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Biesbroek JM, Coenen M, DeCarli C, Fletcher EM, Maillard PM, Barkhof F, Barnes J, Benke T, Chen CPLH, Dal‐Bianco P, Dewenter A, Duering M, Enzinger C, Ewers M, Exalto LG, Franzmeier N, Hilal S, Hofer E, Koek HL, Maier AB, McCreary CR, Papma JM, Paterson RW, Pijnenburg YAL, Rubinski A, Schmidt R, Schott JM, Slattery CF, Smith EE, Sudre CH, Steketee RME, Teunissen CE, van den Berg E, van der Flier WM, Venketasubramanian N, Venkatraghavan V, Vernooij MW, Wolters FJ, Xin X, Kuijf HJ, Biessels GJ. Amyloid pathology and vascular risk are associated with distinct patterns of cerebral white matter hyperintensities: A multicenter study in 3132 memory clinic patients. Alzheimers Dement 2024; 20:2980-2989. [PMID: 38477469 PMCID: PMC11032573 DOI: 10.1002/alz.13765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION White matter hyperintensities (WMH) are associated with key dementia etiologies, in particular arteriolosclerosis and amyloid pathology. We aimed to identify WMH locations associated with vascular risk or cerebral amyloid-β1-42 (Aβ42)-positive status. METHODS Individual patient data (n = 3,132; mean age 71.5 ± 9 years; 49.3% female) from 11 memory clinic cohorts were harmonized. WMH volumes in 28 regions were related to a vascular risk compound score (VRCS) and Aß42 status (based on cerebrospinal fluid or amyloid positron emission tomography), correcting for age, sex, study site, and total WMH volume. RESULTS VRCS was associated with WMH in anterior/superior corona radiata (B = 0.034/0.038, p < 0.001), external capsule (B = 0.052, p < 0.001), and middle cerebellar peduncle (B = 0.067, p < 0.001), and Aß42-positive status with WMH in posterior thalamic radiation (B = 0.097, p < 0.001) and splenium (B = 0.103, p < 0.001). DISCUSSION Vascular risk factors and Aß42 pathology have distinct signature WMH patterns. This regional vulnerability may incite future studies into how arteriolosclerosis and Aß42 pathology affect the brain's white matter. HIGHLIGHTS Key dementia etiologies may be associated with specific patterns of white matter hyperintensities (WMH). We related WMH locations to vascular risk and cerebral Aβ42 status in 11 memory clinic cohorts. Aβ42 positive status was associated with posterior WMH in splenium and posterior thalamic radiation. Vascular risk was associated with anterior and infratentorial WMH. Amyloid pathology and vascular risk have distinct signature WMH patterns.
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Rubinski A, Dewenter A, Zheng L, Franzmeier N, Stephenson H, Deming Y, Duering M, Gesierich B, Denecke J, Pham AV, Bendlin B, Ewers M. Florbetapir PET-assessed demyelination is associated with faster tau accumulation in an APOE ε4-dependent manner. Eur J Nucl Med Mol Imaging 2024; 51:1035-1049. [PMID: 38049659 PMCID: PMC10881623 DOI: 10.1007/s00259-023-06530-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/14/2023] [Indexed: 12/06/2023]
Abstract
PURPOSE The main objectives were to test whether (1) a decrease in myelin is associated with enhanced rate of fibrillar tau accumulation and cognitive decline in Alzheimer's disease, and (2) whether apolipoprotein E (APOE) ε4 genotype is associated with worse myelin decrease and thus tau accumulation. METHODS To address our objectives, we repurposed florbetapir-PET as a marker of myelin in the white matter (WM) based on previous validation studies showing that beta-amyloid (Aβ) PET tracers bind to WM myelin. We assessed 43 Aβ-biomarker negative (Aβ-) cognitively normal participants and 108 Aβ+ participants within the AD spectrum with florbetapir-PET at baseline and longitudinal flortaucipir-PET as a measure of fibrillar tau (tau-PET) over ~ 2 years. In linear regression analyses, we tested florbetapir-PET in the whole WM and major fiber tracts as predictors of tau-PET accumulation in a priori defined regions of interest (ROIs) and fiber-tract projection areas. In mediation analyses we tested whether tau-PET accumulation mediates the effect of florbetapir-PET in the whole WM on cognition. Finally, we assessed the role of myelin alteration on the association between APOE and tau-PET accumulation. RESULTS Lower florbetapir-PET in the whole WM or at a given fiber tract was predictive of faster tau-PET accumulation in Braak stages or the connected grey matter areas in Aβ+ participants. Faster tau-PET accumulation in higher cortical brain areas mediated the association between a decrease in florbetapir-PET in the WM and a faster rate of decline in global cognition and episodic memory. APOE ε4 genotype was associated with a worse decrease in the whole WM florbetapir-PET and thus enhanced tau-PET accumulation. CONCLUSION Myelin alterations are associated in an APOE ε4 dependent manner with faster tau progression and cognitive decline, and may therefore play a role in the etiology of AD.
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Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Lukai Zheng
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Henry Stephenson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin- Madison, Madison, WI, USA
| | - Yuetiva Deming
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin- Madison, Madison, WI, USA
| | - Marco Duering
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Benno Gesierich
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Jannis Denecke
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - An-Vi Pham
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Barbara Bendlin
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin- Madison, Madison, WI, USA
| | - Michael Ewers
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
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Zheng L, Rubinski A, Denecke J, Luan Y, Smith R, Strandberg O, Stomrud E, Ossenkoppele R, Svaldi DO, Higgins IA, Shcherbinin S, Pontecorvo MJ, Hansson O, Franzmeier N, Ewers M. Combined Connectomics, MAPT Gene Expression, and Amyloid Deposition to Explain Regional Tau Deposition in Alzheimer Disease. Ann Neurol 2024; 95:274-287. [PMID: 37837382 DOI: 10.1002/ana.26818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/07/2023] [Accepted: 10/03/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE We aimed to test whether region-specific factors, including spatial expression patterns of the tau-encoding gene MAPT and regional levels of amyloid positron emission tomography (PET), enhance connectivity-based modeling of the spatial variability in tau-PET deposition in the Alzheimer disease (AD) spectrum. METHODS We included 685 participants (395 amyloid-positive participants within AD spectrum and 290 amyloid-negative controls) with tau-PET and amyloid-PET from 3 studies (Alzheimer's Disease Neuroimaging Initiative, 18 F-AV-1451-A05, and BioFINDER-1). Resting-state functional magnetic resonance imaging was obtained in healthy controls (n = 1,000) from the Human Connectome Project, and MAPT gene expression from the Allen Human Brain Atlas. Based on a brain-parcellation atlas superimposed onto all modalities, we obtained region of interest (ROI)-to-ROI functional connectivity, ROI-level PET values, and MAPT gene expression. In stepwise regression analyses, we tested connectivity, MAPT gene expression, and amyloid-PET as predictors of group-averaged and individual tau-PET ROI values in amyloid-positive participants. RESULTS Connectivity alone explained 21.8 to 39.2% (range across 3 studies) of the variance in tau-PET ROI values averaged across amyloid-positive participants. Stepwise addition of MAPT gene expression and amyloid-PET increased the proportion of explained variance to 30.2 to 46.0% and 45.0 to 49.9%, respectively. Similarly, for the prediction of patient-level tau-PET ROI values, combining all 3 predictors significantly improved the variability explained (mean adjusted R2 range across studies = 0.118-0.148, 0.156-0.196, and 0.251-0.333 for connectivity alone, connectivity plus MAPT expression, and all 3 modalities combined, respectively). INTERPRETATION Across 3 study samples, combining the functional connectome and molecular properties substantially enhanced the explanatory power compared to single modalities, providing a valuable tool to explain regional susceptibility to tau deposition in AD. ANN NEUROL 2024;95:274-287.
