD with expert consensus-determined normal cognition at baseline were asked a single question regarding the presence of SCC. Baseline (N = 153) and longitudinal (up to 4 follow-up visits during a 5-year period; N = 121) between-group differences in patients with PD with (+SCC) and without (-SCC) cognitive complaint were examined, including cognitive test performance and self-rated and informant-rated functional abilities. RESULTS A total of 81 (53%) participants reported a cognitive complaint. There were no between-group differences in global cognition at baseline. Longitudinally, the +SCC group declined more than the -SCC group on global cognition (Mattis Dementia Rating Scale-2 total score, F1,431 = 5.71, P = 0.02), processing speed (Symbol Digit Modalities Test, F1,425 = 7.52, P = 0.006), and executive function (Trail Making Test Part B, F1,419 = 4.48, P = 0.04), although the results were not significant after correction for multiple testing. In addition, the +SCC group was more likely to progress to a diagnosis of cognitive impairment over time (hazard ratio = 2.61, P = 0.02). The +SCC group also demonstrated significantly lower self-reported and knowledgeable informant-reported cognition-related functional abilities at baseline, and declined more on an assessment of global functional abilities longitudinally. CONCLUSIONS Patients with PD with normal cognition, but with SCC, report poorer cognition-specific functional abilities, and are more likely to be diagnosed with cognitive impairment and experience global functional ability decline long term. These findings suggest that SCC and worse cognition-related functional abilities may be sensitive indicators of initial cognitive decline in PD. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Rachael Purri
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Laura Brennan
- Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Jacqueline Rick
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Sharon X Xie
- Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Benjamin L Deck
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
| | - Lana M Chahine
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nabila Dahodwala
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Alice Chen-Plotkin
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - John E Duda
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.,Parkinson's Disease Research, Education, and Clinical Center, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - James F Morley
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.,Parkinson's Disease Research, Education, and Clinical Center, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Rizwan S Akhtar
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Andrew Siderowf
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Daniel Weintraub
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.,Parkinson's Disease Research, Education, and Clinical Center, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.,Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
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24
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Breazzano MP, Shen J, Abdelhakim AH, Glass LRD, Horowitz JD, Xie SX, de Moraes CG, Chen-Plotkin A, Chen RWS. Resident physician exposure to novel coronavirus (2019-nCoV, SARS-CoV-2) within New York City during exponential phase of COVID-19 pandemic: Report of the New York City Residency Program Directors COVID-19 Research Group. medRxiv 2020:2020.04.23.20074310. [PMID: 32511652 PMCID: PMC7277008 DOI: 10.1101/2020.04.23.20074310] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background From March 2-April 12, 2020, New York City (NYC) experienced exponential growth of the COVID-19 pandemic due to novel coronavirus (SARS-CoV-2). Little is known regarding how physicians have been affected. We aimed to characterize COVID-19 impact on NYC resident physicians. Methods IRB-exempt and expedited cross-sectional analysis through survey to NYC residency program directors (PDs) April 3-12, 2020, encompassing events from March 2-April 12, 2020. Findings From an estimated 340 residency programs around NYC, recruitment yielded 91 responses, representing 24 specialties and 2,306 residents. 45.1% of programs reported at least one resident with confirmed COVID-19: 101 resident physicians were confirmed COVID-19-positive, with additional 163 residents presumed positive for COVID-19 based on symptoms but awaiting or unable to obtain testing. 56.5% of programs had a resident waiting for, or unable to obtain, COVID-19 testing. Two COVID-19-positive residents were hospitalized, with one in intensive care. Among specialties with >100 residents represented, negative binomial regression indicated that infection risk differed by specialty (p=0.039). Although most programs (80%) reported quarantining a resident, with 16.8% of residents experiencing quarantine, 14.9% of COVID-19-positive residents were not quarantined. 90 programs, encompassing 99.2% of the resident physicians, reported reuse or extended mask use, and 43 programs, encompassing 60.4% of residents, felt that personal protective equipment (PPE) was suboptimal. 65 programs (74.7%) have redeployed residents elsewhere to support COVID-19 efforts. Interpretation Many resident physicians around NYC have been affected by COVID-19 through direct infection, quarantine, or redeployment. Lack of access to testing and concern regarding suboptimal PPE are common among residency programs. Infection risk may differ by specialty. Funding AHA, MPB, RWSC, CGM, LRDG, and JDH are supported by NEI Core Grant P30EY019007, and unrestricted grant from RPB. ACP and JS are supported by Parker Family Chair. SXX is supported by University of Pennsylvania.
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25
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Olsson B, Portelius E, Cullen NC, Sandelius Å, Zetterberg H, Andreasson U, Höglund K, Irwin DJ, Grossman M, Weintraub D, Chen-Plotkin A, Wolk D, McCluskey L, Elman L, Shaw LM, Toledo JB, McBride J, Hernandez-Con P, Lee VMY, Trojanowski JQ, Blennow K. Association of Cerebrospinal Fluid Neurofilament Light Protein Levels With Cognition in Patients With Dementia, Motor Neuron Disease, and Movement Disorders. JAMA Neurol 2020; 76:318-325. [PMID: 30508027 DOI: 10.1001/jamaneurol.2018.3746] [Citation(s) in RCA: 146] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Importance Neuronal and axonal destruction are hallmarks of neurodegenerative diseases, but it is difficult to estimate the extent and progress of the damage in the disease process. Objective To investigate cerebrospinal fluid (CSF) levels of neurofilament light (NFL) protein, a marker of neuroaxonal degeneration, in control participants and patients with dementia, motor neuron disease, and parkinsonian disorders (determined by clinical criteria and autopsy), and determine its association with longitudinal cognitive decline. Design, Setting, and Participants In this case-control study, we investigated NFL levels in CSF obtained from controls and patients with several neurodegenerative diseases. Collection of samples occurred between 1996 and 2014, patients were followed up longitudinally for cognitive testing, and a portion were autopsied in a single center (University of Pennsylvania). Data were analyzed throughout 2016. Exposures Concentrations of NFL in CSF. Main Outcomes and Measures Levels of CSF NFL and correlations with cognition scores. Results A total of 913 participants (mean [SD] age, 68.7 [10.0] years; 456 [49.9%] women) were included: 75 control participants plus 114 patients with mild cognitive impairment (MCI), 397 with Alzheimer disease, 96 with frontotemporal dementia, 68 with amyotrophic lateral sclerosis, 41 with Parkinson disease (PD), 19 with PD with MCI, 29 with PD dementia, 33 with dementia with Lewy bodies, 21 with corticobasal syndrome, and 20 with progressive supranuclear palsy. Cognitive testing follow-up occurred for 1 to 18 years (mean [SD], 0.98 [2.25] years); autopsy-verified diagnoses were available for 120 of 845 participants with diseases (14.2%). There was a stepwise increase in CSF NFL levels between control participants (median [range] score, 536 [398-777] pg/mL), participants with MCI (831 [526-1075] pg/mL), and those with Alzheimer disease (951 [758-1261] pg/mL), indicating that NFL levels increase with increasing cognitive impairment. Levels of NFL correlated inversely with baseline Mini-Mental State Examination scores (ρ, -0.19; P < .001) in the full cohort (n = 822) and annual score decline in the full cohort (ρ, 0.36, P < .001), participants with AD (ρ, 0.25; P < .001), and participants with FTD (ρ, 0.46; P = .003). Concentrations of NFL were highest in participants with amyotrophic lateral sclerosis (median [range], 4185 [2207-7453] pg/mL) and frontotemporal dementia (2094 [230-7744] pg/mL). In individuals with parkinsonian disorders, NFL concentrations were highest in those with progressive supranuclear palsy (median [range], 1578 [1287-3104] pg/mL) and corticobasal degeneration (1281 [828-2713] pg/mL). The NFL concentrations in CSF correlated with TDP-43 load in 13 of 17 brain regions in the full cohort. Adding NFL to β-amyloid 42, total tau, and phosphorylated tau increased accuracy of discrimination of diseases. Conclusions and Relevance Levels of CSF NFL are associated with cognitive impairments in patients with Alzheimer disease and frontotemporal dementia. In other neurodegenerative disorders, NFL levels appear to reflect the intensity of the neurodegenerative processes.