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Affiliation(s)
- Lukai Zheng
- Institute for Stroke and Dementia Research, University Hospital, LMU, Munich, Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research, University Hospital, LMU, Munich, Germany
| | - Jannis Denecke
- Institute for Stroke and Dementia Research, University Hospital, LMU, Munich, Germany
| | - Ying Luan
- Institute for Stroke and Dementia Research, University Hospital, LMU, Munich, Germany
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | | | | | | | - Michael J Pontecorvo
- Eli Lilly and Company, Indianapolis, IN, USA
- Avid Radiopharmaceuticals, Philadelphia, PA, USA
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, University Hospital, LMU, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Michael Ewers
- Institute for Stroke and Dementia Research, University Hospital, LMU, Munich, Germany
- German Center for Neurodegenerative Diseases, Munich, Germany
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Coenen M, Biessels GJ, DeCarli C, Fletcher EF, Maillard PM, Barkhof F, Barnes J, Benke T, Boomsma JMF, P L H Chen C, Dal-Bianco P, Dewenter A, Duering M, Enzinger C, Ewers M, Exalto LG, Franzmeier N, Groeneveld O, Hilal S, Hofer E, Koek HL, Maier AB, McCreary CR, Papma JM, Paterson RW, Pijnenburg YAL, Rubinski A, Schmidt R, Schott JM, Slattery CF, Smith EE, Sudre CH, Steketee RME, van den Berg E, van der Flier WM, Venketasubramanian N, Vernooij MW, Wolters FJ, Xin X, Biesbroek JM, Kuijf HJ. Spatial distributions of white matter hyperintensities on brain MRI: A pooled analysis of individual participant data from 11 memory clinic cohorts. Neuroimage Clin 2023; 40:103547. [PMID: 38035457 PMCID: PMC10698002 DOI: 10.1016/j.nicl.2023.103547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/03/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION The spatial distribution of white matter hyperintensities (WMH) on MRI is often considered in the diagnostic evaluation of patients with cognitive problems. In some patients, clinicians may classify WMH patterns as "unusual", but this is largely based on expert opinion, because detailed quantitative information about WMH distribution frequencies in a memory clinic setting is lacking. Here we report voxel wise 3D WMH distribution frequencies in a large multicenter dataset and also aimed to identify individuals with unusual WMH patterns. METHODS Individual participant data (N = 3525, including 777 participants with subjective cognitive decline, 1389 participants with mild cognitive impairment and 1359 patients with dementia) from eleven memory clinic cohorts, recruited through the Meta VCI Map Consortium, were used. WMH segmentations were provided by participating centers or performed in Utrecht and registered to the Montreal Neurological Institute (MNI)-152 brain template for spatial normalization. To determine WMH distribution frequencies, we calculated WMH probability maps at voxel level. To identify individuals with unusual WMH patterns, region-of-interest (ROI) based WMH probability maps, rule-based scores, and a machine learning method (Local Outlier Factor (LOF)), were implemented. RESULTS WMH occurred in 82% of voxels from the white matter template with large variation between subjects. Only a small proportion of the white matter (1.7%), mainly in the periventricular areas, was affected by WMH in at least 20% of participants. A large portion of the total white matter was affected infrequently. Nevertheless, 93.8% of individual participants had lesions in voxels that were affected in less than 2% of the population, mainly located in subcortical areas. Only the machine learning method effectively identified individuals with unusual patterns, in particular subjects with asymmetric WMH distribution or with WMH at relatively rarely affected locations despite common locations not being affected. DISCUSSION Aggregating data from several memory clinic cohorts, we provide a detailed 3D map of WMH lesion distribution frequencies, that informs on common as well as rare localizations. The use of data-driven analysis with LOF can be used to identify unusual patterns, which might serve as an alert that rare causes of WMH should be considered.
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Affiliation(s)
- Mirthe Coenen
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands.
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, USA
| | - Evan F Fletcher
- Department of Neurology, University of California at Davis, USA
| | | | - Frederik Barkhof
- Radiology & Nuclear Medicine, Amsterdam UMC, Location Vrije Universiteit, the Netherlands; UCL Institute of Neurology, London, UK
| | - Josephine Barnes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Thomas Benke
- Clinic of Neurology, Medical University Innsbruck, Austria
| | - Jooske M F Boomsma
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Christopher P L H Chen
- Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | | | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany; Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Christian Enzinger
- Division of General Neurology, Department of Neurology, Medical University Graz, Austria; Division of Neuroradiology, Interventional and Vascular Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Lieza G Exalto
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Onno Groeneveld
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands; Department of Neurology, Isala, Meppel, the Netherlands
| | - Saima Hilal
- Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Edith Hofer
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Austria; Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Austria
| | - Huiberdina L Koek
- Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Andrea B Maier
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore; Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore; Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Cheryl R McCreary
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Janne M Papma
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Ross W Paterson
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Reinhold Schmidt
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Austria
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Eric E Smith
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Carole H Sudre
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK; Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK; School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Rebecca M E Steketee
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Esther van den Berg
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Neurology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Narayanaswamy Venketasubramanian
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore; Raffles Neuroscience Center, Raffles Hospital, Singapore, Singapore
| | - Meike W Vernooij
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Frank J Wolters
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Xu Xin
- Department of Pharmacology, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | - J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht, the Netherlands; Department of Neurology, Diakonessenhuis Hospital, Utrecht, the Netherlands
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands
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5
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Coenen M, Kuijf HJ, Huenges Wajer IMC, Duering M, Wolters FJ, Fletcher EF, Maillard PM, Barkhof F, Barnes J, Benke T, Boomsma JMF, Chen CPLH, Dal-Bianco P, Dewenter A, Enzinger C, Ewers M, Exalto LG, Franzmeier N, Groeneveld O, Hilal S, Hofer E, Koek DL, Maier AB, McCreary CR, Padilla CS, Papma JM, Paterson RW, Pijnenburg YAL, Rubinski A, Schmidt R, Schott JM, Slattery CF, Smith EE, Steketee RME, Sudre CH, van den Berg E, van der Flier WM, Venketasubramanian N, Vernooij MW, Xin X, DeCarli C, Biessels GJ, Biesbroek JM. Strategic white matter hyperintensity locations for cognitive impairment: A multicenter lesion-symptom mapping study in 3525 memory clinic patients. Alzheimers Dement 2023; 19:2420-2432. [PMID: 36504357 DOI: 10.1002/alz.12827] [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: 04/19/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Impact of white matter hyperintensities (WMH) on cognition likely depends on lesion location, but a comprehensive map of strategic locations is lacking. We aimed to identify these locations in a large multicenter study. METHODS Individual patient data (n = 3525) from 11 memory clinic cohorts were harmonized. We determined the association of WMH location with attention and executive functioning, information processing speed, language, and verbal memory performance using voxel-based and region of interest tract-based analyses. RESULTS WMH in the left and right anterior thalamic radiation, forceps major, and left inferior fronto-occipital fasciculus were significantly related to domain-specific impairment, independent of total WMH volume and atrophy. A strategic WMH score based on these tracts inversely correlated with performance in all domains. DISCUSSION The data show that the impact of WMH on cognition is location-dependent, primarily involving four strategic white matter tracts. Evaluation of WMH location may support diagnosing vascular cognitive impairment. HIGHLIGHTS We analyzed white matter hyperintensities (WMH) in 3525 memory clinic patients from 11 cohorts The impact of WMH on cognition depends on location We identified four strategic white matter tracts A single strategic WMH score was derived from these four strategic tracts The strategic WMH score was an independent determinant of four cognitive domains.
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Affiliation(s)
- Mirthe Coenen
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
| | - Hugo J Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Irene M C Huenges Wajer
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- Medical Image Analysis Center (MIAC) and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Frank J Wolters
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Evan F Fletcher
- Department of Neurology, University of California at Davis, Davis, California, USA
| | - Pauline M Maillard
- Department of Neurology, University of California at Davis, Davis, California, USA
| | - Frederik Barkhof
- Radiology & Nuclear Medicine, Amsterdam UMC, location Vrije Universiteit, Amsterdam, The Netherlands
- UCL Institute of Neurology, London, UK
| | - Josephine Barnes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Thomas Benke
- Clinic of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Jooske M F Boomsma
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Christopher P L H Chen
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | - Peter Dal-Bianco
- Department of Neurology, Medical University Vienna, Vienna, Austria
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Christian Enzinger
- Division of General Neurology, Department of Neurology, Medical University Graz, Graz, Austria
- Division of Neuroradiology, Interventional and Vascular Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Lieza G Exalto
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Onno Groeneveld
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
- Department of Neurology, Isala MS Centre, Isala Hospital, Meppel, The Netherlands
| | - Saima Hilal
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Edith Hofer
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Dineke L Koek
- Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Andrea B Maier
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
- Department of Medicine, National University of Singapore, Singapore, Singapore
| | - Cheryl R McCreary
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Catarina S Padilla
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
| | - Janne M Papma
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Ross W Paterson
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Yolande A L Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Reinhold Schmidt
- Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Catherine F Slattery
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London, UK
| | - Eric E Smith
- Department of Clinical Neurosciences and Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Rebecca M E Steketee
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Carole H Sudre
- MRC Unit for Lifelong Health and Ageing, the Centre for Medical Image Computing, UCL, London, UK
| | - Esther van den Berg
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Narayanaswamy Venketasubramanian
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
- Raffles Neuroscience Center, Raffles Hospital, Singapore, Singapore
| | - Meike W Vernooij
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Xu Xin
- Department of Pharmacology, National University of Singapore, Singapore, Singapore
- Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, Davis, California, USA
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
| | - J Matthijs Biesbroek
- Department of Neurology and Neurosurgery, UMC Utrecht, Brain Center, Utrecht, The Netherlands
- Department of Neurology, Diakonessenhuis Hospital, Utrecht, The Netherlands
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6
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Biel D, Suárez‐Calvet M, Hager P, Rubinski A, Dewenter A, Steward A, Roemer S, Ewers M, Haass C, Brendel M, Franzmeier N. sTREM2 is associated with amyloid-related p-tau increases and glucose hypermetabolism in Alzheimer's disease. EMBO Mol Med 2023; 15:e16987. [PMID: 36620941 PMCID: PMC9906389 DOI: 10.15252/emmm.202216987] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 01/10/2023] Open
Abstract
Microglial activation occurs early in Alzheimer's disease (AD) and previous studies reported both detrimental and protective effects of microglia on AD progression. Here, we used CSF sTREM2 to investigate disease stage-dependent drivers of microglial activation and to determine downstream consequences on AD progression. We included 402 patients with measures of earliest beta-amyloid (CSF Aβ1-42 ) and late-stage fibrillary Aβ pathology (amyloid-PET centiloid), as well as sTREM2, p-tau181 , and FDG-PET. To determine disease stage, we stratified participants into early Aβ-accumulators (Aβ CSF+/PET-; n = 70) or late Aβ-accumulators (Aβ CSF+/PET+; n = 201) plus 131 controls. In early Aβ-accumulators, higher centiloid was associated with cross-sectional/longitudinal sTREM2 and p-tau181 increases. Further, higher sTREM2 mediated the association between centiloid and cross-sectional/longitudinal p-tau181 increases and higher sTREM2 was associated with FDG-PET hypermetabolism. In late Aβ-accumulators, we found no association between centiloid and sTREM2 but a cross-sectional association between higher sTREM2, higher p-tau181 and glucose hypometabolism. Our findings suggest that a TREM2-related microglial response follows earliest Aβ fibrillization, manifests in inflammatory glucose hypermetabolism and may facilitate subsequent p-tau181 increases in earliest AD.
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Affiliation(s)
- Davina Biel
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany
| | - Marc Suárez‐Calvet
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain,IMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain,Servei de NeurologiaHospital del MarBarcelonaSpain,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES)MadridSpain
| | - Paul Hager
- Institute of Radiology and Artificial Intelligence and Informatics in MedicineTU MunichMunichGermany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany
| | - Anna Steward
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany
| | - Sebastian Roemer
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany,Department of Neurology, University HospitalLMU MunichMunichGermany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany,German Center for Neurodegenerative Diseases (DZNE)MunichGermany
| | - Christian Haass
- German Center for Neurodegenerative Diseases (DZNE)MunichGermany,Munich Cluster for Systems Neurology (SyNergy)MunichGermany,Chair of Metabolic Biochemistry, Biomedical Center (BMC), Faculty of MedicineLMU MunichMunichGermany
| | - Matthias Brendel
- German Center for Neurodegenerative Diseases (DZNE)MunichGermany,Munich Cluster for Systems Neurology (SyNergy)MunichGermany,Department of Nuclear Medicine, University HospitalLMU MunichMunichGermany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University HospitalLMU MunichMunichGermany,Munich Cluster for Systems Neurology (SyNergy)MunichGermany,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska AcademyUniversity of GothenburgGothenburgGermany
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7
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Rubinski A, Frerich S, Malik R, Franzmeier N, Ramirez A, Dichgans M, Ewers M. Polygenic Effect on Tau Pathology Progression in Alzheimer's Disease. Ann Neurol 2022; 93:819-829. [PMID: 36571564 DOI: 10.1002/ana.26588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/02/2022] [Accepted: 12/19/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Polygenic variation accounts for a substantial portion of the risk of Alzheimer's disease (AD), but its effect on the rate of fibrillar-tau accumulation as a key driver of dementia symptoms is unclear. METHODS We combined the to-date largest number of genetic risk variants of AD (n = 85 lead single-nucleotide polymorphisms [SNPs]) from recent genome-wide association studies (GWAS) to generate a polygenic score (PGS). We assessed longitudinal tau-positron emission tomography (PET), amyloid-PET, and cognition in 231 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Using the PGS, together with global amyloid-PET, we predicted the rate of tau-PET increases in Braak-stage regions-of-interest and cognitive decline. We also assessed PGS-risk enrichment effects on the required sample size in clinical trials targeting tau pathology. RESULTS We found that a higher PGS was associated with higher rates of tau-PET accumulation, in particular at elevated amyloid-PET levels. The tau-PET increases mediated the association between PGS and faster cognitive decline. Risk enrichment through high PGS afforded sample size savings by 34%. INTERPRETATION Our results demonstrate that the PGS predicts faster tau progression and thus cognitive decline, showing utility to enhance statistical power in clinical trials. ANN NEUROL 2023.
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Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Simon Frerich
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany.,Graduate School of Systemic Neurosciences, Ludwig Maximilian University, Munich, Germany
| | - Rainer Malik
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Alfredo Ramirez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Neurodegenerative diseases and Geriatric Psychiatry, University Hospital Bonn, Medical Faculty, Bonn, Germany.,Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Cluster of Excellence Cellular Stress Responses in Aging-associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research, University Hospital, Ludwig Maximilian University, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
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Franzmeier N, Ewers M, Brendel M, Biel D, Ossenkoppele R, Hager P, Steward A, Dewenter A, Rubinski A, Buerger K, Janowitz D, Binette AP, Smith R, Strandberg O, Mattsson‐Carlgren N, Dichgans M, Frontzkowski L, Hansson O. Earlier Alzheimer's disease onset is associated with a shift of tau pathology towards brain hubs which facilitates tau spreading. Alzheimers Dement 2022. [DOI: 10.1002/alz.067043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Amsterdam University Medical Center Amsterdam Netherlands
| | - Paul Hager
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Anna Steward
- Institute for Stroke and Dementia Research, LMU, Munich Munich Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | | | | | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Lukas Frontzkowski
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig Maximilian University Munich Munich Germany
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
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9
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Rubinski A, Franzmeier N, Dewenter A, Luan Y, Smith R, Strandberg O, Ossenkoppele R, Dichgans M, Hansson O, Ewers M. Higher fiber‐tract myelin levels predict lower longitudinal rates of fibrillar tau independent of amyloid. Alzheimers Dement 2022. [DOI: 10.1002/alz.061179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Ying Luan
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Neurology Clinic, Skåne University Hospital Lund Sweden
| | | | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam UMC Amsterdam Amsterdam Netherlands
- Clinical Memory Research Unit, Lund University, Sweden Lund Sweden
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital, Malmö Sweden
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
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10
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Steward A, Biel D, Luan Y, Brendel M, Dewenter A, Roemer SN, Rubinski A, Dichgans M, Ewers M, Franzmeier N. Brain network segregation attenuates tau spreading in Alzheimer’s disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.067501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Anna Steward
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Ying Luan
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Sebastian Niclas Roemer
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- Department of Neurology, University Hospital, LMU Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Institute for Stroke and Dementia Research, University Hospital, Ludwig‐Maximilian‐University Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
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11
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Rubinski A, Frerich S, Malik R, Franzmeier N, Ramirez A, Dichgans M, Ewers M. Polygenic score is associated with accelerated tau pathology accumulation in Alzheimer’s disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.061627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Simon Frerich
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Rainer Malik
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Alfredo Ramirez
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn Medical Center Bonn Germany
- Department of Psychiatry & Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases San Antonio TX USA
- German Center for Neurodegenerative Diseases (DZNE) Cologne Germany
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, University of Cologne, Medical Faculty Cologne Germany
- Excellence Cluster on Cellular Stress Responses in Aging‐Associated Diseases (CECAD), University of Cologne Cologne Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
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12
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Biel D, Ewers M, Suárez‐Calvet M, Hager P, Rubinski A, Dewenter A, Steward A, Roemer SN, Haass C, Brendel M, Franzmeier N. Soluble TREM2 drives earliest amyloid‐related p‐tau increase in Alzheimer’s disease but attenuates neurodegeneration in advanced disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.063088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Marc Suárez‐Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
| | - Paul Hager
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | - Anna Steward
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
| | | | - Christian Haass
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Germany
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13
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Steward A, Biel D, Brendel M, Dewenter A, Roemer S, Rubinski A, Luan Y, Dichgans M, Ewers M, Franzmeier N. Functional network segregation is associated with attenuated tau spreading in Alzheimer's disease. Alzheimers Dement 2022; 19:2034-2046. [PMID: 36433865 DOI: 10.1002/alz.12867] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/01/2022] [Accepted: 10/05/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Lower network segregation is associated with accelerated cognitive decline in Alzheimer's disease (AD), yet it is unclear whether less segregated brain networks facilitate connectivity-mediated tau spreading. METHODS We combined resting state functional magnetic resonance imaging (fMRI) with longitudinal tau positron emission tomography (PET) in 42 betamyloid-negative controls and 81 amyloid beta positive individuals across the AD spectrum. Network segregation was determined using resting-state fMRI-assessed connectivity among 400 cortical regions belonging to seven networks. RESULTS AD subjects with higher network segregation exhibited slower brain-wide tau accumulation relative to their baseline entorhinal tau PET burden (typical onset site of tau pathology). Second, by identifying patient-specific tau epicenters with highest baseline tau PET we found that stronger epicenter segregation was associated with a slower rate of tau accumulation in the rest of the brain in relation to baseline epicenter tau burden. DISCUSSION Our results indicate that tau spreading is facilitated by a more diffusely organized connectome, suggesting that brain network topology modulates tau spreading in AD. HIGHLIGHTS Higher brain network segregation is associated with attenuated tau pathology accumulation in Alzheimer's disease (AD). A patient-tailored approach allows for the more precise localization of tau epicenters. The functional segregation of subject-specific tau epicenters predicts the rate of future tau accumulation.