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Affiliation(s)
- Bob Olsson
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Erik Portelius
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Nicholas C Cullen
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.,Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Åsa Sandelius
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Molecular Neuroscience, UCL Queen Square Institute of Neurology, London, United Kingdom.,United Kingdom Dementia Research Institute, London, United Kingdom
| | - Ulf Andreasson
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Kina Höglund
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - David J Irwin
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia
| | - Murray Grossman
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia
| | - Daniel Weintraub
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.,Parkinson's Disease Research, Education and Cinical Centers, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania.,Mental Illness Research, Education and Cinical Centers, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania
| | - Alice Chen-Plotkin
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia
| | - David Wolk
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia
| | - Leo McCluskey
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia
| | - Lauren Elman
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia
| | - Jon B Toledo
- Department of Pathology and Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia.,Department of Neurology, Houston Methodist Hospital, Houston, Texas
| | - Jennifer McBride
- Department of Pathology and Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia
| | - Pilar Hernandez-Con
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia
| | - Virginia M-Y Lee
- Department of Pathology and Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
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26
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Toledo JB, Kovacs G, Kvartsberg H, Portelius E, Chen-Plotkin A, Zetterberg H, Blennow K, Shaw LM, Trojanowski JQ. P1-245: CSF BIOMARKER CORRELATES OF ARTAG NEUROPATHOLOGY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.800] [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: 11/17/2022]
Affiliation(s)
| | | | - Hlin Kvartsberg
- The Sahlgrenska Academy, Institute of Neuroscience and Physiology; University of Gothenburg; Gothenburg Sweden
| | - Erik Portelius
- Institute of Neuroscience and Physiology; The Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
| | | | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry; The Sahlgrenska Academy at University of Gothenburg; Mölndal Sweden
- UCL Queen Square Institute of Neurology; London United Kingdom
| | - Kaj Blennow
- The Sahlgrenska Academy at the University of Gothenburg; Mölndal Sweden
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine; University of Pennsylvania; Philadelphia PA USA
| | - John Q. Trojanowski
- Perelman School of Medicine; University of Pennsylvania; Philadelphia PA USA
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27
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Deck BL, Xie SX, Choi G, Rick J, Siderowf A, Rudovsky S, Chen-Plotkin A, Duda JE, Morley JF, Dahodwala N, Trojanowski JQ, Weintraub D. Cognitive Functional Abilities in Parkinson's Disease: Agreement Between Patients and Informants. Mov Disord Clin Pract 2019; 6:440-445. [PMID: 31392244 DOI: 10.1002/mdc3.12781] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 03/22/2019] [Revised: 04/19/2019] [Accepted: 04/22/2019] [Indexed: 12/20/2022] Open
Abstract
Background The Penn Parkinson's Daily Activities Questionnaire-15 (PDAQ-15) assesses cognition-related instrumental activities of daily living (IADL) in Parkinson's disease (PD). Objectives To assess the degree and predictors of disagreement between patients (PT) and knowledgeable informants (KI) on the PDAQ-15. Methods We recruited 254 PT and KI pairs (PT-KI), determined predictors of agreement, and compared scores to a performance-based functional measure (Direct Assessment of Functional Status [DAFS]; N = 61). Results PT and KI total score (intraclass correlation = 0.57) and individual item (Cohen's kappa = 0.46-0.62) agreement were moderate. Patient depression, global cognition, and caregiver burden (all P < 0.05), predicted PT-KI discrepancy. PT-KI discrepancy was highest in patients with a dementia diagnosis, followed by mild cognitive impairment and then normal cognition (all P < 0.01), with PT rating themselves relatively more functionally intact as cognition worsened. DAFS performance was more highly correlated with KI (r = 0.82; P < 0.001) than PT (r = 0.62; P < 0.001) PDAQ-15 score. Conclusions Our results support using KI as proxies when assessing cognitive IADLs in PD PTs, particularly in cases of more advanced cognitive decline.
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Affiliation(s)
- Benjamin L Deck
- Departments of Neurology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA.,Department of Psychology Drexel University Philadelphia Pennsylvania USA
| | - Sharon X Xie
- Departments of Biostatistics, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - Gyujae Choi
- Department of Radiation Oncology Baylor College of Medicine Houston Texas USA
| | - Jacqueline Rick
- Departments of Neurology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - Andrew Siderowf
- Departments of Neurology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - Samuel Rudovsky
- Departments of Neurology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - Alice Chen-Plotkin
- Departments of Neurology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - John E Duda
- Departments of Neurology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA.,Michael J. Crescenz Veterans Affairs Medical Center, Parkinson's Disease Research Education and Clinical Center (PADRECC) Philadelphia Pennsylvania USA
| | - James F Morley
- Departments of Neurology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA.,Michael J. Crescenz Veterans Affairs Medical Center, Parkinson's Disease Research Education and Clinical Center (PADRECC) Philadelphia Pennsylvania USA
| | - Nabila Dahodwala
- Departments of Neurology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - John Q Trojanowski
- Departments of Pathology and Laboratory Medicine, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - Daniel Weintraub
- Departments of Neurology, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA.,Departments of Psychiatry, Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA.,Michael J. Crescenz Veterans Affairs Medical Center, Parkinson's Disease Research Education and Clinical Center (PADRECC) Philadelphia Pennsylvania USA
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28
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Chung CY, Berson A, Kennerdell JR, Sartoris A, Unger T, Porta S, Kim HJ, Smith ER, Shilatifard A, Van Deerlin V, Lee VMY, Chen-Plotkin A, Bonini NM. Aberrant activation of non-coding RNA targets of transcriptional elongation complexes contributes to TDP-43 toxicity. Nat Commun 2018; 9:4406. [PMID: 30353006 PMCID: PMC6199344 DOI: 10.1038/s41467-018-06543-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 09/11/2018] [Indexed: 12/13/2022] Open
Abstract
TDP-43 is the major disease protein associated with amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration with ubiquitinated inclusions (FTLD-TDP). Here we identify the transcriptional elongation factor Ell—a shared component of little elongation complex (LEC) and super elongation complex (SEC)—as a strong modifier of TDP-43-mediated neurodegeneration. Our data indicate select targets of LEC and SEC become upregulated in the fly ALS/FTLD-TDP model. Among them, U12 snRNA and a stress-induced long non-coding RNA Hsrω, functionally contribute to TDP-43-mediated degeneration. We extend the findings of Hsrω, which we identify as a chromosomal target of TDP-43, to show that the human orthologue Sat III is elevated in a human cellular disease model and FTLD-TDP patient tissue. We further demonstrate an interaction between TDP-43 and human ELL2 by co-immunoprecipitation from human cells. These findings reveal important roles of Ell-complexes LEC and SEC in TDP-43-associated toxicity, providing potential therapeutic insight for TDP-43-associated neurodegeneration. TDP-43 is associated with amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration with ubiquitinated inclusions (FTD-TDP). Here, the authors identify the transcriptional elongation factor Ell as a strong modifier of TDP-43-mediated neurodegeneration through the Ell transcriptional elongation complexes LEC and SEC.
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Affiliation(s)
- Chia-Yu Chung
- Department of Biology, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Cell and Molecular Biology Graduate Group, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Amit Berson
- Department of Biology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jason R Kennerdell
- Department of Biology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Ashley Sartoris
- Department of Biology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Travis Unger
- Department of Neurology, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Sílvia Porta
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Hyung-Jun Kim
- Department of Biology, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Department of Neural Development and Disease, Korea Brain Research Institute (KBRI), Daegu, 41068, South Korea
| | - Edwin R Smith
- Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Ali Shilatifard
- Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Vivianna Van Deerlin
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Virginia M-Y Lee
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Alice Chen-Plotkin
- Cell and Molecular Biology Graduate Group, Perelman School of Medicine, Philadelphia, PA, 19104, USA.,Department of Neurology, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Nancy M Bonini
- Department of Biology, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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29
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Portelius E, Olsson B, Höglund K, Cullen NC, Kvartsberg H, Andreasson U, Zetterberg H, Sandelius Å, Shaw LM, Lee VMY, Irwin DJ, Grossman M, Weintraub D, Chen-Plotkin A, Wolk DA, McCluskey L, Elman L, McBride J, Toledo JB, Trojanowski JQ, Blennow K. Cerebrospinal fluid neurogranin concentration in neurodegeneration: relation to clinical phenotypes and neuropathology. Acta Neuropathol 2018; 136:363-376. [PMID: 29700597 PMCID: PMC6096740 DOI: 10.1007/s00401-018-1851-x] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [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: 12/13/2017] [Revised: 04/19/2018] [Accepted: 04/21/2018] [Indexed: 12/14/2022]
Abstract
Neurogranin (Ng) is a post-synaptic protein that previously has been shown to be a biomarker for synaptic function when measured in cerebrospinal fluid (CSF). The CSF concentration of Ng is increased in Alzheimer’s disease dementia (ADD), and even in the pre-dementia stage. In this prospective study, we used an enzyme-linked immunosorbent assay that quantifies Ng in CSF to test the performance of Ng as a marker of synaptic function. In 915 patients, CSF Ng was evaluated across several different neurodegenerative diseases. Of these 915 patients, 116 had a neuropathologically confirmed definitive diagnosis and the relation between CSF Ng and topographical distribution of different pathologies in the brain was evaluated. CSF Ng was specifically increased in ADD compared to eight other neurodegenerative diseases, including Parkinson’s disease (p < 0.0001), frontotemporal dementia (p < 0.0001), and amyotrophic lateral sclerosis (p = 0.0002). Similar results were obtained in neuropathologically confirmed cases. Using a biomarker index to evaluate whether CSF Ng contributed diagnostic information to the core AD CSF biomarkers (amyloid β (Aβ), t-tau, and p-tau), we show that Ng significantly increased the discrimination between AD and several other disorders. Higher CSF Ng levels were positively associated with greater Aβ neuritic plaque (Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuritic plaque score, p = 0.0002) and tau tangle pathology (Braak neurofibrillary tangles staging, p = 0.0007) scores. In the hippocampus and amygdala, two brain regions heavily affected in ADD with high expression of Ng, CSF Ng was associated with plaque (p = 0.0006 and p < 0.0001), but not with tangle, α-synuclein, or TAR DNA-binding protein 43 loads. These data support that CSF Ng is increased specifically in ADD, that high CSF Ng concentrations likely reflect synaptic dysfunction and that CSF Ng is associated with β-amyloid plaque pathology.
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Affiliation(s)
- Erik Portelius
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, 431 80, Mölndal, Sweden.