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Affiliation(s)
- Anna Steward
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine University Hospital LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
| | - Sebastian Roemer
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
- Department of Neurology University Hospital LMU Munich Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
| | - Ying Luan
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
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14
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Biel D, Luan Y, Brendel M, Hager P, Dewenter A, Moscoso A, Otero Svaldi D, Higgins IA, Pontecorvo M, Römer S, Steward A, Rubinski A, Zheng L, Schöll M, Shcherbinin S, Ewers M, Franzmeier N. Combining tau-PET and fMRI meta-analyses for patient-centered prediction of cognitive decline in Alzheimer’s disease. Alzheimers Res Ther 2022; 14:166. [PMID: 36345046 PMCID: PMC9639286 DOI: 10.1186/s13195-022-01105-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022]
Abstract
Background Tau-PET is a prognostic marker for cognitive decline in Alzheimer’s disease, and the heterogeneity of tau-PET patterns matches cognitive symptom heterogeneity. Thus, tau-PET may allow precision-medicine prediction of individual tau-related cognitive trajectories, which can be important for determining patient-specific cognitive endpoints in clinical trials. Here, we aimed to examine whether tau-PET in cognitive-domain-specific brain regions, identified via fMRI meta-analyses, allows the prediction of domain-specific cognitive decline. Further, we aimed to determine whether tau-PET-informed personalized cognitive composites capture patient-specific cognitive trajectories more sensitively than conventional cognitive measures. Methods We included Alzheimer’s Disease Neuroimaging Initiative (ADNI) participants classified as controls (i.e., amyloid-negative, cognitively normal, n = 121) or Alzheimer’s disease-spectrum (i.e., amyloid-positive, cognitively normal to dementia, n = 140), plus 111 AVID-1451-A05 participants for independent validation (controls/Alzheimer’s disease-spectrum=46/65). All participants underwent baseline 18F-flortaucipir tau-PET, amyloid-PET, and longitudinal cognitive testing to assess annual cognitive changes (i.e., episodic memory, language, executive functioning, visuospatial). Cognitive changes were calculated using linear mixed models. Independent meta-analytical task-fMRI activation maps for each included cognitive domain were obtained from the Neurosynth database and applied to tau-PET to determine tau-PET signal in cognitive-domain-specific brain regions. In bootstrapped linear regression, we assessed the strength of the relationship (i.e., partial R2) between cognitive-domain-specific tau-PET vs. global or temporal-lobe tau-PET and cognitive changes. Further, we used tau-PET-based prediction of domain-specific decline to compose personalized cognitive composites that were tailored to capture patient-specific cognitive decline. Results In both amyloid-positive cohorts (ADNI [age = 75.99±7.69] and A05 [age = 74.03±9.03]), cognitive-domain-specific tau-PET outperformed global and temporal-lobe tau-PET for predicting future cognitive decline in episodic memory, language, executive functioning, and visuospatial abilities. Further, a tau-PET-informed personalized cognitive composite across cognitive domains enhanced the sensitivity to assess cognitive decline in amyloid-positive subjects, yielding lower sample sizes required for detecting simulated intervention effects compared to conventional cognitive endpoints (i.e., memory composite, global cognitive composite). However, the latter effect was less strong in A05 compared to the ADNI cohort. Conclusion Combining tau-PET with task-fMRI-derived maps of major cognitive domains facilitates the prediction of domain-specific cognitive decline. This approach may help to increase the sensitivity to detect Alzheimer’s disease-related cognitive decline and to determine personalized cognitive endpoints in clinical trials. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01105-5.
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Rubinski A, Franzmeier N, Dewenter A, Luan Y, Smith R, Strandberg O, Ossenkoppele R, Dichgans M, Hansson O, Ewers M. Higher levels of myelin are associated with higher resistance against tau pathology in Alzheimer’s disease. Alzheimers Res Ther 2022; 14:139. [PMID: 36153607 PMCID: PMC9508747 DOI: 10.1186/s13195-022-01074-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/28/2022] [Indexed: 11/10/2022]
Abstract
Background In Alzheimer’s disease (AD), fibrillar tau initially occurs locally and progresses preferentially between closely connected regions. However, the underlying sources of regional vulnerability to tau pathology remain unclear. Previous brain-autopsy findings suggest that the myelin levels—which differ substantially between white matter tracts in the brain—are a key modulating factor of region-specific susceptibility to tau deposition. Here, we investigated whether myelination differences between fiber tracts of the human connectome are predictive of the interregional spreading of tau pathology in AD. Methods We included two independently recruited samples consisting of amyloid-PET-positive asymptomatic and symptomatic elderly individuals, in whom tau-PET was obtained at baseline (ADNI: n = 275; BioFINDER-1: n = 102) and longitudinally in a subset (ADNI: n = 123, mean FU = 1.53 [0.69–3.95] years; BioFINDER-1: n = 39, mean FU = 1.87 [1.21–2.78] years). We constructed MRI templates of the myelin water fraction (MWF) in 200 gray matter ROIs and connecting fiber tracts obtained from adult cognitively normal participants. Using the same 200 ROI brain-parcellation atlas, we obtained tau-PET ROI values from each individual in ADNI and BioFINDER-1. In a spatial regression analysis, we first tested the association between cortical myelin and group-average tau-PET signal in the amyloid-positive and control groups. Secondly, employing a previously established approach of modeling tau-PET spreading based on functional connectivity between ROIs, we estimated in a linear regression analysis, whether the level of fiber-tract myelin modulates the association between functional connectivity and longitudinal tau-PET spreading (i.e., covariance) between ROIs. Results We found that higher myelinated cortical regions show lower tau-PET uptake (ADNI: rho = − 0.267, p < 0.001; BioFINDER-1: rho = − 0.175, p = 0.013). Fiber-tract myelin levels modulated the association between functional connectivity and tau-PET spreading, such that at higher levels of fiber-tract myelin, the association between stronger connectivity and higher covariance of tau-PET between the connected ROIs was attenuated (interaction fiber-tract myelin × functional connectivity: ADNI: β = − 0.185, p < 0.001; BioFINDER-1: β = − 0.166, p < 0.001). Conclusion Higher levels of myelin are associated with lower susceptibility of the connected regions to accumulate fibrillar tau. These results enhance our understanding of brain substrates that explain regional variation in tau accumulation and encourage future studies to investigate potential underlying mechanisms. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-022-01074-9.
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Frontzkowski L, Ewers M, Brendel M, Biel D, Ossenkoppele R, Hager P, Steward A, Dewenter A, Römer S, Rubinski A, Buerger K, Janowitz D, Binette AP, Smith R, Strandberg O, Carlgren NM, Dichgans M, Hansson O, Franzmeier N. Earlier Alzheimer’s disease onset is associated with tau pathology in brain hub regions and facilitated tau spreading. Nat Commun 2022; 13:4899. [PMID: 35987901 PMCID: PMC9392750 DOI: 10.1038/s41467-022-32592-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 08/08/2022] [Indexed: 12/20/2022] Open
Abstract
AbstractIn Alzheimer’s disease (AD), younger symptom onset is associated with accelerated disease progression and tau spreading, yet the mechanisms underlying faster disease manifestation are unknown. To address this, we combined resting-state fMRI and longitudinal tau-PET in two independent samples of controls and biomarker-confirmed AD patients (ADNI/BioFINDER, n = 240/57). Consistent across both samples, we found that younger symptomatic AD patients showed stronger tau-PET in globally connected fronto-parietal hubs, i.e., regions that are critical for maintaining cognition in AD. Stronger tau-PET in hubs predicted faster subsequent tau accumulation, suggesting that tau in globally connected regions facilitates connectivity-mediated tau spreading. Further, stronger tau-PET in hubs mediated the association between younger age and faster tau accumulation in symptomatic AD patients, which predicted faster cognitive decline. These independently validated findings suggest that younger AD symptom onset is associated with stronger tau pathology in brain hubs, and accelerated tau spreading throughout connected brain regions and cognitive decline.
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17
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Franzmeier N, Ossenkoppele R, Brendel M, Rubinski A, Smith R, Kumar A, Mattsson‐Carlgren N, Strandberg O, Duering M, Buerger K, Dichgans M, Hansson O, Ewers M. The
BIN1
rs744373 Alzheimer’s disease risk SNP is associated with faster Aβ‐associated tau accumulation and cognitive decline. Alzheimers Dement 2021. [DOI: 10.1002/alz.055113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München Munich Germany
| | - Rik Ossenkoppele
- VU University Medical Center, Amsterdam UMC Amsterdam Netherlands
- Clinical Memory Research Unit, Lund University Malmö Sweden
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | | | - Atul Kumar
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Malmö Sweden
| | | | | | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University Malmö Sweden
| | - Michael Ewers
- Institute for Stroke and Dementia Research, University Hospital, Ludwig‐Maximilian‐University Munich Germany
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18
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Neitzel J, Franzmeier N, Rubinski A, Dichgans M, Brendel M, Malik R, Ewers M. Klotho‐VS heterozygosity modifies amyloid‐dependent tau accumulation and memory impairment in Alzheimer’s disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.051343] [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: 11/11/2022]
Affiliation(s)
- Julia Neitzel
- Erasmus MC University Medical Center Rotterdam Netherlands
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
| | - Rainer Malik
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
- German Center of Neurodegenerative Diseases Munich Germany
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19
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Biel D, Brendel M, Rubinski A, Buerger K, Janowitz D, Dichgans M, Franzmeier N. In vivo Braak‐staging using
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F‐Flortaucipir‐tau‐PET as a predictive marker for future cognitive decline in Alzheimer’s disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.054957] [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: 11/11/2022]
Affiliation(s)
- Davina Biel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich Munich Germany
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20
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Rubinski A, Franzmeier N, Dewenter A, Luan Y, Biel D, Ewers M. Higher myelination of grey matter and white matter is associated with lower tau spreading and tau‐associated cortical thinning in Alzheimer’s. Alzheimers Dement 2021. [DOI: 10.1002/alz.052031] [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: 11/12/2022]
Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Anna Dewenter
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Ying Luan
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Davina Biel
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
- German Center of Neurodegenerative Diseases Munich Germany
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21
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Franzmeier N, Brendel M, Beyer L, Arzberger T, Kovacs GG, Rubinski A, Palleis C, Katzdobler S, Finze A, Song M, Biechele G, Kern M, Scheifele M, Rauchmann B, Perneczky R, Rullmann M, Schildan A, Barthel H, Sabri O, Classen J, Lukic MJ, Irwin DJ, Lee EB, Coughlin D, Giese A, Grossman M, Kurz C, McMillan CT, Gelpi E, Compta Y, Swieten JC, Troakes C, Al‐Sarraj S, Roeber S, Xie SX, Lee VM, Herms J, Bartenstein P, Haass C, Dichgans M, Trojanowski JQ, Levin J, Höglinger G, Ewers M. Tau spreads across connected brain regions in progressive supranuclear palsy and corticobasal syndrome. Alzheimers Dement 2021. [DOI: 10.1002/alz.051668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Matthias Brendel
- Department of Nuclear Medicine University Hospital LMU Munich Munich Germany
- Department of Nuclear Medicine University Hospital LMU Munich Munich Germany
| | | | | | | | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Munich Germany
| | | | | | - Anika Finze
- University Hospital LMU Munich Munich Germany
| | - Mengmeng Song
- Ludwig‐Maximilians‐Universität Munich Munich Germany
| | | | - Maike Kern
- University Hospital of Munich Munich Germany
| | | | | | | | - Michael Rullmann
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Andreas Schildan
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Henryk Barthel
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Osama Sabri
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | | | | | - David J. Irwin
- Digital Neuropathology Laboratory Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | - Eddie B. Lee
- Center for Neurodegenerative Disease Research University of Pennsylvania Philadelphia PA USA
| | | | | | - Murray Grossman
- Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
| | - Carolin Kurz
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | | | - Ellen Gelpi
- Neurological Tissue Bank‐IDIBAPS/Hospital Clínic Barcelona Barcelona Spain
| | | | - John C. Swieten
- Department of Neurology Erasmus Medical Center Rotterdam Netherlands
| | - Claire Troakes
- King's College London MRC London Neurodegenerative Diseases Brain Bank London United Kingdom
| | - Safa Al‐Sarraj
- Kings College NHS Foundation Trust London United Kingdom
| | | | | | - Virginia M‐Y Lee
- Perelman School of Medicine at the University of Pennsylvania Philadelphia PA USA
| | | | | | - Christian Haass
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Munich Germany
| | | | | | - Günter Höglinger
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
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22
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Luan Y, Franzmeier N, Rubinski A, Ewers M. Lesion‐network mapping of tau accumulation is predictive of domain‐specific cognitive deficits in Alzheimer’s disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.050775] [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: 11/06/2022]
Affiliation(s)
- Ying Luan
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
- University Hospital LMU Munich Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD) University Hospital LMU Munich Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
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23
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Biel D, Brendel M, Rubinski A, Buerger K, Janowitz D, Dichgans M, Franzmeier N. Tau-PET and in vivo Braak-staging as prognostic markers of future cognitive decline in cognitively normal to demented individuals. Alzheimers Res Ther 2021; 13:137. [PMID: 34384484 PMCID: PMC8361801 DOI: 10.1186/s13195-021-00880-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [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: 05/18/2021] [Accepted: 07/21/2021] [Indexed: 11/20/2022]
Abstract
Background To systematically examine the clinical utility of tau-PET and Braak-staging as prognostic markers of future cognitive decline in older adults with and without cognitive impairment. Methods In this longitudinal study, we included 396 cognitively normal to dementia subjects with 18F-Florbetapir/18F-Florbetaben-amyloid-PET, 18F-Flortaucipir-tau-PET and ~ 2-year cognitive follow-up. Annual change rates in global cognition (i.e., MMSE, ADAS13) and episodic memory were calculated via linear-mixed models. We determined global amyloid-PET (Centiloid) plus global and Braak-stage-specific tau-PET SUVRs, which were stratified as positive(+)/negative(−) at pre-established cut-offs, classifying subjects as Braak0/BraakI+/BraakI–IV+/BraakI–VI+/Braakatypical+. In bootstrapped linear regression, we assessed the predictive accuracy of global tau-PET SUVRs vs. Centiloid on subsequent cognitive decline. To test for independent tau vs. amyloid effects, analyses were further controlled for the contrary PET-tracer. Using ANCOVAs, we tested whether more advanced Braak-stage predicted accelerated future cognitive decline. All models were controlled for age, sex, education, diagnosis, and baseline cognition. Lastly, we determined Braak-stage-specific conversion risk to mild cognitive impairment (MCI) or dementia. Results Baseline global tau-PET SUVRs explained more variance (partial R2) in future cognitive decline than Centiloid across all cognitive tests (Cohen’s d ~ 2, all tests p < 0.001) and diagnostic groups. Associations between tau-PET and cognitive decline remained consistent when controlling for Centiloid, while associations between amyloid-PET and cognitive decline were non-significant when controlling for tau-PET. More advanced Braak-stage was associated with gradually worsening future cognitive decline, independent of Centiloid or diagnostic group (p < 0.001), and elevated conversion risk to MCI/dementia. Conclusion Tau-PET and Braak-staging are highly predictive markers of future cognitive decline and may be promising single-modality estimates for prognostication of patient-specific progression risk in clinical settings. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-021-00880-x.
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Affiliation(s)
- Davina Biel
- Institute, for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, 81377, Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich, 80336, Munich, Germany
| | - Anna Rubinski
- Institute, for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, 81377, Munich, Germany
| | - Katharina Buerger
- Institute, for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, 81377, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany
| | - Daniel Janowitz
- Institute, for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, 81377, Munich, Germany
| | - Martin Dichgans
- Institute, for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, 81377, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Nicolai Franzmeier
- Institute, for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, 81377, Munich, Germany.