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
| | - Bob Olsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, 431 80, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Kina Höglund
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, 431 80, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Nicholas C Cullen
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, 431 80, Mölndal, Sweden
| | - Hlin Kvartsberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, 431 80, Mölndal, Sweden
| | - Ulf Andreasson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, 431 80, 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, 431 80, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1E 6BT, UK
- UK Dementia Research Institute, London, WC1E 6BT, UK
| | - Åsa Sandelius
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, 431 80, Mölndal, Sweden
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Virginia M Y Lee
- Department of Pathology and Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - David J Irwin
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Murray Grossman
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Daniel Weintraub
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Parkinson's Disease and Mental Illness Research, Education and Clinical Centers (PADRECC and MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Alice Chen-Plotkin
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - David A Wolk
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Leo McCluskey
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Lauren Elman
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Jennifer McBride
- Department of Pathology and Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Jon B Toledo
- Department of Pathology and Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Neurology, Houston Methodist Hospital, Houston, TX, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, 431 80, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
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30
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Robinson JL, Lee EB, Xie SX, Rennert L, Suh E, Bredenberg C, Caswell C, Van Deerlin VM, Yan N, Yousef A, Hurtig HI, Siderowf A, Grossman M, McMillan CT, Miller B, Duda JE, Irwin DJ, Wolk D, Elman L, McCluskey L, Chen-Plotkin A, Weintraub D, Arnold SE, Brettschneider J, Lee VMY, Trojanowski JQ. Neurodegenerative disease concomitant proteinopathies are prevalent, age-related and APOE4-associated. Brain 2018; 141:2181-2193. [PMID: 29878075 PMCID: PMC6022546 DOI: 10.1093/brain/awy146] [Citation(s) in RCA: 393] [Impact Index Per Article: 65.5] [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: 12/01/2017] [Accepted: 04/06/2018] [Indexed: 12/11/2022] Open
Abstract
Lewy bodies commonly occur in Alzheimer's disease, and Alzheimer's disease pathology is frequent in Lewy body diseases, but the burden of co-pathologies across neurodegenerative diseases is unknown. We assessed the extent of tau, amyloid-β, α-synuclein and TDP-43 proteinopathies in 766 autopsied individuals representing a broad spectrum of clinical neurodegenerative disease. We interrogated pathological Alzheimer's disease (n = 247); other tauopathies (n = 95) including Pick's disease, corticobasal disease and progressive supranuclear palsy; the synucleinopathies (n = 164) including multiple system atrophy and Lewy body disease; the TDP-43 proteinopathies (n = 188) including frontotemporal lobar degeneration with TDP-43 inclusions and amyotrophic lateral sclerosis; and a minimal pathology group (n = 72). Each group was divided into subgroups without or with co-pathologies. Age and sex matched logistic regression models compared co-pathology prevalence between groups. Co-pathology prevalence was similar between the minimal pathology group and most neurodegenerative diseases for each proteinopathy: tau was nearly universal (92-100%), amyloid-β common (20-57%); α-synuclein less common (4-16%); and TDP-43 the rarest (0-16%). In several neurodegenerative diseases, co-pathology increased: in Alzheimer's disease, α-synuclein (41-55%) and TDP-43 (33-40%) increased; in progressive supranuclear palsy, α-synuclein increased (22%); in corticobasal disease, TDP-43 increased (24%); and in neocortical Lewy body disease, amyloid-β (80%) and TDP-43 (22%) increased. Total co-pathology prevalence varied across groups (27-68%), and was increased in high Alzheimer's disease, progressive supranuclear palsy, and neocortical Lewy body disease (70-81%). Increased age at death was observed in the minimal pathology group, amyotrophic lateral sclerosis, and multiple system atrophy cases with co-pathologies. In amyotrophic lateral sclerosis and neocortical Lewy body disease, co-pathologies associated with APOE ɛ4. Lewy body disease cases with Alzheimer's disease co-pathology had substantially lower Mini-Mental State Examination scores than pure Lewy body disease. Our data imply that increased age and APOE ɛ4 status are risk factors for co-pathologies independent of neurodegenerative disease; that neurodegenerative disease severity influences co-pathology as evidenced by the prevalence of co-pathology in high Alzheimer's disease and neocortical Lewy body disease, but not intermediate Alzheimer's disease or limbic Lewy body disease; and that tau and α-synuclein strains may also modify co-pathologies since tauopathies and synucleinopathies had differing co-pathologies and burdens. These findings have implications for clinical trials that focus on monotherapies targeting tau, amyloid-β, α-synuclein and TDP-43.
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Affiliation(s)
- John L Robinson
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Edward B Lee
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Sharon X Xie
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Biostatistics and Epidemiology, and Informatics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Lior Rennert
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Biostatistics and Epidemiology, and Informatics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - EunRan Suh
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Colin Bredenberg
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Carrie Caswell
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Biostatistics and Epidemiology, and Informatics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Vivianna M Van Deerlin
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Ning Yan
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- University-town Hospital of Chongqing Medical University, China
| | - Ahmed Yousef
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Howard I Hurtig
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Andrew Siderowf
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Murray Grossman
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Frontotemporal Degeneration Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Corey T McMillan
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Frontotemporal Degeneration Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Bruce Miller
- Memory and Aging Center, Department of Neurology, University of California at San Francisco, San Francisco, CA, USA
| | - John E Duda
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Parkinson's Disease Research, Education and Clinical Center, Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - David J Irwin
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Frontotemporal Degeneration Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - David Wolk
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Frontotemporal Degeneration Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Memory Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Lauren Elman
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Leo McCluskey
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Alice Chen-Plotkin
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Daniel Weintraub
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Steven E Arnold
- Translational Neurology Head of the Interdisciplinary Brain Center at Massachusetts General Hospital, Harvard Medical School
| | | | - Virginia M-Y Lee
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - John Q Trojanowski
- Penn Alzheimer's Disease Core Center, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Udall Center of Excellence in Parkinson's Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Penn Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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Deck BL, Rick J, Xie SX, Chen-Plotkin A, Duda JE, Morley JF, Chahine LM, Dahodwala N, Trojanowski JQ, Weintraub D. Statins and Cognition in Parkinson's Disease. J Parkinsons Dis 2018; 7:661-667. [PMID: 28922167 DOI: 10.3233/jpd-171113] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND The relationship between statins and cognition in Parkinson's disease (PD) is poorly understood. OBJECTIVES Analyses were performed to determine associations between statin use and cross-sectional and longitudinal cognitive performance in PD. METHODS Neuropsychological tests, medication logs, and ratings of functional abilities were collected from 313 PD participants longitudinally. RESULTS At baseline, statin users (SU; N = 129) were older, more likely male, and had shorter PD duration than non-statin users (NSU; N = 184). In Cross-sectional analysis, SU performed better on global cognition, Trails B, semantic fluency, and phonemic fluency tasks. Rate of long-term global cognitive (Dementia Rating Scale-2 and MoCA) decline was significantly less in SU.
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Affiliation(s)
- Benjamin L Deck
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jacqueline Rick
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sharon X Xie
- Department of Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John E Duda
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease Research, Education and Clinical Center (PADRECC), Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - James F Morley
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease Research, Education and Clinical Center (PADRECC), Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
| | - Lana M Chahine
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nabila Dahodwala
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel Weintraub
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease Research, Education and Clinical Center (PADRECC), Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
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Irwin DJ, Xie SX, Coughlin D, Nevler N, Akhtar RS, McMillan CT, Lee EB, Wolk DA, Weintraub D, Chen-Plotkin A, Duda JE, Spindler M, Siderowf A, Hurtig HI, Shaw LM, Grossman M, Trojanowski JQ. CSF tau and β-amyloid predict cerebral synucleinopathy in autopsied Lewy body disorders. Neurology 2018; 90:e1038-e1046. [PMID: 29467305 PMCID: PMC5874449 DOI: 10.1212/wnl.0000000000005166] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [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: 07/07/2017] [Accepted: 12/15/2017] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To test the association of antemortem CSF biomarkers with postmortem pathology in Lewy body disorders (LBD). METHODS Patients with autopsy-confirmed LBD (n = 24) and autopsy-confirmed Alzheimer disease (AD) (n = 23) and cognitively normal (n = 36) controls were studied. In LBD, neuropathologic criteria defined Lewy body α-synuclein (SYN) stages with medium/high AD copathology (SYN + AD = 10) and low/no AD copathology (SYN - AD = 14). Ordinal pathology scores for tau, β-amyloid (Aβ), and SYN pathology were averaged across 7 cortical regions to obtain a global cerebral score for each pathology. CSF total tau (t-tau), phosphorylated tau at threonine181, and Aβ1-42 levels were compared between LBD and control groups and correlated with global cerebral pathology scores in LBD with linear regression. Diagnostic accuracy for postmortem categorization of LBD into SYN + AD vs SYN - AD or neocortical vs brainstem/limbic SYN stage was tested with receiver operating curves. RESULTS SYN + AD had higher CSF t-tau (mean difference 27.0 ± 8.6 pg/mL) and lower Aβ1-42 (mean difference -84.0 ± 22.9 g/mL) compared to SYN - AD (p < 0.01, both). Increasing global cerebral tau and plaque scores were associated with higher CSF t-tau (R2 = 0.15-0.16, p < 0.05, both) and lower Aβ1-42 (R2 = 0.43-0.49, p < 0.001, both), while increasing cerebral SYN scores were associated with lower CSF Aβ1-42 (R2 = 0.31, p < 0.001) and higher CSF t-tau/Aβ1-42 ratio (R2 = 0.27, p = 0.01). CSF t-tau/Aβ1-42 ratio had 100% specificity and 90% sensitivity for SYN + AD, and CSF Aβ1-42 had 77% specificity and 82% sensitivity for neocortical SYN stage. CONCLUSIONS Higher antemortem CSF t-tau/Aβ1-42 and lower Aβ1-42 levels are predictive of increasing cerebral AD and SYN pathology. These biomarkers may identify patients with LBD vulnerable to cortical SYN pathology who may benefit from both SYN and AD-targeted disease-modifying therapies.
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Affiliation(s)
- David J Irwin
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA.
| | - Sharon X Xie
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - David Coughlin
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Naomi Nevler
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Rizwan S Akhtar
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Corey T McMillan
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Edward B Lee
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - David A Wolk
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Daniel Weintraub
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Alice Chen-Plotkin
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - John E Duda
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Meredith Spindler
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Andrew Siderowf
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Howard I Hurtig
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Leslie M Shaw
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Murray Grossman
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - John Q Trojanowski
- From Penn Frontotemporal Degeneration Center (D.J.I., N.N., C.T.M., M.G.), Alzheimer's Disease Core Center (D.A.W., J.Q.T.), Department of Neurology (D.J.I., D.C., R.S.A., C.T.M., D.A.W., D.W., A.C.-P., M.S., A.S., H.I.H., M.G.), Penn Morris K. Udall Parkinson's Disease Research Center of Excellence (D.J.I., R.S.A., C.T.M., D.W., A.C.-P., J.E.D., M.G., J.Q.T.), Center for Neurodegenerative Disease Research (L.M.S., J.Q.T.), Translational Neuropathology Research Laboratory (E.B.L.), Department of Pathology and Laboratory Medicine (E.B.L., L.M.S., J.Q.T.), and Department of Biostatistics and Epidemiology Perelman School of Medicine (S.X.X.), University of Pennsylvania; and Parkinson's Disease Research, Education and Clinical Center (D.W., J.E.D.), Michael J. Crescenz VA Medical Center, Philadelphia, PA
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Sheinerman KS, Toledo JB, Tsivinsky VG, Irwin D, Grossman M, Weintraub D, Hurtig HI, Chen-Plotkin A, Wolk DA, McCluskey LF, Elman LB, Trojanowski JQ, Umansky SR. Circulating brain-enriched microRNAs as novel biomarkers for detection and differentiation of neurodegenerative diseases. Alzheimers Res Ther 2017; 9:89. [PMID: 29121998 PMCID: PMC5679501 DOI: 10.1186/s13195-017-0316-0] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/19/2017] [Indexed: 12/11/2022]
Abstract
Background Minimally invasive specific biomarkers of neurodegenerative diseases (NDs) would facilitate patient selection and disease progression monitoring. We describe the assessment of circulating brain-enriched microRNAs as potential biomarkers for Alzheimer’s disease (AD), frontotemporal dementia (FTD), Parkinson’s disease (PD), and amyotrophic lateral sclerosis (ALS). Methods In this case-control study, the plasma samples were collected from 250 research participants with a clinical diagnosis of AD, FTD, PD, and ALS, as well as from age- and sex-matched control subjects (n = 50 for each group), recruited from 2003 to 2015 at the University of Pennsylvania Health System, including the Alzheimer’s Disease Center, the Parkinson’s Disease and Movement Disorders Center, the Frontotemporal Degeneration Center, and the Amyotrophic Lateral Sclerosis Clinic. Each group was randomly divided into training and confirmation sets of equal size. To evaluate the potential of circulating microRNAs enriched in specific brain regions affected by NDs and present in synapses as biomarkers of NDs, the levels of 37 brain-enriched and inflammation-associated microRNAs in the plasma of all participants were measured using individual qRT-PCR. A “microRNA pair” approach was used for data normalization. Results MicroRNA pairs and their combinations (classifiers) capable of differentiating NDs from control and from each other were defined using independently and jointly analyzed training and confirmation datasets. AD, PD, FTD, and ALS are differentiated from control with accuracy of 0.89, 0.90, 0.88, and 0.83 (AUCs, 0.96, 0.96, 0.94, and 0.93), respectively; NDs are differentiated from each other with accuracy ranging from 0.77 (AUC, 0.87) for AD vs. FTD to 0.93 (AUC, 0.98) for AD vs. ALS. The data further indicate sex dependence of some microRNA markers. The average increase in accuracy in distinguishing ND from control for all and male/female groups is 0.06; the largest increase is for ALS, from 0.83 for all participants to 0.92/0.98 for male/female participants. Conclusions The work presented here suggests the possibility of developing microRNA-based diagnostics for detection and differentiation of NDs. Larger multicenter clinical studies are needed to further evaluate circulating brain-enriched microRNAs as biomarkers for NDs and to investigate their association with other ND biomarkers in clinical trial settings. Electronic supplementary material The online version of this article (doi:10.1186/s13195-017-0316-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Jon B Toledo
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Present address: Department of Neurology, Houston Methodist Hospital, Houston, TX, 77030, USA
| | | | - David Irwin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Daniel Weintraub
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Howard I Hurtig
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - David A Wolk
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Leo F McCluskey
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Lauren B Elman
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - John Q Trojanowski
- Institute on Aging, Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
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McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, Aarsland D, Galvin J, Attems J, Ballard CG, Bayston A, Beach TG, Blanc F, Bohnen N, Bonanni L, Bras J, Brundin P, Burn D, Chen-Plotkin A, Duda JE, El-Agnaf O, Feldman H, Ferman TJ, Ffytche D, Fujishiro H, Galasko D, Goldman JG, Gomperts SN, Graff-Radford NR, Honig LS, Iranzo A, Kantarci K, Kaufer D, Kukull W, Lee VMY, Leverenz JB, Lewis S, Lippa C, Lunde A, Masellis M, Masliah E, McLean P, Mollenhauer B, Montine TJ, Moreno E, Mori E, Murray M, O'Brien JT, Orimo S, Postuma RB, Ramaswamy S, Ross OA, Salmon DP, Singleton A, Taylor A, Thomas A, Tiraboschi P, Toledo JB, Trojanowski JQ, Tsuang D, Walker Z, Yamada M, Kosaka K. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology 2017; 89:88-100. [PMID: 28592453 PMCID: PMC5496518 DOI: 10.1212/wnl.0000000000004058] [Citation(s) in RCA: 2297] [Impact Index Per Article: 328.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 03/30/2017] [Indexed: 12/14/2022] Open
Abstract
The Dementia with Lewy Bodies (DLB) Consortium has refined its recommendations about the clinical and pathologic diagnosis of DLB, updating the previous report, which has been in widespread use for the last decade. The revised DLB consensus criteria now distinguish clearly between clinical features and diagnostic biomarkers, and give guidance about optimal methods to establish and interpret these. Substantial new information has been incorporated about previously reported aspects of DLB, with increased diagnostic weighting given to REM sleep behavior disorder and 123iodine-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. The diagnostic role of other neuroimaging, electrophysiologic, and laboratory investigations is also described. Minor modifications to pathologic methods and criteria are recommended to take account of Alzheimer disease neuropathologic change, to add previously omitted Lewy-related pathology categories, and to include assessments for substantia nigra neuronal loss. Recommendations about clinical management are largely based upon expert opinion since randomized controlled trials in DLB are few. Substantial progress has been made since the previous report in the detection and recognition of DLB as a common and important clinical disorder. During that period it has been incorporated into DSM-5, as major neurocognitive disorder with Lewy bodies. There remains a pressing need to understand the underlying neurobiology and pathophysiology of DLB, to develop and deliver clinical trials with both symptomatic and disease-modifying agents, and to help patients and carers worldwide to inform themselves about the disease, its prognosis, best available treatments, ongoing research, and how to get adequate support.
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Davis MY, Johnson CO, Leverenz JB, Weintraub D, Trojanowski JQ, Chen-Plotkin A, Van Deerlin VM, Quinn JF, Chung KA, Peterson-Hiller AL, Rosenthal LS, Dawson TM, Albert MS, Goldman JG, Stebbins GT, Bernard B, Wszolek ZK, Ross OA, Dickson DW, Eidelberg D, Mattis PJ, Niethammer M, Yearout D, Hu SC, Cholerton BA, Smith M, Mata IF, Montine TJ, Edwards KL, Zabetian CP. Association of GBA Mutations and the E326K Polymorphism With Motor and Cognitive Progression in Parkinson Disease. JAMA Neurol 2017; 73:1217-1224. [PMID: 27571329 DOI: 10.1001/jamaneurol.2016.2245] [Citation(s) in RCA: 157] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Importance Parkinson disease (PD) is heterogeneous in symptom manifestation and rate of progression. Identifying factors that influence disease progression could provide mechanistic insight, improve prognostic accuracy, and elucidate novel therapeutic targets. Objective To determine whether GBA mutations and the E326K polymorphism modify PD symptom progression. Design, Setting, and Participants The entire GBA coding region was screened for mutations and E326K in 740 patients with PD enrolled at 7 sites from the PD Cognitive Genetics Consortium. Detailed longitudinal motor and cognitive assessments were performed with patients in the on state. Main Outcomes and Measures Linear regression was used to test for an association between GBA genotype and motor progression, with the Movement Disorder Society-sponsored version of the Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III) score at the last assessment as the outcome and GBA genotype as the independent variable, with adjustment for levodopa equivalent dose, sex, age, disease duration, MDS-UPDRS III score at the first assessment, duration of follow-up, and site. Similar methods were used to examine the association between genotype and tremor and postural instability and gait difficulty (PIGD) scores. To examine the effect of GBA genotype on cognitive progression, patients were classified into those with conversion to mild cognitive impairment or dementia during the study (progression) and those without progression. The association between GBA genotype and progression status was then tested using logistic regression, adjusting for sex, age, disease duration, duration of follow-up, years of education, and site. Results Of the total sample of 733 patients who underwent successful genotyping, 226 (30.8%) were women and 507 (69.2%) were men (mean [SD] age, 68.1 [8.8] years). The mean (SD) duration of follow-up was 3.0 (1.7) years. GBA mutations (β = 4.65; 95% CI, 1.72-7.58; P = .002), E326K (β = 3.42; 95% CI, 0.66-6.17; P = .02), and GBA variants combined as a single group (β = 4.01; 95% CI, 1.95-6.07; P = 1.5 × 10-4) were associated with a more rapid decline in MDS-UPDRS III score. Combined GBA variants (β = 0.38; 95% CI, 0.23-0.53; P = .01) and E326K (β = 0.64; 95% CI, 0.43-0.86; P = .002) were associated with faster progression in PIGD scores, but not in tremor scores. A significantly higher proportion of E326K carriers (10 of 21 [47.6%]; P = .01) and GBA variant carriers (15 of 39 [38.5%]; P = .04) progressed to mild cognitive impairment or dementia. Conclusions and Relevance GBA variants predict a more rapid progression of cognitive dysfunction and motor symptoms in patients with PD, with a greater effect on PIGD than tremor. Thus, GBA variants influence the heterogeneity in symptom progression observed in PD.