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24
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Franzmeier N, Ossenkoppele R, Brendel M, Rubinski A, Smith R, Kumar A, Mattsson-Carlgren N, Strandberg O, Duering M, Buerger K, Dichgans M, Hansson O, Ewers M. The BIN1 rs744373 Alzheimer's disease risk SNP is associated with faster Aβ-associated tau accumulation and cognitive decline. Alzheimers Dement 2021; 18:103-115. [PMID: 34060233 DOI: 10.1002/alz.12371] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/16/2021] [Accepted: 04/16/2021] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The BIN1 rs744373 single nucleotide polymorphism (SNP) is a key genetic risk locus for Alzheimer's disease (AD) associated with tau pathology. Because tau typically accumulates in response to amyloid beta (Aβ), we tested whether BIN1 rs744373 accelerates Aβ-related tau accumulation. METHODS We included two samples (Alzheimer's Disease Neuroimaging Initiative [ADNI], n = 153; Biomarkers for Identifying Neurodegenerative Disorders Early and Reliably [BioFINDER], n = 63) with longitudinal 18 F-Flortaucipir positron emission tomography (PET), Aβ biomarkers, and longitudinal cognitive assessments. We assessed whether BIN1 rs744373 was associated with faster tau-PET accumulation at a given level of Aβ and whether faster BIN1 rs744373-associated tau-PET accumulation mediated cognitive decline. RESULTS BIN1 rs744373 risk-allele carriers showed faster global tau-PET accumulation (ADNI/BioFINDER, P < .001/P < .001). We found significant Aβ by rs744373 interactions on global tau-PET change (ADNI: β/standard error [SE] = 0.42/0.14, P = 0.002; BioFINDER: β/SE = -0.35/0.15, P = .021), BIN1 risk-allele carriers showed accelerated tau-PET accumulation at higher Aβ levels. In ADNI, rs744373 effects on cognitive decline were mediated by faster global tau-PET accumulation (β/SE = 0.20/0.07, P = .005). DISCUSSION BIN1-associated AD risk is potentially driven by accelerated tau accumulation in the face of Aβ.
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Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Atul Kumar
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Marco Duering
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany.,Medical Image Analysis Center (MIAC AG), Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Katharina Buerger
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
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25
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Ewers M, Luan Y, Frontzkowski L, Neitzel J, Rubinski A, Dichgans M, Hassenstab J, Gordon BA, Chhatwal JP, Levin J, Schofield P, Benzinger TLS, Morris JC, Goate A, Karch CM, Fagan AM, McDade E, Allegri R, Berman S, Chui H, Cruchaga C, Farlow M, Graff-Radford N, Jucker M, Lee JH, Martins RN, Mori H, Perrin R, Xiong C, Rossor M, Fox NC, O'Connor A, Salloway S, Danek A, Buerger K, Bateman RJ, Habeck C, Stern Y, Franzmeier N. Segregation of functional networks is associated with cognitive resilience in Alzheimer's disease. Brain 2021; 144:2176-2185. [PMID: 33725114 DOI: 10.1093/brain/awab112] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [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: 09/02/2020] [Revised: 11/26/2020] [Accepted: 12/29/2020] [Indexed: 11/14/2022] Open
Abstract
Cognitive resilience is an important modulating factor of cognitive decline in Alzheimer's disease, but the functional brain mechanisms that support cognitive resilience remain elusive. Given previous findings in normal ageing, we tested the hypothesis that higher segregation of the brain's connectome into distinct functional networks represents a functional mechanism underlying cognitive resilience in Alzheimer's disease. Using resting-state functional MRI, we assessed both resting-state functional MRI global system segregation, i.e. the balance of between-network to within-network connectivity, and the alternate index of modularity Q as predictors of cognitive resilience. We performed all analyses in two independent samples for validation: (i) 108 individuals with autosomal dominantly inherited Alzheimer's disease and 71 non-carrier controls; and (ii) 156 amyloid-PET-positive subjects across the spectrum of sporadic Alzheimer's disease and 184 amyloid-negative controls. In the autosomal dominant Alzheimer's disease sample, disease severity was assessed by estimated years from symptom onset. In the sporadic Alzheimer's sample, disease stage was assessed by temporal lobe tau-PET (i.e. composite across Braak stage I and III regions). In both samples, we tested whether the effect of disease severity on cognition was attenuated at higher levels of functional network segregation. For autosomal dominant Alzheimer's disease, we found higher functional MRI-assessed system segregation to be associated with an attenuated effect of estimated years from symptom onset on global cognition (P = 0.007). Similarly, for patients with sporadic Alzheimer's disease, higher functional MRI-assessed system segregation was associated with less decrement in global cognition (P = 0.001) and episodic memory (P = 0.004) per unit increase of temporal lobe tau-PET. Confirmatory analyses using the alternate index of modularity Q revealed consistent results. In conclusion, higher segregation of functional connections into distinct large-scale networks supports cognitive resilience in Alzheimer's disease.
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Affiliation(s)
- Michael Ewers
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Ying Luan
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany
| | - Lukas Frontzkowski
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany
| | - Julia Neitzel
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster for Systems Neurology, SyNergy, Ludwig-Maximilian-University LMU, Munich, Germany
| | - Jason Hassenstab
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
| | - Brian A Gordon
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
| | - Jasmeer P Chhatwal
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, MA, USA
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Peter Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Tammie L S Benzinger
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - John C Morris
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Alison Goate
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Ronald M. Loeb Center for Alzheimer's Disease, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Celeste M Karch
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO, USA
| | - Anne M Fagan
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO, USA
| | - Eric McDade
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Ricardo Allegri
- Department of Neurology, FLENI Fondation, Buenos Aires, Argentina
| | - Sarah Berman
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Helena Chui
- Alzheimer's Disease Research Center, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA.,Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carlos Cruchaga
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO, USA.,NeuroGenomics and Informatics, Washington University School of Medicine, St. Louis, MO, USA
| | - Marty Farlow
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Mathias Jucker
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Department of Cellular Neurology, Hertie Institute for Clinical Brain Research, Tübingen, Germany.,Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ralph N Martins
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia.,Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia.,KaRa Institute of Neurological Diseases, Sydney, NSW, Australia
| | - Hiroshi Mori
- Department of Clinical Neuroscience, Osaka City University Medical School, Osaka, Japan
| | - Richard Perrin
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO, USA.,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Chengjie Xiong
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Biostatistics, Washington University, St Louis, MO, USA
| | - Martin Rossor
- Dementia Research Centre, University College London, Queen Square, London, UK
| | - Nick C Fox
- Dementia Research Centre, University College London, Queen Square, London, UK
| | - Antoinette O'Connor
- Dementia Research Centre, University College London, Queen Square, London, UK.,UK Dementia Research Institute at UCL, UCL, London, UK
| | - Stephen Salloway
- Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Randall J Bateman
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Christian Habeck
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany
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26
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Ewers M, Frontzkowski L, Neitzel J, Rubinski A, Habeck C, Gordon BA, Benzinger TLS, Levin J, Cruchaga C, Goate AM, Fagan AM, Karch CM, Morris JC, Holtzman DM, Bateman RJ, Stern Y, Franzmeier N. Global system segregation enhances reserve in normal aging and Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.037930] [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: 11/06/2022]
Affiliation(s)
| | - Lukas Frontzkowski
- Institute for Stroke and Dementia Research, Klinikum der Universität München Ludwig Maximilian University Munich Munich Germany
| | - Julia Neitzel
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | | | - Brian A Gordon
- Knight Alzheimer Disease Research Center St. Louis MO USA
| | | | | | - Carlos Cruchaga
- Hope Center for Neurological Disorders Washington University School of Medicine St. Louis MO USA
| | - Alison M Goate
- Ronald M. Loeb Center for Alzheimer’s Disease New York NY USA
| | - Anne M Fagan
- Washington University School of Medicine St. Louis MO USA
| | - Celeste M Karch
- Washington University in St. Louis School of Medicine St. Louis MO USA
| | - John C Morris
- Knight Alzheimer Disease Research Center St. Louis MO USA
| | - David M Holtzman
- Washington University in St. Louis School of Medicine St. Louis MO USA
| | - Randall J Bateman
- Washington University in St. Louis School of Medicine St. Louis MO USA
| | | | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
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27
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Franzmeier N, Frontzkowski L, Rubinski A, Neitzel J, Smith R, Strandberg O, Ossenkoppele R, Hansson O, Ewers M. Modeling patient‐specific tau spreading patterns in Alzheimer’s disease: Towards precision medicine. Alzheimers Dement 2020. [DOI: 10.1002/alz.040587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Lukas Frontzkowski
- Institute for Stroke and Dementia Research, Klinikum der Universität München Ludwig Maximilian University Munich Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Julia Neitzel
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Mälmo Lund University Lund Sweden
| | - Rik Ossenkoppele
- VU University Medical Center Amsterdam UMC Amsterdam Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
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28
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Rubinski A, Franzmeier N, Neitzel J, Ewers M. BIN1 rs744373 SNP is associated with increased mean diffusivity in non‐demented elderly. Alzheimers Dement 2020. [DOI: 10.1002/alz.045135] [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: 11/12/2022]
Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Julia Neitzel
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
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29
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Neitzel J, Franzmeier N, Rubinski A, Binette AP, Poirier J, Villeneuve S, Ewers M. ApoE4 associated with higher tau accumulation independent of amyloid burden. Alzheimers Dement 2020. [DOI: 10.1002/alz.046206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Julia Neitzel
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Alexa Pichet Binette
- Centre for Studies on Prevention of Alzheimer's Disease (StoP‐AD Centre), Douglas Mental Health Institute Montreal QC Canada
| | - Judes Poirier
- Centre for Studies on Prevention of Alzheimer's disease (StoP‐AD Centre) Montreal QC Canada
| | | | - Michael Ewers
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
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30
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Franzmeier N, Dewenter A, Frontzkowski L, Dichgans M, Rubinski A, Neitzel J, Smith R, Strandberg O, Ossenkoppele R, Buerger K, Duering M, Hansson O, Ewers M. Patient-centered connectivity-based prediction of tau pathology spread in Alzheimer's disease. Sci Adv 2020; 6:eabd1327. [PMID: 33246962 PMCID: PMC7695466 DOI: 10.1126/sciadv.abd1327] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/02/2020] [Indexed: 05/25/2023]
Abstract
In Alzheimer's disease (AD), the Braak staging scheme suggests a stereotypical tau spreading pattern that does, however, not capture interindividual variability in tau deposition. This complicates the prediction of tau spreading, which may become critical for defining individualized tau-PET readouts in clinical trials. Since tau is assumed to spread throughout connected regions, we used functional connectivity to improve tau spreading predictions over Braak staging methods. We included two samples with longitudinal tau-PET from controls and AD patients. Cross-sectionally, we found connectivity of tau epicenters (i.e., regions with earliest tau) to predict estimated tau spreading sequences. Longitudinally, we found tau accumulation rates to correlate with connectivity strength to patient-specific tau epicenters. A connectivity-based, patient-centered tau spreading model improved the assessment of tau accumulation rates compared to Braak stage-specific readouts and reduced sample sizes by ~40% in simulated tau-targeting interventions. Thus, connectivity-based tau spreading models may show utility in clinical trials.