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Affiliation(s)
- Marie Y Davis
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington2Department of Neurology, University of Washington School of Medicine, Seattle
| | - Catherine O Johnson
- Department of Neurology, University of Washington School of Medicine, Seattle
| | - James B Leverenz
- Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Daniel Weintraub
- Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia
| | | | - Vivianna M Van Deerlin
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia
| | - Joseph F Quinn
- Portland Veterans Affairs Medical Center, Portland, Oregon8Department of Neurology, Oregon Health and Science University, Portland
| | - Kathryn A Chung
- Portland Veterans Affairs Medical Center, Portland, Oregon8Department of Neurology, Oregon Health and Science University, Portland
| | - Amie L Peterson-Hiller
- Portland Veterans Affairs Medical Center, Portland, Oregon8Department of Neurology, Oregon Health and Science University, Portland
| | - Liana S Rosenthal
- Neurodegeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland10Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ted M Dawson
- Neurodegeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland10Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland11Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland12Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Marilyn S Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jennifer G Goldman
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Glenn T Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Bryan Bernard
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | | | - Owen A Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
| | | | - David Eidelberg
- Center for Neurosciences, Feinstein Institute for Medical Research, Manhasset, New York17Department of Neurology, Northwell Health, Manhasset, New York
| | - Paul J Mattis
- Center for Neurosciences, Feinstein Institute for Medical Research, Manhasset, New York17Department of Neurology, Northwell Health, Manhasset, New York
| | - Martin Niethammer
- Center for Neurosciences, Feinstein Institute for Medical Research, Manhasset, New York
| | - Dora Yearout
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington2Department of Neurology, University of Washington School of Medicine, Seattle
| | - Shu-Ching Hu
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington2Department of Neurology, University of Washington School of Medicine, Seattle
| | - Brenna A Cholerton
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington18Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| | - Megan Smith
- Department of Epidemiology, University of California, Irvine, School of Medicine
| | - Ignacio F Mata
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington2Department of Neurology, University of Washington School of Medicine, Seattle
| | - Thomas J Montine
- Department of Pathology, University of Washington School of Medicine, Seattle
| | - Karen L Edwards
- Department of Epidemiology, University of California, Irvine, School of Medicine
| | - Cyrus P Zabetian
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington2Department of Neurology, University of Washington School of Medicine, Seattle
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Gwinn K, David KK, Swanson-Fischer C, Albin R, Hillaire-Clarke CS, Sieber BA, Lungu C, Bowman FD, Alcalay RN, Babcock D, Dawson TM, Dewey RB, Foroud T, German D, Huang X, Petyuk V, Potashkin JA, Saunders-Pullman R, Sutherland M, Walt DR, West AB, Zhang J, Chen-Plotkin A, Scherzer CR, Vaillancourt DE, Rosenthal LS. Parkinson's disease biomarkers: perspective from the NINDS Parkinson's Disease Biomarkers Program. Biomark Med 2017; 11:451-473. [PMID: 28644039 PMCID: PMC5619098 DOI: 10.2217/bmm-2016-0370] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 04/11/2017] [Indexed: 11/21/2022] Open
Abstract
Biomarkers for Parkinson's disease (PD) diagnosis, prognostication and clinical trial cohort selection are an urgent need. While many promising markers have been discovered through the National Institute of Neurological Disorders and Stroke Parkinson's Disease Biomarker Program (PDBP) and other mechanisms, no single PD marker or set of markers are ready for clinical use. Here we discuss the current state of biomarker discovery for platforms relevant to PDBP. We discuss the role of the PDBP in PD biomarker identification and present guidelines to facilitate their development. These guidelines include: harmonizing procedures for biofluid acquisition and clinical assessments, replication of the most promising biomarkers, support and encouragement of publications that report negative findings, longitudinal follow-up of current cohorts including the PDBP, testing of wearable technologies to capture readouts between study visits and development of recently diagnosed (de novo) cohorts to foster identification of the earliest markers of disease onset.
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Affiliation(s)
- Katrina Gwinn
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Karen K David
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Christine Swanson-Fischer
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Roger Albin
- Neurology Service & GRECC, VAAAHS, UM Udall Center, University of Michigan, Ann Arbor, MI, USA
| | | | - Beth-Anne Sieber
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Codrin Lungu
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - F DuBois Bowman
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Roy N Alcalay
- Department of Neurology, Columbia University, New York, NY, USA
| | - Debra Babcock
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Ted M Dawson
- Neuroregeneration & Stem Cell Programs, Institute for Cell Engineering, Solomon H Snyder Department of Neuroscience, Pharmacology & Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard B Dewey
- Department of Neurology & Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tatiana Foroud
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Dwight German
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Xuemei Huang
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Vlad Petyuk
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA, USA
| | - Judith A Potashkin
- Department of Cellular & Molecular Pharmacology, Rosalind Franklin University of Medicine & Science, North Chicago, IL, USA
| | - Rachel Saunders-Pullman
- Department of Neurology, Mount Sinai Beth Israel & Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Margaret Sutherland
- National Institute of Neurological Disorders & Stroke, National Institutes of Health, Bethesda, MD, USA
| | - David R Walt
- Department of Chemistry, Tufts University, Medford, MA, USA
| | - Andrew B West
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jing Zhang
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Alice Chen-Plotkin
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Clemens R Scherzer
- Department of Neurology, Harvard Medical School, Brigham & Women's Hospital, Cambridge, MA, USA
| | - David E Vaillancourt
- Departments of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, USA
| | - Liana S Rosenthal
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Espay AJ, Schwarzschild MA, Tanner CM, Fernandez HH, Simon DK, Leverenz JB, Merola A, Chen-Plotkin A, Brundin P, Kauffman MA, Erro R, Kieburtz K, Woo D, Macklin EA, Standaert DG, Lang AE. Biomarker-driven phenotyping in Parkinson's disease: A translational missing link in disease-modifying clinical trials. Mov Disord 2017; 32:319-324. [PMID: 28233927 DOI: 10.1002/mds.26913] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [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: 10/03/2016] [Revised: 11/19/2016] [Accepted: 12/11/2016] [Indexed: 01/18/2023] Open
Abstract
Past clinical trials of putative neuroprotective therapies have targeted PD as a single pathogenic disease entity. From an Oslerian clinicopathological perspective, the wide complexity of PD converges into Lewy bodies and justifies a reductionist approach to PD: A single-mechanism therapy can affect most of those sharing the classic pathological hallmark. From a systems-biology perspective, PD is a group of disorders that, while related by sharing the feature of nigral dopamine-neuron degeneration, exhibit unique genetic, biological, and molecular abnormalities, which probably respond differentially to a given therapeutic approach, particularly for strategies aimed at neuroprotection. Under this model, only biomarker-defined, homogenous subtypes of PD are likely to respond optimally to therapies proven to affect the biological processes within each subtype. Therefore, we suggest that precision medicine applied to PD requires a reevaluation of the biomarker-discovery effort. This effort is currently centered on correlating biological measures to clinical features of PD and on identifying factors that predict whether various prodromal states will convert into the classical movement disorder. We suggest, instead, that subtyping of PD requires the reverse view, where abnormal biological signals (i.e., biomarkers), rather than clinical definitions, are used to define disease phenotypes. Successful development of disease-modifying strategies will depend on how relevant the specific biological processes addressed by an intervention are to the pathogenetic mechanisms in the subgroup of targeted patients. This precision-medicine approach will likely yield smaller, but well-defined, subsets of PD amenable to successful neuroprotection. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Alberto J Espay
- Department of Neurology, UC Gardner Neuroscience Institute, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA
| | - Michael A Schwarzschild
- MassGeneral Institute for Neurodegenerative Disease, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Caroline M Tanner
- Department of Neurology, University of California-San Francisco and the Parkinson's Disease Research Education and Clinical Center, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Hubert H Fernandez
- Center for Neurological Restoration, Cleveland Clinic, Cleveland, Ohio, USA
| | - David K Simon
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - James B Leverenz
- Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Aristide Merola
- Department of Neurology, UC Gardner Neuroscience Institute, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Patrik Brundin
- Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, Michigan, USA
| | - Marcelo A Kauffman
- Consultorio y Laboratorio de Neurogenética, Centro Universitario de Neurología "José María Ramos Mejía" y División Neurología, Hospital JM Ramos Mejía, Facultad de Medicina, UBA, and Programa de Medicina de Precision y Genomica Clinica, Instituto de Investigaciones en Medicina Traslacional, Facultad de Ciencias Biomédicas, Universidad Austral-CONICET, Pilar, Argentina
| | - Roberto Erro
- Sobell department of Motor Neuroscience and Movement Disorders, University College London, Institute of Neurology, London, United Kingdom.,Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy
| | - Karl Kieburtz
- Department of Neurology and CHET, University of Rochester Medical Center, Rochester, New York, USA
| | - Daniel Woo
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Eric A Macklin
- Department of Medicine, Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - David G Standaert
- Center for Neurodegeneration and Experimental Therapeutics, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorders Center, Toronto Western Hospital and The Edmond J. Safra Program in PD, Toronto, Ontario, Canada, University of Toronto, Toronto, Ontario, Canada
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Brennan L, Devlin KM, Xie SX, Mechanic-Hamilton D, Tran B, Hurtig HH, Chen-Plotkin A, Chahine LM, Morley JF, Duda JE, Roalf DR, Dahodwala N, Rick J, Trojanowski JQ, Moberg PJ, Weintraub D. Neuropsychological Subgroups in Non-Demented Parkinson's Disease: A Latent Class Analysis. J Parkinsons Dis 2017; 7:385-395. [PMID: 28387684 PMCID: PMC5548408 DOI: 10.3233/jpd-171081] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Methods to detect early cognitive decline and account for heterogeneity of deficits in Parkinson's disease (PD) are needed. Quantitative methods such as latent class analysis (LCA) offer an objective approach to delineate discrete phenotypes of impairment. OBJECTIVE To identify discrete neurocognitive phenotypes in PD patients without dementia. METHODS LCA was applied to a battery of 8 neuropsychological measures to identify cognitive subtypes in a cohort of 199 non-demented PD patients. Two measures were analyzed from each of four domains: executive functioning, memory, visuospatial abilities, and language. Additional analyses compared groups on clinical characteristics and cognitive diagnosis. RESULTS LCA identified 3 distinct groups of PD patients: an intact cognition group (54.8%), an amnestic group (32.2%), and a mixed impairment group with dysexecutive, visuospatial and lexical retrieval deficits (13.1%). The two impairment groups had significantly lower instrumental activities of daily living ratings and greater motor symptoms than the intact group. Of those diagnosed as cognitively normal according to MDS criteria, LCA classified 23.2% patients as amnestic and 9.9% as mixed cognitive impairment. CONCLUSIONS Non-demented PD patients exhibit distinct neuropsychological profiles. One-third of patients with LCA-determined impairment were diagnosed as cognitively intact by expert consensus, indicating that classification using a statistical algorithm may improve detection of initial and subtle cognitive decline. This study also demonstrates that memory impairment is common in non-demented PD even when cognitive impairment is not clinically apparent. This study has implications for predicting eventual emergence of significant cognitive decline, and treatment trials for cognitive dysfunction in PD.
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Affiliation(s)
- Laura Brennan
- Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, PA
| | | | - Sharon X. Xie
- Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine; Philadelphia, PA
| | - Dawn Mechanic-Hamilton
- Department of Psychiatry, University of Pennsylvania School of Medicine; Philadelphia, PA
| | - Baochan Tran
- Department of Psychology, Widener University
- Department of Neurology, University of Pennsylvania School of Medicine; Philadelphia, PA
| | - Howard H. Hurtig
- Department of Neurology, University of Pennsylvania School of Medicine; Philadelphia, PA
| | - Alice Chen-Plotkin
- Department of Neurology, University of Pennsylvania School of Medicine; Philadelphia, PA
| | - Lama M. Chahine
- Department of Neurology, University of Pennsylvania School of Medicine; Philadelphia, PA
| | - James F. Morley
- Department of Neurology, University of Pennsylvania School of Medicine; Philadelphia, PA
- Parkinson's Disease Research, Education, and Clinical Center, Philadelphia Veterans Affairs Medical Center; Philadelphia, PA
| | - John E. Duda
- Department of Neurology, University of Pennsylvania School of Medicine; Philadelphia, PA
- Parkinson's Disease Research, Education, and Clinical Center, Philadelphia Veterans Affairs Medical Center; Philadelphia, PA
| | - David R. Roalf
- Department of Psychiatry, University of Pennsylvania School of Medicine; Philadelphia, PA
| | - Nabila Dahodwala
- Department of Neurology, University of Pennsylvania School of Medicine; Philadelphia, PA
| | - Jacqueline Rick
- Department of Neurology, University of Pennsylvania School of Medicine; Philadelphia, PA
| | - John Q. Trojanowski
- Department of Pathology, and Laboratory Medicine, University of Pennsylvania School of Medicine; Philadelphia, PA
| | - Paul J. Moberg
- Department of Psychiatry, University of Pennsylvania School of Medicine; Philadelphia, PA
| | - Daniel Weintraub
- Department of Psychiatry, University of Pennsylvania School of Medicine; Philadelphia, PA
- Department of Neurology, University of Pennsylvania School of Medicine; Philadelphia, PA
- Parkinson's Disease Research, Education, and Clinical Center, Philadelphia Veterans Affairs Medical Center; Philadelphia, PA
- Mental Illness Research, Education, and Clinical Center, Philadelphia Veterans Affairs Medical Center; Philadelphia, PA
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39
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Rosenthal LS, Drake D, Alcalay RN, Babcock D, Bowman FD, Chen-Plotkin A, Dawson TM, Dewey RB, German D, Huang X, Landin B, McAuliffe M, Petyuk VA, Scherzer CR, St Hillaire-Clarke C, Sieber BA, Sutherland M, Tarn C, West A, Vaillancourt D, Zhang J, Gwinn K. The NINDS Parkinson's disease biomarkers program. Mov Disord 2016; 31:915-23. [PMID: 26442452 PMCID: PMC4824671 DOI: 10.1002/mds.26438] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [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: 01/10/2015] [Revised: 08/11/2015] [Accepted: 08/16/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Neuroprotection for Parkinson's disease (PD) remains elusive. Biomarkers hold the promise of removing roadblocks to therapy development. The National Institute of Neurological Disorders and Stroke has therefore established the Parkinson's Disease Biomarkers Program to promote discovery of PD biomarkers for use in phase II and III clinical trials. METHODS Using a novel consortium design, the Parkinson's Disease Biomarker Program is focused on the development of clinical and laboratory-based biomarkers for PD diagnosis, progression, and prognosis. Standardized operating procedures and pooled reference samples were created to allow cross-project comparisons and assessment of batch effects. A web-based Data Management Resource facilitates rapid sharing of data and biosamples across the research community for additional biomarker projects. RESULTS Eleven consortium projects are ongoing, seven of which recruit participants and obtain biosamples. As of October 2014, 1,082 participants have enrolled (620 PD, 101 with other causes of parkinsonism, 23 essential tremor, and 338 controls), 1,040 of whom have at least one biosample. Six thousand eight hundred ninety-eight total biosamples are available from baseline, 6-, 12-, and 18-month visits: 1,006 DNA, 1,661 RNA, 1,419 whole blood, 1,382 plasma, 1,200 serum, and 230 cerebrospinal fluid (CSF). Quality control analysis of plasma, serum, and CSF samples indicates that almost all samples are high quality (24 of 2,812 samples exceed acceptable hemoglobin levels). CONCLUSIONS By making samples and data widely available, using stringent operating procedures based on existing standards, hypothesis testing for biomarker discovery, and providing a resource that complements existing programs, the Parkinson's Disease Biomarker Program will accelerate the pace of PD biomarker research. © 2015 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Liana S. Rosenthal
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD
| | - Daniel Drake
- Department of Biostatistics, Columbia University, New York, New York
| | - Roy N. Alcalay
- Department of Neurology, Columbia University, New York, New York
| | - Debra Babcock
- National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD
| | - F. DuBois Bowman
- Department of Biostatistics, Columbia University, New York, New York
| | | | - Ted M. Dawson
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore MD
- Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, Solomon H. Snyder Department of Neuroscience, Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Richard B. Dewey
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas TX
| | - Dwight German
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas TX
| | - Xuemei Huang
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA
| | - Barry Landin
- Center for Information Technology, National Institutes of Health, Bethesda, MD
| | - Matthew McAuliffe
- Center for Information Technology, National Institutes of Health, Bethesda, MD
| | - Vladislav A. Petyuk
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA
| | - Clemens R. Scherzer
- Department of Neurology, Brigham & Women’s Hospital, Harvard Medical School, Cambridge, MA
| | | | - Beth-Anne Sieber
- National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD
| | - Margaret Sutherland
- National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD
| | - Chi Tarn
- Coriell Institute for Medical Research, Camden, NJ
| | - Andrew West
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
| | - David Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL
| | - Jing Zhang
- Department of Pathology, University of Washington, Seattle, WA
| | - Katrina Gwinn
- National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, MD
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Swanson CR, Alcalay RN, Chen-Plotkin A. Reply to letter: Plasma fasting cholesterol profiles and age at onset in Parkinson's disease. Mov Disord 2015; 30:1975-6. [PMID: 26584479 PMCID: PMC4715726 DOI: 10.1002/mds.26447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 09/23/2015] [Accepted: 09/24/2015] [Indexed: 11/06/2022] Open
Affiliation(s)
- Christine R. Swanson
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Roy N. Alcalay
- Department of Neurology, Columbia University Medical School, New York, NY
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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Pigott K, Rick J, Xie SX, Hurtig H, Chen-Plotkin A, Duda JE, Morley JF, Chahine LM, Dahodwala N, Akhtar RS, Siderowf A, Trojanowski JQ, Weintraub D. Longitudinal study of normal cognition in Parkinson disease. Neurology 2015; 85:1276-82. [PMID: 26362285 DOI: 10.1212/wnl.0000000000002001] [Citation(s) in RCA: 164] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 05/07/2015] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To report the rates and predictors of progression from normal cognition to either mild cognitive impairment (MCI) or dementia using standardized neuropsychological methods. METHODS A prospective cohort of patients diagnosed with Parkinson disease (PD) and baseline normal cognition was assessed for cognitive decline, performance, and function for a minimum of 2 years, and up to 6. A panel of movement disorders experts classified patients as having normal cognition, MCI, or dementia, with 55/68 (80.9%) of eligible patients seen at year 6. Kaplan-Meier curves and Cox proportional hazard models were used to examine cognitive decline and its predictors. RESULTS We enrolled 141 patients, who averaged 68.8 years of age, 63% men, who had PD on average for 5 years. The cumulative incidence of cognitive impairment was 8.5% at year 1, increasing to 47.4% by year 6. All incident MCI cases had progressed to dementia by year 5. In a multivariate analysis, predictors of future decline were male sex (p = 0.02), higher Unified Parkinson's Disease Rating Scale motor score (p ≤ 0.001), and worse global cognitive score (p < 0.001). CONCLUSIONS Approximately half of patients with PD with normal cognition at baseline develop cognitive impairment within 6 years and all new MCI cases progress to dementia within 5 years. Our results show that the transition from normal cognition to cognitive impairment, including dementia, occurs frequently and quickly. Certain clinical and cognitive variables may be useful in predicting progression to cognitive impairment in PD.
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Affiliation(s)
- Kara Pigott
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Jacqueline Rick
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Sharon X Xie
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Howard Hurtig
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Alice Chen-Plotkin
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - John E Duda
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - James F Morley
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Lama M Chahine
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Nabila Dahodwala
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Rizwan S Akhtar
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Andrew Siderowf
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - John Q Trojanowski
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA
| | - Daniel Weintraub
- From the Departments of Neurology (K.P., J.R., H.H., A.C.-P., J.E.D., J.F.M., L.M.C., N.D., R.S.A., D.W.), Pathology and Laboratory Medicine (J.Q.T.), and Psychiatry (D.W.), Perelman School of Medicine at the University of Pennsylvania; the Department of Biostatistics and Epidemiology (S.X.X.), University of Pennsylvania; Philadelphia Veterans Affairs Medical Center (J.E.D., J.F.M., D.W.); and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA.