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Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany.
| | - Anna Dewenter
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Lukas Frontzkowski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Julia Neitzel
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Ruben Smith
- Department of Neurology, Skåne University Hospital, Lund, Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Katharina Buerger
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Michael Ewers
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
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31
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Rubinski A, Franzmeier N, Neitzel J, Ewers M. FDG-PET hypermetabolism is associated with higher tau-PET in mild cognitive impairment at low amyloid-PET levels. Alzheimers Res Ther 2020; 12:133. [PMID: 33076977 PMCID: PMC7574434 DOI: 10.1186/s13195-020-00702-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/05/2020] [Indexed: 12/04/2022]
Abstract
Background FDG-PET hypermetabolism can be observed in mild cognitive impairment (MCI), but the link to primary pathologies of Alzheimer’s diseases (AD) including amyloid and tau is unclear. Methods Using voxel-based regression, we assessed local interactions between amyloid- and tau-PET on spatially matched FDG-PET in 72 MCI patients. Control groups included cerebrospinal fluid biomarker characterized cognitively normal (CN, n = 70) and AD dementia subjects (n = 95). Results In MCI, significant amyloid-PET by tau-PET interactions were found in frontal, lateral temporal, and posterior parietal regions, where higher local tau-PET was associated with higher spatially corresponding FDG-PET at low levels of local amyloid-PET. FDG-PET in brain regions with a significant local amyloid- by tau-PET interaction was higher compared to that in CN and AD dementia and associated with lower episodic memory. Conclusion Higher tau-PET in the presence of low amyloid-PET is associated with abnormally increased glucose metabolism that is accompanied by episodic memory impairment.
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Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen-Straße 17, 81377, Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen-Straße 17, 81377, Munich, Germany
| | - Julia Neitzel
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen-Straße 17, 81377, Munich, Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen-Straße 17, 81377, Munich, Germany. .,German Center for Neurodegenerative Diseases, Munich, Germany.
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32
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Caballero MÁA, Song Z, Rubinski A, Duering M, Dichgans M, Park DC, Ewers M. Age‐dependent amyloid deposition is associated with white matter alterations in cognitively normal adults during the adult life span. Alzheimers Dement 2020; 16:651-661. [DOI: 10.1002/alz.12062] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 12/10/2019] [Accepted: 01/03/2020] [Indexed: 01/01/2023]
Affiliation(s)
| | - Zhuang Song
- Center for Vital LongevityUniversity of Texas at Dallas Dallas Texas
| | - Anna Rubinski
- Institute for Stroke and Dementia ResearchUniversity HospitalLMU Munich Munich Germany
| | - Marco Duering
- Institute for Stroke and Dementia ResearchUniversity HospitalLMU Munich Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia ResearchUniversity HospitalLMU Munich Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Denise C. Park
- Center for Vital LongevityUniversity of Texas at Dallas Dallas Texas
| | - Michael Ewers
- Institute for Stroke and Dementia ResearchUniversity HospitalLMU Munich Munich Germany
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33
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Franzmeier N, Neitzel J, Rubinski A, Smith R, Strandberg O, Ossenkoppele R, Hansson O, Ewers M. Functional brain architecture is associated with the rate of tau accumulation in Alzheimer's disease. Nat Commun 2020; 11:347. [PMID: 31953405 PMCID: PMC6969065 DOI: 10.1038/s41467-019-14159-1] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [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: 04/10/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022] Open
Abstract
In Alzheimer's diseases (AD), tau pathology is strongly associated with cognitive decline. Preclinical evidence suggests that tau spreads across connected neurons in an activity-dependent manner. Supporting this, cross-sectional AD studies show that tau deposition patterns resemble functional brain networks. However, whether higher functional connectivity is associated with higher rates of tau accumulation is unclear. Here, we combine resting-state fMRI with longitudinal tau-PET in two independent samples including 53 (ADNI) and 41 (BioFINDER) amyloid-biomarker defined AD subjects and 28 (ADNI) vs. 16 (BioFINDER) amyloid-negative healthy controls. In both samples, AD subjects show faster tau accumulation than controls. Second, in AD, higher fMRI-assessed connectivity between 400 regions of interest (ROIs) is associated with correlated tau-PET accumulation in corresponding ROIs. Third, we show that a model including baseline connectivity and tau-PET is associated with future tau-PET accumulation. Together, connectivity is associated with tau spread in AD, supporting the view of transneuronal tau propagation.
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Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universitat München, Ludwig-Maximilians-Universitat LMU, Munich, Germany.