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Mata IF, Leverenz JB, Weintraub D, Trojanowski JQ, Chen-Plotkin A, Van Deerlin VM, Ritz B, Rausch R, Factor SA, Wood-Siverio C, Quinn JF, Chung KA, Peterson-Hiller AL, Goldman JG, Stebbins GT, Bernard B, Espay AJ, Revilla FJ, Devoto J, Rosenthal LS, Dawson TM, Albert MS, Tsuang D, Huston H, Yearout D, Hu SC, Cholerton BA, Montine TJ, Edwards KL, Zabetian CP. GBA Variants are associated with a distinct pattern of cognitive deficits in Parkinson's disease. Mov Disord 2015; 31:95-102. [PMID: 26296077 DOI: 10.1002/mds.26359] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [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: 03/18/2015] [Revised: 06/18/2015] [Accepted: 07/06/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Loss-of-function mutations in the GBA gene are associated with more severe cognitive impairment in PD, but the nature of these deficits is not well understood and whether common GBA polymorphisms influence cognitive performance in PD is not yet known. METHODS We screened the GBA coding region for mutations and the E326K polymorphism in 1,369 PD patients enrolled at eight sites from the PD Cognitive Genetics Consortium. Participants underwent assessments of learning and memory (Hopkins Verbal Learning Test-Revised), working memory/executive function (Letter-Number Sequencing Test and Trail Making Test A and B), language processing (semantic and phonemic verbal fluency), visuospatial abilities (Benton Judgment of Line Orientation), and global cognitive function (MoCA). We used linear regression to test for association between genotype and cognitive performance with adjustment for important covariates and accounted for multiple testing using Bonferroni's corrections. RESULTS Mutation carriers (n = 60; 4.4%) and E326K carriers (n = 65; 4.7%) had a higher prevalence of dementia (mutations, odds ratio = 5.1; P = 9.7 × 10(-6) ; E326K, odds ratio = 6.4; P = 5.7 × 10(-7) ) and lower performance on Letter-Number Sequencing (mutations, corrected P[Pc ] = 9.0 × 10(-4) ; E326K, Pc = 0.036), Trail Making B-A (mutations, Pc = 0.018; E326K, Pc = 0.018), and Benton Judgment of Line Orientation (mutations, Pc = 0.0045; E326K, Pc = 0.0013). CONCLUSIONS Both GBA mutations and E326K are associated with a distinct cognitive profile characterized by greater impairment in working memory/executive function and visuospatial abilities in PD patients. The discovery that E326K negatively impacts cognitive performance approximately doubles the proportion of PD patients we now recognize are at risk for more severe GBA-related cognitive deficits.
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Affiliation(s)
- Ignacio F Mata
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, Washington, USA
| | - James B Leverenz
- Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Daniel Weintraub
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Institute on Aging, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alice Chen-Plotkin
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Vivianna M Van Deerlin
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Beate Ritz
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, California, USA.,Department of Environmental Health Sciences, School of Public Health, University of California Los Angeles, Los Angeles, California, USA.,Department of Neurology, University of California Los Angeles, Los Angeles, California, USA
| | - Rebecca Rausch
- Department of Neurology, University of California Los Angeles, Los Angeles, California, USA
| | - Stewart A Factor
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Cathy Wood-Siverio
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Joseph F Quinn
- Portland Veterans Affairs Medical Center, Portland, Oregon, USA.,Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | - Kathryn A Chung
- Portland Veterans Affairs Medical Center, Portland, Oregon, USA.,Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | - Amie L Peterson-Hiller
- Portland Veterans Affairs Medical Center, Portland, Oregon, USA.,Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
| | - Jennifer G Goldman
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Glenn T Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Bryan Bernard
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Alberto J Espay
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Fredy J Revilla
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio, USA.,Cincinnati Veterans Affairs Medical Center, Cincinnati, Ohio, USA
| | - Johnna Devoto
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Liana S Rosenthal
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ted M Dawson
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Solomon H. Snyder Department of Neuroscience and Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Marilyn S Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Debby Tsuang
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Haley Huston
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Dora Yearout
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Shu-Ching Hu
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Brenna A Cholerton
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Thomas J Montine
- Department of Pathology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Karen L Edwards
- Department of Epidemiology, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Cyrus P Zabetian
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, Washington, USA
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Fitts W, Weintraub D, Massimo L, Chahine L, Chen-Plotkin A, Duda JE, Hurtig HI, Rick J, Trojanowski JQ, Dahodwala N. Caregiver report of apathy predicts dementia in Parkinson's disease. Parkinsonism Relat Disord 2015; 21:992-5. [PMID: 26117435 DOI: 10.1016/j.parkreldis.2015.06.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 02/27/2015] [Revised: 05/27/2015] [Accepted: 06/06/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Apathy is a common, troublesome symptom in Parkinson's disease (PD). However, little is known about its relationship with long-term cognition. We sought to determine if a caregiver-reported apathy measure predicts the development of PD dementia. METHODS Non-demented PD patients were recruited as part of a longitudinal study of cognition. Demographics, medications, Dementia Rating Scale-2, Unified Parkinson's Disease Rating Scale, Geriatric Depression Scale and the Neuropsychiatric Inventory-Questionnaire (NPI-Q) ratings were obtained. Apathy was defined as an NPI-Q apathy score ≥1. Participants were evaluated annually with cognitive and functional assessments until the end of the study period or a physician consensus diagnosis of dementia was assigned. Cox proportional hazard models were used to assess the effects of baseline apathy on dementia development while controlling for other clinical and demographic factors. RESULTS Of 132 PD patients 12.1% (N = 16) scored in the apathetic range at baseline. A total of 19.6% (N = 26) individuals developed dementia over the course of the study, 8 of whom (30.8% of future dementia patients) had baseline apathy. In bivariate analyses baseline apathy, older age, and worse cognitive, motor, and depressive symptom scores predicted the development of dementia. In a multivariate analysis the predictive effects of baseline apathy were still significant (HR = 3.56; 95% CI = 1.09-11.62; p = 0.04). CONCLUSIONS A simple, caregiver-reported measure of apathy is an independent predictor of progression to dementia in PD. This highlights the importance of apathy as a clinical characteristic of PD and could prove useful for the prediction of future dementia.
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Affiliation(s)
- Whitney Fitts
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel Weintraub
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lauren Massimo
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lama Chahine
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John E Duda
- Parkinson Disease Research, Education and Clinical Center, Veterans Affairs, Philadelphia, PA, USA
| | - Howard I Hurtig
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jacqueline Rick
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nabila Dahodwala
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Mollenhauer B, Rochester L, Chen-Plotkin A, Brooks D. What can biomarkers tell us about cognition in Parkinson's disease? Mov Disord 2014; 29:622-33. [PMID: 24757111 DOI: 10.1002/mds.25846] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [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: 12/17/2013] [Revised: 01/23/2014] [Accepted: 01/27/2014] [Indexed: 01/13/2023] Open
Abstract
Cognitive decline is common in Parkinson's disease (PD), even in the early motor stage, and this non-motor feature impacts quality of life and prognosis tremendously. In this article, we discuss marker candidates for cognitive decline in PD from different angles, including functional and structural imaging techniques, biological fluid markers in cerebrospinal fluid, and blood genetic predictors, as well as gait as a surrogate marker of cognitive decline. Specifically, imaging-based markers of cognitive impairment in PD include cortical atrophy, reduced cortical metabolism, loss of cortical cholinergic and frontal dopaminergic function, as well as an increased cortical amyloid load. Reduced β-amyloid(1-42) in cerebrospinal fluid and lower plasma levels of epidermal growth factor are predictors for cognitive decline in PD. In addition, genetic variation in the apolipoprotein E (APOE), catechol-O-methyltransferase (COMT), microtubule-associated protein tau (MAPT), and glucocerebrosidase (GBA) genes may confer risk for cognitive impairment in PD; and gait disturbance may also indicate an increased risk for dementia. Other marker candidates have been proposed and are discussed. All of the current studies are hampered by gaps in our knowledge about the molecular causes of cognitive decline, which will have to be considered in future biomarker studies.
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Affiliation(s)
- Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel and University Medical Center, Göttingen, Germany
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van Steenoven I, Aarsland D, Hurtig H, Chen-Plotkin A, Duda JE, Rick J, Chahine LM, Dahodwala N, Trojanowski JQ, Roalf DR, Moberg PJ, Weintraub D. Conversion between mini-mental state examination, montreal cognitive assessment, and dementia rating scale-2 scores in Parkinson's disease. Mov Disord 2014; 29:1809-15. [PMID: 25381961 PMCID: PMC4371590 DOI: 10.1002/mds.26062] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [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: 07/14/2014] [Revised: 09/15/2014] [Accepted: 09/23/2014] [Indexed: 12/23/2022] Open
Abstract
Cognitive impairment is one of the earliest, most common, and most disabling non-motor symptoms in Parkinson's disease (PD). Thus, routine screening of global cognitive abilities is important for the optimal management of PD patients. Few global cognitive screening instruments have been developed for or validated in PD patients. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Dementia Rating Scale-2 (DRS-2) have been used extensively for cognitive screening in both clinical and research settings. Determining how to convert the scores between instruments would facilitate the longitudinal assessment of cognition in clinical settings and the comparison and synthesis of cognitive data in multicenter and longitudinal cohort studies. The primary aim of this study was to apply a simple and reliable algorithm for the conversion of MoCA to MMSE scores in PD patients. A secondary aim was to apply this algorithm for the conversion of DRS-2 to both MMSE and MoCA scores. The cognitive performance of a convenience sample of 360 patients with idiopathic PD was assessed by at least two of these cognitive screening instruments. We then developed conversion scores between the MMSE, MoCA, and DRS-2 using equipercentile equating and log-linear smoothing. The conversion score tables reported here enable direct and easy comparison of three routinely used cognitive screening assessments in PD patients.
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Affiliation(s)
- Inger van Steenoven
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Dag Aarsland
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Centre for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway
- Department of Neurology, Akershus University Hospital, Oslo, Norway
| | - Howard Hurtig
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - John E. Duda
- Parkinson’s Disease Research, Education and Clinical Center, Philadelphia Veterans Affairs Medical Center, Philadelphia, USA
| | - Jacqueline Rick
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - Lama M. Chahine
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - Nabila Dahodwala
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - John Q. Trojanowski
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - David R. Roalf
- Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - Paul J. Moberg
- Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - Daniel Weintraub
- Parkinson’s Disease Research, Education and Clinical Center, Philadelphia Veterans Affairs Medical Center, Philadelphia, USA
- Mental Illness Research, Education and Clinical Center, Philadelphia Veterans Affairs Medical Center, Philadelphia, USA
- Department of Psychiatry, Geriatric Psychiatry Section, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
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Abstract
There is a pressing need for biomarkers to diagnose Parkinson's disease (PD), assess disease severity, and prognosticate course. Various types of biologic specimens are potential candidates for identifying biomarkers--defined here as surrogate indicators of physiological or pathophysiological states--but blood has the advantage of being minimally invasive to obtain. There are, however, several challenges to identifying biomarkers in blood. Several candidate biomarkers identified in other diseases or in other types of biological fluids are being pursued as blood-based biomarkers in PD. In addition, unbiased discovery is underway using techniques including metabolomics, proteomics, and gene expression profiling. In this review, we summarize these techniques and discuss the challenges and successes of blood-based biomarker discovery in PD. Blood-based biomarkers that are discussed include α-synuclein, DJ-1, uric acid, epidermal growth factor, apolipoprotein-A1, and peripheral inflammatory markers.
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Affiliation(s)
- Lama M Chahine
- Parkinson's Disease and Movement Disorders Center, Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
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47
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Chahine LM, Qiang J, Ashbridge E, Minger J, Yearout D, Horn S, Colcher A, Hurtig HI, Lee VMY, Van Deerlin VM, Leverenz JB, Siderowf AD, Trojanowski JQ, Zabetian CP, Chen-Plotkin A. Clinical and biochemical differences in patients having Parkinson disease with vs without GBA mutations. JAMA Neurol 2013; 70:852-8. [PMID: 23699752 DOI: 10.1001/jamaneurol.2013.1274] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
IMPORTANCE Biochemical abnormalities present in GBA (mut/wt) carriers may offer new pathogenetic insights to and potential therapeutic targets in Parkinson disease (PD). OBJECTIVE To determine whether patients having PD with vs without GBA mutations differ in clinical phenotype or plasma protein expression. DESIGN AND SETTING Case-control study of patients having PD with vs without GBA mutations. Clinical characteristics were compared between groups, and biochemical profiling of 40 plasma proteins was performed to identify proteins that differed in expression between groups. PARTICIPANTS The discovery cohort included 20 patients having PD with GBA mutations. Clinical characteristics of GBA-associated PD cases were compared with those of 242 patients having PD in whom GBA mutations were excluded by full gene sequencing. MAIN OUTCOME MEASURES Biochemical profiling was available for all 20 GBA-associated PD cases, as well as a subset (87 of 242) of the GBA-negative PD cases. The replication cohort included 19 patients having PD with GBA mutations and 41 patients having PD without GBA mutations. RESULTS Compared with patients having PD without GBA mutations, patients having PD with GBA mutations were younger at disease onset (P = .04) and were more likely to demonstrate cognitive dysfunction (P = .001). In a multiple regression model that included age, sex, and assay batch as covariates, GBA mutation status was significantly associated with plasma levels of interleukin 8 (P = .001), monocyte chemotactic protein 1 (P = .008), and macrophage inflammatory protein 1α (P = .005). The association between interleukin 8 and GBA mutation status was replicated (P = .03) in a separate cohort of patients having PD with vs without GBA mutations. CONCLUSIONS AND RELEVANCE Patients having PD with GBA mutations have earlier age at disease onset and are more likely to demonstrate cognitive dysfunction. Monocyte-associated inflammatory mediators may be elevated in patients having PD with GBA mutations.
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Affiliation(s)
- Lama M Chahine
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia 19104, USA
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48
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Toledo JB, Van Deerlin VM, Lee EB, Suh E, Baek Y, Robinson JL, Xie SX, McBride J, Wood EM, Schuck T, Irwin DJ, Gross RG, Hurtig H, McCluskey L, Elman L, Karlawish J, Schellenberg G, Chen-Plotkin A, Wolk D, Grossman M, Arnold SE, Shaw LM, Lee VMY, Trojanowski JQ. A platform for discovery: The University of Pennsylvania Integrated Neurodegenerative Disease Biobank. Alzheimers Dement 2013; 10:477-484.e1. [PMID: 23978324 DOI: 10.1016/j.jalz.2013.06.003] [Citation(s) in RCA: 154] [Impact Index Per Article: 14.0] [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: 02/25/2013] [Revised: 05/10/2013] [Accepted: 06/03/2013] [Indexed: 12/12/2022]
Abstract
Neurodegenerative diseases (NDs) are defined by the accumulation of abnormal protein deposits in the central nervous system (CNS), and only neuropathological examination enables a definitive diagnosis. Brain banks and their associated scientific programs have shaped the actual knowledge of NDs, identifying and characterizing the CNS deposits that define new diseases, formulating staging schemes, and establishing correlations between neuropathological changes and clinical features. However, brain banks have evolved to accommodate the banking of biofluids as well as DNA and RNA samples. Moreover, the value of biobanks is greatly enhanced if they link all the multidimensional clinical and laboratory information of each case, which is accomplished, optimally, using systematic and standardized operating procedures, and in the framework of multidisciplinary teams with the support of a flexible and user-friendly database system that facilitates the sharing of information of all the teams in the network. We describe a biobanking system that is a platform for discovery research at the Center for Neurodegenerative Disease Research at the University of Pennsylvania.
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Affiliation(s)
- Jon B Toledo
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Vivianna M Van Deerlin
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Edward B Lee
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - EunRan Suh
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Young Baek
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - John L Robinson
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Sharon X Xie
- Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jennifer McBride
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Elisabeth M Wood
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Theresa Schuck
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - David J Irwin
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Rachel G Gross
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Howard Hurtig
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Leo McCluskey
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lauren Elman
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jason Karlawish
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gerard Schellenberg
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David Wolk
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Steven E Arnold
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Leslie M Shaw
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Virginia M-Y Lee
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - John Q Trojanowski
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA.
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49
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Schadt EE, Banerjee O, Fang G, Feng Z, Wong WH, Zhang X, Kislyuk A, Clark TA, Luong K, Keren-Paz A, Chess A, Kumar V, Chen-Plotkin A, Sondheimer N, Korlach J, Kasarskis A. Modeling kinetic rate variation in third generation DNA sequencing data to detect putative modifications to DNA bases. Genome Res 2012; 23:129-41. [PMID: 23093720 PMCID: PMC3530673 DOI: 10.1101/gr.136739.111] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Current generation DNA sequencing instruments are moving closer to seamlessly sequencing genomes of entire populations as a routine part of scientific investigation. However, while significant inroads have been made identifying small nucleotide variation and structural variations in DNA that impact phenotypes of interest, progress has not been as dramatic regarding epigenetic changes and base-level damage to DNA, largely due to technological limitations in assaying all known and unknown types of modifications at genome scale. Recently, single-molecule real time (SMRT) sequencing has been reported to identify kinetic variation (KV) events that have been demonstrated to reflect epigenetic changes of every known type, providing a path forward for detecting base modifications as a routine part of sequencing. However, to date no statistical framework has been proposed to enhance the power to detect these events while also controlling for false-positive events. By modeling enzyme kinetics in the neighborhood of an arbitrary location in a genomic region of interest as a conditional random field, we provide a statistical framework for incorporating kinetic information at a test position of interest as well as at neighboring sites that help enhance the power to detect KV events. The performance of this and related models is explored, with the best-performing model applied to plasmid DNA isolated from Escherichia coli and mitochondrial DNA isolated from human brain tissue. We highlight widespread kinetic variation events, some of which strongly associate with known modification events, while others represent putative chemically modified sites of unknown types.
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Affiliation(s)
- Eric E Schadt
- Department of Genetics and Genomic Sciences, Mount Sinai School of Medicine, New York, New York 10029, USA.
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50
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Hu WT, Holtzman DM, Fagan AM, Shaw LM, Perrin R, Arnold SE, Grossman M, Xiong C, Craig-Schapiro R, Clark CM, Pickering E, Kuhn M, Chen Y, Van Deerlin VM, McCluskey L, Elman L, Karlawish J, Chen-Plotkin A, Hurtig HI, Siderowf A, Swenson F, Lee VMY, Morris JC, Trojanowski JQ, Soares H. Plasma multianalyte profiling in mild cognitive impairment and Alzheimer disease. Neurology 2012; 79:897-905. [PMID: 22855860 DOI: 10.1212/wnl.0b013e318266fa70] [Citation(s) in RCA: 173] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES While plasma biomarkers have been proposed to aid in the clinical diagnosis of Alzheimer disease (AD), few biomarkers have been validated in independent patient cohorts. Here we aim to determine plasma biomarkers associated with AD in 2 independent cohorts and validate the findings in the multicenter Alzheimer's Disease Neuroimaging Initiative (ADNI). METHODS Using a targeted proteomic approach, we measured levels of 190 plasma proteins and peptides in 600 participants from 2 independent centers (University of Pennsylvania, Philadelphia; Washington University, St. Louis, MO), and identified 17 analytes associated with the diagnosis of very mild dementia/mild cognitive impairment (MCI) or AD. Four analytes (apoE, B-type natriuretic peptide, C-reactive protein, pancreatic polypeptide) were also found to be altered in clinical MCI/AD in the ADNI cohort (n = 566). Regression analysis showed CSF Aβ42 levels and t-tau/Aβ42 ratios to correlate with the number of APOE4 alleles and plasma levels of B-type natriuretic peptide and pancreatic polypeptide. CONCLUSION Four plasma analytes were consistently associated with the diagnosis of very mild dementia/MCI/AD in 3 independent clinical cohorts. These plasma biomarkers may predict underlying AD through their association with CSF AD biomarkers, and the association between plasma and CSF amyloid biomarkers needs to be confirmed in a prospective study.
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Affiliation(s)
- William T Hu
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, USA.
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