| | - Julia Neitzel
- Institute for Stroke and Dementia Research, Klinikum der Universitat München, Ludwig-Maximilians-Universitat LMU, Munich, Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research, Klinikum der Universitat München, Ludwig-Maximilians-Universitat LMU, Munich, Germany
| | - Ruben Smith
- Department of Neurology, Skane University Hospital, Lund, Sweden.,Clinical Memory Research Unit, Department of Clinical Sciences Malmo, Lund University, Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmo, Lund University, Lund, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences Malmo, Lund University, Lund, Sweden.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmo, Lund University, Lund, Sweden.,Memory Clinic, Skane University Hospital, Malmo, Sweden
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universitat München, Ludwig-Maximilians-Universitat LMU, Munich, Germany
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34
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Franzmeier N, Neitzel J, Rubinski A, Ewers M. IC-P-026: FUNCTIONAL BRAIN ARCHITECTURE PREDICTS LONGITUDINAL TAU SPREADING IN ALZHEIMER'S DISEASE. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4188] [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: 11/30/2022]
Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
| | - Julia Neitzel
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research; Ludwig-Maximilians-Universität LMU; Munich Germany
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35
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Neitzel J, Franzmeier N, Rubinski A, Ewers M. P2-357: STRUCTURAL AND FUNCTIONAL CONNECTIVITY MODULATE THE ASSOCIATION BETWEEN THE RATE OF REGIONAL AMYLOID-PET CHANGE AND TAU-PET. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.2764] [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: 10/25/2022]
Affiliation(s)
- Julia Neitzel
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
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36
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Franzmeier N, Neitzel J, Rubinski A, Ewers M. O5‐01‐02: FUNCTIONAL BRAIN ARCHITECTURE PREDICTS LONGITUDINAL TAU SPREADING IN ALZHEIMER'S DISEASE. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4835] [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: 10/25/2022]
Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Julia Neitzel
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research Klinikum der Universität München Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research Ludwig-Maximilians-Universität Munich Germany
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37
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Rubinski A, Franzmeier N, Neitzel J, Ewers M. P3-327: TAU PATHOLOGY IS ASSOCIATED WITH PERFUSION DEFICITS IN THE ENTORHINAL CORTEX IN NON-DEMENTED SUBJECTS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3359] [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: 11/29/2022]
Affiliation(s)
- Anna Rubinski
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
| | - Julia Neitzel
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
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38
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Franzmeier N, Rubinski A, Neitzel J, Ewers M. IC-P-053: THE BIN1 RS744373 SNP IS A RISK FACTOR FOR DEVELOPING TAU PATHOLOGY INDEPENDENT OF AMYLOID. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4896] [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: 10/25/2022]
Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
| | - Julia Neitzel
- Institute for Stroke and Dementia Research; Klinikum der Universität München; Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research; Ludwig-Maximilians-Universität LMU; Munich Germany
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39
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Neitzel J, Franzmeier N, Rubinski A, Ewers M. Left frontal connectivity attenuates the adverse effect of entorhinal tau pathology on memory. Neurology 2019; 93:e347-e357. [PMID: 31235661 DOI: 10.1212/wnl.0000000000007822] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 03/08/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To investigate whether higher global left frontal cortex (gLFC) connectivity, a putative neural substrate of cognitive reserve, attenuates the effect of entorhinal tau PET levels on episodic memory in older adults. METHODS Cross-sectional 18F-AV-1451 PET (to assess tau pathology), 18F-AV-45 or 18F-BAY94-9172 PET (to assess β-amyloid [Aβ]), and resting-state fMRI were obtained in 125 elderly participants from the Alzheimer's Neuroimaging Initiative, including 82 cognitively normal participants (amyloid PET-positive [Aβ+], n = 27) and 43 patients with amnestic mild cognitive impairment (Aβ+ = 15). Resting-state fMRI gLFC connectivity was computed for each participant as the average functional connectivity between the left frontal cortex (LFC) (seed) and each remaining voxel in the gray matter. As a measure of tau pathology, we assessed the mean tau PET uptake in the entorhinal cortex. In linear mixed-effects regression analysis, we tested the interaction term gLFC connectivity × entorhinal tau PET on delayed free recall performance. In addition, we assessed whether higher connectivity of the whole frontoparietal control network (FPCN), of which the LFC is a major hub, is associated with reserve. RESULTS Higher entorhinal tau PET was strongly associated with poorer delayed free recall performance (β/SE = -0.49/0.07, p < 0.001). A significant gLFC connectivity × entorhinal tau PET interaction was found (β/SE = 0.19/0.06, p = 0.003), such that at higher levels of gLFC connectivity, the decrease in memory score per unit of entorhinal tau PET was attenuated. The FPCN connectivity × tau interaction was also significant (β/SE = 0.10/0.04, p = 0.012). CONCLUSION Both gLFC and FPCN connectivity are associated with higher resilience against the adverse effect of early-stage entorhinal tau pathology on memory performance.
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Affiliation(s)
- Julia Neitzel
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Nicolai Franzmeier
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Anna Rubinski
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Michael Ewers
- From the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany.
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40
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Franzmeier N, Rubinski A, Neitzel J, Kim Y, Damm A, Na DL, Kim HJ, Lyoo CH, Cho H, Finsterwalder S, Duering M, Seo SW, Ewers M. Functional connectivity associated with tau levels in ageing, Alzheimer's, and small vessel disease. Brain 2019; 142:1093-1107. [PMID: 30770704 PMCID: PMC6439332 DOI: 10.1093/brain/awz026] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [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: 07/16/2018] [Revised: 11/27/2018] [Accepted: 12/21/2018] [Indexed: 12/14/2022] Open
Abstract
In Alzheimer's disease, tau pathology spreads hierarchically from the inferior temporal lobe throughout the cortex, ensuing cognitive decline and dementia. Similarly, circumscribed patterns of pathological tau have been observed in normal ageing and small vessel disease, suggesting a spatially ordered distribution of tau pathology across normal ageing and different diseases. In vitro findings suggest that pathological tau may spread 'prion-like' across neuronal connections in an activity-dependent manner. Supporting this notion, functional brain networks show a spatial correspondence to tau deposition patterns. However, it remains unclear whether higher network-connectivity facilitates tau propagation. To address this, we included 55 normal aged elderly (i.e. cognitively normal, amyloid-negative), 50 Alzheimer's disease patients (i.e. amyloid-positive) covering the preclinical to dementia spectrum, as well as 36 patients with pure (i.e. amyloid-negative) vascular cognitive impairment due to small vessel disease. All subjects were assessed with AV1451 tau-PET and resting-state functional MRI. Within each group, we computed atlas-based resting-state functional MRI functional connectivity across 400 regions of interest covering the entire neocortex. Using the same atlas, we also assessed within each group the covariance of tau-PET levels among the 400 regions of interest. We found that higher resting-state functional MRI assessed functional connectivity between any given region of interest pair was associated with higher covariance in tau-PET binding in corresponding regions of interest. This result was consistently found in normal ageing, Alzheimer's disease and vascular cognitive impairment. In particular, inferior temporal tau-hotspots, as defined by highest tau-PET uptake, showed high predictive value of tau-PET levels in functionally closely connected regions of interest. These associations between functional connectivity and tau-PET uptake were detected regardless of presence of dementia symptoms (mild cognitive impairment or dementia), amyloid deposition (as assessed by amyloid-PET) or small vessel disease. Our findings suggest that higher functional connectivity between brain regions is associated with shared tau-levels, supporting the view of prion-like tau spreading facilitated by neural activity.
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Affiliation(s)
- Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, Munich, Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, Munich, Germany
| | - Julia Neitzel
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, Munich, Germany
| | - Yeshin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Alexander Damm
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, Munich, Germany
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute of Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
| | - Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hana Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sofia Finsterwalder
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, Munich, Germany
| | - Marco Duering
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, Munich, Germany
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute of Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
- Center for Imaging of Neurodegenerative Diseases, University of California, San Francisco
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, Munich, Germany
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41
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Neitzel J, Rubinski A, Franzmeier N, Ewers M. P4‐327: LEFT FRONTAL CONNECTIVITY ATTENUATES THE AVERSIVE EFFECT OF TAU PATHOLOGY ON MEMORY PERFORMANCE IN NONDEMENTED ELDERLY SUBJECTS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.07.150] [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: 10/28/2022]
Affiliation(s)
- Julia Neitzel
- Institute for Stroke and Dementia Research (ISD)MunichGermany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research (ISD)MunichGermany
| | | | - Michael Ewers
- German Center for Neurodegenerative DiseasesMunichGermany
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42
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Shaltiel-Karyo R, Tsarfati Y, Rubinski A, Zawoznik E, Weinstock I, Nemas M, Schiffenbauer YS, Ramot Y, Nyska A, Yacoby-Zeevi O. Magnetic Resonance Imaging as a Noninvasive Method for Longitudinal Monitoring of Infusion Site Reactions Following Administration of a Novel Apomorphine Formulation. Toxicol Pathol 2017; 45:472-480. [DOI: 10.1177/0192623317706111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Infusion site reactions are common following subcutaneous infusion of drugs. Such reactions can lead to discontinuation of the treatment. Therefore, assessment of such reactions is essential during preclinical safety studies, and magnetic resonance imaging (MRI) can assist in evaluation. Here, in vivo and ex vivo MRI evaluations were used in addition to classical histopathology to assess the infusion site reaction to ND0701, a novel formulation of apomorphine base developed for the treatment of Parkinson’s disease, in comparison to the commercial apomorphine hydrochloride (HCl) formulation. Both formulations, each at two concentrations, were continuously administered subcutaneously for 20 hr to each of 3 male and 3 female domestic pigs. Based on MRI evaluations, there was a gradual decrease in the volume of the subcutaneous lesions over 4 weeks, with smaller lesions and quicker resolution with ND0701 at concentrations 2.5- to 5-fold higher when compared to the commercial apomorphine HCl formulation. Histopathological evaluation of ND0701 revealed only minimal inflammation at the sites of infusion, whereas the commercial apomorphine HCl caused persistent inflammatory reactions and necrosis. This study provides support to the use of MRI in preclinical testing of subcutaneous drugs when evaluating local site reactions.
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Affiliation(s)
| | | | | | | | | | | | | | - Yuval Ramot
- Hadassah–Hebrew University Medical Center, Jerusalem, Israel
| | - Abraham Nyska
- Sackler School of Medicine, Tel Aviv University, Israel
- Consultant in Toxicologic Pathology, Timrat, Israel
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